Variation in WIC Cash-Value Voucher Redemption Among American Indian Reservation Communities in Washington State

ABSTRACT: In 2009, a cash-value voucher (CVV) was added to the U.S. Department of Agriculture (USDA) Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) package to encourage fresh fruits and vegetable purchases. Access to fresh fruit and vegetables on American Indian (AI) reservations is limited. We compared the average proportion of CVVs redeemed between 27 reservation-based WIC clinics with 185 non-reservation-based WIC clinics and the proportion of CVVs redeemed in WIC clinics in tribes with high access to fresh fruits and vegetables with their counterparts with low access. Reservation-based WIC clinics had significantly lower CVV redemption compared to non-reservation-based clinics (65 vs 81%, respectively, P <.0001). Additionally, CVV redemption was similar among reservation-based WIC clinics where a supermarket was located within or outside the reservation. CVV redemption is significantly lower in tribal than non-tribal WIC clinics. Research is needed to identify barriers to CVV redemption within the tribal WIC population.