title: Women, infants, and children cash value voucher (CVV) use in Arizona: a qualitative exploration of barriers and strategies related to fruit and vegetable purchases.
abstract: OBJECTIVE
  Women, Infants, and Children (WIC) cash value vouchers (CVV) have been inconsistently redeemed in Arizona. The objective of this study was to explore perceived barriers to use of CVV as well as strategies participants use to overcome them.
  
  
  METHODS
  Eight focus groups were conducted to explore attitudes and behaviors related to CVV use.
  
  
  METHODS
  Focus groups were conducted at 2 WIC clinics in metro-Phoenix, AZ.
  
  
  METHODS
  Participants in WIC who were at least 18 years of age and primarily responsible for buying and preparing food for their households.
  
  
  METHODS
  Perceived barriers to CVV use and strategies used to maximize their purchasing value.
  
  
  METHODS
  Transcripts were analyzed using a general inductive approach to identify emergent themes.
  
  
  RESULTS
  Among 41 participants, multiple perceived barriers emerged, such as negative interactions in stores or confusion over WIC rules. Among experienced shoppers, WIC strategies also emerged to deal with barriers and maximize CVV value, including strategic choice of times and locations at which to shop and use of price-matching, rewards points, and other ways to increase purchasing power.
  
  
  CONCLUSIONS
  Arizona WIC participants perceived barriers that limit easy redemption of CVV. Useful strategies were also identified that could be important to explore further to improve WIC CVV purchasing experiences.
authors.affiliation: Gretchen Swanson Center for Nutrition, Omaha, NE.
authors.forename: Farryl M W
authors.initials: FM
authors.lastname: Bertmann
authors.affiliation: School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ.
authors.forename: Cristina
authors.initials: C
authors.lastname: Barroso
authors.affiliation: School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ.
authors.forename: Punam
authors.initials: P
authors.lastname: Ohri-Vachaspati
authors.affiliation: School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Hampl
authors.affiliation: Arizona Department of Health Services, Bureau of Nutrition and Physical Activity, Phoenix, AZ.
authors.forename: Karen
authors.initials: K
authors.lastname: Sell
authors.affiliation: School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ. Electronic address: Christopher.Wharton@asu.edu.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Wharton
mesh_terms: D001130:Arizona; D002648:Child; D005260:Female; D017144:Focus Groups; D005522:Food Services / Q000191:economics*; D005523:Food Supply / Q000191:economics*; D005638:Fruit; D006801:Humans; D011203:Poverty; D014675:Vegetables
keywords: WIC food package; cash value vouchers; focus group; food access; fruits; low-income; vegetables