Evaluation of the WIC migrant demonstration project : a final report

              !Jepository
PROPERTY OF THE
LIBRARY
SEP 2 0 1979
U : ersity of North Caroli:ta ~
81 ALUA T I ON OF THE at Grc:;n~coro
WIC MIGRANT DEMONSTRATION PROJECT
A FINAL REPORT
CONTRACT NO. 53-31988-35
Submitted To:
FOOD AND NUTRITION SERVICE
U.S. DEPARTMENT OF AGRICULTURE
Submitted By:
DEVELOPMENT ASSOCIATES, INC.
2924 Columbia Pike
Arlington, Virginia 22204
ASERL
The work reported herein was performed pursuant
to a contract with the United States Department
of Agriculture. The statements, findings, con­clusions,
recommendations, and other data in
this report are solely those of the Contractor
and do not necessarily reflect the views of the
Food and Nutrition Service.
ACKNOWLEDGEMENTS
During the course of this study, Development
Associates received full cooperation and assist­ance
from the Food and Nutrition Service of the
Department of Agriculture. Importantly, this
assistance was provided from both the Washington
and the regional offices. Special recognition
should also be extended to the state and local
agencies participating in the Migrant Demonstration
Project who provided invaluable assistance during
the data collection effort.
Finally, Development Associates wishes to acknow­ledge
the important assistance provided by the
Washington office of FNS, particularly by Mrs.
Virginia Hungerford, the Contracting Officer's
Representative. She provided the necessary guidance
and encouragement throughout this study and was
always available when needed .
•
TABLE OF CONTENTS
CHAPTER 1. INTRODUCTION
A.
B.
Background ....................................... .
The WIC Migrant Demonstration Project ...........•.
CHAPTER 2. STUDY DESIGN AND METHODOLOGY
A.
B.
c.
D.
E.
F.
Summary of Basic Design ........................... . .
Study Design ..................................... .
Selection of Participants for Interview .......... .
Selection of Eligible but Non-participating
Migrants for Interview ........................... .
Selection of Medical Records of Participants ..... .
Methodological Concerns and Issues ............... .
CHAPTER 3. CONTEXT AND OPERATIONS OF THE PROGRAM
A.
B.
c.
D.
E.
Overview .... ........................... ~ .......... .
Project-Wide Innovations ......................... .
Additional/Special Features ...................... .
Community and Local Agency Characteristics ....... .
Participant Characteristics ...................... .
CHAPTER 4. ASSESSMENT OF PROGRAM INNOVATIONS
A.
B.
c.
D.
E.
F.
Overview ......................................... .
Migrant Verification of Certification Cards ...... .
Migrant Participation Log ........................ .
WIC Program Directory of Local Agencies .......... .
Nutrition Education Modules ...................... .
Summary ....................................... · · ·.
- i-
PAGE
1
3
6
7
9
12
13
14
19
19
24
25
53
61
61
67
69
71
84
CHAPTER 5. MEDICAL DATA
TABLE OF CONTENTS
(Continued)
A. Medical and Pregnancy History Data on
Women Participants ............................... .
B.
c.
Medical Data of Children Participants ............ .
Medical Data of Infant Participants ...............
CHAPTER 6. CONCLUSIONS AND RECOMMENDATIONS
A.
B.
Overall Conclusions .............................. .
The WIC Migrant Demonstration Project
Innovations ...................................... .
c. Recommendations
APPENDICES
A. Evaluation Design and Instrumentation
B. Local Agency List
C. Data Analysis Formats
D. Additional Detailed Tables
E. Instrumentation
-ii-
PAGE
85
104
113
123
126
129
Table
2.1
2. 2
3.1
3.2
3.3
3.4
3.5
3.6
3. 7
3.8
.,
3.9
•
3.10
3.11
LIST OF TABLES
Local Agencies Participating in WIC Migrant Demonstra­tion
Project and Distribution of Sample of Local
Agencies Visited by State, Region, and Agency Prior
Affiliation With the WIC Program and/or the Migrant
Health Service ........ . ....... .
Sampling Frames, Samples and Number of Completed
Interviews of Participants at Local Agencies in
Texas . . . . . . . . . . . . . . . . . . . . . .
Participating Local Agencies by State, Region, and
Agency Prior Affiliation With the WIC Progr~m and the
Migrant Health Service ............... .
Local Agencies Participating in WIC Demonstration
Project by Agency Affiliation for All Upstream Local
Agencies for the Sample of Upstream Local Agencies and
for All Local Agencies in Texas . . . . . . . . . . .
Services Available in the Community for Migrant Farm-
8
11
27
28
workers. . . . . . . . . . . . . . . . . . . . . 29
Staff and Staffing Characteristics of Texas and
Upstream Local Agencies . . . . . . . . . . . . 31
Staff and Staffing Characteristics of Upstream Local
Agencies by Agency Affiliation . . . . . . . . . . 32
Staff and Staffing Characteristics of Texas Local
Agencies by Agency Affiliation . . . . . . . . . . 33
Outreach Methods Used to Increase Migrant Participa-tion
in WIC in 19 78 by State Agencies . . . . . . . . 34
Outreach Methods Used to Increase Migrant Participa­tion
in WIC in Texas and Upstream States by Local
Agencies ·. . . . . . .· . . . . . . . . . . . . . . . . 35
Number of Respondents Who First Heard About the WIC
Program in 1978 and Source . . . . . . . . . . . 36
Responses of Members of the Migrant Population/
Community Who Were Not Participants of WIC . . . 38
The Number of State Agencies Which Made Provision for
Local Agencies to Offer Special Services to Facilitate
Migrant Participation in WIC in Summer 1978 (in Texas,
Read Fall 1978). . . . . . . . . . . . . . . . . . . • 39
-iii-
Table
3.12
3.13
3.14
3.15
3.16
3.17
3.18
3.19
3.20
3.21
3.22
3.23
3.24
3.25
3.26
Number of Local Agencies Offering Services to
Facilitate Migrant Participation in WIC During the
Summer of 1978 (in Texas, the Fall of 1978) ....
Single Most Important Additional Service Which Local
Agencies Would Like to Implement to Improve Services
to Migrants . . . . . . . . . . . . . . . . . . .
Selected Participation Information of Household/
Traveling Units Containing WIC Participants
Services Offered at WIC Agencies Visited by Partici-pants
in 1978 . ................. .
Problems Encountered by Participants While Visiting
WIC Agencies in 1978 . . . . . ....... .
Transportation Used to Get to and from the Clinic
for WIC Services . . . . . . . . . . . . . . . .
State Agencies' Experience with Farmworkers' Organi­zations
as Part of the WIC Migrant Demonstration
Project . . . . . . . . . . . . . . . . . . . . . . . . .
Functional Tasks Performed by Farmworker Organizations
in 1978 as Reported by State Agency Administrators
Local Agency Experience With Farmworker Organizations
as Part of the WIC Migrant Demonstration Project
Functional Tasks Performed by Farmworker Organizations
in 1978 as Reported by Local Agencies Indicating that
an Organization was in the Area . . . . . . . . . . . .
Number of State and Local Agencies Using NAFO Hotline
During Period of the WIC Migrant Demonstration
Project . . . . . . . . . . . . . . .. . . . . . . .
Frequency Which Participants Contacted Farmworkers'
Program When They Arrived in an Area ...... .
State Summary of Major Work Sites Visited for Work
During the 1977 Migration Se~son, During the 1978
Season, and Work Sites Which Participants Expect to
Visit in 1979 ............... .
States Most Frequently Visited by Respondents
in 1978 .................. .
Number of Households/Traveling Units Visiting Only
One Work Site in 1978 by State ........... .
-iv-
40
42
43
44
46
47
48
49
so
51
52
52
53
53
55
Table
3. 2 7
3.28
3.29
3.30
3.31
3.32
4.1
4.2
4.3
4.4
4.5
4.6
4.7
Characteristics of Households/Traveling Units of
Participants Interviewed . . . . . . . . .
Frequency of Women Performing Agricultural Work and
Year of Work . . . . . . . . . . . . . . . . .
Characteristics of Women Within Traveling Unit and
Described by Respondents . . . . . . . . . . . . .
Number of Households/Traveling Reporting Members
Persons not Traveling With Unit in 1978 ....
Facilities and Utilities Often Found at Migrant
Camp Housing Used by Participants of the WIC Migrant
Demonstration Project ............... .
Facilities and Utilities Always Found at Migrant
Camp Housing Used by Participants of the WIC Migrant
Demonstration Project ................ .
Frequency of Eligible Migrants Arriving at the Local
Agency With Verification of Certification (VOC)
Cards . . . . . . . . . . . . . . . . . . . . . . .
Problems With Verification of Certification Cards
Encountered by State Agency Administrators . . . .
Problems With Verification of Certification Cards
Encountered by Local Agency Administrators .....
Number and Percent of Recommendations for Continuing
the Use of the Verification of Certification Cards
by Types of Respondents .... ........... .
Frequency of Difficulties With .Mairitaining.Participa­tio.
n .. L.ogs . Encountered by State and Local Agencies ...
Number of Local Agencies Recommending the Use of the
Participant Logs for Migrants in the Future. . . .' . .
Frequency of Difficulties Experienced With the "WIC
Program Directory of Local Agencies" by State and
Local Agencies . . . . . . . . . . . . . . . . . .
4.8 State Agency Overall Rating of Aspects of the WIC
Nutrition Education Modules' Quality: Texas and
4.9
Upstream . . . . . . . . . • .
Local Agency Overall Rating of Aspects of the WIC
Education Modules Quality .•...........
-v-
56
58
58
59
59
60
62
63
64
65
67
68
70
72
74
Table
4.10
4.11
4.12
4.13
4.14
4.15
4.16
4.17
4.18
5.1
5.2
5. 3
5.4
5.5
5.6
Languages Used for Nutrition Education of Migrants
at Local Agencies . . . . . . . . . . .
Instructional Modes for WIC Nutrition Education at
Local Agencies . . ..... . .... . . . . .. .
Characteristics of WIC Nutrition Education Group
Classes Given to Adult Migrant Participants . . ..
Locations Where Migrant Farmworkers Usually Receive
WIC Nutrition Education from Local Agencies ....
Instructional Modes for Children Who Receive WIC
Nutrition Education ............ .
Bilingual Staff and Agencies Using USDA Nutrition
Education Modules in Texas and Upstream States, by
Local Agency. . . . . . . . . . . .
Participant Assessment of Nutrition Education
Charts. . . . . . . . . . . . . . . . . . . .
Participants Use and Opinion of Handouts Prepared by
Department of Agriculture ........... .
Characteristics of Nutrition Education at Local
Agencies Visited by Participants in 1978 .. ..
Age (as of December 1978) of Women Participants of
the Demonstration Project and the Regular Program .
Age at First Menses for Women in Sample of Demonstra­tion
Project Pa-rticipants and in Sample of Regular
Program Participants. . . . . . ... .. ... .
Age at First Pregnancy for Women in Sample of Demon­stration
Project Participants and in Sample of Regular
Program Participants ............... .
Age at Most Recent Pregnancy for Women in Sample of
Demonstration Project Participants and in Sample of
Regular Program Participants ... .... . ... .
Number of Pregnancies for Women in t he Demonstration
Project Participant Sample and in the Regula r Program
Participant Sample . . . . . . . . . . . . .
Number of Reported Miscarriages for Women in the Demon­stration
Project Participant Sample and in t he Regular
Program Participant Sample . ....... . ..... .
-vi-
75
76
77
78
79
80
81
82
83
88
89
90
90
91
92
Table
5. 7
5.8
5.9
5.10
5.11
5.12
5.13
5.14
5.15
5.16
5.17
5.18
Number of Reported Pre-Term Births for Women in the
Demonstration Project Participant Sample and in the
Regular Program Participant Sample . . . . .
Number of Reported Full-Term Births for Women in
the Demonstration Project Participant S&mple and in
the Regular Program Participant Sample . . . . .
Number of Infants Below and Above 2,500 Grams (5-1/2
lbs.) at Birth for Women in the Demonstration Project
Participant Sample and in the Regular Participant
Sample . . . . . . . . . . . . . . . . . . . . . . ~ .
Number of Presently Living Children for Women in the
Demonstration Project Participant Sample and in the
Regular Program Participant Sample . . . . . . . . . .
Trimester of Pregnancy for Women in the Demonstration
Project Sample and for the Regular Program Sample ..•
Date of First and Second Certification for Women in
Demonstration Project Participant Sample and in the
Regular Participant Sample . . . . . . . . . . .
Age of Women at First and Second Certifications ....
Number of Women, by Sample, With Hematocrit and Hemo­globin
Data Available for First, Second, Both or
Neither Certifications ............... .
Hematocrit Levels (Percent) for Women Participants of
the Demonstration Project and for Participants of the
Regular WIC Programs . . . . . . . . . . . . . . . . .
Hematocrit Levels (Percent) for Women Participants of
the Demonstration Project and of the Regular WIC Pro­gram
Who Were Certified Twice During Study Period ...
Summary of Eligibility Conditions for Women in Demon­stration
Participant Sample and in Regular Program
Participant Sample . . . . . . . . . . . . . . . . . .
Sex of Children in Demonstration Project Participant
Sample and in Regular Program Participant Sample .
93
94
95
96
97
99
100
100
lOL
102
103
105
5.19 Age at First Certification by Sex for Children in
Demonstration Project Sample and Regular Program
Sample . . . . . . . . . . . . . . . . . . . . . . 106
-vii-
Table
5.20 Number of Siblings for Children in Demonstration Pro-ject
Sample and in Regular Program Sample . . . . . . 107
5.21 Date of Certification for Children in Demonstration
Project Participants Sample and in Regular Program
Participant Sample. . . . . . . . . . . . . . . . . 108
5.22 Availability of Certification Data on Children in the
Demonstration Project Participant Sample and Regular
Participant Sample. . . . . . . . . . . . . . . . . . . 109
5.23 Hematocrit Data for Children in the Demonstration Pro-ject
Sample and in Regular Sample Who Had Hematocrit
Data for Two Certifications • . . . • . . . . . . . . . 110
5.24 Hematocrit Data for Children in Demonstration Project
and in Regular Program Participant Sample . . . . . . . 111
5.25 Length-for-Age and Weight-for-Length Percentiles for
Children in Demonstration Project Participant Sample .
and for Regular Program Participant Sample. . . . . 112
5.26 Sex of Infants in Demonstration Project Participant
Sample and in Regular Program Participant Sample. 114
5.27 Computed Age at First Certification by Sex. . . . . 115
5. 28 Number of Siblings for Infants in Demonstration Pro-ject
Participant Sample and in the Regular Program
Participant Sample. . . . . . . . . . . . . . . . . 116
5.29 Date of Certification for Infants in Demonstration
Project Participant Sample and in Regular Program
Participant Sample. . . . . . • . . . . . . . . . . 117
5.30 Availability of .Certification Related Data on Infants
in the Demonstration Project Participant Sample and
in the Regular Program Participant Sample . . . . . . . 118
5.31 Hematocrit Data for Infants in Samples Who Had Hema-tocrit
Data for Two Certifications During Study
Period. . . . . . . . . . . . . . . . . . . . 120
5.32 Hematocrit Data for Infants in the Demonstration
Project Participant Sample and in Regular Program
Participant Sample. . . . . . . . . . . . . 121
5.33 Length for Age and Weight for Length Percentiles for
Children in Demonstration Project Participant Sample
and for Regular Program Participant Sample. . . . . 122
6.1 Local Agency Rating of Nutrition Education Modules. . . 128
-viii-
•
A. Background
CHAPTER 1
INTRODUCTION
Public Law 92-433, enacted September 26, 1972, amended the Child
Nutrition Act of 1966 (42 U.S.C. 1786) and authori~ed the Special
Supplemental Food Program for Women, Infants, and Children (WIC)
on a pilot basis for fiscal years 1973 and 1974. The program has
been subsequently amended by various law~ and funding has steadily
increased. According to the present program design, and spelled
out in the current legislation, the WIC program:
• Is operated through departments of health or equivalent
agencies in each state or through Indian tribal health
organizations;
• Has participant eligibility determined by health
professionals;
• Provides nutritious food supplements to participants;
• Provides nutrition education that considers the
participants' nutritional needs and household
situations; and
• Pays for the administration and management of the
programs.
The WIC program is designed to provide nutritious food supplements
to infants, children, and pregnant, postpartum, or breastfeeding
women who are determined to be at risk because of nutrition and
income. (It should be noted that low income alone does not qualify
a woman or child for the program.) According to the 1977 Federal
Regulations, eligibility criteria include the following:
• Residence within the area served by the local agency
or membership in a particular target group;
• Meeting income standards approved by the state
agency; and
• Possessing nutritional·need, as determined by a
competent health professional.
-2-
Within the WIC program, participants are provided specific
WIC authorized foods and allotments of these foods based on
individual need. There are several ways in which food is made
available to program participants. These include retail purchase,
home delivery, distribution at the clinic itself or a combina­tion
of th~se approaches. The pr?cedures for a~inistering
these serv1ces and how these are 1ntegrated with other ser-vices
such as nutrition education and health care vary from area
to area.
An important landmark for the WIC program was achieved when the fina
regulations were published in 1977. In these regulations migrants
and off-reservation Indians were identified as members of special
populations to be served by the program. As a group, migrant
populations presented certain unique problems with regard to the WIC
program, since as transients they might not seek or might have
difficulty locating services. In addition, given their transciency,
there were the associated problems of residence based certification
and food voucher redemption systems.
As a result of the identified needs and the recognition of barriers
to participation that migrants have experienced in health, nutrition,
and social services, Section 246.7 (i) of the final WIC Regulations
(1977) allowed local service agencies to honor, for the purposes of
WIC program participation, certifications of eligibility completed
in another state or local agency in the same state. In a further
response to the special needs of migrant ·populations, in January
1978, the Food and Nutrition Service of the Department of
Agriculture funded a Migrant Demonitration Project as part of the
Special Supplemental Food Program for Women, Infants, and Children.
The overall purpose of the Demonstration Project was to test methods
of improving program services to migrant families. In addition to
funds made available by USDA, the Community Services Administration
made available to FNS a grant for such project expenses as travel,
printing, project materials, and evaluation.
Women, infants, and children served by the WIC demonstration project
were primarily Spanish surnamed members of migrant and seasonal
farmworker families based in Texas . These families moved from state
to state for up to nine months a year and then returned to Texas.
In most instances migrants reside in substandard housing and
experience generally poor living conditions, which leads to
additional problems with regard to their health and nutrition. For
example, it is not uncommon for migrant children to suffer from
rickets, pinworm, scurvy, nutritional anemia, and protein deficiency
~nd for adults to exhibit a variety of health and nutritional
problems. Further, pregnant and postpartum women -often have
significant nutritional deficiencies leading not only to the poor
. -3-
health of the mother but also to premature or low birth weight
infants or to stillbirths.*
B. The WIC Migrant Demonstration Project
Designed to meet the needs of these groups, the Migrant Demonstratio
Project had three objectives:
• Provision of funds to implement or expand WIC projects
where there was a large migrant population;
• Tracking of participants as they moved from Texas into
other states within the mid-continental migrant stream
and back to Texas; and
• Experimentation with innovative program methods.
At the local level, the Migrant Demonstration Project was integrated
within the WIC program. The demonstration agencies were designated
in Texas and 12 participating upstream states: Colorado, Iowa,
Kansas, Missouri, Nebraska, North Dakota, Illinois, Indiana,
Michigan, Minnesota, Ohio, and Wisconsin. Service providers that
were part of the demonstration were required by FNS to maintain a
participation log, provide nutrition education in Spanish, and when
necessary, complete a standard Verification of Certification card
for each client. When program participants were migrating to anothe
state where coverage was provided, the Verification of Certification
card was used by the local agency for verification of eligibility
and for information on the needs of the client enabling the migrant
participant to transfer to WIC programs in other states.
Since there is a high nutritional need among migrant farmworkers and
their families, the importance of the Migrant Demonstration Project
has been recognized not only by USDA/FNS, but also by advocacy ·
groups and the Community Services Administration. Furthermore, it
has been addressed in Senate and House testimony by both the
Assistant Secretary and Secretary of Agriculture. Because of the
interest in the program and its importance, it ~as highly appropriat
to determine the effectiveness of the Migrant Demonstration effort
to ensure optimal allocation of scarce funding resources. To this
end,. FNS with financial support from the Community Services Ad!!i.iiii"!~..:
trat1o~ (who as noted earlier provided some of the funds for program
operat1ons~ spons?red a procurement for an evaluation of the Migrant
~mo~strat1on ProJect. In October 1978, following a competitive
b1dd1ng process, Development Associates, Inc., was awarded a contract
to implement the evaluation. The purpose of this evaluative studv
was to: · ·· ·
• Assess the effectiveness of the administrative structure in
promoting continuity of benefits for participants;
Based on Developnent Associates' contract experience in family planning and
working with migrant and farmworker programs, DA has become very familiar
with migrant health and nutritional problems. ·
-4-
• Assess the reduction of real and perceived barriers to
participation; and
• Assess the provision of WIC food, health, and nutrition
education services to migrants in the region of the pilot
project.
The initial evaluation . design developed by FNS staff called for a
comprehensive field survey of the participating institutions, local
agencies, and migrants. The final design, developed by DA based
on the initial FNS design, called for the data collection activities
in all 13 participating states as follows:
• State level agencies in states participating in the
demonstration project would be visited and their key
personnel interviewed;
• One participating local agency in each of the twelve upstream
states was selected, visited, and key personnel were interviewed;
• All participating local agencies in Texas were visited
and key personnel were interviewed;
• In 11 of the 13 local agencies in Texas, the following
activities were conducted:
- Participants of the demonstration project were
selected and interviewed;
- Migrants who were eligible for participation in
the demonstration project but were not participating
were isolated, sampled, and interviewed;
- Medical records of women, infants, and children who
were participating in the demonstration project were
selected and specific data were collected; and
- Medical records of women, infants, and children who
were participating in the standard WIC program were
selected and specific data were collected.
These data collection efforts used instrumentation that was
developed and cleared through OMB by FNS prior to the start of the
contract. All instrumentation was formatted to facilitate computer
processing and a Spanish version of the participant questionnaire
was developed as a guide for these interviews. The majority of the
interviews of participants were conducted in Spanish.
The remainder of this report describes the evaluative framework used
to guide these interviews and meet the study objectives and the
results obtained from the data collection and analysis. Chapter 2
contains a detailed discussion of the study scope and methods.
Following that, in Chapter 3, special features of the Migrant Demon­stration
Project and characteristics of communities, related agen-
-5-
cies, and participants are described. Chapter 4 assesses program
innovations and Chapter 5 presents the medical data for partici-pants.
For a final chapter, we present our conclusions and recommendations,
both from the perspectives of major findings and policy issues of
importance to FNS and to those community and special interest
groups concerned with migrant welfare.
-6-
CHAPTER 2
STUDY DESIGN AND METHODOLOGY
A. Summary of Basic Design
FNS sponsored the special Migrant Demonstration Project to facilitate
increased participation of migrants in the WIC program. As an
integral part of the Demonstration Project, FNS also designed an
evaluation of the Demonstration Project in order to assess its
effectiveness in terms of:
• Promoting the continuity of benefits for the
participants (i.e., migrants in the mid-continental
stream);
• Reducing real and perceived barriers to participation; and
• Providing WIC food, health care, and nutrition education
services to mitrants in the states participating in the
demonstration.
The FNS-developed evaluation design and instrumentation provided for
a survey of state WIC agency representatives, local agency staff,
participants of the demonstration projects, and eligible but non­participating
migrants. In addition, FNS prepared a separate
instrument for collecting medical data on participants of the
Demonstration Project and on participants of the regular WIC program.
The study design and the instruments were submitted for OMB clearance
prior to release of the Request for Proposals (RFP) for the contract .
to make it possible for field data collection to take place before
the expiration of the Demonstration Project period.
The FNS design provided for the evaluation to cover all 13 states
participating in the demonstration project. Questionnaires were
developed for state and local agency administrative staff and for
participants of the demonstration project. A questionnaire was also
developed by FNS for eligible but non-participating migrants. This
group consisted of members of the target population (eligible women,
and/or parent/guardian of eligible infants and/or children) who had
migrated during the 1978 season ..
In addition to the data from these interviews, the FNS design
included the collection of specific medical data on a standardized
form in order to assess the nutritional impact of the project. The
data to be collected included information on the medical certifica­tion
and other related information. These data were to be obtained
at the Texas local agencies for a sample of participants of the
Migrant Demonstration Project and for a sample of non-migrating
participants of the regular WIC program. These non-migrating
participants of,the WIC programs were, by definition, not a part of
the Demonstration Project but were served by the same local agency
which served participants of the Demonstration Project.
-7-
Because of data collection scheduling needs and other programmatic
interventions, some design modifications became necessary. The
original design is described in Appendix A to this report.
B. Study Design
Before a final study design was developed, pilot tests were
conducted at one local agency in an upstream state, at one local
agency in Texas, and at the state agencies of both the upstream
state and Texas. During each pilot test visit, the DA project.staff
were accompanied by representatives from FNS' regional and
Washington offices. These visits, which were conducted within the
first 15 days of the contract,were to test the instruments and to
ascertain the quality and reliability of records and recordkeeping
systems at the local agencies. Based on the findings from the
pilot test, a modified design was developed which called for the
following:
• Administration of the state agency questionnaire in all
states participating in the Demonstration Project;
• Selection of one local agency in each upstream state for
the administration of the local agency questionnaire;
• Administration of the local agency questionnaire at all
13 participating local agencies in Texas;
• Administration of only the local agency questionnair~ at
two participating local agencies in Texas at which less
than 20 participants had reported permanent residence in me
service area of the local agency (based on analysis of
the participation logs);
• At the remaining eleven local agencies in Texas, the
following activities were to occur:
- Administration of the local agency questionnaire;
- Selection and interview of participants of the
demonstration project;
~ Isolation, selection, and interview of eligible but
non-participating migrants;
- Selection and review of medical records of participants
of the WIC Demonstration Project; and
- Selection and review of medical records of participants
of the WIC program who were not participants of the
Demonstration Project.
Table 2.1 displays the final sample selection matrix for both up­stream
and Texas local agencies; all Texas local agencies were
visited. Within these 11 agencies sampling was conducted for
interviews with participants and with eligible but non~participating
migrants and for the review of medical records. This sampling and
-8-
TABLE 2.1
LOCAL AGENCIES PARTICIPATING IN WIC }.ITGRANJ' DEMJNSTRATION PROJECI'
AND DISTRIBtiTION OF SAMPLE OF LOCAL AGENCIES VISITED BY STATE,
REGION, AND AGENCY PRIOR AFFILIATION WITH TIIE WIC PROGRAM AND/OR .
TIIE MIGRANT HEALTH SERVICE
(Number of Local Agencies selected in each State/Agency Affiliation
is given in parentheses)
Agen£l Affiliationsll
REGION STATE A B c D TOTAL
Mountain/Plains co 5 (1) 4 - - 9
IA 2 3 (1) - - 5
NE - - 1 1 (1) 2
ND - 2 (1) - - 2
KS - 1 (1) 1 - 2
}.{) - - 1 (1) - 1
Subtotal 7 (1) 10 (3) 3 (1) 1 (1) 21
Midwest MI 5 (1) 3 - - 8
IL 4 (1) 1 - - 5
WI 4 (1) 1 - - 5
OH 1 3 (1) - - 4
IN 1 (1) 1 - - 2
t-1N - 1 (1) - - 1
Subtotal 15 (4) 10 (2) 0 (O) 0 (O) 25
TOTAL UPSTREAM 22 (S) 20 (5) 3 (1) 1 (1) 46
STATES
TexasY 5 (S) 3 (3) 5 (S) 0 (O) 13
T 0 TAL 27 (10)1 23 (8) 8 (6) 1 (1) 59
Y A = Agency previously operating the WIC Program; not affiliated with the
Migrant Health Service (}1HS)
B = Agency not previously operating the WIC Program, affiliated with M-IS
C = Agency previously Gperating the WIC Program, affiliated with MHS
SAMPLE
1
1
1
1
1
1
6
1
1
1
1
1
1
6
12
13
25
D = Agency not previously operating the WIC Program, not affiliated with MHS
Y All local agencies in Texas were included in sample.
-9-
selection procedure for these data collection efforts are described
in the following sections.
C. Selection of Participants for Interview
The study design required that for a participant interview only one
person would be interviewed for each household or traveling unit
containing one or more participants of the Demonstration Project.
A household/traveling_ unit was defined as that group of persons
related either by blood or by marriage who traveled and/or lived
together during a majority of the 1978 migration season. Before
the final selection of the sample of persons for interview could
be performed, a sampling frame had to be developed of these house­holds/
traveling units. As will be explained later in this se.,ction,
the sampling frame relied upon the program Participation Log. This
log was developed by FNS as part of the Demonstration Project and
was intended for use by local agencies. The Participation Log, a
copy of which appears in Exhibit 3.2, was designed to collect the
following information:
• The family name and the participant's first name;
• The WIC migrant project identification number;
• The birth date of the participant;
• The latest certification date and county and state of
permanent residence;
• A column indicating whether the participant has been
terminated;
• Date of most recent food issuance;
• Data on nutrition education;
• Date participant put on waiting list; and
• Remarks .
Since this information was collected on each participant who
received services at a WIC program site, the Participation Log
was used as the basis for selection of respondents for interview.
The Participation Log, however, could not be used directly as the
sampling frame. In particular, because only one interview was
to be conducted for each household/traveling unit, participants
who had the same surname and other similarities, had to be grouped
and a sample of these "family groups" selected.
In general, the procedures for selecting respondents for the
participant interview included the following steps:
• At the 11 local agencies in Texas, a review was performed
of the Demonstration Project Participation Logs for the
months of August and September 1978;
-10-
• Eligible participants were identified for possible inter­view
(e.g., participants first certified after May 1, 1978,
were excluded);
• Participants were grouped by surname and similar or
sequential Verification of Certification (VOC) identifica­tion
number and/or sequential listing on the Participation
Log into "family groups";
• For each local agency a listing was ~eveloped of the
family groups and the number of women, infants, and/or
children indicated for each family group;
• This listing was divided into two sampling frames: one
of family groups containing a woman, (regardless of the
number of infants and children) and one of family groups
containing no women (only an infant and/or children as
participants);
• For each local agency a sample of family groups selected
independently from each sampling frame (from 30% to 100% of
the family groups listed were selected depending on the
number of family groups in a sampling frame) and ensuring
a minimum of 17 participant interviews at each local
agency; and
• The exact person to be interviewed was the Demonstration
Project participant if a woman participant was in the family
group or the parent/guardian of the child or infant par­ticipant.
Only one interview was to be conducted for each
family group and for each household/traveling unit.
For 9 of the 11 local agencies the August and September 1978
participation information was available from the FNS Washington
office. For these local agencies the development of the sampling
frames and the selection of respondents for interview were performed
before the site visits at the Texas local agencies. More
specifically, at 7 of the 11 local agencies in Texas a simple
random sample was selected from the family groups developed from
the logs. At three of the other local agencies, a census was
attempted of all family groups listed on the August and September
logs. At the fourth local agency, the number of migrants served
was so low that a census was attempted of every family served by
the agency since January 1978. The final sample sizes and the
number of successful interviews are presented in Table 2.2 on the
following page.
As shown in this table, a total of 259 (49%) of the total estimated
number of potential respondents were selected to be interviewed.
Of this 259, it was found that 61 respondents (24%) should have been
excluded from the sampling frame because five family groups were
not migrants, one (the participating infant) had died, thirty-five
were known to be in transit outside the survey area, nineteen had
no known address or point of local contact, and for one, two
respondents were selected in the same household. Therefore, of the
-11-
TABLE 2. 2
SAMPLING FRAMES, SAMPLES AND NUMBER OF CCNPLETED INrERVIEWS
OF PARTICIPANTS AT LOCAL AGENCIES IN TEXAS
I Est:i:rirated- Number
Number of of Possible
. Estimated I Interviews Interviews Number of Number of
L,:>eal , Sampling I Drawn From Samples Successful Unsuccessful
Agency ' Frame Size For Sample Drawn y Interviews . Interviews
!
A 35 18 16 13 i 3
B 58 18 17 17 0
c 17y y 17 10 9 1
D 66 22 22 21 1
E 67 27 25 21 4
F 3ly y 31 18 17 1
G Zly 21 14 13 1
H 12li/ 36 32 30 2
I 2oY Y 20 10 9 1
J 66 32 25 25 0
K 32il 17 9 7 2
TOTAL 534 259 198 182 16
Notes:
!/ A census approach was taken at these local agencies.
Y These local agencies were located in northern Texas and the majority
of unsuccessful interviews were attributable to migrants leaving to
return to southern Texas or Mexico.
Y This local agency served only approximately twenty families from
January 1978 through November 1978. Interviews of all families
were attempted. Eight of the 20 families were migrating.
if The participation logs at these local agencies included persons who
did not consider themselves as migrant and/or did not migrate in
1978. Individuals who were not migrants, if sampled, were considered
as unsuccessful interviews.
Y The number of possible interviews include all respondents who were
migrants and were still in the area and for which at least some
information was available on the address of their residence.
-12-
259 selected, only 198 were potentially eligible for inclusion in
the survey. Of these, interveiws were successfully completed with
182. The sixteen unsuccessful interviews occurred despite numerous
return visits (sometimes six or more) to the home of the respondent.
D. Selection of Eligible but Non-Participating Migrants for Interview
The study design required interviews with a sample of eligible but
non-participating migrants. Based on design requirements this
sample was to contain migrating persons in the WIC program target
population, i.e., pregnant, breastfeeding, or postpartum women (up
to six months postpartum if not breastfeeding and up to one year
postpartum if breastfeeding), or the parent or guardian of an
infant or child up to 5 years of age by October 1, 1978. The
persons could not be participating in the WIC program or on a waitin
list to participate or be the parent or guardian of a participant
or a person on a waiting list.
For the non-participants selected for interview, it was not possible
to achieve a completely representative sample for two reasons.
First, information on the characteristics of this population was
unavailable from any standard report or source. Second, it was
expected that local agencies would not have information about the
size or availability of this population.
Therefore, less rigorous procedures were developed to select the
non-participants fat interviews. DA field staff used these
procedures and on arriving at the local agency asked the agency
official if a list could be constructed of non-participating
migrating persons who were eligible for the WIC program. This list
was to be developed from the clinic appointment log or a similar
record for the week during when the local agency visit occurred
and/or for the previous week which the local agency was open five
or more days. It was also requested that the list contain the
address and telephone number next to the person's name. After the
list was developed, eight names were to be randomly selected from
the list using a random numbers table and these people were contacte
to arrange for an interview. If these people could be contacted
by telephone, the interview was conduted by telephone.
At 11 local agencies, a listing of eligible but non-participating
migrants could not be developed. Therefore, a quota sampling
approach was instituted to attempt to obtain eight interviews at ·
each of these agencies. Possible respondents were isolated at all
eleven local agencies, but many did not fulfill the criterion.
At two local agencies, no eligible respondents would be isolated,
five or more respondents could be isolated at only six of the eleven
local agencies, and the remaining three local agencies had between
one and four migrants isolated and interviewed. A total of 49
interviews were conducted.
-13-
E. Selection of Medical Records of Participants
In order to co\duct an assessment of the nutritional impact of the
Demonstration Project, the study design included the collection of
medical data on a sample of particip~nts. Therefore, at the eleven
local agencies in Texas, a sample of participants was selected from
the August and September Parti~ipation Logs and from the regular WIC
program. The study design specified the collection of data on
1,000 participants, 500 participants of the Demonstration Project
and 500 participants of the regular WIC progra~. Of the 500 in each
sample, 300 were to be women, 100 were to be infants (born on or
after October 1, 1977 and before May 1, 1978) and ioo were to be
children (born on or after October 1, 1973, and before October 1,
1977).
Detailed procedures were developed for selecting each sample. The
selection of participants from each group is discussed below.
1. Selection of Medical Records of Participants of the
Demonstration Project
As noted above, the Participation Logs formed the basis for
selecting the medical records of participants. After the August
and September 1978 Participation Logs of the 11 Texas local
agencies were reviewed and the respondents for participant
interview were selected, listings were made of women, infant, and
children participants.
In order to obtain sufficient medical data for each participant
type, data were collected from the medical records of all women
and of all infants listed on the August and September logs and
for 40% of the children listed. After the participant names and
VOC identification numbers were obtained, DA field staff located
the medical files a~d collected the data.
2. Selection of Medical Records of Participants of the Regular
WIC Program
As part of the study design, data were to be collected on
participants of the WIC program who were served by the same WIC
program as the Demonstration Project participants but who did not
migrate in 1978. Unlike the Demonstration Project participants
in general, there was no standardized listing of participants
of the regular WIC program. In order to select the sample of
medical records a double sampling scheme was developed and used.
The double sampling scheme required the field staff to select a
systematic sample of all medical files at the local agency. Each
medical file was reviewed in order to determine the number of
women, infants, and children participants who were certified in
the period January through April 1978 and recertified in the
period June through October 1978. This initial review resulted
in three sampling frames: a sampling frame of women, a sampling
- 4-
frame of infants, and a sampling frame of children. After the
sampling frames were developed, relatively few women and few
infants were isolated so all women and infants were included
in sample; a random sample of children were selected, the medi­cal
file obtained, and the desired data collected.
For the children samples, only one child was selected in a family
group.
F. Methodological Concerns and Issues
In this study, the final study design sought to max1m1ze the amount
of objective and substantive information obtained, given the
priorities set forth by FNS and the practical constraints of the
study. This section discusses some of the methodological issues
and concerns of the study and describes the limitations imposed on
the findings. The discussion has been organized to address
contextual issues, procedural and methodolog i cal issues, and study
limitations. Because the issues and concerns are also interwoven
with the study findings, the study findings are touched on briefly
in this section. The reader should refer to subsequent chapters
of this report for a more detailed discussion of the study findings.
1. Contextual Issues
The primary purpose of the Migrant Demonstration Project was to
ensure a continuity of participation and services to migrants.
However, fundamental to this purpose and to the evaluation is the
definition of who should be considered a migrant an~ therefore,
be eligible for the benefits of participation. At the federal
level, there are differing definitions of migrants among and
within agencies. For the WIC Migrant Demonstration Project, FNS
defined a migrant as anyone leaving the county of permanent
residence during the migration season. All persons meeting this
criteria were eligible to receive a VOC identification number
and card.
The issue of differing definition of migrants is noted here
because it caused a problem at some local agencies. In
p~rticular, the definition of migrant used by one local agency
resulted in the issuance of VOC cards to individuals who did not
migrate during the 1978 season as well as the listing of their
names on Participation Logs. Because these non-migrating persons
were listed on the logs, both the sample of respondents for
interview and the samples of medical data included persons who
did not migrate. Except in the cases when the person was
interviewed could non-migrating participants be isolated. In
particular, the medical data for the non-migrating participants
cannot be isolated from the data for migrating participants
and, therefore, this confounds the comparisons between the data
obtained on participants of the Demonstration Project and the
data obtained on participants of the regular WIC program. This
problem is significant in that it affects the reliability of
the sampling frame and the results of the medical data and
participant data.
-15-
Another contextual issue arose because of the transitory nature
of the migrant population. At the two local agencies in the
northern part of Texas, the majority of the participants listed
on the August and September Participation Logs were not in the
area in December. As an alternative, at these local agencies
the most recent logs were used, and a complete census was
conducted for the participant interviews.
In general, the participant interviews were achieved with few
problems. However, locating the participants posed the greatest
difficulty because, in a number of cases, the only information
available was a post office box number or a route number. There
was the additional problem caused by suspicion of strangers
(i.e., the interviewer). One or two interviews could not be
conducted because the persons contacted denied being the .
participant or having knowledge of the participant. The inter ~
viewers felt that these people suspected that the interviewers
were from the local authorities or from the Immigration and
Naturalization Service. These individuals could not be dissuaded.
However, the use of bilingual data collection staff did
facilitate interviewing. All six field staff were bilingual in
Spanish and English and some were natives of the South Texas
area. Of the 182 interviews conducted, 142 (78.0%) of the inter­views
were conducted in Spanish following a standardized Spanish
translation of the ques tionn~~re. This Spanish translation was
developed using the dialect of southern Texas and was designed to
give the respondent the opportunity to choose the language for
the interview. We believe that allowing the respondent to choose
the language of questionnaire administration resulted: (a) in
better and more accurate responses; and (b) in a greater number
of successful interviews. In addition to these contextual
issues, there are others related to procedures and the method­ology.
These are discussed more fully below.
2. Procedural and Methodological Issues
The major procedural and methodological issues in the study were
related to the Participation Logs maintained by the local
agencies. These logs were used for sampling and were both a
primary source of information for the evaluation of the project
and an element of the administrative structure which was being
evaluated.
The Participation Logs and instructions for their completion and
submittal were provided to the local agencies by FNS in the early
spring of 1978 . Although these procedures specified how informa­tion
was t o be ente red, some misunderstandings and problems arose
on the part of local agency staff. Because the evaluation
approach relied upon data from these logs, these misunderstand­ings
and problems also have methodological implications. For
example, the process for submitting a log to the national office
of FNS required error checks at the regional office. Although
this step helped to minimize the errors reaching the national
office, it resulted in substantial delays. In addition, local
-16-
agencies were often late in submitting their logs to the regional
office. For example, in terms of this study, Participation Logs
for August and September for two Texas local agencies were not
available at the start of the site visits in late November.
Therefore, at these local agencies, the number of persons to be
interviewed had to be estimated from data from prior months.
Additional problems with the Participation Logs generally in­volved
incomplete or missing information. In particular, one
local agency in Texas thought that only participants being issued
a Verification of Certification number and card should be
included on the logs and that returning participants were not to
be indicated on the logs. This error resulted in the systematic
undercounting of participants in the vicinity of this local
agency. Problems such as these affected the survey design
because the logs were the basis for the sampling frame for both
the participant interview survey and the medical data collection
effort. Because of these problems, sampling weights for the
responses cannot be estimated.
Related to the problems with the Participation Logs are the
recordkeeping systems at the local agencies which also affected
the sampling design. Since the recordkeeping systems for medical
data and participation were designed by the local agencies to fit
their own specific needs and the needs of the people and areas
served, there was a great amount of variation among agencies.
In most agencies, listing of all participants (both participants
of the Demonstration Project and of the regular WIC program) were
available to associate clinic medical data file folders and/or
clinic identification numbers to individual VOC identification
numbers. However, in some cases VOC identification numbers were
missing or more than one number was given to a single partici­pant.
Further, medical data file folders for Demonstration
Project participants generally were mixed in with the folders
of the participants of the regular program. These folders usually
were alphabetized by name of the male head of the household. Thus,
the VOC numbers and names had to be associated with a male head
of household name before a file folder could be · located.
3. Study Limitations
Some of the methodological issues and concerns discussed above
have resulted in limitations on the scope of the study. The
primary problems causing limitations to this study were:
• The information on the Participation Logs was subject
to error and misinterpretation by the local agencies
who completed them and, therefore, the sampling frames
. for selecting respondents and data were subject to error;
I
-17-
• There was variation among local agencies in the amount
of data available on the population served (i.e., not
all local agencies recorded the same type or amount of
medical data); this sometimes resulted in severe
diffic~lties in locating persons for interviews as well
as limiting the analysis of the medical data; and
• The lateness of the 1978 migration season and eligible
migrants leaving without a VOC card resulted in many
migrants being certified after April which resulted
in relatively large proportions of migrants having on~y
one certification during the primary period of the study.
In particular, because at some local agencies the sampling frames
were subject to a high degree of error, generalizing the results
to the universe of participants cannot be justified. Specifically,
because non-migrating persons were issued VOC numbers and cards
and were listed on the Participant Logs, the total number of
valid participants of the Demonstration Project cannot be
estimated.
As previously described, the sample of participants for interview
was selected randomly in seven of the eleven local agencies . For
these agencies, the number selected at each agency was
proportional to the total number of participants indicated on
the August and September Participation Logs for all local
agencies in Texas. In the other four local agencies, a census
approach was taken. In addition, in viewing these data, it must
be recognized that all interviews were with migrants in the local
agency service areas at the time of the survey (i.e., not those
who had gone back to Mexico, moved to Florida, etc.). Overall,
however, a total of 182 interviews were conducted, and we believe
this sample can be considered a good representation of all
migrant participants based on counties served by the participat­ing
Texas local agencies.
In addition, because medical records were also selected based on
the August and September Participation Logs, the medical data is
also subject to limitations similar to those described above .
For the women participants of the Demonstration Project and of
the regular WIC program, the original design specified the
selection of three samples of women, a sample of women for each
trimester of pregnancy. Results of the pretest conducted in
October showed that trimester data were not always available
for women and selection of samples by trimester was not feasible.
Further, the number of women listed on the Participation Logs
were fewer than had been expected. Therefore, a census approach
was taken for selecting the women samples. As noted previously,
because pregnancy data on women were available at only some of
the local agencies, descriptive analyses based on the pregnancy
data is only possible for a portion of the women.
-18-
Finally, because of the relatively brief period of eligibility
for women, in addition to the use of a census approach, the
criterion of a first certification in the period of January to
April 1978, and a second certification during the months of June
through September was relaxed to include participants first
certified in May, June, July, and August. This criterion was
also relaxed because a high number of participants were first
certified in the upstream states in June, July, and August. The
overall effect of these modifications will be that some of the
analyses of the nutritional impact of the project on the
participants will be limited.
A limitation of the general usefulness of the medical data is
attributable to the migration of participants during the time
frames addressed by the study and by the Demonstration Project
itself. For example, some of the participants may have been
migrating and . served by another local agency for only a
relatively short time (e.g., one or two months) and then returned
to the home base local agency. In this situation, only a
limited amount of change in medical data could be attributed to
the Demonstration Project. This would confound the comparative
analysis of the Demonstration Project participant's medical data
and the regular WIC participant's medical data.
Although there were certain unavoidable study limitations, they
did not grossly affect the study design, and the methodology
was successfully implemented. Moreover, the data collection
effort obtained sufficient data to meet the study objectives.
Further, it is the professional judgement of the study team that
the data collected using the sampling strategies previously
described are highly reliable in giving a general indication of
the characteristics and outcomes of the WIC Migrant Demonstration
Project.
-19-
CHAPTER 3
CONTEXT AND OPERATIONS OF THE WIC MIGRANT DEMONSTRATION PROGRAM
A. Overview
As noted earlier, in January 1978 the Food and Nutrition Service
implemented the WIC Migrant Demonstration Project as part of its
Special Supplemental Food Program for Women, Infants and Children ..
The overall purpose of this project was to test methdds of improving
program services to migrant families. In order to do this, the
Demonstration Project opened WIC programs in high impact areas and
instituted a tracking system to record services that participants
received, sites where services were provided, and lapses in service
continuity. This tracking system called for the use of a migrant
Verification of Certification (VOC) card, a migrant Participation
Log, and a WIC Program Directory of Local Agencies. In addition,
each clinic was encouraged to use the FNS developed nutrition
educat1on modules for the required nutrition education.* Beyond
these elements or features that are specified by FNS, local agencies
also have options relating to project staffing, involvement with
farmworker organizations, outreach, and additional services.
This chapter describes the features that are present in every
project as well as those that are present according to local option.
Further, utilizing data collected during the evaluation, the chapter
discusses the state and local agency grantees and the services they
provide to migrant farmworkers.
Overall, the data collected on the program components, special
services, and characteristics of local agencies and program
participants was rather comprehensive. This information is not only
valuable in providing the descriptive context of the demonstration
project, it is also essential in order to assess the various program
features and ultimately the impact of the WIC migrant demonstration.
B. Project-wide Innovations
According to the FNS design for the Migrant Demonstration Project,
each of the 13 participating states and their associated local
agencies were to implement. their programs according to the steps
set forth in the Migrant Demonstration Pro~ect Guide. In addition
to requiring the track1ng components, theuide also described the
nutrition education package. Below we discuss the components of
the tracking system (Verification of Certification Card, Participa­tion
Log, and Program Directory of Local Agencies) and the nutrition
education modules.
These FNS modules are described later in this chapter on page_23.
-20-
1. Migrant Verification of Certification (VOC) Card
The certification requirement for WIC eligibility upon arrival
at a new location was a chronic problem for migrant farmworkers .
In order for projects to adhere to the WIC program regulations
which call for them to honor the certification of eligibility
that migrants have received in other agencies, FNS developed a
VOC card designed to facilitate the transfer of certification
information to each agency site in which migrants traveled (see
Exhibit 3.1). The VOC card was designed to be issued to each
migrant participant by the local agency at the time when the
participant was ready to travel to another state or the next
local agency which was participating in the WIC Demonstration
Project. If not received when the participant left, the VOC card
was issued to participants at clinics where they arrived at the
next local agencies. Each VOC card contained a unique identifier
number for each participant and spaces for entering codes
indicating the standardized nutrition education the participant
had received, food issuance, and the date certification began and
ended, and the participant's nutritional status. It also
provided each new local agency visited by the participant with
necessary information on the participant (e.g., birthdate,
parent/guardian, county of permanent residence) and recorded
the nutrition education module given. To further assist receiv­ing
agencies, according to FNS pilot procedures, agencies were
encouraged to refer each participant's certification record form
(non-medical) to tfte local agency where the participant planned
to go prior to the migrant•s departure.
2. Migrant Participation Log
During the pilot period,each local agency maintained a monthly
project Participation Log which recorded information on each
migrant participant in the Demonstration Project. The informa­tion
on the log corresponded to the data recorded on the VOC
card. The log was submitted each month to the state agency by
the seventh day of the following month and forwarded to the FNS
Regional Office by the fifteenth day of that month. A sample
of the Participation Log appears in Exhibit 3.2.
After review by the FNS Regional Office, the log was forwarded
for tabulation in Washington, D.C. by the Automated Data
Processing (ADP) Division of FNS. Based on the log data, the
ADP Division was able to generate reports needed in the evalua­tion
of the project. Specifically, the logs permitted the
tabulation of the following totals:
• Number of participants issued food;
• Number of participants who completed a nutrition module;
• Number of participants certified;
• Number of participants placed on a waiting list;
•
"'
•
Completed
Nutrition
Ed. Module
-21-
EXHIBIT 3.1
EXAMPLE OF A COMPLETED VERIFICATION OF CERTIFICATION CARD
WIC Program
Verification of Certification
Birthdate · 7/10/76 # 15, 159
Name Julio Parez
Parent/Guardian ~El~d~a~P~a~r~e~z~---------
State 48 County -.:2w1""5....._ _ _
City Edi phur~
Clinic Officiai
Part. Signature
N. Ed. Assigned
Nutritionc--~M
Education
Modules
Assigned
Nutritio
Need Fac
Code
nal
tor
Special
Conditi on
Certification Record
'U -7 • Need 1 Start 2/12/78 End8.LJ..;
2. Need Start . End -
Date of Food Local Agency
Issuance Number BACK
2ll2£Z8 ~-Q!2---:--
3poL78 J2-QJZ
4 1/78 2f!-QJJ
State Code
Local Agency Code
~!l G6 2fl-QJJ
~ Hemarks: Milk allergy
EXHIBIT 3.2
Project Partici~Htion Ioq
Reporting Period Ending - ~rll .28, 1978 (1-6)
.
State 26
I.Dcal Agency
013
Nane I.DI Birth Certificaticn ~. hcnl ~c
Q5
Date Date Olty St 5fu ule
e
12-40 41-45 46-51 52-57 'iB-60 61-62 ~ 3 66-69 70-74
Julio Parez 15,159 7/10/76 4/1 4/1 11
Elda Mercedes U.897 12/24/53 4/1/78 189 48 4/1 4/1 1
Maria Sanchez 22,898 5/8/56 2/18/7 06 4/19 4/19 3
Thomas Baca 20,001 4/3/73 T
Grace Morena 22,899 9/11/77 4/20/7 323 48 4/20
Jose llernandez 15,759 7/10/76 4/20
Steven Craig 16,785 6/29/75
~1.
SAMPLE
(7-8)
(9-11)
blbting Remarks
76-80
Was WIC participant in
California
Reached his 5th birth-dav
Reissue-Old card issued in
Jan. at ~f:tv<>rirk r.t-nu TY
4/20
Rf1.A.-<L ~;7r;u
1-:;tS 71!
N
N
-23-
• Number of participants whose certifications were
termi~ated due to ineligibility;
• Number of participants who had participated continuously;
• Number of new participants;
• Number of participants who were not participating one
month but were issued food in the previous month;
• Number of participants who were participating in the
reporting month after a lapse in participation;
• A list indicating the number of all participants by
identification number and code numbers of the state
and local agencies where the participants received WIC
Demonstration Project services; and
• A list of counties listed as permanent residence by the
participants. This was to help identify areas in the
home base state where WIC services or outreach was needed.
3. WIC Program Directory of Local Agencies
The directory was developed to assist state and local agencies in
the identification of sites where migrants could obtain WIC
benefits and other health services. Participants received a
directory from a local agency upon issuance of the VOC card.
Within the directory, all local agencies in the thirteen states
participating in the Demonstration Project were listed by state
and county. For each local agency, there was a listing of the
counties served by the agency and an indication as to whether
the local agency was participating in the demonstration project.
Migrants could seek services at any local agency but only those
participating in the demonstration were prepared to serve migran
(e.g., filling out logs and cards, etc.).
Specifically, the directory included state and local agency code
numbers necessary for the VOC card and the Project Participation
Log. As far as possible, telephone numbers were included for
each WIC local agency in the thirteen states. The directory also
listed agencies which operated a Commodity Supplemental Food
Program. (See Appendix B for a list of participating local
agencies.)
4. Nutrition Education
The Food and Nutrition Service developed for this pilot project
uniform national nutrition education materials in modular form
for use in all participating agencies. These materials were
based upon ethnic patterns and unique circumstances of the
migrant family and were in both Spanish and English. FNS
provided the state and local agencies the option to use these
modules as supplements to other existing local agency developed
nutrition education materials. An essential aspect of the
modules' design was that it provided basic nutrition education
-24-
concepts through a series of flip charts consisting of color­fully
illustrated lessons designed to provide a short-term,
intensive focus of essential information. Further, the modules
were designed to be presented sequentially so as to avoid
repetition as participants moved from clinic to clinic. The
package was designed for use by paraprofessional staff, but the
application was the responsibility of the project nutritionist.
At the time of initial entrance to the WIC program, the
participating agencies were to determine the participant's
nutritional needs and establish what nutritional education the
migrant required. On the participant's VOC card, the specific
nutrition education modules needed by the participant were to
be indicated and those completed were indicated by ~circled date.
The modules included lessons designed for pregnant women,
breastfeeding mothers, and mothers with a child and/or infant.
As the participant traveled, the staff of the next local agency
visited would be able to see from the VOC card what nutrition
education the participant· needed and which modules the partici­pant
had completed. From this information the local agency could
determine what the nutrition education and/or module should be
provided to the participant. All of the nutritional education
that a participant received was to be recorded on the VOC card
in order to indicate what nutritional education instruction
remained to be completed at the next local agency.
C. Additional/Special Features
The WIC Migrant Demonstration Project was designed to allow for
diversity and innovation in local program design so as to ensure
the maximum utilization and ease of participation by persons
requiring and eligible for WIC services. The local agencies
differed in responses to client needs depending upon the geographic
and demographic characteristics of the areas and population served.
This being the case, there was some flexibility at the local level
as to staffing patterns. Also, state agencies had made provisions
for, and local agencies had implemented to varying degrees, linkages
with farmworker organizations and several different methods of
program outreach. Those local options are discussed below.
1. Farmworker Organization Involvement
FNS encouraged local agencies to work with migrant farmworker
organizations to help reduce barriers to WIC participation for
migrants. Through linkages with farmworker organizations, it ~
was envisioned that the local agencies could augment their
present services by establishing a cooperative system of referral
and outreach, language services, transportation, and other
miscellaneous supportive services for migrants (i.e., day care,
mobile clinics, etc.).
-25-
2. Outreach Methods
At the local level, the study revealed that outreach was
accomplished by formal home visitation, cooperative efforts
with local community social service educators, and manpower
training agencies. Nearly all of the state and local agencies
participating in the pilot project used publicity/informational
outreach methods such as radio/TV, posters, and local newspaper
notices. Also included were literature to profession?ls and
speeches to professional and target groups. For the most part,
state agencies did not maintain formal policies or mandates for
outreach systems to be implemented at the state or local levels,
and the number of outreach methods carried out at the local level
were a matter of local administrative selection.
3. Staffing Patterns
A majority of the project's participating state and local agencies
contain three types of staff: (1) administrative; (2) super­visory;
and (3) paraprofessional. The administrative time at
the state agency level is devoted to administrative and program
monitoring functions of local agency service providers.
Included at this level are health program managers, nutritionists,
and registered nurses. Within the local agencies there are
similar types of staff in addition to paraprofessionals who are
used as nutrition education instructors, outreach workers, and
clerks. Staff training is provided at the state and local levels
through workshops and seminars on health and nutritional service
delivery.
D. Community and Local Agency Characteristics
The Demonstration Project was designed to serve the mid-continental
migrant stream and to operate in primary states of that stream.
Thirteen states were selected to participate in the Demonstration
Project. The states included Texas (the home state of most migrant
farmworkers traveling the mid-continental stream), Colorado, Iowa,
Nebraska, North Dakota, Kansas, Missouri, Michigan, Illinois,
Wisconsin, Ohio, Indiana, and Minnesota. The state agencies in
these 13 states were granted funds to: (a) implement a WIC program
if a county or counties served by an eligible agency expected to
serve a high number of migrant farmworkers or had previously served
such a group, or (b) provide additional funds to a pre-existing WIC
program if the local WIC agency had or was expected to have a high
number of migrant farmworkers.
As of October 1978, the total number of participating local agencies
was 59, 46 local agencies in the 12 upstream states and 13 local
agencies in Texas. Of the 59 participating agencies, about half
of the local agencies (24) had not previously operated a WIC program
and 21 of these 24 were located in the upstream states. Just over
half (31) of the 59 local agencies were affiliated with the Migrant
Health Service of DHEW.
J
-26-
1. Migrant Demonstration Project Local Agencies
As part of the study design, FNS was interested in whether pre­vious
affiliation with the WIC program and/or the Migrant Health
Service might result in the provision of different services and/
or the use of alternative service systems. Therefore, FNS
classified local agencies into four categories based on previous
affiliation as follows:
• A: Agency previously operating the WIC program; not
affiliated with the Migrant Health Service (MHS).
• B: Agency not previously in WIC, affiliated with MHS.
• C: Agency previously in WIC; affiliated with MHS.
• D: Agency not previously in WIC; not affiliated with MHS.
As mentioned above, there were 59 agencies participating in the
Demonstration Project. The distribution of participating local
agencies by state, FNS region, and local agency affiliation is
presented in Table 3.1 on the following page.
From the information provided by FNS, there were 46 local agencie
in upstream states and 13 local agencies in Texas participating in
the Demons.tration Project (i.e., completing and submitting
Participation Logs, etc.). With regard to the upstream states,
as shown in Table 3.1, 22 local agencies had previously operated
the WIC program and were not affiliated with the Migrant Health
Service (MHS) and 20 local agencies had not previously operated
the WIC program but were affiliated with MHS. Three local
agencies had previously operated the WIC program and were
affiliated with MHS. Only one local agency had not previously
operated the WIC program and was not affiliated with MHS. For
Texas, five agencies had previously operated a WIC program and
were not affiliated with the MHS; three had not previously
operated the WIC program but were affiliated with MHS; and five
had previously operated a WIC program and were affiliated with
MHS.
Of the 46 upstream local agencies, for purposes of evaluation,
one local agency was selected from each state for an onsite inter­view.
Of the local agencies, there were .5 Type A agencies,
5 Type B agencies, 1 Type C agency, and 1 TypeD agency.* All
participating local agencies in Texas received onsite interviews.
This information is also summarized in Table 3.2.
M:>re infonnation on the selection of the upstream sample of local agencies
is given in Chapter 2.
1
-27-
TABLE 3.1
PARTICIPATING LOCAL AGENCIES BY STATE, REGION, AND AGENCY
PRIOR AFFILIATION Willi THE WIC PROGRAM AND THE MIGRANT HEALTH SERVICE
Agency Affiliations 11
Region State A B c D
Mountain/Plains co 5 4 - -
IA 2 3 - -
NE - - 1 1
ND - 2 - -
KS - 1 1 -
MO - - 1 -
Subtotal 7 10 3 1
'Midwest MI 5 3 - -
IL 4 1 - -
WI 4 1 - -
OH 1 3 - -
IN 1 1 - -
MN - 1 - -
Subtotal 15 10 0 0
TOTAL UPSTREAM STATES 22 20 3 1
Texas 5 3 s· 0
T 0 T A L 27 23 8 1
1/
A· Agency previously operating the WIC Program; not affiliated
with the Migrant Health Service (MHS).
B: Agency not previously in WIC, affiliated with MHS.
C: Agency previously in WIC; affiliated with MHS.
D: Agency not previously in WIC; not affiliated with MHS.
Total
9
5
2
2
2
1
21
8
5
5
4
2
1
25
46
13
59
-28-
TABLE 3.2
LOCAL AGENCIES PARTICIPATING IN WIC DEMONSTRATION PROJECT BY
AGENCY AFFILIATION FOR ALL UPSTREAM LOCAL AGENCIES FOR THE SAMPLE
OF UPSTREAM LOCAL AGENCIES AND FOR ALL LOCAL AGENCIES IN TEXAS
Total Sample
Upstream Upstream Texas
Agency Affiliation Local Local Local
Agencies Agencies Agencies
A = Agency previously operating the
WIC Program; not affiliated 22 5 51/ with the Migrant Health
Service (MHS)
B = Agency not previously in WIC,
affiliated with MHS 20 5 3
C = Agency previously in WIC;
affiliated with MHS 3 1 5
D = Agency not previously in WIC;
not affiliated with MHS 1 1 0
T 0 T A L 46 12 13
l/Two of these agencies were visited only for local agency questionnaire
administration.
-29-
2. Community Characteristics at Selected Local Agencies
To provide a context for this study, the 25 local agencies
selected for visits and interview were queried about services
available in the community for migrant farmworkers. The local
agency administrator was asked to indicate specific services
available, a description of the service and the service provider.
The general areas of services suggested are as follows:
• Employment; • Legal Services;
• Health; • Translators;
• Child Care; • Education;
• Summer Food Service; • Transportation; and
• Food Stamps; • Housing.
The responses indicated that health services were the service
most likely to be available. This was the case in all Texas
local agencies and eleven of the twelve upstream local agencies.
Other services frequently reported to be available to migrant
farmworkers included food stamps, employment services, transporta
tion, and child care. The availability of transportation and
child care services was cited more frequently by Texas local
agencies than by the upstream local agencies. Among the other
services specified by local agencies were mental health services,
relocation or resettling services and emergency funds. Responses
from the local agency administrators are summarized in Table 3.3,
below. TABLE 3.3
SERVICES AVAILABLE IN THE COMMUNITf fOR MIGRANT FARMWORKERS
Upstream Texas All
Local Agency Local Agencies Local Agencies
GENERAL TYPE (N=l2) (N=l3) (N-25)
OF SERVICE Ntmtber Percent Ntmtber Percent Ntmtber Percent
Employment 8 - 67 12 92 20 80
Health 11 92 13 100 24 96
Child Care 7 58 12 92 19 76
Summer Food Service 4 33 7 54 11 44
Food Stamps 10 83 12 92 22 88
Legal Services 4 33 11 85 15 60
Translation 8 67 6 46 14 56
Education 7 58 10 77 17 68
Transportation 8 67 11 85 19 76
Housing 9 75 9 69 18 72
Other 5 42 5 38 10 40
...
-30-
3. Staffing
Since FNS was interested only in the presence of bilingual staff
and changes due to the migrant demonstration, the survey
questionnaires did not gather specific data for developing
comprehensive state or local agency administrative and program­matic
staff profiles. However, the administrative questionnaires
did produce important information about staffing at the sites.
More specifically, the local agency questionnaire queried
administrators about the size of the permanent staff, the number
of permanent staff who were bilingual and the number of
additional personnel utilized during the Demonstration Project
(Table 3.4). Data . indicate that most state and local agency
personnel in the demonstration area were registered dietitians
and that local agency administrative and program staff were, for
the most part, bilingual in Spanish and English at the Texas
local agencies visited.
This was not the case at the upstream local agencies where
approximately 14% of the total of permanent staff were reportably
bilingual. Tables 3.5 and 3.6 present additional information
on staff characteristics (upstream and Texas local agen~ies,
respectively) by agency affiliation. In general , more bilingual
staff were found within agencies that were affiliated with MHS
than 4those which were not.
For upstream and Texas (Table 3.6) local agencies which had
previously oper~ted the WIC program and were affiliated with
MHS (Agency Type C) tended to have larger staffs and a high
percentage of staff who were bilingual. Agencies which had
previously operated the WIC program and were not affiliated with
MHS (Agency Type A) tended to have smaller staffs that were some­what
similar in size to the staff sizes of the upstream Type A
agencies. Three of the five Type A agencies were located in
northern Texas which is, in terms of migration patterns, more
similar to the upstream states than to the remainder of Texas.
..
-31-
TABLE 3.4
Staff and Staffing Characteristic~ of Texas and Upstream Local Agencies
No. of Permanent Bilingual No. of
Permanent Staff Additional
Staff Number Percent Staff Utilized
Texas: Local Agency 1/
A 65 52 80 0
B 28 28 100 5
c 25 25 100 0
D 19 19 100 .. 0
E 13 13 100 0
F 10 10 100 1
G 8 8 100 0
H 8 7 88 3
I 6 6 100 0
J 5 3 60 0
K 5 3 60 5
L 2 1 so 0
TOTAL 194 90 90 13
Upstream: Local Agency
A 9 4 44 5
B 8 0 0 0
c 7 0 0 0
D 7 1 14 0
E 6 0 0 0
F 5 0 0 1
G 4 1 25 5
H 4 1 25 0
I 3 0 0 2
J 2 0 0 1
K 1 1 100 26
L 2/ 0 0 0 0
TOTAL 56 8 14 40
l/Data for one local agency in Texas were excluded because the agency was in the
process of being closed.
2/This local agency has no permanent staff.
)
-32-
TABLE 3.5
STAFF AND STAFFING CHARACTERISTICS OF UPSTREAM LOCAL AGENCIES
BY AGENCY AFFILIATION
I
Permanent Bilingual
Ntmlber of Staff Ntmlber of
I Local Permanent Additional
Affiliation; Agency Staff Nt.mlber Percent Staff Utilized
' I c 7 0 0 0
D 7 1 14 0
A G 4 1 25 5
I 3 0 0 2
J 2 0 0 1
Total I I 23 2 9 8
I A 9 4 44 5
I B 8 0 0 0
B I F 5 0 0 1
I K 1 1 100 26
! L 0 0 0 0
Total i 23 5 22 32
c E 6 0 0 0
D H 4 1 25 0
Total 56 8 14 40
A: Agencies previously affiliated with WIC bqt not affiliated with-the
Migrant Health Service (MiS)
B: Agencies not previously affiliated with WIC but affiliated with MiS
C: Agencies previously affiliated with WIC and affiliated with MHS
D: Agencies not previously affiliated with WIC and not affiliated
with M-IS .
-33-
TABLE 3.6
STAFF AND STAFFING CHARACTERISTICS OF TEXAS LOCAL AGENCIES
BY AGENCY AFFILIATION
Permanent Bilingual
Number of Staff Number of
Local Permanent Additional
Affiliation Agency Staff Number I Percent Staff Utilized
G 8 8 100 0
H 8 7 88 3
A I 6 6 100 0
K 5 3 60 0
L 2 1 so 0
Total 29 25 86 3
B D 19 19 100 0
J 5 3 60 5
Total 24 22 92 5
A 65 52 80 0
B 28 28 100 5 c c 25 25 100 0 .
E 13 13 100 0
F 10 10 100 1
Total 141 128 91 6
TOTAL 194 175 90 14
A: Agenc~es previously affiliated with WIC but not affiliated with
the Migrant Health Service (MiS)
B: Agencies not previously affiliated with WIC but affiliated with MHS
C: Agencies previously affiliated with WIC and affiliated with MHS
D: Agencies not previously affiliated with WIC and not affiliated
with MiS
-34-
4. Outreach Methods
The interviews of state agency administrators and local agen­cy
administrators requested specific information on outreach
methods and activities which were used. In addition, inter­views
conducted with participants inquired as to whether the
participant first heard of the WIC program in 1978 and, if
so, from where. Both state and local WIC agencies sponsored
outreach to encourage migrant participation in the Demonstra­tion
Project. These outreach activities and materials
included pamphlets and posters in both Spanish and English,
speeches and contacts with other agencies and organizations
and a variety of other activities.
A summary of state agency responses appears below in Table
3.7. As can be seen from the table, except television
spots, state agencies used a variety of outreach methods.
Other outreach methods noted were:
*
• Newsletter (1)*;
• Information dissemination to migrant councils,
farmworker organizations, social services agen­cies
and churches (4)*; and
• Linkages with migrant camp directors for refer­ral
(1)*.
TABLE 3.7
OUTREACH METHODS USED TO INCREASE MIGRANT PARTICIPATION
IN WIC IN 1978 BY STATE AGENCIES
State Agency (N=l3) Number
Outreach Methods 'Yes' 'Don't Know'
A. Newspapers 6 1
B. Television spots 0 2
c. Radio 4 1
D. Pamphlets 7 0
E. Posters 10 0
F. Speeches to professional groups 8 0
G. Speeches to target groups 8 0
H. Other 7 0
Instances i tan was reported.
A.
B.
c.
D.
E.
F.
G.
H.
-35-
A similar diversity of outreach methods was present at the
local agencies as demonstrated in Table 3.8. As shown in
the table, pamphlets were the method used most frequently,
followed by posters and speeches to professional and target
groups. Other methods used included:
• Use of clinic staff or others as outreach worker
and/or home visits (4)*:
• Development of a referral system with the migrant.
council . or other local agencies (2)*; and
• Development of referral systems with other
clinics (2)*.
TABLE 3. 8
OUTREACH METHODS USED TO INCREASE MIGRANT PARTICIPATION IN WIC IN
TEXAS AND UPSTREAM STATES BY LOCAL AGENCIES
Texas . Upstream All Local
Local Agency (N=l3) (N=l2) Agencies
Outreach Methods
(N=25)
Ntnnber Percent Number · Percent Ntunber
'Yest 'Yes' 'Yes'
Newspapers 6 46 0 0 6
Television 5 38 0 0 5
Radio 8 62 1 8 9
Pamphlets 12 92 8 67 20
Posters 11 85 3 25 14
Speeches to professional 10 77 5 42 15
groups
Speeches to target groups 8 62 5 42 13
Other 5 38 6 so 11
As described in Chapter 2, using the Participation Logs, a
sample was selected of migrant households/traveling units
containing one or more participants in the Demonstration
Project. A household/traveling unit was defined as one or
more families related by blood or marriage who lived and/or
traveled together during the migration season. The person
interviewed in these units was either a WIC participant
... . Instances i tern was reported.
Percent
24
20
36
80
56
60
52
44
-36-
(if a woman in the unit was participating in the Demon­stration
Project) or the parent/guardian of a child or
infant participant. For brevity and to simplify the
presentation of the findings, we will define the person
interviewed as a participant regardless of whether the
person was a participant or was a parent/guardian of a
participant. The participants interviewed were asked
whether they first heard about the WIC program in 1978
and, if so, from what source. Only 54 respondents (30%)
indicated that they first heard about WIC in 1978; the
most frequently cited source (21 of 54 interviews, 39%)
was from someone at a public clinic (Table 3.9). Other
sources of information on the WIC program included family
members, neighbors, and posted information. It is of
interest that 129 (70%) of the households interviewed
already knew about the WIC program prior to 1978.
TABLE 3.9
NUMBER OF RESPONDENTS WHO FIRST HEARD ABOUT THE
WIC PROGRAM IN 1978 AND SOURCE
Sources Number Percent Total
'Yes' 'Yes' Number
First lieard of WIC program in 1978? 54 29.5
If yes, Sources:
A.
B.
c.
D.
E.
F.
G.
From another migrant 16 29.6
From a community worker 9 16.7
From someone in a public clinic 21 38.8
From a private doctor 4 7.4
From a farmworkers' organization 6 11.1
From an advertisement 3 5.5
Somewhere else 10 18.5
5. Non-participants in the Migrant Community
As part of the final design, migrants who were eligible but
not participating in the WIC program were to be interviewed
at each local agency in Texas. These interviews were to
provide additional relevant information related to outreach.
Non-participants were defined as members of the migrant
population/community who were not participating in the WIC
program. Respondents were first asked whether they: (a) were
183
54
54
54
54
54
54
54
-37-
pregnant, breastfeeding, or postpartum women, or the
parent or guardian of an infant or child up to age 5
years old; and (b) were a participant of the WIC program
or were on a waiting list to participate. Eight poten­tially
eligible non-participants were to be selected by
quota sampling at each of 11 local agencies. Possible
respondents were isolated at all local agencies but
because the majority of those potentially eligible
appeared to be receiving services, many did not fulfill
the criteria for selection. At two local agencies, no
eligible respondents could be isolated and five or more
respondents could be isolated at only six of the 11 local
agencies.
Table 3.10 indicates the questions asked of non-participants
and their responses. Of the ~9 successful interviews con­ducted,
36 (74%) non-participants indicated that they had
heard of WIC and 23 of the 36 respondents indicated that
they knew what the WIC program did. When asked for reasons
for not applying to the WIC program, 35 of the 36 who knew
about WIC gave specific reasons, and 13 (37%) indicated
that the long waits deterred them from applying, and 11 (31%)
indicated that they were deterred because of the need for
child day care. Twenty-three of the 35 respondents provided
other reasons. Eight of these indicated that either they
had just recently been referred by someone to the WIC pro­gram,
had just arrived in the area, or for some other reason,
had not been able to get around to applying. An additional
eight respondents indicated that they or their children were
determined ineligible (three of these respondents had been
WIC participants and became ineligible).
J
TABLE 3.10
RESPONSES OF MEMBERS OF THE MIGRANT POPULATION/COMMUNITY
WHO WERE NOT PARTICIPANTS OF WIC*
Total Responding Responding
Question Number 'Yes' 'Don't Know' No
Respondents Response Number Percent Number Percent
Have you heard of the WIC 49 • 36 73.5 0 0.0 0
program?
If yes, do you know what 32 23 71.9 4 12.5 4
the WIC program does?
Reasons for not having
applied for WIC program:
(1) It's hard to find 35 1 2.9 - - 1
the clinics
(2) It's hard to get to 35 6 17.1 - - 1
the clinics
(3) The clinics are 35 2 5.7 - - 1
closed when I need
to go
(4) There are long waits 35 13 37.1 - - 1
at the clinics '
(5) It's hard to get 35 11 31.4 - - 1
child care
(6) No one speaks 35 3 8.6 - - 1
Spanish at clinics
(7) The clinic staff is 35 5 14.3 - - 1
not helpful
(8) Other reason(s) 35 23 65.7 - - 1
Would you like to be · in
something like the WIC 49 45 91.8 2 4.1 0
program?
* 29 interviews were conducted in Spanish and 19 in English.
-39-
6. Special/Additional Ser~ices
During the survey, state agencies were asked whether they
had made provisions for the local agencies to offer certain
services that facilitated migrant participation and the
local agencies were asked whether they offered the same
services during the migrant season. Also, the participants
were asked whether they encountered these services at local
agencies in Texas or at local agencies in "upstream"
states. The services specified for all three respondent
groups are as follows:
• Transportation to/from clinics;
• Clinics open evenings (after 5 p.m.);
• Clinics open weekends;
• Mobile clinics;
• Day care for children; and
• Spanish speaking staff.
The state agency administrators indicated most frequently
that provisions were made for clinics to be open evenings
and for the hiring of bilingual staff. A majority of the
administrators also stated that provisions were made for
mobile clinics and for transportation to or from the clinics
(see Table 3.11 below).
TABLE 3.11
THE NUMBER OF STATE AGENCIES WHICH MADE PROVISION FOR LOCAL AGENCIES
TO OFFER SPECIAL SERVICES TO FACILITATE MIGRANT PARTICIPATION
IN WIC IN SUMMER 1978 (IN .TEXAS, READ FALL 1978)
Number
Services 'Yes'
(N=l3)
A. Clinics open evenings (after 5 p.m.) 10
B. Clinics open weekends 4
c. Mobile clinics 8
D. Transportation to/from clinics 7
E. Day care 4
F. Bilingual staff 10
G •. Other 2
-40-
When asked what would be the single most important addi ­tional
service which the state agency could offer to
improve services to migrant farmworkers in WIC, nine of
the 13 state agency administrators cited increased
staffing, particularly bilingual staff, outreach workers
and/or bilingual nutritionists, and increased training of
staff.*
Two administrators reported that services could be im­proved
if FNS, the state, and the local agencies were
better coordinated. Other services indicated by state
agency administrators included better outreach, mobile
clinics, transportation services, and changes in the food
delivery system. Three of the state agency administrators
stated that services to migrants could be improved if
migrant services and agencies could be coordinated within
states.
The local agency administrators were asked about services
offered and additional service needs. These questions
paralleled those asked the state agency administrators
and, in general, the responses were parallel as well. The
responses from the local agency administrators are sum­marized
in Table 3.12, below.
TABLE 3.12
NUMBER OF LOCAL AGENCIES OFFERING SERVICES TO FACILITATE
MIGRANT PARTICIPATION IN WIC DURING
THE SUMMER OF 1978 (IN TEXAS, THE FALL OF 1978)
*Same state agency administrators indicated two or more services.
-41-
As shown, all Texas local agencies had bilingual staff as
did nine of the 12 upstream agencies. Likewise, just
under half of the local agencies in Texas and in the up­stream
states offered evening hours during the migration
period. These services and facilities were generally in
place prior to the Demonstration Project and, therefore,
were available to all participants of the WIC program.
Also shown in Table 3.12, local agencies reported they
offered mobile clinics and transportation to or from the
clinics with some degree of frequency, but not as fre­quently
as indicated by the state agency administrators.
This may be attributed to the autonomy given to the local
agencies by the state agencies. That is, the state agen­cies
provided for the local agencies to offer certain
services, when necessary, in response to the needs of the
population served, but the use of individual services is
a local decision.
Local agency administrators were also asked what they
thought was the single most important additional services
that the agency could offer to improve services to migrants
in WIC. This information is summarized in Table 3.13, on
the following page. Eight local agency administrators
indicated that additional staff would improve services,
and four of the upstream local agency administrators indi­cated
that additional bilingual staff would be an improve­ment.
Transportation-related services (i.e., transportation
to and from clinics and mobile clinics) were also noted
relatively often by the local agency administrators. One
local agency indicated that no additional services were
needed and one had no opinion.
-42-
TABLE 3.13
SINGLE MOST IMPORTANT ADDITIONAL SERVICE WHICH LOCAL AGENCIES
WOULD LIKE TO IMPLEMENT TO IMPROVE SERVICES TO MIGRANTS*
Services
Upstream
(N=l2)
Texas
(N=l3)
Total
(N=25)
Number Percent Number Percent Number Percent
Additional Staff
- Additional Bilingual Staff
Transportation
Mobile Clinics
Better Nutrition Education
More Maternal and Child
Health Care
Re£errals to Other Services
in Community
Other Services**
No Additional Services
No Opinion
1
1
0
0
so
33
0
8
17
0
8
8
0
0
1
3
1
1
15
0
31
15
8
15
8
23
8
8
* Some local agencies indicated two or more additional services.
2
4
1
1
32
16
16
12
12
8
8
16
4
4
**Each other service was indicated by only one local agency; including day care,
clinics open on weekends, clinics nearer migrants, and more advertisements.
Finally, participants were asked a series of questions con­cerning
their participation in the WIC program and about local
agencies that they encountered during 1978. Data on these
questions are shown in Table 3.14. Eighty-one percent (147)
of 181 respondents indicated that they were served by more
than one agency in 1978 and 53% (78) of the responding
participants indicated that they always or frequently re­ceived
directions as to the location of the next agency.
Thirty-nine percent (57) of the respondents indicated that
they rarely or never received directions. Participants were
also asked whether they found a WIC agency in the areas
where they stopped to work. Eighty-nine percent (146) of 164
responding participants indicated that they always or fre­quently
found a WIC agency and only ten or 6% stated that
they rarely or never found a WIC local agency in 1978. Most
participants not responding to this question indicated that
they were not served by more than one agency in 1978.
-43-
TABLE 3.14
SELECTED PARTICIPATION INFORMATION OF HOUSEHOLD/TRAVELING UNITS
CONTAINING WIC PARTICIPANTS
Number Percent
Number of household/traveling units served by more 147 81.2
than one agency (N=l81)
If served by more than one agency, frequency of
receiving directions to get to the next agency:
(N=l47)
Always 68 46.3
Frequently 10 6.8
Sometimes 11 7.5
Rarely 16 10.9
Never 41 27.9
No response 1 0.7
In 1978, did you find a WIC agency at the place
where you stopped to work: (N=l64)
Always 121 73.8
Frequently 25 15.2
Sometimes 8 4.9
Rarely 1 0.6
Never • 9 5.5
The interviewers also asked if the participants in
had ever been placed on a waiting list at any WIC agency.
Specifically, the question asked was as follows:
Were you every put on a waiting list to participate in the
WIC program after you were determined eligible at any
agency when you applied in 1978?
The respondents were to answer "yes," "no," or "not
applicable." Fifty-three (29.3%) of the 181 responding
participants indicated "yes" to this question, 126 (69.6%)
stated "no," and two (1.1%) stated "not applicable." Of
the 53 respondents who indicated that they were placed on
a waiting list, 48 (91%) indicated that they were served
by more than one local agency in 1978. On the other hand,
of the 126respondents who indicated that they were not
placed on a waiting list, 96 (76%) indicated that they
were served by more than one local agency and 23 (23%)
indicated that they were not served by more than one
agency. In terms of other data, the respondents indicat­ing
being put on a waiting list after determined eligible,
..
A.
B.
c.
D.
E.
F.
-44-
exhibited no characteristics (states of migration, prob­lem
with VOC card, etc.) that differed from respondents
were not put on a waiting list.
Participants were also asked about the services they found
at local agencies and problems encountered while visiting
local agencies in 1978 (Table 3.15). In general, for
services found at local agencies, the responses from the
participants interviewed followed the pattern of those of
the local agency administrators. Ninety-four percent of
the participants visiting the program found Spanish speak­ing
staff was available in Texas and 90% found such staff
in the upstream agencies.
TABLE 3.15
SERVICES OFFERED AT WIC AGENCIES VISITED
BY PARTICIPANTS IN 1978
Texa·s Upstream:!./
SERVICES N2/
Ntmlber
N~
Ntmlber
'Yes! Percent 'Yes'
Clinics open evenings (after 5 p.m.) 164 32 19.5 113 65
Clinics open weekends 174 2 1.1 115 21
Mobile Clinics 159 • 10 6.3 110 13
Transportation to/from Clinics 170 36 21.2 114 ' 45
Day Care for Children 170 23 13.5 113! 60
I
Spanish Speaking Staff 180 169 93.9 117 ; 105
Percent
57.5
18.2
11.8
39.5
53.1
89.7
!!Totals and percentages are based on 119 participants who had visited more than
one local agenciy and who had migrated outside of Texas during 1978.
Y The total number of respondents vary primarily because same respondents indi­cated
that an i tern did not apply to them or did not know.
-45-
As shown, only 20% of the participants responding found
clinics open evenings at Texas agencies whereas 58% of
the participants who visited upstream local agencies
reported finding clinics open after 5 p.m. There was
also a difference in the availability of child day care
services between upstream and Texas agencies. Specifi­cally,
only 13% of the participants responding found
day care for children at Texas agencies whereas 53% of
the participants who visited more than one local agency
and had migrated o~tside Texas reported the availability
of day care services.
Thirty-one respondents indicated other services that they
found at Texas local agencies. Fourteen of the 31 re­spondents
stated that they found medical, dental, and/or
family planning and job referral, welfare and education
services at the Texas local agencies. These services
were also found at upstream local agencies. In particular,
32 respondents who had migrated outside of Texas and had
visited more than one local agency commented about ser­vices
that they found at upstream local agencies. Ten of
the 32 respondents said that they found additional ser­vices
not usually associated with WIC program activities.
In addition, six respondents stated that they found fast
service, short waits and/or well trained staff at Texas
local agencies and seven respondents indicated likewise
for upstream local agencies.
When asked about problems participants encountered while
visiting local agencies in 1978, over half of the re­sponding
participants (103 of 179 responses, 57.5%)
indicated that long waits at the clinics were a problem
at Texas local agencies (see Table 3.16 on the following
page). Long waits at the upstream clinics were reported
by 26% (31) of 117 participant respondents who had
migrated outside of Texas and had visited more than one
local agency. ·
Participants also indicated relatively frequently that
clinic staff were not helpful both at Texas local agen­cies
and at upstream local agencies. For Texas local
agencies, 42% (74 of 177 interviews) reported that clinic
staff were not helpful and for upstream local agencies,
32% (37 of 117 interviews) also reported this.
Thirty-two respondents commented on problems encountered
at Texas agencies. Over half of the comments (17) were
related to the respondent having difficulties getting an
appointment at the clinic (especially if they had pre­viously
missed an appointment) and having encountered long
waiting lists. Other comments relating to Texas local
agencies were related to inexperienced and/or unorganized
-46-
staff (this was stated by six respondents). On the
other hand, five of 11 respondents providing additional
comments about upstream local agencies also indicated
problems related to inexperienced and/or disorganized
staff.
TABLE 3.16
PROBLEMS ENCOUNTERED BY PARTICIPANTS WHILE VISITING
WIC AGENCIES IN 1978
Texas UpstreamY
Problems
A. Clinics were hard to find
B. Transportation was hard to find
C. Clinic closed when you needed
to visit
D. Long waits at the clinic
E. Child care was hard to arrange
F. It was hard to find a store that
would take WIC coupons
G. No one at the WIC clinics spoke
Spanish
H. Clinic staff was not helpful
¢1 Number
'Yes'
180 11
176 45
178 35
179 103
167 58
179 13
178 52
177 74
Percent ~ Number 'Yes' Percent
6.1 118 18 15.3
25.6 116 21 18.1
19.7 117 12 10.2
57.5 117 31 26.4
34.7 104 19 18.3
7.3 117 8 6.8
29.2 117 31 26.5
41.8 117 . 37 31.6
!!Totals and percentages are based on 119 participants who had visited more than
one local agency and who had migrated outside of Texas during 1978.
Y The total number of respondents vary primarily because some respondents :indi­cated
that an item did not apply to them or did not know.
In many cases, the unavailability of bilingual staff was
reported as important. Specifically, 29% of the partici­pants
visiting Texas local agencies (52 of 178 interviews)
and 27% of the participants visiting upstream local agen­cies
(31 of 117 interviews) indicated that no one at the
WIC clinic spoke Spanish.
In terms of child day care services, although only 13% of
the respondents indicated that child care was available at
Texas local agencies, 35% (58 of 167 respondents) indicated this
as a problem encountered while visiting Texas local agencies;
18% (19 of the 104 interviews) indicated that child care was
ha _r~:L_1.P~rrang~ __ .tJ,pst ream.
-47-
With regard to transportation problems, 45 (26% of 176)
participants in Texas and 21 (18% of 116) participants
in upstream states indicated that finding transportation
was a problem. Participants were also asked an addi­tional
question relating to transportation; i.e., how
they got to and from the clinic. These responses are
summarized on Table 3.17. Sixty-three percent of the
respondents (115 of 182 interviewed) indicated that
someone in the household drove them and later returned
to pick them up. Fifty-six percent (101 of 182) of the
respondents indicated that they drove themselves in a car.
Clinic arranged transportation was used by only 7% (13)
of 182 participants. Other modes of transportation in­cluded
walking (stated by nine respondents) and a neighbor
drove (reported by eight respondents).
TABLE 3.17
TRANSPORTATION USED TO GET TO AND FROM THE
CLINIC FOR WIC SERVICES
Transportation N Number * 'Yes' Percent
Drove myself in a car 182 101
Someone in my household drove me and later picked 182 115
~~
Crew leader of labor contractor drove 182 0
Public transportation 182 2
Clinic arranged 182 13
Farmworkers' organization arranged 182 4
Some other transportation . 181 20
* Most respondents noted more than one way of getting to and from the clinics.
7. The Role of Farmworkers Organizations
The Food and Nutrition Services sought to increase partici­pation
of migrants in WIC and to remove barriers to partici­pation.
One means of accomplishing these objectives was
through cooperation with farmworker organizations. There
are two basic types of farmworker organizations. One is the
private non-profit organization chartered to seek funds
(federal, state, local, and private) to provide farmworkers,
be they migrant or seasonal, with the following: health
55.5
63.2
0.0
1.1
7.1
2.2
11.0
-48-
and medical services; employment; education; employment
training, and supportive social service assistance. A
second type is the state or local government agency
which provides services to migrant and seasonal farm­workers
in their localities. During the survey, state
and local agency administrators were asked about the
availability of these organizations and the extent of
cooperation. These administrators were also asked if
farmworker organizations performed some specific tasks
within the state or within the service area of the local
agency. Further, the participant interviews included a
question relating to the extent the households contacted
farmworker organizations when they arrived in an area.
With regard to the state agency responses, 12 of the 13
state agency administrators indicated that they inter­acted
with a farmworker organization within the state.
Further, seven of the 12 state agency administrators
indicated that the farmworker organization was very co­operative
(see Table 3.18, below). Only one of the 12
indicated a very uncooperative relationship.
TABLE 3.18
STATE AGENCIES' .EXPERIENCE WITH FARMWORKERS' ORGANIZATIONS
AS PART OF THE WIC MIGRANT DEMONSTRATION PROJECT
I Number
I 'Yes'
~b=e13~ of States Re.p orting Farmworkers' Organization . 12
State Agency's Experience:
1. Very Cooperative 7
2. Somewhat Cooperative 2
3. Neutral 2
4. Somewhat Uncooperative 0
5. Very Uncooperative 1
These state agency administrators indicated most frequently
that the farmworker organizations provided a referral ser­vice
and performed outreach to migrants (see T~ble_3.19,
on t~e following page). Some farmworker organ~zat~ons
operated WIC programs and therefore perform all of the
tasks specified.
-49-
TABLE 3.19
FUNCTIONAL TASKS PERF0~1ED BY FARMWORKER ORGANIZATIONS IN 1978
AS REPORTED BY STATE AGENCY ADMINISTRATORS
Number Number
Functional Tasks 'Yes' 'Don' t Know'
A. WIC referrals (interstate and/or 10 1
intrastate)
B. Outreach to migrants 10 1
c. Transportation to or from the clinics 8 2
D. Certification of migrants 8 .;
E. WIC food delivery 6 2
F. WIC nutrition education 7 1
G. Day care 6 2
H. Administration 7 1
II. Other 5 6
In the responses from local agencies, five of the upstream
local agency administrators and three of ~he Texas local
agency administrators indicated that there were no farm­worker
organizations with the agency's service area. How­ever,
of the 17 local agency administrators indicating an
organization in the area, eight (47%) indicated that there
was a very cooperative relationship existing (see Table
3.20 on the following page).
(
-so-
TABLE 3.20
LOCAL AGENCY EXPERIENCE WITH FARMWORKER ORGANIZATIONS AS
PART OF THE WIC MIGRANT DEMONSTRATION PROJECT
Experience
N
Texas
(N=l3)
Percent N
Upstream
(N=l2)
Percent
All Local
Agencies
(N=25)
N Percent
Number of Local Agencies Reporting 10 77 7 58 17 68
Farmworker Organizations
Local Agency Experience: (N=lO) (N=7) (N=l7)
1. Very Cooperative 2 20 6 86 8 47
2. Somewhat Cooperative 3 30 0 0 3 18
3. Neutral 3 30 1 14 4 24
4. Somewhat Uncooperative 0 0 0 0 0 0
5. Very Uncooperative 0 0 0 0 0 0
No Response!/ 2 20 0 0 2 12
Yo£ ten local agencies in Texas reported FWO in area served, one indicated
no interaction with FWO and did not respond, and for one data are not
available.
When asked what functional services farmworker organizations
performed, like the state agency respondents, the local
agency administrators indicated that the farmworker organi­zations
most frequently provided referral services and
performed outreach (see Table 3.21 on the following page).
-51-
TABLE 3.21
FUNCTIONAL TASKS PERFORMED BY FARMWORKER ORGANIZATIONS IN 1978
AS REPORTED BY LOCAL AGENCIES INDICATING THAT
AN ORGANIZATION WAS IN THE AREA
Functional ~~~~2/ u~N~7Tam , AifN~I~lfies
Task Number Number
'Yes' 'Yes' N Percent
A. wrc Referral 6 (2)Y 5 (0) 11 (2) 73
B. Outreach to Migrants 4 (1) 5 (2) .. 9 (3) 60
c. Transportation to/from Clime 1 (1) 3 (2) 4 (3) 27
D. Certification of Migrants 3 (3) 4 (3) 7 (6) 47
E. WIC Food Delivery 1 (0) 3 (3) 4 (3) 27
F. WIC Nutrition Education 3 (3) 5 (4) 8 (7) 53
G. Day Care 3 (0) 3 (2) 6 (2) 40
H. Administration 2 (2) 4 (3) 6 (5) 40
I I. Other Tasks ! 1 (1) I 1 (0) 2 (1) 13 I
!/Numbers in parenthesis indicate respondents including their own
agency as a farmworkers organization.
Y Qf ten local <J,gencies. in T~xas_r_eported. FWO in area $erved 1- one
1nd1cated no tnteract1on Wlth FWO and d1d not respond and ror
one data are not available.
Both the state agency and the local agency administrators
were asked if their agency had used the National Association
of Farmworkers' Organization Hotline (NAFO) during the
period of the Demonstration Prqject. The "HOT LINE" is com­prised
of seven community and nutrition program conduits
which form a communication network. The network provides
immediate information regarding local agencies, subcontrac­tors,
and other groups concerned with migrants to indivi­duals
or agencies requesting information. As can be seen
in Table 3.22 on the following page, only one state agency
and one local agency indicated the use of the hotline.
I
I
I
-52-
TABLE 3.22
NUMBER OF STATE AND LOCAL AGENCIES~/ USING NAFO* HOTLINE
DURING PERIOD OF THE WIC MIGRANT DEMONSTRATION PROJECT
Total Number Number Number
N 'Yes' 'No' Don't Know
State Agencies 13 1 11 1
Texas Local Agencies 10 1 8 1
Upstream Local Agencies 7 0 7 0
All Local Agencies 17 1 16 1
!!Local agencies responded to this question only if a farmworkers' organization
was known to be in the area served by agency.
* National Association of Farmworkers' Organization.
Finally, participants were asked how often they made contact
with a farmworkers program when they arrived in an area.
Fifty-four percent (97) of the 180 responding to the question
indicated that they never made such contact. Only 32% (57)
indicated that they always or frequently made such contact (see
Table 3.23, below).
TABLE 3.23
FREQUENCY WHICH PARTICIPANTS CONTACTED FARMWORKERS' PROGRAM
WHEN THEY ARRIVED IN AN AREA
Migrated Within
TotalY Migrated Within Texas and
Texas Only Elsewhere
Number Percent Number Percent Number Percent
Always 42 23.3 3 7.3 39 29.1
Frequently 15 8.3 0 - 15 11.2
Sometimes 24 13.3 2 4.9 21 15.7
Rarely 2 1.1 0 - 2 1.5
Never 97 53.9 36 87.8 57 42.5
Total 180 100.0 41 100.0 134 100.0
No response 2 - -
.Y Seven respondents selected for sample did not migrate in 1978. For
this question of the seven, one indicated sometimes, four indicated
never, and two did not respond to this question.
•
-53-
E. Participant Characteristics
A total of 182 interviews were conducted with households/traveling
units containing participants. As part of the interview, data were
collected on the 1977 and 1978 work sites and on the 1979 expected
work sites. A great deal of information was collected on the
characteristics and the size of the household/traveling units and
on the characteristics of housing encountered during 1978. The
data collected on these items provide a wealth of information on
migrant farmworkers in the mid-continental system and provide the
context for the findings on the components of the Demonstration
Project. The following sections present data on the migration
patterns, the characteristics of the households of WIC participants,
and the characteristics of household food preparation facilities.
1. Migration Pattern
Almost all of the participant interviews indicated that Texas
was the home state for the household or traveling unit. Further,
for the major work sites cited, those in Texas were mentioned
more frequently for 1977, 1978, and 1979. Other than in Texas,
the next most frequently mentioned work site locations for 1977,
1978, and expected work site locations for 1979 were in Michigan
or Minnesota, Ohio, North Dakota, and Nebraska (Table 3.24). A
total of 235 major work sites were reported for the 1978 migra­tion
by the 175 participant respondents. Fifty-six (24%) of
these work sites were in Texas and these work sites were visited
by 54 different respondents; 138 (59%) of the 235 work sites were
in the six states, Michigan, Minnesota, Ohio, North Dakota,
Nebraska, and Colorado.
Of the 175 respondents, 126 (72%) indicated that they went to
only one work site, 38 (22%) indicated that they went to two
work sites, and 11 (6%) went to three work sites in 1978.
For the seven most frequently cited states, 31%
went to Texas, and approximately 19% of the 175
who migrated went to Michigan and to Minnesota.
are summarized in Table 3.25 below.
TABLE 3.25
of the sample
respondents
These data
STATES MOST FREQUENTLY VISITED BY RESPONDENTS IN 1978
Number of Number ot
Work Sites Respondents
State Cited Citing Work Site Percent (N=l75)
Texas 56 54 30.8
Michigan . 39 34 19.4
Minnesota 35 33 18.9
Ohio 24 22 12.6
North Dakota 18 18 10.3
Nebraska 11 10 5.7
Colorado 11 10 5.7
TABLE 3.24
STATE SUMMARY OF MAJOR WORK SITES VISITED FOR WORK DURING THE 1977 MIGRATION SEASON,
DURING THE 1978 SEASON, AND WORK SITES WHICH PARTICIPANTS EXPECT TO VISIT IN 1979
(Total Number of Completed Interviews is 182)
MIGRATION IN 1977 MIGRATION IN 1978 EXPOCTED MIGRATION IN 1979
No. of Percent!! No. of 1/ States States Percent- States No. of ~rcent.!l Sites (N=l47) Sites (N=l75) Sites N=119)
Texas 43 29.3 Texas 56 "32. 0 Texas 33 27.7
Minnesota 31 21.1 Michigan 39 l2.3 Michigan 24 20.2
Michigan 26 18.7 Minnesota 35 ' 20.0 Minnesota 22 18.5
Ohio 24 16.3 Ohio 24 13.7 Ohio 15 12.6
North Dakota 15 10.2 North Dakota 18 10.3 North Dakota 14 11.8
Nebraska 12 8.2 Nebraska 11 6.3 Nebraska 7 5.9
Wisconsin 8 5.4 Colorado 11 6.3 Colorado 6 5.0·
Colorado 6 4.1 Indiana 7 4.0 Illinois 5 4.2
Florida 6 4.1 Iowa 7 4.0 Wisconsin 4 3.4
Illinois 6 4.1 ·Illinois 6 3.4
Iowa 5 3.4 .Wisconsin 6 3.4
Indiana · 4 2.7 Florida 4 2.3
Ten states 3 or les~ Six states 13 or less ITen states 3 or les<
TOTAL 203 235 147
----
!/The percent is based on the number of canpleted interviews less the non-response and inter­views
for ~1ich the participant stated that they either did not migrate in 1977, did not
migrate in 1 n7e, cr -::l.id no~ expec~ to "lir,rate in 1979. The t<:-i:Cli T1'Wllher of rP.o;;~n<:P.<: fnr
the adjusted percentages is 147 for 1977 migration, 175 for 1978 migration, and 119 for the
1979 migration.
..1
I
V1
~
I
•
-55-
Further, 40 respondents indicating a work site in Texas went
only to the one work site. The specific states visited in 1978
which were the only work sites indicated by a respondent are
indicated on Table 3.26 below.
TABLE 3.26
NUMBER OF HOUSEHOLDS/TRAVELING UNITS VISITING ONLY ONE WORK
SITE IN 1978 BY STATE
Number of Percent of
State of Major Interviews Households
Work Sites Indicating Only Visiting Only
Indicated One Work Site On.e Work Site
State By Respondent* Visited in 1978 (n = 175)
Texas 56 40 22.9
Michigan 39 18 10.3
Minnesota 35 21 12.0
Ohio 24 12 6.9
North Dakota 18 9 5.1
Nebraska 11 8 4.6
Colorado 11 5 2.9
Indiana 7 2 1.1
Iowa 7 1 0.6
Illinois 6 4 2.3
Wisconsin 6 0 0.0
Florida 4 1 0.6
Other States 11 5 2.9
TafAL 235 126 72.0
Number Visiting
Two Sites -- 38 21.7
Number Visiting Three Sites -- 11 6.3
Total for All
Responding 235 175 100.0
r··
* These numbers include units visiting more than one work site in a given state.
I
-56-
2. Characteristics of the Participants Interviewed
All
As noted previously, a total of 182 interviews were successfully
conducted. The interviews were conducted either with female or
male guardians of infant or child participants or with the women
participants. Therefore, in most cases, data were ebtained in a
single interview that represented the experiences of two or mar~
participants.
Based on these interviews, it was determined that the average
household/traveling unit size was 8.1 persons for participants
interviewed, the median number of persons per unit was 7.0
persons, and the mode was 4.0 persons (28 respondents, 15.3%).
For the households, there were on average 3.7 persons 16 or
older of which 1.9% were women. Additionally, there were on
average 2.2 persons between the ages of 6 and 15, 1.6 persons
1 to 5 years of age, and 0.5 infants per household/traveling unit.
The total number of persons in these households/traveling units
was 1,474, and approximately 28% (408) of the persons in these
units were participants of the Demonstration Project. These
data and additional information are provided in Table 3.27.
More detailed tables are in Appendix B.
TABLE 3.27
CHARACTERISTICS OF HOUSEHOLDS/TRAVELING UNITS OF
PARTICIPANTS INTERVIEWED ' Number Per Household/Traveling Unit
Responding
To Item* Total Mean Median Minimum Maximum
Total: All Persons · 182 1,474 8.1 7.0 2 44
Persons 16 or older 182 677 3.7 2.0 1 25
WOmen: 16 or older 182 342 1.9 i.o 0 12
Women who are Participants 182 99 0.5 0.0 0 3
Women who are Pregnant 182 31 --- --- 0 3
Persons 6 to 15 years:
TOTAL 182 403 2.2 2.0 0 12
Participants 182 6 --- --- 0 2
Persons 1 to 5 years:
TOTAL 182 299 1.6 1.0 0 10
Participants 181 222 1.2 1.0 0 6
Infants 0 to 12 months:
TOTAL 182 192 0.5 0.0 0 5
Participants 182 83 0.5 0.0 0 5
Total Number Participants 181 408 2.3 2.0 1 11
r
•
-57-
In terms of participation, 99 of the 342 (29%) of the women in
the WIC households of participants were participants of WIC. A
total of 222 of the 299 children (74%) aged one through five
were WIC participants, and 83 of the 92 infants (90%) were WIC
participants. In total, in the households/traveling units of
participants interviewed, 305 of the 391 (78%) children aged 0
to 5 years were participants of the WIC program. On average,
there were 2.3 participants for each household/traveling unit
which was interviewed .
As part of the participant questionnaire information was
obtained from the respondents on women who were with the house­hold
or traveling unit.* The questions asked about whether the
women did migrant agricultural work and the number of years of
such work. Approximately 91% of the 332 women for which data
were available did perform migrant agricultural work and 37.6%
.(123) of these women had worked for 1 to 5 years and !7. 7% (91)
of the women had performed migrant agricultural work for 6 to
10 years.
Questions were also asked the respondents about whether the
women in the household were pregnant, had an infant, and had a
child. Nine percent (31) of 329 women were known to be pregnant
and of this 31, 21 women were known to be pregnant before leaving
home. Approximately 31% (103) of the 331 women were a mother
of an infaat. Of the 103 women with an infant, 9 (8.7%)
indicated that they were breastfeeding the infants. Data were
also gathered on women with school-aged children. Fourty-eight
percent (158) of the women described had school-aged children
and of these 158 women described, 98% (155) indicated
having their children with them when they were traveling. In
addition, for 77 percent (121) of the 158 women with school­aged
children, their children did complete school before travel­ing.
These data are summarized on Tables 3.28, and 3.29 on the
following page.
The household/traveling units of the participants interviewed
tended to include complete families. More specifically, 159
(87.4%) of 182 respondents indicated that a husband and wife
were traveling together in the unit. Further, the persons
interviewed were queried on whether other members of the house­hold/
traveling unit were not with the traveling unit. Only
19 (10.6%) of 180 participant interviews indicated that there
were persons in their immediate family who were not with the
traveling unit. Only one interviewee indicated that a pregnant
women was not traveling, and three interviewees indicated that
a child between the ages of one and five years was not traveling.
None of the interviewees indicated that an infant of less than
12 months was not traveling. The data on persons who were part
of the unit but did not travel with the unit in 1978 are
summarized in Table 3.30 (page 59).
*For 14 (4%) of the women, data were not gathered by interviewers.
-58-
TABLE 3.28
FREQUENCY OF WOMEN PERFORMING AGRICULTURAL WORK AND YEARS OF WORK
Characteristics of Women Nt.unber "Yes" Percent
Women Performed Migrant Agricultural Work (N = 332) 303 91.3
Nt.unber of Years of Work (N = 303)
1 36 11.8
2 27 8.9
3 23 7.6
4 20 6.6
5 17 5.6
6 19 6.3
7 20 6.6
8 21 6.9
9 8 2.6
10 23 .. 7.6
11-15 37 12.2
16-20 32 10.6
21 or More 17 5.6
No Nt.unber Given 3 1.0
TABLE 3.29
CHARACTERISTICS OF WOMEN WITHIN TRAVELING UNIT AND
DESCRIBED BY RESPONDENTS
Characteristics of Women Nt.unber ''Yes" Percent
Women known to be Pregnant (N=329) 31 9.4
Women known to be Pregnant Before 21 67.7 Migration (N=31)
Woman is Mother of Infant (N=331) 103 31.1
Woman Breastfeeding the Infant (N=l03) 9 8.7
Woman is Mother of School-Aged 158 48.2 Children (N=328)
Women with School-Aged Children 155 98 .1 Traveling with Unit (N=l58)
Women with School-Aged Children Who
Left After School Year Was 121 76.6
Completed (N=l58)
r
-59-
TABLE 3.30
NUMBER OF HOUSEHOLDS/TRAVELING REPORTING MEMBERS
PERSONS NOT TRAVELING WITH UNIT IN 1978
Number of
Persons Not with Traveling Unit Units Reporting Percent
Any Person: (N==l80) * 19 10.6
Pregnant Women 1 0.5
Children Ages 1 - 5 3 1.7
Children Ages 0 - 1 0 0.0
* Data are not available for two respondents.
3. Household Food and Housing Data
As part of the assessment of the characteristics of the migrants
participating in the Demonstration Project, specific questions
were asked concerning the characteristics and the facilities
available to migrants during the migration season, and one
question asked whether a member or members of the household/
traveling unit were receiving food stamps. A total of 128
(71.5%) of the 179 persons responding to the question about
food stamps indicated that a member or members of the household
were receiving food stamps.
In regard to the questions above, characteristics of the housing
encountered by participants during the migration season,
Tables 3.31 and 3.32 present a summary of the responses.
TABLE 3.31
FACILITIES AND UTILITIES OFTEN FOUND AT MIGRANT CAMP HOUSING
USED BY PARTICIPANTS OF THE WIC MIGRANT DEMONSTRATION PROJECT
In 1978, did you often have the following Number
in your migrant camp housing (N=l63) ''Yes" Percent
A. A refrigerator 154 94.5
B. Safe indoor cold water 120 73.6
c. Safe indoor hot water 99 60.7
D. A wood stove 18 11.1 *
E. A gas, bottled gas or 158 96.9 electric stove
* Based on 162 responses.
-60-
TABLE 3.32
FACILITIES AND UTILITIES ALWAYS FOUND AT MIGRANT CAMP HOUSING
USED BY PARTICIPANTS OF THE WIC MIGRANT DEMONSTRATION PROJECT
In migrant camps, you stayed in the Number
St.UllmeT of 1978, did you always have: (N=l40) ''Yes" Percent
A. A refrigerator 133 95.0
B. Safe indoor water 105 75.0
c. A stove indoors 132 94.3
More specifically, Table 3.31 presents the number and percent
of households which often found certain facilities at migrant
camp housing during all of 1978. In particular, t he responses
indicated that a refrigerator (95%) and a gas, bottled gas or
electric stove (97%) were often available at migrant camp
housing. Only about 74% indicated that safe indoor cold water
was often available and 61% indicated that safe indoor hot water
was often available.
Table 3.32 provides information paralleling that shown on the
previous table. The reference period for this question was the
summer of 1978 which may have contributed to the greater number
of nonresponses. In this question, participant households
were asked about facilities and utilities always found at migrant
camp housing. As can be seen from the table, 95% of the 140
responding households indicated that they always encountered a
stove indoors and a refrigerator at the migrant camps. Only
75% of the responding households indicated that safe indoor
water was available.
(
' ..
-61-
CHAPTER 4
ASSESSMENT OF PROGRAM INNOVATIONS
A. Overview
The previous chapter of this report has presented descriptive and
statistical information about the WIC Migrant Demonstration Project
in terms of project components and agency and parti~ipant charac­teristics.
This chapter focuses on data collected during the
evaluation to assess the effectiveness of the primary fP.atures of
the Demonstration Project itself.
As noted in Chapter 3, there were four project-wide innovations.
that the projec~ addressed. These were the migrant VerificatioA
of Certification card, the migrant Participant Log, the WIC program
Directory of local agencies, and the nutrition education modules.
These features were present in all participating programs. During
the evaluation, state and local agency staff as well as participants
were asked a series of questions designed to assess these features.
This chapter has been organized first to describe the types of
questions that were asked, followed by a discussion of the findings
related to each area of questioning, both in terms of statistical
results and the implications of these findings. Although, overall,
a number of problems were identified by the various respondent
groups, almost all respondents recommended the continued use of the
feature or something similar. Further, in their opinion, the
identified problems could be corrected by better planning and
training.
B. Migrant Verification of Certification Cards
A problem experienced by migrants in the WIC program is the certi­fication
of WIC eligibility in each new location. The purpose of
the FNS-developed Verification of Certification (VOC) card available
under the Demonstration Project was to facilitate transfer of
certification, thus benefiting both migrants and program adminis­trators.
To assess the effectiveness of the certification cards,
state and local program administrators were questioned regarding
the extent to which their agencies encountered eligible migrants
who used the cards. In addition, these administrators plus migrants
participating in the WIC Demonstration Project were asked about
problems they may have experienced with the cards and for their
recommendations regarding future use.
1. Findings Regarding VOC's
Administrators in 12 states were asked how often eligible
migrants arrived in their state with VOC cards