List of Tables

Page No.
Section IT
1 Number and Percentage of Agencies and of Participants by Agency Size ....-.. I-1
Number and Percentage of Agencies and of Participants
by Percentage Growth .......--- 222-220 e ee eee eee eee -2
3 Number and Percentage of Agencies and of Participants
by Agency Sponsorship ......--.. 0.2022 e eee eee eee II-3
4 Number and Percentage of Agencies and of Participants by Catchment Area .... II-5
5 Number and Percentage of Agencies and of Participants
by Ethnic Populations Served .....-. 22-2. 0002 eee eee T-7
IA.6 Number and Percentage of Agencies and of Participants
by Caseload Change Since 1988 and Ethnic Populations Served ............ I-13
IB.6 Number and Percentage of Agencies and of Participants
by Operating Capacity and Ethnic Populations Served .....-......---.--- I-19
6 Number and Percentage of Agencies and of Participants
by Size of WIC Local Agency ......... 0-0-0 0 eee eee ete W-25
7 Number and Percentage of Agencies and of Participants
by Perceived Caseload Change Since 1988 and Actual Growth............- 11-26
8 Number and Percentage of Agencies and of Participants
by Caseload Change Since 1988 and Agency Sponsorship ..........-..-.- I-27
9 Number and Percentage of. Agencies and of Participants
by Caseload Change Since 1988 and Catchment Area ...........----0-5> T1-28
10 Number and Percentage of Agencies and of Participants
by Caseload Change Since 1988 and Ethnic Populations Served ............ TI-30
11 Number and Percentage of Agencies and of Participants
by Operating Capacity and Agency Size .....-- 22... . ee eee eee eee eee TI-36
12 Number and Percentage of Agencies and of Participants
by Operating Capacity and Percentage Growth .......--..-----2--0---- I-37
13 Number and Percentage of Agencies and Affected Participants
by Agencies’ Perceived Impact of Caseload Fluctuations ................-. I-39
14 Number and Percentage of Agencies and Affected Participants
by Agencies’ Perceived Impact of Factors Related to Economic Factors ...... I-40
15 Number and Percentage of Agencies and Affected Participants
by Agencies’ Perceived Impact of New Program Requirements ............ I-42
16 Number and Percentage of Agencies and Affected Participants
by Agencies’ Perceived Impact of Other Initiatives and Factors ............ 1-43
17 Number and Percentage of Agencies and Affected Participants
by Percentage of Clinics/Sites Within Agency Having Selected
Operating Characteristics ©... 6... eee T-45
18 Number and Percentage of Agencies and Affected Participants in Agencies
by Use of Vans, Mobile Units, or Other Motorized Facilities .............- 11-46
19 Number and Percentage of Agencies and Affected Participants
by Whether the Agencies Uses Non-WIC Funded Medical Providers
for Certification and Consulting Staff to Provide WIC Services ...........- I-47



33

35

36

37

38

List of Tables (continued)

Standard Errors of Agencies and Affected Participants by Changes

in Scheduling Practices ©... 2.0... cece cee TI-44
Standard Errors of Agencies and Affected Participants by Changes

in Staffing Practices Since 1988 ............-- 02-22 e ee eee eee ee TI-46
Standard Errors of Agencies and Affected Participants by Changes

in Waiting List Practices Since 1988 ... 2.1.2.2... ee eee eee eee {I-48
Standard Errors of Agencies and Affected Participants by Changes

in Administrative Practices and Operations Since 1988 ........---...--. Til-49
Standard Errors of Agencies and Affected Participants by Changes

in Facilities Since 1988 0.0.0.2. c eee eee ee TH-51
Standard Errors of Agencies and Affected Participants by Other

Changes Made Since 1988 ... 1.0.2... eee eee ee ees TH-52

Section IV

Number and Percentage of State Agencies by Selected

Service Characteristics 20... ee tte Iv-1
Number and Percentage of State Agencies, Affected Local Agencies,

and Affected Participants by Percentage Growth in Participation

Since 1988 2.0... cee ee ttt e eee IV-3
Number and Percentage of State Agencies, Affected Local Agencies,

and Affected Participants by Agencies’ Perceived Impact

of Caseload Fluctuations ... 2.6... 00. e eee eee ete eee ete Iv-4
Number and Percentage of State Agencies, Affected Local Agencies,

and Affected Participants by Agencies’ Perceived Impact

of Economic Factors .... 6... 20 ee eee tee tees Iv-5
Number and Percentage of State Agencies, Affected Local Agencies,

and Affected Participants by Agencies’ Perceived Impact

of New Program Requirements ....... 2.025020 00 sees eee teers IV-7
Number and Percentage of State Agencies, Affected Local Agencies,

and Affected Participants by Agencies’ Perceived Impact

of Other Initiatives and Factors .. 2... 2-602 eee eee IV-9.
Number and Percentage of State Agencies, Affected Local Agencies,

and Affected Participants by Other Non-Federal Sources

of Funding for WIC 2... 2-6. tee tee Iv-11
Number and Percentage of State Agencies, Affected Local Agencies,

and Affected Participants by Whether Unspent State-Appropriated

Funds Can be Carried Forward .. 0.0.00. eee eee ee TV-12
Number and Percentage of State Agencies, Affected Local Agencies,

and Affected Participants by Change in the Availability and Amount

of Funding from Other Non-Federal Sources Since 1988 ............-4-- IV-13

vi



39

40

41

42

43

45

46

47

48

49

50

51

52

53

34

55

56

57

58

59

List of Tables (continued)

Page No.
Number and Percentage of Agencies by Ratio of Type of Nutrition
Staff to Total Nutritional Staff Levels... 0... 00.2 eee TI-70
Number and Percentage of Agencies and Affected Participants
by Topics Covered and Methods Used........-.------ 002-2 +e sees I-71
Number and Percentage of Agencies and Affected Participants
by Whether Nutrition Services Covered by Medicaid ............-.--..-- H-73
Number and Percentage of Agencies and Affected Participants
by Frequency of Nutrition Education Contacts ............-----++-+-5- TI-74
Number and Percentage of Agencies and Affected Participants
by Group Size for Providing Nutrition Education ............--------++ I-75
Number and Percentage of Agencies and Affected Participants
by Use of Nutrition Education Materials and Methods ..............--.-- II-76
Number and Percentage of Agencies and Affected Participants
by Use of Nutrition Education Materials and Methods ..............--.-. I-78
Number and Percentage of Agencies and Affected Participants
by Factors that May Act as Barriers to Providing High Quality
Nutrition Education .. 0... 2-2... 6 eee ee I-80
Number and Percentage of Agencies by Children Provided
Nutrition Education .... 0.0.2... 202-00 eee eee II-81
Number and Percentage of Agencies and Affected Participants
by Factors Ranked Most Often as Promoting High Quality WIC Services ..... II-82
Number and Percentage of Agencies and Affected Participants
by Factors Ranked Most Often as Hindering High Quality WIC Services ..... TI-84
Number and Percentage of Agencies and Affected Participants
by Changes in Certification Practices Since 1988 ................-.---- TI-86
Number and Percentage of Agencies and Affected Participants
by Changes in Nutrition Education Practices Since 1988 ................. TI-88
Number and Percentage of Agencies and Affected Participants
by Changes in Food Instrument Practices Since 1988 ...........-....-.. T1-90
Number and Percentage of Agencies and Affected Participants
by Changes in Scheduling Practices .........-.-.2---2--2-0-2-2 000055 II-92
Number and Percentage of Agencies and Affected Participants
by Changes in Staffing Practices Since 1988 ..........--2-.--.---..--. I-94
Number and Percentage of Agencies and Affected Participants
by Changes in Waiting List Practices Since 1988 ..............--..-..- TI-96
Number and Percentage of Agencies and Affected Participants
by Changes in Administrative Practices and Operations Since 1988 ......... I-97
Number and Percentage of Agencies and Affected Participants
by Changes in Facilities Since 1988 ...... 20.00... ccc eee eee eee TI-99
Number and Percentage of Agencies and Affected Participants
by Other Changes Made Since 1988 ........--...0-. 0.0.2.0. 000 0000 ee TI-100

Number and Percentage of Agencies and Affected Participants
by Degree of Change in Funding Sources for Labor and
Non-Labor Items Compared to 1988... 0.0. 0..0200-0 0000.0 e eee eee II-101

iii



20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

List of Tables (continued)

Number and Percentage of Agencies and Affected Participants

by Use of Consultants or Contracting Staff to Provide WIC Services .......- I-48
Number and Percentage of Agencies and Affected Participants

by Use of Itinerant Professional, Paraprofessional, or Clerical/Support Staff .... 11-49
Number and Percentage of Agencies and Affected Participants

by Agency Non-Labor Items and Funding Source .....-...-.-++------++ 11-50
Number and Percentage of Agencies and Affected Participants

by Sufficiency and Appropriateness of Professional, Paraprofessional,

and Clerical Support Staff ......-- 62.6 see eee ee etree I-51
Number and Percentage of Agencies and Affected Participants

by Ratio of Vacant Positions to Current Full-Time Employees for

Professional, Paraprofessional, and Clerical/Support Staff ..........-+++-- TI-53
Number and Percentage of Agencies and Affected Participants

by Degree of Difficulty Experienced by Agency in Recruiting

Professional, Paraprofessional, and Clerical/Support Staff ........------+- TI-54
Number and Percentage of Agencies and Affected Participants

by Degree of Difficulty Experienced by Agency in Retaining

Professional, Paraprofessional, and Clerical/Support Staff ......-.-----+-- I-55
Number and Percentage of Agencies and Affected Participants
by Perceived Reasons for Not Filling Vacant Positions ..........---05055 11-56
Number and Percentage of Agencies and Affected Participants
by Perceived Reasons for Not Retaining Staff ...-.-.------+- +++ esses TI-58
Number and Percentage of Agencies and Affected Participants
by Languages Available at Agency .......- +++ 0-22 essere rte I-59
Number and Percentage of Agencies and Affected Participants
by Perceived Adequacy of Current Space ..... 2022-262 e erect II-61

Number and Percentage of Agencies and Affected Participants

by Type of Service and Estimated Typical Number of Minutes

Waiting for Service 2.0... ee eee eee teeter nte Tl-62
Number and Percentage of Agencies and Affected Participants

by Type of Service and Estimated Typical Number of

Minutes Receiving Service .......-- +--+ 02-200 errr teers TI-63
Number and Percentage of Principal Clinics by Method

of Obtaining Hematological Measurements ......------++++- eee cttree Tl-64
Number and Percentage of Principal Clinics by Specified

Health Services Available on Site... 2.62.22 eee ee eee T1-65
Number and Percentage of Principal Clinics by Specified

Non-Health Referral Services Available on Site .......------++ eee 5-505 TI-66
Number and Percentage of Principal Clinics by Opportunity

to Apply for Selected Non-Health Services on Site ......-...--00 02ers II-67
Number and Percentage of Principal Clinics in Which Obtaining

Health Care and Non-Health Care Services is a Problem .....--------+--- I1-68

Number and Percentage of Agencies by Reported Problems in
Referring Clients to Other Agencies ©... 6... 0-002 eects T1-69


12

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

List of Tables (continued)

Standard Errors of Agencies and Affected Participants by Degree

of Difficulty Experienced by Agency in Recruiting Professional,

Paraprofessional, and Clerical/Support Staff ...........--------000--- TH-15
Standard Errors of Agencies and Affected Participants by Degree

of Difficulty Experienced by Agency in Retaining Professional,

Paraprofessional, and Clerical/Support Staff .......-.....---- 25ers Ill-16
Standard Errors of Agencies and Affected Participants by Languages

Available at Agency ©... 2.6.6.0 2 ee eee eee T-17
Standard Errors of Agencies and Affected Participants by Perceived

Adequacy of Current Space ......- 0-22.62 eee eee eee ee TH-19
Standard Errors of Agencies and Affected Participants by Type of Service

and Estimated Typical Number of Minutes Waiting for Service ........... TII-20
Standard Errors of Agencies and Affected Participants by Type of Service

and Estimated Typical Number of Minutes Receiving Service ...........- I-21
Number and Percentage of Principal Clinics by Method

of Obtaining Hematological Measurements ....-.......--------++ 05 TH-22
Number and Percentage of Principal Clinics by Specified Health

Services Available on Site ....- 2-22. 2- eee eee eee TH-23
Number and Percentage of Principal Clinics by Specified Non-Health

Referral Services Available on Site ........... 5-000 e ee eee eee eee TI-24
Number and Percentage of Principal Clinics by Opportunity to

Apply for Selected Non-Health Services on Site .....-.. 22.0.0... 0-- TH-25
Number and Percentage of Principal Clinics in Which Obtaining

Health Care and Non-Health Care Services is a Problem ..............-- I-26

Standard Errors of Agencies by Reported Problems in Referring
Clients to Other Agencies
Standard Errors of Agencies and Affected Participants by Topics

Covered and Methods Used ........... 0... e ee eee eee eee 11-28
Standard Errors of Agencies and Affected Participants by Frequency

of Nutrition Education Contacts «0... 2... 6. ee eee ee eee TH-30
Standard Errors of Agencies and Affected Participants by Group Size

for Providing Nutrition Education ............... 0.00000 eee eee eee Tl-31
Standard Errors of Agencies and Affected Participants by Use

of Nutrition Education Materials and Methods ..........---------++-- I-32
Standard Errors of Agencies and Affected Participants by Use

of Nutrition Education Materials and Methods ...........--.--....-.. TI-34
Standard Errors of Agencies and Affected Participants by Factors

that May Act as Barriers to Providing High Quality Nutrition Education ..... TlI-36
Standard Errors of Agencies and Affected Participants by Changes

in Certification Practices Since 1988 .... 2.22... 2.2.2 ee eee eee I-38

Standard Errors of Agencies and Affected Participants by Changes
in Nutrition Education Practices Since 1988
Standard Errors of Agencies and Affected Participants by Changes

in Food Instrument Practices Since 1988 .............-.-.-0-000-05- TH-42



Final Report — WIC Dynamics
Volume 2

Contract No. 53-3198-0-049

Submitted to:

USDA, Food and Consumer Service
3101 Park Center Drive - Room 201
Alexandria VA 22302
Denise Thomas, Project Officer

by:

Macro International Inc.

11785 Beltsville Drive
Calverton, Maryland 20705
JoAnn Kuchak, Project Director
and
The Urban Institute
2100 M Street, N.W.
Washington, DC 20037
Nancy M. Pindus, Subcontract Director

February 1995



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29

30

31

32

33

35

36

List of Tables (continued)

Page No.
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Current Usage of Automation
for WIC Functions .... 0.0200 c tte ee Iv-33
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Shifts in Automated Processing Since 1988... .. IV-35
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Shift in Type and Location
of Computer Equipment Since 1988 .......---- 00-2 - eee eee e eee IV-36
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Perceived Effect of Automation
on Productivity and Quality of Program .......-... 6000-2 e eee ees IV-38
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Change in WIC Coordination With Other
Programs Since 1988... .. 0... e cece teens IV-39
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by State Program Initiatives and Activities ....... Iv-40
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Current Capacity at Which Local Agencies
in State Are Operating ..... 2.0... 0-0 cece eee ee Iv-42
Number and Percentage of State Agencies Reporting Major Changes
in State Operations Since 1988... 2.0... eee eee ee tees IvV-43
Number and Percentage of State Agencies by Factors Ranked
Most Often as Promoting High Quality WIC Services .........----++---- Iv-49
Number and Percentage of State Agencies by Factors Ranked
Most Often as Hindering High Quality WIC Services ...........-.--+-- IV-50

viii


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15

16

17

18

19

20

21

22

23

24

25

26

List of Tables (continued)

Page No.
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Whether State Agency Uses an
Administrative Cost Per Participant to Allocate Administrative Funds ....... IV-14
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Methods Used to Compute Administrative
Funding for Local Agencies ... 2... 26-22 eee eee eee IV-15
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Funding Allocation Practices .........-.---- IV-16
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Funding Allocation Practices .........--..-- IV-17
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Methods for Allocating Caseload ............ TV-18
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Methods for Allocating Caseload ..........-.- IV-19
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Factors Used in Assigning Caseload
Increases or Decreases to a Local Agency .........-...-- 0-00 secures IV-20
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Most Frequently Used Method for
Allocating Caseload Under Conditions of Rapid Growth ..........-.---- IV-23
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Whether State Agency Developed
Participant-to-Staff Ratios Are Used ........-.----2 22 eee eee eee eee IV-24
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Identification of Local WIC Staff Employer .... IV-26
Number and Percentage of State Agencies, Affected Local Agencies, and
Affected Participants by the Presence of Program Performance Standards .... IV-27
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by the Presence of Performance Standards
for Nutrition Education... 2.2... 2. ee IV-27
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by the Use of Program Performance Standards ... . . IV-28
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by State Sponsorship of Breastfeeding
Promotional Activities... 0.0... 2.0... 000 eee eee Iv-29
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Food Voucher or Instrument Practices ........ IV-30
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Food Voucher or Instrument Practices ........ IV-31
Number and Percentage of State Agencies, Affected Local Agencies,
and Affected Participants by Proportion of Agencies Using PC
or Mini-Computers Versus Mainframe Computers ...............-..--- IV-32



List of Tables (continued)

Page No.
60 Number and Percentage of Agencies and Affected Participants
by Degree of Change in Number and Appropriateness of Staff ..........-- TI-103
61 Number and Percentage of Agencies and Affected Participants
by Degree of Change Perceived in Recruiting and Retaining Staff ........- 11-105
62 Number and Percentage of Agencies and Affected Participants
by Degree of Change in Space Since 1988 ........-- 6. + sees eee e ees TI-106
63 Number and Percentage of Agencies and Affected Participants
by Degree of Change in Waiting Time and Time Spent Receiving
Specific Services... 6.2... . 00 eee ee eee etter eens 11-107
64 Number and Percentage of Principal Clinics by Degree of Change
in Staff Time Spent on Referrals .......-- 6-0-0000 eee eee rte eee 11-109
65 Number and Percentage of Agencies and Affected Participants
by Degree of Change in the Quality of Nutrition Education Since 1988... ... TI-110
66 Number and Percentage of Agencies and Affected Participants
by Degree of Change in Caseload Since 1988 .........---.+e0e seers I-11
Section IIT
1 Standard Errors of Agencies and of Participants
by Percentage Growth «0.0.0.2... ee eee eee eet Tll-1
2 Standard Errors of Agencies and of Participants
by Size of WIC Local Agency ...... 25-0. -00 22 eee etter eens Il-2
3 Standard Errors of Agencies and of Participants
by Caseload Change Since 1988 and Agency Sponsorship .......----+-++> Tl-3
4 Standard Errors of Agencies and of Participants
by Operating Capacity and Percentage Growth .........-- +--+ see rere 4
5 Standard Errors of Agencies and Affected Participants
by Agencies’ Perceived Impact of Caseload Fluctuations ........---.----- Tl-6
6 Standard Errors of Agencies and Affected Participants by Agencies’
Perceived Impact of Factors Related to Economic Factors ....-....++++--+ Il-7
7 Standard Errors of Agencies and Affected Participants by Agencies’
Perceived Impact of New Program Requirements ........-..-+-++ss0005 If1-8
8 Standard Errors of Agencies and Affected Participants by
Agencies’ Perceived Impact of Other Initiatives and Factors ........-.---- I-9
9 Standard Errors of Agencies and Affected Participants by Percentage
of Clinics/Sites Within Agency Having Selected Operating Characteristics . .. . T-11

10 Standard Errors of Agencies and Affected Participants by Sufficiency

and Appropriateness of Professional, Paraprofessional, and

Clerical Support Staff... 6.2... cee ett tes HI-12
i Standard Errors of Agencies and Affected Participants by Ratio

of Vacant Positions to Current Full-Time Employees for

Professional, Paraprofessional, and Clerical/Support Staff .......-------- I-14

iv





Table of Contents

Section 1

Section 2

Section 3

Section 4

Section 5

Section 6

Study Design and Methodolgy
Local Agency Tables
Standard Errors Tables

State Agency Tables
Sampling and Estimation

Survey Instrumentation