In August 2009, the Oregon program for Women, Infants and Children (WIC) implemented new food packages that included a Cash Value Voucher (CVV) providing WIC participants with $6-$15 per month to use towards the purchase of fresh or frozen fruit and vegetables. Early tracking of the redeemed dollar value for each denomination of CVV showed an average redemption value approximately $0.25 less than the maximum value.

Evaluation of the use of vouchers by participants The purpose of this study was to explore WIC participants’ understanding of how to use the vouchers, what factors influenced their produce purchasing decisions, how having a cost-offset for produce impacted other grocery purchases, and their experiences in grocery stores using the CVV.

A stratified random sample of WIC participants was drawn based on caseload size of the WIC local agency and participants’ language (English/Spanish). Ninety-seven current WIC participants completed telephone interviews averaging 30 minutes in length. All interviews were conducted in April 2010, eight months after introduction of the fruit and vegetable cash value voucher.

The most commonly purchased items : apples, oranges and bananas

WIC participants reported being very appreciative of the new CVV and stated that only under extraordinary circumstances would they not use their CVV. The majority reported hearing from their WIC clinic that they could pay over the amount of their CVV. The three most commonly purchased items were apples, oranges, and bananas. Grapes, strawberries, and kiwis were mentioned less often and in the context of purchasing a treat. Lettuce, broccoli, baby carrots, and mushrooms were the most frequently mentioned vegetable purchases. A few bought frozen items, largely peas, carrots and broccoli.

The CVV, an efficient tool to reinforce WIC nutrition messages

The vast majority of participants chose their produce based on their family’s taste preferences, with meal planning also influencing purchases. Participants were evenly split as to whether they primarily used weight or count to determine how much produce to pick and estimate its cost. Eightypercent reported paying over the amount of their CVV and largely had positive experiences with using the CVV at checkout. A few did share that selection was somewhat limited in small, rural stores.

When asked if they would purchase the same items without the CVV, responses were split. Of those who would keep their produce items, half would cut back on snack or processed foods to balance their funds, while others would buy fewer produce items or not buy produce considered to be more of a treat. Multiple participants stated that the CVV helped reinforce the nutrition messages they received in WIC.

The importance of fruits and vegetables for family’s health

While most respondents indicated clearly understanding that they could pay over the amount of their voucher, and often doing so, the average redemption value remains at about $0.25 less than the maximum value. Participants unmistakably valued the CVV and the importance of fruits and vegetables in their family’s health. Correspondingly, much thought is given to which produce items to purchase in response to family favorites, meal and snack plans, and to a lesser extent, budget.

Future work to help more WIC participants maximize their use of the CVV should focus on the positive health beliefs and purchasing patterns that already exist within the population, while exploring ways to help participants estimate purchase costs and encouraging full redemption of each CVV.