Predictors of WIC uptake among low-income pregnant individuals: a longitudinal nationwide analysis.

Autor:	Collin DF; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, United States., Guan A; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States., Hamad R; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, United States; Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA, United States. Electronic address: rita.hamad@ucsf.edu.
Jazyk:	angličtina
Zdroj:	The American journal of clinical nutrition [Am J Clin Nutr] 2023 Jun; Vol. 117 (6), pp. 1331-1341. Date of Electronic Publication: 2023 Apr 23.
DOI:	10.1016/j.ajcnut.2023.04.023
Abstrakt:	Background: Nutrition during pregnancy is important for maternal and infant health. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides nutritional support for low-income pregnant and postpartum individuals and children under the age of 5 y. However, WIC participation was in decline in the decade leading up to 2019. Objectives: This study examined individual and state predictors associated with WIC uptake among eligible individuals so as to identify subgroups for targeted intervention to improve participation. Methods: Data came from the 2004-2019 waves of the Pregnancy Risk Assessment Monitoring System (PRAMS), a national survey of individuals who recently gave birth (N = 288,531). Multivariable logistic regressions were used to examine individual- and state-level and temporal predictors of WIC uptake among WIC-eligible respondents. Results: Among WIC-eligible respondents, ages of >35 (OR: 0.68; 95% CI: 0.66, 0.70), more than high school education (OR: 0.63; 95% CI: 062, 0.65), English language proficiency (OR: 0.71; 95% CI: 0.68, 0.74), being married (OR: 0.70; 95% CI: 0.69, 0.72), White race, smaller family size, not having prepregnancy diabetes, and higher income were associated with lower odds of WIC uptake. Respondents in states with higher earned income tax credit rates and in the Northeast, Midwest, and West (compared with the South) had lower WIC uptake. Respondents in states with higher gross domestic product, higher unemployment rates, higher Supplemental Nutrition Assistance Program, Temporary Assistance for Needy Families, and Medicaid caseloads, and Democrat governors had higher uptake; however, effect estimates were small and may not represent a meaningful change. Associations were the strongest during 2009-2015 than during other years, particularly for race/Hispanic origin, language, marital status, prepregnancy diabetes, family size, and prepregnancy. Conclusions: This study identified several individual- and state-level characteristics associated with WIC uptake among low-income eligible respondents, paving the way for future interventions to target key subgroups to improve program participation. (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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