Community Based Nutrition Programs

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Each community will have a unique response to the need for adolescent services and for others in need of nutrition support. There may be churches or food pantries that assist those with food insecurity. Health care professionals should become familiar with these local resources (or with the social worker, nurse, or person in the office answering the phones who knows these resources), understand how they can be utilized to assist the adolescent, and know their limits. Networking with community health care providers and health service employees is a skill that can be modeled for these young learners.

In addition, each community should have some way to access the WIC program. Many adolescent patients will be eligible for WIC services. To be eligible, the pregnant adolescent must meet specific residency, income, and nutritional risk criteria as specified by WIC. To qualify based on nutritional risk, the adolescent must have a medically-based risk such as anemia, be underweight (less than 100 pounds) or overweight (over 200 pounds), have a history of pregnancy complications or poor pregnancy outcomes, or have other dietary risks such as failure to meet the dietary guidelines for any food groups or have inappropriate nutrition practices, e.g., pica.

The WIC fact sheet states in part [31]: "In most WIC state agencies, WIC participants receive checks or vouchers to purchase specific food each month that are designed to supplement their diets. A few WIC state agencies distribute the WIC foods through warehouses or deliver the foods to participants' homes. The foods provided are high in one or more of the following nutrients: protein, calcium, iron, and vitamins A and C. These are the nutrients frequently lacking in the diets of the program's target population. Different food packages are provided for different categories of participants.

"WIC foods include iron-fortified infant formula and infant cereal, iron-fortified adult cereal, vitamin C-rich fruit or vegetable juice, eggs, milk, cheese, peanut butter, dried beans/peas, tuna fish, and carrots. Special therapeutic infant formulas and medical foods may be provided when prescribed by a physician for a specified medical condition."

The WIC program was started in 1974. Since its inception, numerous studies have been performed to evaluate its effectiveness, and it has earned a reputation of being one of the most effective nutrition intervention programs in the United States [32]. Various studies performed by Food and Nutrition Services (FNS) of the US Department of Agriculture (USDA) and other entities have demonstrated benefits for WIC participants including longer pregnancy duration, less low-birth-weight infants, reduced infant morbidity and mortality, improved infant feeding practices, and higher diet quality of pregnant and postpartum mothers [32].

The WIC program is a proven effective resource that should be pursued for any pregnant adolescent who qualifies. The general guidelines for the program are nationwide, but each individual state has flexibility in implementing the program. Contacting the local agency implementing the program and obtaining details of community specifics will allow tailoring of interventions to build around the existing programs. The webpage www.fns.usda.gov/wic/Contacts/ContactsMenu.HTM has agency contacts listed by state. Providing a list for your patients of the locations of WIC offices along with other local resources such as food banks, churches with meals, etc should be considered.

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