Georgia WIC FFY 2010 Advocate Public Comment Survey [2011]

Georgia WIC FFY 2010 Advocate Public Comment Survey
Cherie Long, MPH1, Lynn Flen1, Cathi Durham, RN, BSN2, Kylia Crane, RD, LD3, Abdul Lindsay, MScFT, RD, LD, CPT1, Brian Castrucci, MPH1
1Georgia Department of Community Health, Division of Public Health, Maternal and Child Health Program; 2Georgia Academy of Family Physicians; 3Georgia Chapter of the American Academy of Pediatrics

Background

Results

Every Federal Fiscal Year (FFY) the Georgia Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) conducts an Advocate Public Comment Survey to evaluate advocate knowledge of and satisfaction with WIC services provided, as well as WIC customer service. A WIC advocate is a Physician, nurse, dietitian, public health colleague, or other partner who works with Georgia WIC to improve the nutrition of Georgia families.
Methods
In FFY 2010, the Georgia WIC partnered with the Georgia Academy of Family Physicians (GAFP) and Georgia's American Academy of Pediatrics (GA AAP) for distribution of the Georgia's WIC 2010 Advocate Public Comment Survey.

Figure 1. Percentage of completed surveys by WIC Advocate reported description (n=499)

Table 1. WIC Advocates' level of agreement with the following statements

n=421

Strongly agree

Agree

Strongly Does not Disagree disagree apply Missing

My questions and correspondence are promptly answered by Georgia WIC.

7%

48%

8%

3%

32%

2%

I believe my patients/clients benefit from WIC. 43%

52%

3%

<1%

<1%

2%

The benefits of WIC are not worth the added

work it takes for me to complete medical docu-

mentation forms.

5%

15%

39%

24%

14%

3%

95% of Georgia WIC Advocates believe WIC benefits their patients/clients. But 20% of WIC Advocates did voice concern regarding the added work required to complete medical documentation forms.

Figure 2. Percentage of WIC Advocates who reported referring patients/clients to WIC (n=499)

The Advocate Public Comment Survey was available for completion from June 14, 2010 through July 14, 2010. WIC Advocates received the survey by either mail or e-mail.
Georgia WIC receives an annually updated listing of WIC Advocates from all WIC Districts. An introductory letter and a copy of the paper survey were mailed to the WIC Advocates included on this list. These WIC advocates were given the option of either completing a paper survey and mailing it to the Georgia WIC State office or going to a website, via Survey Monkey, to complete the survey online.

Received 499 completed surveys The majority of responses were from Family Physicians (39%) and Pediatricians (33%)
Figures 3. Percentage of WIC Advocates who report being aware Figures 4. Percentage of WIC Advocates who report being that WIC provides support to women, infants, and children to aware that WIC provides... (n=477) improve the following outcomes... (n=479)

28% of Advocates reported not referring patients/

clients to WIC

Figures 5. Percentage of WIC Advocates who report being aware

21 (15%) Advocates did not report a reason for not referring to WIC.

that the 2009 WIC food package now includes...(n=472)

Reason marked (n=121)

37 (30%) - `I do not know how.'

38 (31%) - ` I do no know who to contact.'

13 (9%) - `I am not confident in WIC services.'

46 (32%) - `Patients/clients are already partici-

pating in the program.'

33 (23%) - `Other reason'

To ensure we reached all Georgia WIC Advocates, our partners, GAFP and the GA AAP, e-mailed the Advocate Public Comment Survey to all their association members.

Most common written in response was `Patient/client demographics do no qualify for WIC services.'

These WIC Advocates received the introductory e-mail, in-

cluding a web link with instructions directing them to

complete the survey online via Survey Monkey. Two re-

minder e-mails were sent to all association members dur-

ing the survey period. It was noted that some of the Georgia WIC Advocates

Conclusions

may have received both a letter as well as an e-mail regarding the survey. Results from paper surveys were entered into Survey Monkey and downloaded into Excel file and analyzed using SAS version 9.2.
Survey Response Rate
499 completed Advocate Public Comment Surveys entered into Survey Monkey.
4,951 surveys were mailed to GA WIC Advocates using the updated listing from all WIC Districts. 458 were returned due to incorrect address.

Table 2. Summary by WIC Advocate reported description

Advocate description
Pediatrician OB/GYN

Percentage of WIC Advocates who report being aware that WIC provides sup- Percentage of WIC Advocates who report being Percentage of WIC Advocates who report being aware that the 2009 WIC

port to women, infants, and children to improve the following outcomes... aware that WIC provides the following services... food package includes the following... (n=472 )

(n= 479)

(n=477)

Decrease Improve

the growth rate increase

incidence of of

early

Support

Reduce fetal

Reduce the iron nutritionally prenatal Nutrition

from

Extra food

deaths and Reduce low number of deficiency at-risk care for education

breastfeed- Breast

for breast-

infant birth weight premature anemia in infants and pregnant

and Breastfeed- ing Peer pumps and Whole Fruits and

Infant

Low fat feeding

mortality rates

births

children children women counseling ing classes Counselors supplies grains Vegetables Less Juice foods

milk

mothers

81%

85%

77%

96%

96%

73%

91%

50%

43%

29.81%

80%

81%

70%

86%

82%

73%

87%

87%

87%

87%

87%

87%

93%

80%

73%

73.33%

73%

80%

67%

80%

80%

73%

Georgia WIC Advocates agree that WIC benefits their patients/clients. WIC Advocates did comment on the added work required to complete the medical documentation forms
Georgia's WIC Advocates are aware that WIC provides WIC participants with support to improve outcomes among women, infants, and children.
More advertisement might be necessary to promote awareness among specific WIC Advocate groups regarding How to refer patients for WIC services What services WIC provides to its participants. Nutrition education and counseling

GAFP includes 1,279 association members Estimated response 197/1,279 = 15%
GA AAP includes 1,400 association members Estimated response 165/1,400 = 12%
Overall estimated response rate 499/7,172* = 7%

Family physician Nurse Other hospital staff Nutritionist Health dept staff Child care center School/head start

88%

88%

85%

93%

96%

84%

86%

72%

90%

97%

93%

97%

90%

93%

90%

70%

100%

100%

100%

86%

100%

100%

100%

86%

86%

86%

86%

100%

100%

86%

86%

86%

100%

100%

100%

100%

100%

89%

100%

95%

83%

89%

86%

92%

94%

97%

94%

83%

100%

100%

90%

100%

100%

80%

100%

70%

66%

53.26%

63%

64%

49%

74%

64%

59%

70%

43.33%

90%

87%

73%

87%

90%

77%

86%

85.71%

86%

86%

86%

86%

86%

86%

57%

28.57%

71%

86%

57%

100%

86%

71%

89%

84.21%

89%

100%

84%

100%

100%

89%

72%

58.33%

89%

86%

66%

83%

80%

63%

60%

50.00%

90%

90%

80%

90%

100%

80%

Breastfeeding classes Support from breastfeeding Peer Counselors Breast pumps and supplies What items are and are no longer included in the WIC food package.
Contact information:

The results of this survey are considered accurate at the 95% Missing response

89%

100%

78%

100%

100%

89%

100%

50%

50%

50.00%

75%

87.50%

75%

100%

88%

100%

Cherie Long, MPH

confidence, +/- 4.2%

Total

86%

89%

84%

94%

96%

82%

90%

66%

60%

46.96%

75%

76.48%

63%

82%

77%

69%

Nutrition and WIC Epidemiologist, Maternal and Child Health Program

*Estimated Advocate population (denominator) includes some duplicate advocates due to receipt of both mailed survey and emailed survey from GAFP and GA AAP.

Percentages under 70% are highlighted in red. Example interpretation: 80.86% of pediatricians surveyed report being aware that WIC provides support to women, infants, and children to reduce fetal deaths and infant mortality

Georgia Department of Community Health, Division of Public Health 2 Peachtree St., NW, Atlanta, GA 30303 cmlong@dhr.state.ga.us