# A Qualitative Study To Understand Parental, Health Care Provider and WIC Nutritionist Perspectives on Early Childhood Beverage Choices for WIC-enrolled Families in a Southeastern US Health System

## TL;DR

This study explores how parents, WIC nutritionists, and healthcare providers in the southeastern US view beverage choices for young children, revealing communication gaps and differing opinions on juice and tap water.

## Contribution

The study uniquely includes perspectives from WIC nutritionists and clinicians alongside parents, highlighting communication barriers and differing views on juice and tap water safety.

## Key findings

- Parents and providers agree children should avoid sugar-sweetened beverages but disagree on tap water safety.
- Parents support fruit juice in WIC packages, while clinicians oppose it.
- WIC nutritionists and clinicians face communication challenges but see value in better coordination.

## Abstract

Nutritionists for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), along with healthcare providers, can influence beverage choices for young children in WIC-enrolled families. Coordination of messaging about beverages and between-provider communication may be important for facilitating behavior change.

In preparation for a planned intervention, during Spring through Fall of 2021, we conducted a qualitative study to understand perceptions around family beverage choice discussions across three groups: parents of WIC-enrolled children, WIC nutritionists and practicing clinicians. Semi-structured interviews were conducted with 25 individuals, with sample size determined a priori. Thematic content analysis was used to summarize transcribed data.

There was broad agreement that children should not consume sugar-sweetened beverages (SSB), but disagreement on tap water safety. Both clinicians and WIC nutritionists reported educating families about healthy drink choices, and parents recalled similar messages during these conversations. Parents were very supportive of fruit juice as part of the WIC package, with near universal opposition among clinicians. Many parents expressed concerns about tap water. Both provider groups perceived difficulty in reaching out to each other, and felt more communication would be helpful.

Our findings highlight a need for more regular communication between WIC nutritionists and children’s healthcare providers within our system, and more consistent parental education on juice and tap water safety. Future studies could evaluate whether these types of communication gaps and perceptions are regional or more widespread across the US.

Prior studies explored perceptions of WIC-enrolled families regarding beverage choice. Our study builds on this by interviewing WIC nutritionists and clinicians to better inform consistent family counseling around beverage choices. Our findings showed broad agreement across groups that children should not consume SSB, but parents expressed concerns about tap water. Parents and WIC nutritionists were supportive of fruit juice being part of WIC package, while pediatric clinicians were almost universally opposed to this. Both provider groups reported difficulty in communicating with each other about patients, but felt it would be helpful if there were a way to efficiently do so.