Missouri WIC CustomerSatisfaction Survey:

Summary

Fiscal Year 2010

Overall Purpose of the Survey

• To determine how Missouri WIC can improve service for non-native English speaking participants;

• To determine how service needs differ between English and non-native English speaking participants;

• To determine how service needs differ among specific groups of non-native English speaking participants.

Sampling Method

• A language proficiency summary report was generated from the Missouri WIC Information Network System (MOWINS), which collects the language spoken by participant.

• 21 local WIC providers were selected to participate in the FY 2010 WIC Customer Satisfaction Survey based on the number of participants who spoke various languages.

Survey Instrument

• The FY 2006 survey instrument was developed by consultants from Sinclair School of Nursing, University of Missouri-Columbia and the MO WIC Cultural Competency Team based on research questions provided by the Cultural Competency Team.

• The Missouri WIC Program revised the content and format to include additional education & FI redemption questions in the FY 2008 WIC Customer Satisfaction Survey.

• The FY 2008 survey instrument was again used for the FY 2010 WIC Customer Satisfaction Survey.

Selected Local WIC Providers NW NE Central SE SW Eastern

St. Joseph/ Buchanan

Saline Columbia-Boone

Dunklin Barry St. Charles

Truman Camden Howell Springfield-Greene

St. Louis HDC

Crescent Pettis Joplin Family Care

Samuel Rodgers

McDonald Grace Hill

Newton St. Louis County

Taney

Language of Surveys Returned by AgencyDistrict LWP Arabic Bosnian English Russian Somali Spanish Vietnamese

NW St. Joseph/Buchanan

Truman

Crescent

Samuel Rodgers

NE Saline

C Columbia-Boone

Camden

Pettis

SE Dunklin

Howell

SW Barry

Springfield-Greene

Joplin

McDonald

Newton

Taney

Language of Surveys Returned by Agency (continued)

District LWP Arabic Bosnian English Russian Somali Spanish Vietnamese

E St. Charles

St. Louis HDC

Family Care

Grace Hill

St. Louis County

Distribution of Completed Surveys by LanguageLanguage Distributed Surveys Completed Surveys Response Rate

English 630 592 94.0%

Spanish 700 532 76.0%

Somali 145 94 64.8%

Vietnamese 85 66 77.6%

Russian 65 52 80.0%

Arabic 85 47 55.2%

Bosnian 90 29 32.2%

Blank -- 11 --

Total 1,800 1,423 79.1%

Categories of Questions for Evaluation

• Application and education processes

• WIC staff and vendors

• WIC checks

• Favorite things and hard requirements

• Overall satisfaction

Note: The percentages in Question 14 are out of the total numbers of ELS and NELS participants.

Conclusions

• Overall, in FY 2010, both ELS* and NELS† participants were very satisfied with most aspects of the WIC program - even more were satisfied than in previous years.

• Both ELS and NELS participants’ three most favorite things about WIC: 1. Information on healthy eating and lifestyle2. Checks for healthy foods3. Checks for infant formula

*English Language Surveys† Non-English Language Surveys

Conclusions (continued)

• Three hardest requirements from WIC:• ELS participants:

1. Bringing in children 2. Keeping appointments 3. Attending nutrition education sessions

• NELS participants: 1. Keeping appointments2. Completing forms3. Bringing in children

Conclusions (continued)

• Improvements are recommended if more than 20% of participants from one or more groups chose the less positive responses.

Conclusions (continued)

• > 20% of the participants who completed Bosnian, Somali and Vietnamese surveys said that the application process and health assessment process were “somewhat difficult” or “difficult”;

• > 20% of the participants who completed Arabic, Bosnian, Somali and Vietnamese surveys said that the nutrition assessment process was “somewhat difficult” or “difficult” and that they “sometimes” or “never” understand the words used by WIC staff;

Conclusions (continued)

• > 20% of the participants who completed Somali surveys said that the nutrition education was “somewhat helpful” or “not helpful”;

• > 20% of the participants who completed Bosnian, Russian, Somali, Spanish, and Vietnamese surveys said that they did not have access to the Internet;

Conclusions (continued)

• > 20% of the participants who completed Arabic, Bosnian, English, Somali, Spanish, and Vietnamese surveys said the cashiers at the WIC store or pharmacy are helpful “sometimes” or “never”;

• > 20% of the participants who completed Arabic, Bosnian, English, Russian, Somali, Spanish, and Vietnamese surveys said the WIC store they shop at has the WIC foods they want “sometimes” or “never”;

Conclusions (continued)

• > 20% of the participants who completed English surveys said they use all the WIC checks they are given “sometimes” or “never”.

Recommendations

• WIC Vendors: One specific program component should be investigated - WIC vendors. Although more than half of participants from both groups responded favorably to questions about WIC vendors, these proportions were much lower than those for other areas.

Recommendations (continued)

• Communication:• More than 60% of the NELS participants whose first

language was not English said that they “sometimes” or “always” need an interpreter. Data indicates that some participants have difficulty communicating with WIC staff and completing forms. More interpreters need to be made available to non-native English speaking participants.

• Educational materials that are designed to be culturally-sensitive should be provided to participants in their first language.

Recommendations (continued)

• Due to the large Spanish-speaking population served by WIC, it may be beneficial to provide brief Spanish language training on words or phrases specific to WIC.

• Refresher cultural competency training should be provided for local WIC providers in the metropolitan areas and other areas with pockets of non-native English speaking WIC participants.

Recommendations (continued)

• The three groups who consistently chose a less positive answer throughout the FY 2010 survey included those who completed Bosnian, Somali, and Vietnamese surveys. This indicates a possible language and/or cultural barrier that should be investigated and addressed in order for WIC to better meet the needs of these populations. It may be necessary to bring in experts to provide cultural competency trainings on these specific cultures.

Recommendations (continued)

• Nutrition Education:• Local WIC providers should consider scheduling individual counseling

sessions for NELS participants who prefer this method of gaining nutrition information, especially for the Somali, Bosnian, Arabic, and Vietnamese populations.

• Encourage local WIC providers to use alternative methods to provide nutrition education in addition to individual and group nutrition sessions. It may be beneficial to the groups above to be offered nutrition classes in their first language. Data also indicates the need to develop web-based nutrition education modules for English-speaking participants and take home nutrition education modules for both English and Non-native English speaking participants.