A Systems Approach to Identify Factors Influencing Participation in Two Tribally-Administered WIC Programs
Native American populations experience highly disproportionate rates of poor maternal-child health outcomes. The WIC program aims to safeguard health by providing greater access to nutritious foods, but for reasons not well understood, participation in many tribally-administered WIC programs has dec...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/15/5/1210 |
| _version_ | 1797614644328660992 |
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| author | Michelle Estradé Samantha Grace Alarcon Basurto Abbegayle McCarter Joel Gittelsohn Takeru Igusa Siyao Zhu Lisa Poirier Susan Gross Marla Pardilla Martha Rojo Kevin Lombard Henry Haskie Veronica Clark Jacqueline Swartz Yeeli Mui |
| author_facet | Michelle Estradé Samantha Grace Alarcon Basurto Abbegayle McCarter Joel Gittelsohn Takeru Igusa Siyao Zhu Lisa Poirier Susan Gross Marla Pardilla Martha Rojo Kevin Lombard Henry Haskie Veronica Clark Jacqueline Swartz Yeeli Mui |
| author_sort | Michelle Estradé |
| collection | DOAJ |
| description | Native American populations experience highly disproportionate rates of poor maternal-child health outcomes. The WIC program aims to safeguard health by providing greater access to nutritious foods, but for reasons not well understood, participation in many tribally-administered WIC programs has declined to a greater extent compared to the national average decline in participation over the last decade. This study aims to examine influences on WIC participation from a systems perspective in two tribally-administered WIC programs. In-depth interviews were conducted with WIC-eligible individuals, WIC staff, tribal administrators, and store owners. Interview transcripts underwent qualitative coding, followed by identifying causal relationships between codes and iterative refining of relationships using Kumu. Two community-specific causal loop diagrams (CLDs) were developed and compared. Findings from interviews in the Midwest yielded a total of 22 factors connected through 5 feedback loops, and in the Southwest a total of 26 factors connected through 7 feedback loops, resulting in three overlapping themes: Reservation and Food Store Infrastructure, WIC Staff Interactions and Integration with the Community, and State-level Administration and Bureaucracy. This study demonstrates the value of a systems approach to explore interconnected barriers and facilitators that can inform future strategies and mitigate declines in WIC participation. |
| first_indexed | 2024-03-11T07:14:18Z |
| format | Article |
| id | doaj.art-224be7094ab54466b4f02af4485e6b79 |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-11T07:14:18Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-224be7094ab54466b4f02af4485e6b792023-11-17T08:21:09ZengMDPI AGNutrients2072-66432023-02-01155121010.3390/nu15051210A Systems Approach to Identify Factors Influencing Participation in Two Tribally-Administered WIC ProgramsMichelle Estradé0Samantha Grace Alarcon Basurto1Abbegayle McCarter2Joel Gittelsohn3Takeru Igusa4Siyao Zhu5Lisa Poirier6Susan Gross7Marla Pardilla8Martha Rojo9Kevin Lombard10Henry Haskie11Veronica Clark12Jacqueline Swartz13Yeeli Mui14Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USAJohns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USAJohns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USAJohns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USAWhiting School of Engineering, Johns Hopkins University, 3400 North Charles St., Baltimore, MD 21218, USAWhiting School of Engineering, Johns Hopkins University, 3400 North Charles St., Baltimore, MD 21218, USAJohns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USAJohns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USAJohns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USACollege of Nursing, University of Arkansas for Medical Sciences, 220 UAMS Campus Dr., Little Rock, AR 72205, USACollege of Argicultural, Consumer, and Environmental Sciences, New Mexico State University, 300 Road 4063, Farmington, NM 87401, USANavajo Nation WIC, Window Rock, NM 86515, USANavajo Nation WIC, Window Rock, NM 86515, USAJohns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USAJohns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD 21205, USANative American populations experience highly disproportionate rates of poor maternal-child health outcomes. The WIC program aims to safeguard health by providing greater access to nutritious foods, but for reasons not well understood, participation in many tribally-administered WIC programs has declined to a greater extent compared to the national average decline in participation over the last decade. This study aims to examine influences on WIC participation from a systems perspective in two tribally-administered WIC programs. In-depth interviews were conducted with WIC-eligible individuals, WIC staff, tribal administrators, and store owners. Interview transcripts underwent qualitative coding, followed by identifying causal relationships between codes and iterative refining of relationships using Kumu. Two community-specific causal loop diagrams (CLDs) were developed and compared. Findings from interviews in the Midwest yielded a total of 22 factors connected through 5 feedback loops, and in the Southwest a total of 26 factors connected through 7 feedback loops, resulting in three overlapping themes: Reservation and Food Store Infrastructure, WIC Staff Interactions and Integration with the Community, and State-level Administration and Bureaucracy. This study demonstrates the value of a systems approach to explore interconnected barriers and facilitators that can inform future strategies and mitigate declines in WIC participation.https://www.mdpi.com/2072-6643/15/5/1210WICNative Americansystem dynamicscausal loop diagramhealth equitynutrition |
| spellingShingle | Michelle Estradé Samantha Grace Alarcon Basurto Abbegayle McCarter Joel Gittelsohn Takeru Igusa Siyao Zhu Lisa Poirier Susan Gross Marla Pardilla Martha Rojo Kevin Lombard Henry Haskie Veronica Clark Jacqueline Swartz Yeeli Mui A Systems Approach to Identify Factors Influencing Participation in Two Tribally-Administered WIC Programs Nutrients WIC Native American system dynamics causal loop diagram health equity nutrition |
| title | A Systems Approach to Identify Factors Influencing Participation in Two Tribally-Administered WIC Programs |
| title_full | A Systems Approach to Identify Factors Influencing Participation in Two Tribally-Administered WIC Programs |
| title_fullStr | A Systems Approach to Identify Factors Influencing Participation in Two Tribally-Administered WIC Programs |
| title_full_unstemmed | A Systems Approach to Identify Factors Influencing Participation in Two Tribally-Administered WIC Programs |
| title_short | A Systems Approach to Identify Factors Influencing Participation in Two Tribally-Administered WIC Programs |
| title_sort | systems approach to identify factors influencing participation in two tribally administered wic programs |
| topic | WIC Native American system dynamics causal loop diagram health equity nutrition |
| url | https://www.mdpi.com/2072-6643/15/5/1210 |
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