RE-AIM Framework: Best Practices for Implementing Cooking Matters in Georgia’s District 4 WIC Clinics Open Access
Kanemitsu, Marisa (Spring 2020)
Abstract
The Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) has been highlighted as one of the most effective federal nutrition assistance programs in the United States. As rates of childhood obesity continue to increase, WIC’s nutrition education service has been recognized as a key target area to help combat this issue. Calls for innovation in nutrition education have resulted in various programs and services across the country; in Georgia, Georgia’s WIC District 4 and Open Hand Atlanta have partnered to implement Cooking Matters, a hands-on nutrition education and cooking curriculum designed to help low-income families shop, cook, and eat healthier.
Using an implementation science tool known as the RE-AIM framework, this report highlights the lessons learned in the Cooking Matters implementation experience in Georgia. In-depth interviews with program implementers, unstructured observation of classes, and participant surveys were analyzed to understand the challenges and best practices of implementation. Over the course of nearly 5 years, the program has been adopted into all 14 District 4 WIC clinics and primarily reached parents and caretakers of children 1-5 years old. It has also led to positive outcomes among participants, such as improved confidence in nutritional concepts and shopping for and cooking healthy foods using WIC vouchers.
Important best practices that have helped District 4 overcome barriers or address concerns and achieve positive outcomes at multiple levels of the framework include: strategic and sustained partnerships, a highly skilled and dedicated nutrition educator, a culture of and innovation and prioritizing participant needs, and program champions at multiple levels of the organization. The best practices that program implementers used in the District 4 experience can help guide successful implementation of Cooking Matters in other WIC districts in Georgia and nationally.
Table of Contents
Chapter 1: Introduction
1
Diet Quality Among Pediatric Populations in the US
1
Effective Interventions to Improve Diet Quality
2
Chapter 2: Comprehensive Review of the Literature
3
Introduction to WIC
3
History of WIC
3
Eligibility and Benefits
4
2007 Interim Rule
5
Administration
6
Priority System and Cost Containment
6
Georgia WIC
7
WIC Nutrition Education
8
WIC Challenges
10
Effective WIC Nutrition Education Programs
10
WIC Cooking Matters and Social Marketing Campaign
11
Chapter 3: Project Content
13
Methods
13
Study Design
13
Setting
13
Data Collection Methods
14
RE-AIM Measures
15
Data Analysis
16
Results
17
Cooking Matters Reach
17
Cooking Matters Effectiveness
19
Cooking Matters Adoption
22
Cooking Matters Implementation
24
Cooking Matters Maintenance
25
Chapter 4: Discussion, Recommendations, and Conclusion
28
Discussion
28
Limitations
31
Policy and Practice Recommendations
33
Conclusions
35
Appendix A1: Interview Guide, District 4 WIC Administrators
37
Appendix A2: Interview Guide, District 4 WIC Nutrition Educator
39
Appendix A3: Interview Guide, Open Hand
41
Appendix B: Complete List of Best Practices
43
Appendix C: References
45
About this Master's Thesis
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