Assessing Impact of Federal Nutrition Programs on Health Outcomes

项目总结/摘要 妇女、婴儿和儿童特别补充营养方案是第三个方案， 美国最大的联邦营养援助计划。成立于1972年，服务于低... 有收入孕妇和产后妇女以及0-5岁儿童面临营养风险。WIC 耗资近60 B美元，为约800万孕妇、产后妇女和幼儿提供服务， 2016.尽管WIC的影响范围广，历史悠久，但缺乏证据支持其影响 （c）世界信息中心对参与者的健康和福祉以及社会成本的影响。少数研究 研究了产前参与WIC对妊娠结局的影响， 研究了WIC对年轻人的营养状况以及生长和发育的影响。 孩子 加强WIC影响的证据基础的最大障碍之一是缺乏 提供科学上适当的对照组，特别是在婴儿和儿童中。 这样一个比较组将允许设计和实施严格的科学研究 （随机对照试验）。拟议的研究将利用一个不寻常的机会， 将洛杉矶（LA）县WIC参与者的唯一数据库与可比数据库合并 Kaiser Permanente（KP）患者的研究，以形成这样的对照组。KP是最大的健康- 加州的医疗服务提供者，约25%的KP患者使用Medi-Cal（加州的医疗补助计划 程序）。通过合并这两个数据库，并开发一种创新的方法， 符合WIC条件但未入组WIC的Kaiser患者，我们将尝试创建一个科学的 严格的比较组，为未来的WIC计划对幼儿的影响的评估。 为了评估这个对照组（以及为形成它而开发的方案）的有效性，我们将 调查一个随机选择的KP患者样本，以确定我们制定的方案是否 足够敏感和具体。我们将重点关注2-5岁的儿童，因为缺乏 妇女信息中心对儿童成长和发展影响的评估研究。这项研究的结果 这项研究将对未来影响支持增长的项目的资金决策产生影响， 贫困家庭儿童的发展和营养状况。

PROJECT SUMMARY/ABSTRACT The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is the third largest federal nutrition assistance program in the United States. Established in 1972, it serves low- income pregnant and postpartum women and children ages 0-5 years who are at nutritional risk. WIC costs nearly $6 b, and served about 8 m pregnant and post-partum women and young children in 2016. Despite WIC's wide reach and long history, there is a dearth of evidence supporting the impact of WIC on the health and well-being of its participants and on societal costs. A few studies have examined the impact of prenatal participation in WIC on pregnancy outcomes, and even fewer studies have examined the impact of WIC on the nutritional status, and growth and development of young children. One of the greatest barriers to strengthening the evidence base for WIC's impact is the lack of availability of a scientifically appropriate comparison group, especially among infants and children. Such a comparison group would allow for the design and implementation of a rigorous scientific study (a randomized controlled trial). The proposed study will take advantage of an unusual opportunity to merge a unique database of Los Angeles (LA) County WIC participants with a comparable database of Kaiser Permanente (KP) patients to form such a comparison group. KP is one the largest health- care providers in California, and about 25% of KP patients are on Medi-Cal (California's Medicaid program). By merging these two databases, and developing an innovative approach for identifying WIC-eligible Kaiser patients who are not enrolled in WIC, we will attempt to create a scientifically rigorous comparison group for future evaluations of the impact of the WIC program on young children. To assess the validity of this comparison group (and the protocol developed for forming it), we will survey a randomly selected sample of KP patients to determine if the protocol we develop is adequately sensitive and specific. We will focus on children ages 2-5 years because there is a dearth of evaluation research on the impact of WIC on child growth and development. The findings of this study will have implications for future funding decisions affecting programs that support the growth, development and nutritional status of children from disadvantaged families.