Increasing WIC Fruit and Vegetable Voucher Redemption Rates


Impact Statement: 
This QI project used many QI tools to identify and design improvement actions to increase the redemption of food vouchers by WIC clients. While this project did not achieve the improvement target, , the development and application of tools could be helpful to other community health programs seeking to improve their client outcomes.

Meeker-McLeod-Sibley Community Health Services (MMS CHS) applied for and participated in the National Network of Public Health Institutes (NNPHI) Quality Improvement (QI) Award Program, which is part of the Community of Practice for Public Health Improvement (COPPHI), funded by the Robert Wood Johnson Foundation. The application included a proposed QI project focused on improving the rate at which Women, Infants, and Children Program (WIC) participants redeem fruit and vegetable voucher dollars. Initial data were collected and revealed that participants used 76.10% of the fruit and vegetable voucher dollars issued. The project aim was that by August 31, 2013, WIC participants will increase redemption of fruit and vegetable voucher dollars from 76% to 85%. Focus groups with WIC participants, WIC staff, and local grocers were conducted as part of the problem analysis phase. Other tools included an affinity diagram, a fishbone diagram, the 5-Hows, brainstorming, and the multi-voting technique. The root cause of the problem was the lack of a fruit and vegetable culture in WIC participants’ homes. (In other words, it is not the norm for participants to have a variety of fruits and vegetables available at home.)

The selected intervention to address this root cause was implementing fruit and vegetable tastings during WIC clinic hours. Families could taste fruits and vegetables and were offered a one-page information sheet about that fruit or vegetable, which included information (e.g., how to pick it out at the store; how to cook, cut, or prepare it; how to store it) and other interesting facts on nutrition. Data were collected through reports from the state’s WIC database before the project and during and after the intervention phase. The percentages of voucher dollars redeemed during the intervention were 76.59% in May, 78.97% in June, and 76.04% in July. In summary, the team found slight upward trends for pregnant women, non-breastfeeding women, and children. However, these trends were not significant. In contrast, the breastfeeding women showed a downward trend. Also, almost all of the groups showed a bump in redemption rates in May–July 2012; therefore, the upward trend in the post-intervention group might have been seasonal rather than a result of the intervention.

Organization that conducted the QI initiative: 

Remington, J. Public Health Quality Improvement Exchange. Increasing WIC Fruit and Vegetable Voucher Redemption Rates. Tue, 03/04/2014 - 10:27. Available at Accessed May 23, 2024.

Submission Status: 
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jloewe's picture
Submitted by jloewe on

We need promising interventions to address this issue. Would love to see further work done to increase WIC fruit and vegetable vouchers! One thing we did in Green Lake County (for starters) is address the number of produce stands/farmers that accept the vouchers.

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Jeri Loewe