Addressing Weight Stigma in WIC: A Qualitative Study Exploring Advice and Training Needs of Minnesota WIC Staff

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutritious foods, nutrition education, breastfeeding support, and referrals to low-income women and their children up to age 5. WIC participants' weight is measured and discussed at appointments, creating an opportunity for weight stigma to be transmitted. Weight stigma has recently received attention within the WIC setting because experiencing weight stigma in health care is associated with delays in care and health care avoidance. This study aimed to fill a gap in our understanding of WIC staff's training needs and advice to reduce weight stigma experienced by WIC clients.

We conducted semi-structured in-depth qualitative interviews with WIC clinic staff in partnership with the Minnesota Department of Health WIC. The study included 25 staff members across 16 local agencies. We employed a rapid qualitative template analysis to analyze the interviews.

Staff sought guidance on how much emphasis to place on weight and wanted to focus on health behavior goals, rather than weight. Staff wanted comprehensive training on weight stigma and practical skills to confidently discuss weight with clients, including across diverse cultural contexts. Finally, staff desired virtual trainings that are WIC-specific and include interactive components.

Appropriate training on weight stigma and guidance for how weight should be discussed during appointments can improve the client experience in WIC and, in turn, may improve program retention. Findings from this study will be used to develop a systems-level intervention, including comprehensive workforce training, to address weight stigma at WIC.