Association for Public Policy Analysis & Management

The Women, Infants, and Children (WIC) program assists over 7 million individuals every year with funding to alleviate some of the nutritional risks they face. For those who qualify (pregnant, postpartum and breastfeeding women, and children up to age 5), the program provides a monthly allowance via WIC electronic benefit transfer (EBT) cards to help participants supplement their diets with necessary nutrients – tailored to each one’s needs based on the group category they belong to.

In spite of the many successes of the WIC program, its complexity also has brought some inconveniences that frequently lead participants to purchase less WIC-eligible foods than what is available for them. Indeed, research suggests that approximately 20% of the WIC benefits go unredeemed. Among the multiple factors causing participants to ‘leave money on the table’, research suggests that negative feelings experienced at checkout due to multiple payment methods involved, the inability to access WIC EBT card balances until after the transaction concludes, and a fear of embarrassment are most notable (Najjar, 2013; Gleason & Pooler, 2011; Herman et al., 2006; Payne, et al. 2018).

To address some of these barriers, we developed an intervention in collaboration with a partnering grocery store chain and federal and state agencies. Prior to the intervention, WIC balances were available to participants only after a transaction concluded; hence, redemption of any remaining WIC benefit required a new transaction. Often, to avoid potential stigma and perceptions that they were ‘holding the line’, participants acknowledged any remaining balance as a loss. Our goal was to change such behavior and increase WIC benefits redemption rates.

The intervention consisted in the modification and software upgrade of the cash registers in two New Mexico stores, with prior approval from state-level entities; the upgrade allowed WIC participants to access their remaining WIC balance before the end of the transaction. This modification streamlined the purchasing process and allowed cashiers to engage in suggestive selling of healthy WIC-approved fruits and vegetables stored conveniently by the checkout lanes. The healthy products were sold either as individual items (e.g. bananas @ $0.20) or bundled in micro packs (e.g., 3 nectarines @ $0.99), and provided a quick and healthy alternative to not using the remaining WIC balance.

In the process, we track more than a dozen UPC codes of healthy items advertised in the checkout lanes, and look for changes in actual sales during the intervention period.