Exploring the Utilization of Benefits and Participation Experiences Among Immigrants and Refugees in WIC Program: A Mixed-Method Study

Food insecurity is a critical issue globally and in the United States. The USDA’s Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) aims to address this by improving the nutrition of low-income pregnant women and children. However, immigrants and refugees, who are particularly vulnerable to food insecurity, often encounter barriers to accessing WIC benefits. This study aimed to: i) evaluate how immigrant and refugee families in Utah utilize WIC benefits, and ii) explore their experiences, challenges, and suggestions for improving the program. This mixed-method study combined surveys with 116 participants and in-depth interviews with 25 participants. Surveys were analyzed using multinomial logistic regression, while interviews provided deeper insight into personal experiences and improvement ideas. Participants represented 19 countries and diverse racial/ethnic backgrounds. Most were refugees (95%), women (97%), and aged 25–34. The study found high utilization rates for eggs (100%), fruits/vegetables (98%), and milk (91%), but low rates for peanut butter (27%), whole wheat bread/grains (18%), infant cereal (16%), cheese (14%), infant fruits/vegetables (13%), and breakfast cereal (12%). Factors such as card understanding, WIC duration, education, marital status, household size, and continent of origin influenced utilization rates for certain foods. Interviews revealed key themes, including motivations for WIC enrollment (e.g., financial support, health worker referrals), challenges (e.g., language barriers, transportation, navigating WIC cards), and suggestions for improvement. Participants recommended providing culturally relevant foods, flexible options, multilingual resources, better communication, extended office hours, and transportation services. The findings emphasize the need to make WIC more accessible and inclusive for immigrant and refugee families. Addressing identified barriers could enhance benefit utilization and improve nutritional outcomes for these vulnerable populations. Future research should explore additional demographic and psychosocial factors and focus on the low utilization of specific foods, such as infant fruits and cereals, to optimize program effectiveness further.