Barriers and Enablers to WIC Participation: Review of Evidence From Studies Published Between 2019 and 2024

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) supports low-income mothers and children aged <5 years in the U.S. with nutrition and healthcare resources; however, not all eligible individuals participate. This scoping review aimed to synthesize evidence on factors associated with WIC participation from the perspective of WIC program implementers; WIC participants; and WIC-eligible nonparticipants.

Qualitative, quantitative, and mixed-methods studies published between March 2019 and December 2024 in peer-reviewed journals were included. Eligible studies were U.S. based, were published in English, and included at least 12 participants. Systematic searches were conducted across the following databases: MEDLINE, PsycINFO, Cochrane Library, Web of Science, and Scopus. Screening and data extraction were completed in Covidence, and the study quality was assessed using the Mixed Methods Appraisal Tool.

Among 33 studies included, 15 were qualitative (45.4%), 13 were quantitative (39.3%), and 5 were mixed methods (15.1%). On average, studies met 85.1% of the quality criteria. Overall, the most commonly assessed barriers and enablers were at the organizational level-particularly program logistics and staff interactions. For individual factors, the most assessed concepts were knowledge, awareness, perceptions, and feelings about Special Supplemental Nutrition Program for Women, Infants, and Children. Fewer studies examined interpersonal (n=6) or community/cultural (n=5) factors, although participants frequently reported a lack of culturally relevant food options and mixed experiences with staff interactions.

In summary, there are multiple factors at the individual, interpersonal, organizational, and structural levels that are associated with WIC participation. Barriers and enablers at the individual and organizational levels were most common in the published literature from 2019 to 2024. Although the overall study quality was moderate to high, findings across levels were mixed.