Nutrition Education


  1. 1. Nutrition Education Plans (§246.11)
  2. 2. Annual Assessment of Participant Views on Nutrition Education and Breastfeeding Promotion
  3. 3. Nutrition Education Contacts (§246.11(a)(1-3):
  4. 4. Nutrition Education Materials (§246.11(c)(1,3-8):
  5. 5. Special Nutrition Education Needs of Special Populations
  6. 6. Breastfeeding Promotion and Support Plan
  7. 7. The State agency coordinates with local agencies to develop a breastfeeding peer counseling program that contains the following components:

1. Nutrition Education Plans (§246.11)

  1. The State agency develops and coordinates the nutrition education component with consideration of local agency plans, needs and available nutrition education resources. (§246.11(c))
  2. The State agency monitors local agency activities to ensure compliance with provisions set forth in paragraphs §246.11 (c)(8), (d), and (e) of this section. [Note: The reference to (c)(8) will by replaced with (c)(7) once the Miscellaneous Rule is published.] (§246.11(c)(5))
  3. The local agency develops an annual nutrition education plan that is consistent with the State's nutrition education component of Program operations. (§246.11(d)(2))
    1. The State agency requires that local agency nutrition education include:
      • a needs assessment  - Checked
      • goals and objectives for participants  - Checked
      • evaluation/follow-up  - Checked
      • other (list):
    2. The State agency monitors local agency progress toward meeting nutrition education goals, nutrition education action plans and objectives via:
      • quarterly or annually written reports
      • year-end summary report  - Checked
      • annually at local agency reviews  - Checked
      • other (specify):
  4. State policies reflect the revised definition of "nutrition education" found in Public Law 108-265, the Child Nutrition and WIC Reauthorization Act of 2004, enacted on June 30, 2004. The revised definition is "Nutrition education means individual and group sessions and the provision of materials that are designed to improve health status and achieve positive change in dietary and physical activity habits, and that emphasize the relationship between nutrition, physical activity, and health, all in keeping with the personal and cultural preferences of the individual."
    • Yes  - Checked
    • No

ADDITIONAL DETAIL: Nutrition Services Appendix and/or Procedure Manual (citation): WIC PPM, Part 4, Nutrition Education policies reflect the revised definition of "nutrition education".

2. Annual Assessment of Participant Views on Nutrition Education and Breastfeeding Promotion

  1. Is an annual Assessment of Participant Views on Nutrition Education and Breastfeeding Promotion conducted:
    • Yes - Checked
    • No
  2. Check below the method(s) used in the past fiscal year to assess participant views on nutrition education and breastfeeding promotion and support provided by WIC:
    • State-developed questionnaire issued by local agencies  - Checked
    • Locally developed questionnaires (need approval by SA: Yes No)
    • State-developed questionnaire issued by State agency
    • Focus groups
    • Other (specify):
  3. Results of participant views are:
    • used in the development of the State Plan
    • used in the development of local agency nutrition education plans and breastfeeding promotion and support plans  - Checked
    • other (specify):

ADDITIONAL DETAIL: Nutrition Services Appendix and/or Procedure Manual (citation):

3. Nutrition Education Contacts (§246.11(a)(1-3):

(1)Nutrition education shall be considered a benefit of the program, and shall be made available at no cost to the participant. Nutrition education shall be designed to be easily understood by participants, bear a practical relationship to participant nutritional needs, household situations, and cultural preferences including information on how to select food for themselves and their families.)

(2) Nutrition education is made available to all participants.

(3) The State agency shall ensure that local agencies provide drug and other harmful substance abuse information to all pregnant, postpartum, and breastfeeding women and parents or caretakers of infants and children participants.

  1. The State agency assures that each local agency offers adult participants, parents or caretakers of infant and child participants, and whenever possible, the child participants themselves at least two (=2) nutrition education contacts per certification period to ensure adequate nutrition education in accordance with §246.11(e) via:
    • local agency addresses in annual nutrition education plan  - Checked
    • state nutrition staff monitor annually during local agency reviews  - Checked
    • local agency provides periodic reports to State agency
    • other (specify):
  2. The State agency has developed minimum nutrition education standards for the following participant categories:
    • pregnant women - Checked
    • breastfeeding women  - Checked
    • postpartum women - Checked
    • infants  - Checked
    • children - Checked
    • high-risk participants  - Checked
    • The minimum nutrition education standards address:
      • number of contacts - Checked
      • documentation  - Checked
      • protocols - Checked
      • referrals  - Checked
      • breastfeeding promotion - Checked
      • care plans  - Checked
      • information on drug and other harmful substance abuse  - Checked
      • counseling methods/teaching strategies  - Checked
      • content (WIC appropriate topics)
      • relevant to participant assessment  - Checked
      • appropriate use of educational reinforcements (videos, brochures, posters, etc.)  - Checked
  3. The State agency allows the following nutrition education delivery methods:
    • face-to-face, individually or group  - Checked
    • online/Internet  - Checked
    • telephone
    • take-home activity  - Checked
    • food demonstration  - Checked
    • a delivery method performed by other agencies, i.e., EFNEP  - Checked
    • other (specify):
  4. An individual care plan is provided based on:
    • nutritional risk - Checked
    • CPA discretion  - Checked
    • priority level - Checked
    • participant request  - Checked
    • other:
  5. Individual care plans developed include the following components:
    • identification of nutrition-related problems  - May Include
    • individualized food package - May Include
    • plan for follow-up - May Include
    • referrals - May Include
    • timeframes for completing action plan - May Include
    • documentation for completing action plan - May Include
    • bear a practical relationship to participant nutritional needs, household situations, and cultural preferences including information on how to select food for themselves and their families - May Include
    • other (specify):
  6. Check the following individuals allowed to provide general or high-risk nutrition education:
General
Nutrition
Education
High-risk
Nutrition
Contact
Paraprofessionals (non B.S. degree with formal WIC training by SA or LA) Checked
Licensed Practical Nurses Checked
Registered Nurses Checked Checked
B.S. in Home Economics Checked Checked
B.S. in the field of Human Nutrition Checked Checked
Registered Dietitian or M.S. in Nutrition (or related field) Checked Checked
Dietetic Technician (2-year program completed) Checked

Other (specify): EFNEP staff provide group education. - General Nutrition Education

  1. The State agency allows adult participants to receive nutrition education by proxy.
    • No
    • Yes (If yes, check the applicable conditions below):  - Checked
      • proxy is spouse/significant other  - Checked
      • proxy is parent of adolescent prenatal participant  - Checked
      • proxy is neighbor  - Checked
      • only for certain priorities (specify):
      • other (specify):
  2. The State agency allows parents/guardians of infant and child participants to
    • receive nutrition education by proxy.
    • No
    • Yes (If yes, check the applicable conditions below):  - Checked
      • proxy is grandparent or legal guardian of infant or child participant  - Checked
      • proxy is neighbor  - Checked
      • only for certain priorities (specify):
      • other (specify):

ADDITIONAL DETAIL: Nutrition Services Appendix and/or Procedure Manual (citation):WIC PPM, Nutrition Education, Part 4

4. Nutrition Education Materials (§246.11(c)(1,3-8):

(1) The State agency shall develop and coordinate the nutrition education component of Program operations with consideration of local agency plans, needs and available nutrition education resources.

(3) Identify or develop resources and educational materials for use in local agencies, including breastfeeding promotion and instruction materials, taking reasonable steps to include materials in languages other than English in areas where a significant number or proportion of the population needs the information in a language other than English.

(4) Develop and implement procedures to ensure that nutrition education is offered to all adult participants and to parents/caregivers of infant or child participants, as well as child participants whenever possible.

(6) Establish standards for participant contacts that ensure adequate nutrition education in accordance with paragraph 246.11(e).

(7) Establish standards for breastfeeding promotion and support, including a positive breastfeeding supportive clinic environment, a local agency breastfeeding coordinator, breastfeeding promotion and support for new staff .)

  1. The State agency recommends and/or makes available nutrition education materials for the following topics:
English Spanish Other Languages
(specify):
General Nutrition Checked Checked
Specific nutrition related disorders Checked Checked
Maternal nutrition Checked Checked
Infant nutrition Checked Checked Brochures for Infant Nutrition have been translated into nine different languages: Arabic, Bosnian, Chinese, Hindi, Korean, Polish, Russian, Spanish and Vietnamese
Child nutrition Checked Checked Brochures for Child Nutrition that have been translated into the nine different languages: Arabic, Bosnian, Chinese, Hindi, Korean, Polish, Russian, Spanish and Vietnamese.
Nutritional needs of homeless Checked Checked
Nutritional needs of migrant farmworkers & their families Checked Checked
Nutritional needs of Native Americans
Nutritional needs of teenage prenatal women Checked Checked
Breastfeeding promotion and support (including troubleshooting problems) Checked Checked Brochures for Breastfeeding Promotion and Support have been translated into nine different languages, Arabic, Bosnian, Chinese, Hindi, Korean, Polish, Russian, Spanish and Vietnamese.
Danger of harmful substance (alcohol, tobacco and other drugs and second-hand smoke) use during pregnancy and breastfeeding Checked Checked
Other:

Attach a listing of the nutrition education resources available from the State agency or other sources for use by local agencies or specify the location in the Procedure Manual and reference below.

  1. The State agency follows written procedures to ensure that nutrition education materials recommended/made available are appropriate in terms of the following:
    • content - Checked
    • reading level/language - Checked
    • graphic design - Checked
    • ethnicity  - Checked
  2. Locally developed nutrition education materials must be approved by State agency prior to use.
    • Yes
    • No  - Checked
  3. If no, State agency requires local agency to follow a standardized format for evaluating nutrition education materials.
    • Yes
    • No  - Checked

ADDITIONAL DETAIL: Nutrition Services Appendix and/or Procedure Manual (citation):WIC PPM, Nutrition Education, Part 4

5. Special Nutrition Education Needs of Special Populations

The State agency tailors its nutrition education efforts to address the specific needs of migrant farmworkers (M), homeless individuals (H), substance-abusing individuals (S), and/or breastfeeding women (B) through (check all that apply):

M H S B
provision of nutrition education materials appropriate to this population and language needs X X X X
provision of nutrition curriculum or care guidelines specific to this population X
requiring local agencies who serve this population to address its special needs in local agency nutrition education plans X X X X
arranging for special training of local agency personnel who work with this population X X X X
distribution of resource materials related to this population X X X X
encouraging WIC local agencies to network with one another X X X X
coordinating at the State and local levels with agencies who serve this population X X X X
other (specify):

ADDITIONAL DETAIL: Nutrition Services Appendix and/or Procedure Manual (citation):

6. Breastfeeding Promotion and Support Plan

  1. The State agency coordinates with local agencies to develop a breastfeeding promotion plan that contains the following elements (check all that apply):
    • activities such as development of breastfeeding coalitions, task forces, or forums to address breastfeeding promotion and support issues  - Checked
    • identification of breastfeeding promotion and support materials  - Checked
    • procurement of breastfeeding aids which support the initiation and continuation of breastfeeding (e.g., breast pumps, breastshells, nursing supplementers, and nursing pads and bras).  - Checked
    • training for State/local agency staff.  - Checked
    • designating roles and responsibilities of staff  - Checked
    • evaluation of breastfeeding promotion and support activities  - Checked
    • other (specify):
  2. The State agency has established minimum protocols for breastfeeding promotion and support which include, at a minimum, the following (check all that apply):
    • a policy that creates a positive clinic environment which endorses breastfeeding as the preferred method of infant feeding  - Checked
    • a requirement that each local agency designate a local agency staff person to coordinate breastfeeding promotion and support activities  - Checked
    • a requirement that each local agency incorporate task-appropriate breastfeeding promotion and support training into orientation programs for new staff involved in direct contact with WIC clients  - Checked
    • a plan to ensure that women have access to breastfeeding promotion and support activities during the prenatal and postpartum periods  - Checked
    • participant assessment  - Checked
    • food package prescription  - Checked
    • data collection  - Checked
    • referral criteria  - Checked
    • peer counseling  - Checked
    • other (specify):
    • other (specify):

State agencies that receive WIC Breastfeeding Peer Counseling Funds complete item 7.

7. The State agency coordinates with local agencies to develop a breastfeeding peer counseling program that contains the following components:

  1. An appropriate definition of peer counselor defined as follows: paraprofessional; recruited and hired from target population; available to WIC clients outside usual clinic hours and outside the WIC clinic
    • Yes - Checked
    • No
  2. Designated breastfeeding peer counseling program managers/coordinators at State and/or local level
    • Yes - Checked
    • No
  3. Defined job parameters and job descriptions for breastfeeding peer counselors
    • Yes - Checked
    • No
    • If yes, the job parameters for peer counselors (check all that apply):
      • Define settings for peer counseling service delivery  - Checked
        • Home (peer counselor makes telephone calls from home  - Checked
        • Home (peer counselor makes home visits  - Checked
        • Clinic  - Checked
        • Hospital  - Checked
      • Define frequency of client contacts  - Checked
      • Define procedures for making referrals  - Checked
  4. Adequate compensation and reimbursement of breastfeeding peer counselors
    • Yes - Checked
    • No
  5. Training of State and local management staff through Using Loving Support to Manage Peer Counseling Programs training curriculum
    • Yes - Checked
    • No
  6. Training of WIC clinic staff about the role of the WIC peer counselor
    • Yes - Checked
    • No
  7. Establishment of standardized breastfeeding peer counseling program policies and procedures (check all that apply):
    • documentation of client contacts  - Checked
    • referral protocols  - Checked
    • confidentiality  - Checked
    • other, (specify)
  8. Adequate supervision and monitoring of breastfeeding peer counselors through (check all that apply):
    • regular, systematic contact with peer counselor  - Checked
    • regular, systematic review of peer counselor contact logs  - Checked
    • spot checks  - Checked
    • other, (specify)
  9. Establishment of community partnerships to enhance the effectiveness of breastfeeding peer counseling programs (check all that apply):
    • breastfeeding coalitions  - Checked
    • businesses
    • community organizations  - Checked
    • cooperative extension
    • La Leche League  - Checked
    • hospitals  - Checked
    • home visiting programs  - Checked
    • private clinics  - Checked
    • other, (specify)
  10. Adequate support of peer counselors by providing the following (check all that apply):
    • timely access to WIC designated breastfeeding experts for referrals outside peer counselors' scope of practice  - Checked
    • regular contact with supervisor  - Checked
    • participation in clinic staff meetings as part of WIC team  - Checked
    • opportunities to meet regularly with other peer counselors  - Checked
    • other, (specify)regular statewide Peer Counselor Conference Calls  - Checked
  11. Provision of training and continuing education of peer counselors (check all that apply):
    • standardized training using Loving Support through Peer Counseling curriculum  - Checked
    • ongoing training at regularly scheduled meetings  - Checked
    • home study
    • opportunities to "shadow" or observe lactation experts and other peer counselors
    • training/experience to become senior level peer counselors, IBCLC, etc.)  - Checked
    • other, (specify)

ADDITIONAL DETAIL: Nutrition Services Appendix and/or Procedure Manual (citation):