Challenges and barriers to WIC participation vary by participation status and language: Findings from focus groups in Missouri

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is one of the largest federal food and nutrition program serving women and young children and has a low coverage rate of about 50 percent. There is no peer-reviewed article that compares maternal perceptions of challenges and barriers to WIC participation by language and participation status. We compare challenges and barriers faced by English-speaking mothers to those faced by Spanish-speaking mothers to enrollment and retention in WIC within each group: current participants (n = 43), prior participants (dropouts; n = 27), and eligible non-participants (n = 18), using focus groups we conducted in Missouri in 2021-2023. We used thematic analysis to generate core themes in NVivo 14. We find heterogeneous barriers to WIC participation by participation status and language spoken by the mother. While all participants identified the difficulty in attending WIC appointments as a top barrier, a higher percentage of Spanish-speaking mothers in comparison to English-speaking mothers reported it more frequently. Only eligible non-participants identified lack of information on the WIC program, its benefits, and certification requirements as barrier. Unlike common belief, language was not considered a barrier, but rather a challenge exhibited among Spanish-speaking mothers. While dissatisfaction with food alternatives is a top challenge for current WIC participants, it only becomes a barrier for Spanish-speaking mothers but not for English-speaking ones. Findings highlight the importance of designing creative ways to inform WIC-eligible mothers about the program's benefits and enrollment requirements, and to consider differences by maternal tongue and culture. Increases in food amount and variety may lead to higher participation rates. Moreover, extending hours of operation at the WIC clinics and providing virtual meetings may lead to increasing retention rates and benefits redemption.