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Defining and Applying Age-Specific Retention Measures Among Infants and Children in the WIC Program
Ana Beatriz Ronan1, Emily M Melnick1, Francesco Acciai1
1College of Health Solutions, Arizona State University, Phoenix, AZ, USA.
Insights
New metrics improve assessment of continued participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Increased cash-value benefits (CVB) were linked to higher WIC retention rates.
Area of Science:
- Public Health
- Nutrition Policy
- Health Services Research
Background:
- Assessing continued participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is crucial for program effectiveness.
- Standardized retention and engagement metrics for WIC participants are lacking, hindering policy impact evaluation.
Purpose of the Study:
- To propose and validate novel child-level retention and engagement metrics for WIC participants.
- To evaluate the association between an increase in the WIC cash-value benefit (CVB) and participant retention.
Main Methods:
- A longitudinal observational study using administrative data from a tribal WIC agency (March 2019-December 2023).
- Development of three child-level metrics: age-specific retention, summary retention ratio, and benefit redemption engagement.
- Analysis included cross-tabulations, t-tests, and logistic regression to assess retention and policy impact.
Main Results:
- WIC participant retention varied from 63-72% across age groups.
- Higher benefit redemption was observed among retained participants.
- A four percentage point increase in retention from infancy to age one was associated with the CVB increase (P = .026).
Conclusions:
- The proposed metrics offer a practical framework for monitoring WIC retention and engagement.
- These metrics facilitate the evaluation of policy changes, such as CVB increases, on program participation.
Abstract:
PurposeAssessing continued participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is challenging due to the lack of standardized retention measures. We propose child-level retention and engagement metrics and demonstrate their application in evaluating associations between a specific WIC policy change-the increase in the cash-value benefit (CVB)-and retention.DesignLongitudinal observational study.SettingAdministrative data (March 2019-December 2023) from a tribal WIC state agency.Sample5,794 WIC participants enrolled as infants (0-11 months).MeasuresThree measures were constructed: (1) age-specific retention (2) a summary retention ratio, capturing participation over the entire eligibility period, and (3) an engagement measure based on household benefit redemption during certification periods.AnalysisCross-tabulations and t-tests were used to analyze retention and engagement. Logistic regression models estimated the odds of retention following the CVB policy change.ResultsRetention ranged from 63-72% across age groups. Retained participants redeemed benefits more frequently than non-retained participants during their prior certification period. Among children with full follow-up, 34% completed all eligible certifications. After CVB increase, retention from infancy to age one was four percentage points higher (P = .026).ConclusionThe proposed measures provide a practical framework for monitoring WIC retention and engagement and for examining changes over time, including in relation to policy changes.
