State & Local WIC Agencies

State Interview Questions: Pre-implementation (P1)

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OMB Clearance Number: 0584-NEW Expiration Date: xx/xx/2011

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ello, my name is [INTERVIEWER]. I work for Abt Associates Inc., which is conducting a study sponsored by the U.S. Department of Agriculture’s Food and Nutrition Service to learn about the pending changes to food packages for postpartum women and infants.

You have been invited to participate in a telephone interview for this study to offer your perspective on the WIC food package changes that your State is going to implement in the near future. Your input is important to help us understand the different issues surrounding these changes and how your State/local agency is preparing for them.

The interview will take approximately one hour. Your responses will not be attributed to you but will be merged with responses from other interviews we conduct in your [State/local agency/clinic] to create an overall summary of the implementation plans. Do you have any questions before I begin?

State Policies/Practice on the Partial Breastfeeding Package

1. At present, what is the State policy regarding food package issuance for partially breastfeeding mothers and their infants? Do partially breastfeeding mothers ever receive the fully breastfeeding food package? If so, under what circumstances?

2. Have you studied the variations in food package issuance related to breastfeeding across LWAs? If yes, to what degree do you see local variation in the proportion of postpartum breastfeeding mothers in LWAs who receive the different packages? Is there variation in how much formula infants of partially breastfeeding mothers receive? What do you think are the reasons for this variation?

Implementing the New Regulations

3. What systems are you changing to implement the food package changes?

4. Are food package changes going to be phased in for different participant groups or done all at once? If phased in, please explain the plan.

5. What is your State’s timeline for implementing the Interim Rule?

6. Is additional staffing being arranged at the State level to implement the changes associated with the Interim Rule? If so, is a new position going to be created (or perhaps already has been) to deal exclusively with implementation efforts? If no, which staff members will be responsible for implementation?

7. What do you anticipate are the biggest challenges to making these changes? Are there particular challenges related to food packages for mother-infant pairs? What kind of administrative burden do you see for LWAs? Do you anticipate taking any steps to try to ease the burden? If so, what?

8. Will there be “temporary” changes that you make during the implementation period that may affect your administrative data on food package choices for postpartum breastfeeding women and their infants? If yes, please describe.

9. What is the planned role of the LWAs in implementing these food package changes?

Support to Local WIC Agencies

10. What has been the general reaction to the changes in food packages among local WIC staff in your State? What are their main questions and concerns? How are you addressing questions and concerns (additional training or meetings, changes in written materials, additional communication, etc.)?

11. Does LWA staff have any specific concerns about the implementation of the new food packages for breastfeeding and partially breastfeeding mothers and their infants? What are their main questions or concerns?

12. Is there any training planned for local WIC directors and other staff? If so, what type of training?

For local WIC Directors:

For local WIC staff:

13. In addition to training, what, if any, kinds of other assistance and support will be given to local WIC agencies (additional funding, training, computer programming, additional equipment, etc)?

Information for WIC Participants

14. How much do you think postpartum WIC participants currently know about the difference in the content of food packages? To what degree do you think this affects their decision to breastfeed?

15. Is your State developing written guidelines for staff about communicating the food package changes to pregnant and postpartum women? If so, please describe the guidelines.

16. Is your State going to provide written materials (brochures/posters/etc.) to describe the food package changes?

If so, how do you think these materials will be used? Will LWAs create/supplement State- developed materials with ones they also develop?

Anticipated Effects of Food Package Changes

17. How do you think WIC participants will react to the changes in the breastfeeding food packages in your State?

18. How do you think the food package changes will influence the decisions of WIC participants in your State about breastfeeding initiation? Breastfeeding intensity? Breastfeeding duration? Why do you think this?

19. In your opinion, how will changes in food packages affect mothers in your State who would have received a modified full formula package under the previous rule because they were partially breastfeeding? What proportion of such women do you think will take the full formula package? Why do you think this?

20. Do you plan to track the effects of food package changes on women’s breastfeeding behavior or food package receipt? In what ways?

21. How will State policies regarding assessments be modified, if at all, to measure the effects of the food package changes?

Abt Associates Inc. State Interview Questions_P1 3