Attention WIC Shoppers

Transcription

1 Attention WIC Shoppers Reducing Barriers at the Grocery Store Project Research Goals Gain insight into ways to improve the shopping experience for both WIC participants and vendors Increase retention and program participation Research Sites 1. Tyler 2. Dallas Metroplex Denton, Irving, Dallas 3. Houston 4. Temple 5. Lubbock 6. San Antonio 7. Rio Grande Valley Edinburg, Pharr, Harlingen, McAllen 1

2 Research Components Client Focus Groups 16 groups(english & Spanish) N = 122 Learn food package and shopping education/experience Field test Texas WIC app prototype and new Shopping Guide Grocery Shopping Observations 21 clients Learn how clients interact with the labeling, the store staff, and cash registers 7 staff Observe staff knowledge about grocery shopping for WIC foods 2

3 Client Survey 250 respondents English & Spanish Gather quantitative insights into clients experience on WIC and as a WIC shopper Grocery Store Staff Interviews Interview 53 grocery store staff members 10 corporate reps 23 managers 20 cashiers Assess level of training on WIC Current processes and areas for improvement Vendor Liaison & Clinic Staff Vendor Liaison Interviews (7) In-person or phone interviews Learn about the role, responsibility, and impact on clients grocery store shopping experience Clinic Staff Discussions (7) Clerical staff, nutrition educators, dieticians, and other clinical staff Learn about staff and client training on the food package and shopping experience 3

4 Ethnographies and Director Interviews Ethnographies (8 clinics) SUMA staff follow clients through appointments Observe current procedures Note best practices WIC Director Interviews (10) Learn about staff training and procedure Explore relationship between clinics and local vendors Best Practices Nationwide reports & initiatives USDA, state and local WIC agencies, the National WIC Association, and various community partners WIC Client Findings 4

5 Food Benefits Clients say food benefits are the best part of being on WIC They also like: Saving money Breastfeeding education Healthcare for children Nutrition education I like everything about WIC. It s good for my daughter. It s good for me. There isn t anything I don t like. Everything is great. -San Antonio WIC Client Mostly Positive about WIC Staff Friendly Flexible Helpful Knowledgeable I like that they have a nutritionist, because it is really hard to get good advice for you and your baby. Concern About Bringing Newborns to Clinic You walk in the front door. This is Health and Human Services.. There are people coughing everywhere. There s seating all through here then you go through the door when your number is called. -Denton WIC Client 5

6 Class Preferences Online flexible, convenient That way I could do it when my kids are asleep and I get to pay attention. -Denton WIC Client In-person provides opportunity to ask questions, interactive with other mothers The times I ve gone to classes, I like it. It s good, because the lady who was giving the class, she discusses our opinions. What we do, what are we planning on doing, what did we learn? I think that is a lot of help to discuss. -Rio Grande Valley WIC Client Self-paced or information board classes less favorite Client Shopping Education 25% said shopping for WIC foods is the most difficult part about being on WIC Most do not receive any hands-on training from WIC on how to shop for WIC products Handed the Shopping Guide and the Shopping List with little explanation Think the store rather than WIC is responsible for educating them on how to shop Client Shopping Education I don t remember ever being taught about the shopping. I just remember that they told me about breastfeeding, nutrition for your child, and what they should and shouldn t have. --Tyler WIC Client 6

7 Smart Choices, Healthy Families DVD Directors and staff say the DVD is an important tool but only 39% of clients were given one to take home Many clients have never seen the DVD 43% never watched the DVD 36% watched in the clinic 24% watched at home Clients are unlikely to watch unless required to do so in the clinic DVD made the shopping process seem simpler than it is Clinic Environment Most of appointment time spent in waiting rooms 44% of clients surveyed said total wait time in clinic is the most difficult part of being on WIC Clients in focus groups complained about long waits Food Package Preferences Many participants said that the fruits and vegetables component was their favorite part of their WIC package. The best part of receiving WIC is the fruits and vegetables, because we eat a whole lot of it at home. Milk was the item most frequently left over at the end of the month. Too much milk, not enough fruits and veggies. Many participants said they did not like skim milk and wanted to be able to purchase 2% milk on their packages again. They switched to 1%, and no one in my household will get with it. 7

8 Confusion Over Brands Most complicated aspect of shopping for WIC foods is store-to-store variation in brand (LEB) Receives little mention in the Shopping Guide or by WIC staff The pamphlet did not work for me the peanut butter in there is not the peanut butter you can get at Walmart or HEB. There s a lot of things in there that says you can get it, but once you get the register, they re like, No. You can t get this. The thing about the brochure, sometimes they don t have the name brands that they want us to get, and we re like, What are we supposed to get? Confusion Over Brands Participants who did not purchase a WIC item while shopping: 40% Participants who did not purchase a WIC item because of confusion about brands / allowable foods: 45% Participants reporting embarrassment at checkout because of confusion about approved foods: over 33% Mislabeled WIC Items 22% did not purchase an item because of mislabeling Many expressed frustration with mislabeled items 8

9 2% labeled with LEB sticker. No packages currently cover 2% milk. Multiple labeling issues on case of whole milk. Store Labeling Researchers confirmed poor labeling when they shadowed WIC shoppers Poor labeling and misunderstandings about approved foods results in unredeemed benefits and frustration for participants and vendors Selecting Wrong Food Items 85% selected wrong products at least once and sent back to get a different item at checkout In 15/21 client observations, researchers saw clients told they selected the wrong food at checkout Store staff could not explain why In some cases, store rules are at odds with what is stated in the Shopping Guide 9

10 LEB Label WIC-Approved Bread Improving the Shopping Experience Expand education on grocery shopping 75% are very likely to use an app designed to help them grocery shop for WIC WIC app prototype tested very well in focus groups Clients overwhelmingly said they would shop at major grocery stores that had a WIC aisle and/or section If you could change one thing about shopping for WIC foods, what would it be? = offering a WIC-only aisle or section WIC Mobile Application Prototype Universal enthusiasm during the field test from participants App Prototype Features: Fruits-and-vegetables calculator Store locator Bar-code scanner Store-specific approved foods lists 10

11 WIC Staff Findings Staff Training on Grocery Shopping No state-required staff training specific to grocery store experience Most directors report they do not conduct specific training around grocery store experience Staff Training on Grocery Shopping New Staff Review materials Shadow coworkers Current Staff Review state memos on food package changes 11

12 Staff Training on Grocery Shopping Like I said, we watch the video and everything, too, but a lot of us have never actually shopped. It s a lot different being there picking stuff out where there s 50 million cereals there and try to choose one to get Staff Training Best Practices Attend vendor training Shop with EBT cards Many said this would be helpful They came down to Odessa and actually walk you through the training, the actually shopping experience I just did it last month and that was the first time after being here that we went on the actual trip That s the best training. Vendor Relations Directors and staff are unaware of how vendors communicate with the state, local agencies Untrained cashiers are a recognized problem, but directors and staff are unsure of current training practices 12

13 Vendor Liaisons Original Role Create relationship between vendor and WIC Handle client complaints Help stores stay compliant State training in Austin Current Implementation Complete VL duties in addition to other roles Role varies widely & not every agency has one Funding change No state-mandated reporting No state training Grocery Shopping with Staff Most had not experienced shopping like a client, unless former client Challenges Finding allowable brands Identifying proper product sizes Navigating missing/incorrectly placed WIC labels Experience brought home the need to prioritize improved training for clients on shopping for approved foods Vendor Findings 13

14 Store Staff and WIC Positive opinion of WIC s mission Lack sufficient training on WIC = not equipped to answer WIC shoppers questions about allowable foods Training on WIC at the store level is not standardized, even within large chains Vendor Training Corporate staff and store managers who attended WIC vendor training spoke highly of the experience BUT Information gained in the training is not disseminated to the rest of the management staff and cashiers Cashiers Key to a successful WIC transaction BUT many are not well trained and do not receive updates on allowable foods 14

15 Cashier Training Current training practices: Varies from vendor to vendor, and within company Shadowing senior cashier Changes communicated by word of mouth from managers to cashiers Receptive to additional training and want to better understand the program Key Shopping Challenges Wide variation in how stores handle LEBs Shoppers are told that when the store is out of a LEB, the store does not offer a backup item Customers exceed cash balances for produce Key Shopping Challenges Bagged fruit fails to scan as WIC-approved Incompatibility between EBT cards and point-of-sale systems Managers have no relationship with local WIC clinics/vendor liaisons 15

16 WIC Clients and Staff Recommendations At the Clinic Conduct a pilot test at a selected WIC agency to implement recommended changes and perform pre- and post-evaluations to determine effectiveness so that strategies can be adjusted accordingly before statewide rollout Have a display that shows the difference in LEB products among stores Have WIC clinics offer local store-specific LEB guides At the Clinic Educate WIC clients that the WIC clinic is their goto place for grocery store education, and not the responsibility of the store Use wait time at WIC clinics to educate clients on how to shop for WIC-approved foods via peer educators. Training should be mandatory for new clients. Offer more materials in Spanish explaining how to shop, including information on brand variance 16

17 Serving Clients Expedite development of Texas WIC app Offer a website with printable LEB information for stores using the app s database Develop formal way to update clients on changes in approved foods Increase amount of fruits and vegetables cash value benefit WIC Staff Have agencies work with local vendors to promote store-created LEB guides Required training for all staff: Grocery shopping experience State vendor training Reinvigorate vendor liaison position Sole responsibilities should be to establish store partnerships and educate clients about the grocery store experience Vendor Recommendations 17

18 Improving Vendor Training Offer hands-on cashier training by WIC staff that includes LEB policy information Provide more opportunities for store staff to attend state training; maintain and expand interactive nature of the training Provide training materials for managers to take back to their stores, including videos and visual aids Improving Vendor Training Hold training sessions in store to include more employees and give them a hands-on feel for WIC requirements Expand access to online, interactive, creative training; offer online training as continuing educational opportunities, but not as the primary form of training for store staff At the Store Address challenges to the stores internal register system, such as difficulties clearing and starting over a WIC transaction. Design a way to identify WIC products as they are rung up, rather than reviewing products manually or relying on memory. Develop a formal way to update stores on approved item changes Design an alternative system for identifying LEB items other than WIC labels 18

19 QUESTIONS 19