Cooking Matters for WIC Clinics (CM for WIC) is a direct education intervention designed to enhance the WIC client experience and to improve maternal and child diets and health through improved knowledge and self-efficacy for healthy eating on a budget, increased WIC voucher redemption (particularly the fruit and vegetable vouchers), and increased WIC client retention beyond the first year postpartum. CM for WIC includes nutrition education and hands-on cooking classes adapted from the Cooking Matters for Parents (CMP) curriculum to correspond with the time frame of other client classes offered at WIC clinics, Cooking Matters at the Store for WIC Parents (CMATS WIC) pop-up grocery store tours in clinics, and customized survey tools.

Target Behavior: Healthy Eating, Other: Food Resource Management  
Intervention Type: Direct Education 

CM for WIC targets WIC clients at the clinics where they receive WIC services and pick up their WIC vouchers. The CM for WIC program offers nutritional supports to families, mothers and children that are eligible for WIC and SNAP benefits. The intervention was designed to be facilitated by WIC nutritionists in WIC clinic settings – urban, suburban, and rural. 100% of eligible sites in Public Health District 4 participate in the intervention, and three WIC clinics in District 2 now participate in intervention activities. 

Setting: Health care, USDA program sites (not National School Lunch Program). 
Target Audience: Pregnant/Breastfeeding Women, Parents/Mothers/Fathers.  
Race/Ethnicity: All 

CM for WIC includes direct nutrition education and CMATS WIC pop-up store tours. Intervention components provide education in healthy eating and cooking habits, food resource management practices, like using nutrition labels and unit pricing, and utilizing WIC vouchers. CM for WIC includes the following core intervention components:  

• Lessons that include nutrition education followed by hands-on cooking where participants prepare and eat a healthy meal 
• CMATS WIC, where WIC clients practice shopping skills and experience a different venue besides the WIC nutritionist’s office to discuss using WIC vouchers.  

CMP and CMATS WIC classes are incorporated into the WIC District’s system of nutrition education options for clients. WIC nutritionists in each partnering Georgia Public Health District are trained by Open Hand Cooking Matters (OHCM) staff in CMP and CMATS WIC curricula and facilitation. OHCM provides ongoing technical support, data management and analysis, and teaching supplies for WIC nutritionists to conduct classes. Individual WIC clinics recruit clients to participate in classes that include incentives like the opportunity for a hands-on cooking experience and a shared meal or the opportunity to earn a $10 grocery gift card to practice heathy shopping skills. 

Steps for implementation, tracking, and evaluation:  

• WIC nutritionists are trained in CMP and CMATS WIC  
• Select clinics to participate in pilot 
• CM for WIC supplies distributed 
• Clinic staff recruit participants and incorporate CM for WIC classes into current nutrition education offerings at clinics 
• WIC nutritionist conduct classes and tours at clinics 
• WIC staff upload/submit data and participation logs 
• Program evaluated yearly 

CM for WIC nutrition and cooking education curriculum is adapted from the Cooking Matters for Parents (CMP) curriculum. Healthy shopping habits are taught using Cooking Matters at the Store for WIC Parents (CMATS WIC) curriculum: instructor guide and participant booklets. 

CM for WIC programming utilizes two survey tools: pre-post session surveys assess healthy eating and food resource management practices and intention to change for CMP-adapted education sessions, and post-session surveys assess intention to utilize food resource management practices learned during CMATS WIC in-clinic pop-up tours. 

Visit the Cooking Matters website for more information about materials associated with the CMP and CMATS WIC curricula. 

Materials available at no cost

Both the pre-post nutrition education session surveys, post pop-up tour surveys, and intercept surveys conducted periodically in clinic waiting areas by the evaluation team include items to assess acceptability of the CM for WIC intervention. Pre-post session and post-tour surveys collect what participants liked and what they think needs to be improved about the class. Participants most commonly state that they like hands-on cooking, learning about nutrition labels and unit pricing, learning new recipes to share with family, and like the way the instructor taught the class. Intercept surveys ask about which classes or services clients find most valuable at the WIC clinic as well as gage awareness of and interest in CM for WIC classes. Intercept surveys showed that only a small percentage of clients had participated in CM for WIC classes, and majority of those clients enjoyed it; more promotional strategies are needed to increase awareness of and participation in these classes. 

Participants largely have positive feedback about the Cooking Matters sessions and higher levels of confidence are reported post-session compared to pre-session. Respondents enjoy the Cooking Matters classes offered at WIC clinics and report increases in confidence regarding the skills for a healthy diet on a budget. Many respondents reported that they were very likely to read nutritional labels to identify healthy foods, use MyPlate to plan meals, use their fruit and vegetable vouchers, and prepare a recipe from class in the near future.  

An unintended outcome from implementation of CM for WIC in Public Health District 4 includes WIC leadership from two other Public Health Districts reaching out to OHCM, requesting to partner in order to implement the intervention in their areas. Recommendations in regards to setting objectives and choosing recipes for classes include focusing on one key objective per nutrition education session and choosing recipes that are simple enough for mothers to do with their children or while tending to children too young to participate in any aspect of preparing the recipe.   

Evidence-based Approach: Emerging

Based on the SNAP-Ed Evaluation Framework, the following outcome indicators can be used to evaluate intervention progress and success.

	Readiness and Capacity – Short Term (ST)	Changes – Medium Term (MT)	Effectiveness and Maintenance – Long Term (LT)	Population Results (R)
Individual		MT2
Environmental Settings			LT5
Sectors of Influence

MT2: Food Resource Management 

• MT2b: Statistically significant increase in confidence in reading nutrition facts labels or nutrition ingredients lists. (p<0.001) 
• MT2h: Statistically significant increase in confidence in comparing unit prices before buying foods (p<0.001)
   

LT5: Nutrition Supports Implementation 

• LT5a: WIC nutritionists in 2 Georgia Public Health Districts are now trained in CM for WIC class curricula and provide ongoing program implementation in multiple WIC clinics in each District.  
• LT5b: 4 WIC clinics in District 4 are piloting a social marketing campaign; 20 WIC clinics, including 3 sites in District 2, implement CM for WIC classes and CMATS WIC pop-up grocery store tours. 

Website: The OHCM website (ohcookingmatters.org) includes information of the CM for WIC program, as well as recipes and other Cooking Matters courses.  

Contact Person(s):
Tammy Reasoner – Director of Programs
Phone: 404-419-3325
Email: treasoner@projectopenhand.org