A Qualitative Exploration of Predominantly White Non-Hispanic Tennessee WIC Participants’ Food Retail and WIC Clinic Experiences During COVID-19

Published:February 03, 2021DOI:



      The novel coronavirus disease 2019 (COVID-19) has widened many existing nutrition disparities. In response, federal nutrition assistance programs have introduced flexibility waivers in programs, including the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), to rapidly respond to support the nutritional health status of income-eligible participants during COVID-19. Waivers were approved that permitted flexibilities in the WIC food package, WIC vendor guidelines, and WIC clinic experience. The impact of these waivers on WIC participants’ retail and clinic experiences remains unknown.


      Our aims were to understand the experiences of WIC participants in food retail settings and with WIC clinics during the COVID-19 pandemic and to explore WIC participants’ perceptions of the impact of COVID-19 on their family’s overall health, well-being, and daily lives.


      We conducted semi-structured phone interviews between April 30 and May 7, 2020.


      Participants were 24 adults in WIC-enrolled families residing in Tennessee.


      Using grounded theory as the analytical framework, 2 coders completed an iterative, data-driven analytic process within NVivo, version 12. Hierarchical maps, coding matrices, and concept maps were used to aid direct content analysis for theme detection.


      Five primary themes emerged, including shopping barriers (existing compounded with new), coping strategies, impact on mental and emotional health, social comparison, and unintended consequences of COVID-19 on WIC families.


      COVID-19 created additional barriers to food security among WIC families and negatively affected their health and well-being. To meet the needs of this vulnerable population during and beyond the pandemic, the carryover of WIC flexibilities (ie, physical presence and food package substitution waivers) after COVID-19 may improve the ease of overall program participation.


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      M. McElrone is an assistant professor, Department of Health and Human Performance, The University of Tennessee, Chattanooga.


      M. C. Zimmer is a Cancer Research Training Award Fellow, National Cancer Institute; at the time of the study, she was a graduate student, Department of Public Health, The University of Tennessee, Knoxville.


      E. T. Anderson Steeves is an assistant professor, Department of Nutrition, The University of Tennessee, Knoxville.