WIC Participant and Local Agency Staff Perspectives on Increased Cash‐Value Benefits for Fruits and Vegetables Within an American Indian Tribal Organization

In 2021, participants in the United States Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) received an unprecedented increase in a cash-value benefit for fruits and vegetables (CVB) as a part of their monthly food package. Responses to this increase among WIC staff and American Indian populations are poorly understood. The objective of this study was to assess perceptions and diet-related behaviors of both WIC staff and participants within an Indian Tribal Organization state agency following the CVB increase. To accomplish these objectives, we conducted interviews with WIC local agency staff members (n = 15) and distributed a survey to WIC participants (n = 1,587) at the Inter Tribal Council of Arizona WIC. Thematic analysis of interviews showed that the CVB increase enabled WIC staff to provide more actionable nutrition education regarding fruits and vegetables and that staff and participants highly valued higher CVB amounts. Participant survey results showed improved fruit and vegetable consumption and high satisfaction following the increase, especially among households receiving larger amounts of CVBs. Interview and survey findings both suggested that limited access to fresh produce on rural tribal lands may limit benefits of the CVB increase. Taken together, findings indicate that both WIC staff and participants have very positive perceptions of the CVB increase. However, systemic barriers to redemption on rural tribal lands highlight the need for additional strategies to improve benefit use.