Research & Practice

An Exploration of a WIC Staffing Model Allowing Intermediate Nutrition Risk Appointments to Be Completed by Bachelor-Level Nutrition Consultants

The Washington State Department of Health (DOH) requested an examination of WIC staffing models in all US states to determine the feasibility of allowing bachelors-level nutritionists to perform intermediate nutrition risk appointments rather than registered dietitians (RD.) This project aimed to address WIC staffing shortages and their lack of access to RDs, particularly in rural areas, which would be compounded by new requirements forthcoming for RDs. The potential policy change was assessed for its impact on WIC participant access to quality nutrition services and diversity in dietetics. Qualitative interviews with WIC leadership and an examination of WIC data reports addressed the following questions:

  • What are the current trends in WIC staff recruitment and retention?
  • Why are WIC clinics currently facing higher rates of staff turnover than in the past?
  • How might the staffing of bachelors-level nutritionists in WIC clinics impact participant access to quality nutrition services?
  • Which risk criteria should be included as “intermediate risk”?
  • How might this potential policy change impact diversity among WIC nutritionists?
  • How might WIC-registered dietitian wages and job security be impacted by this policy change?
  • What are the equity considerations to consider with this policy change?

Based on interview themes, current practices in other US states, scrutiny of Didactic Programs in Dietetics (DPDs), trends in WIC Risk Code Reports, and the 2021 WIC Recruitment and Retention Survey, it is recommended that Washington allow WIC agencies the option of having bachelors-level nutritionists conduct intermediate nutrition risk appointments. To further explore this policy, the WA state DOH may conduct interviews and/or focus groups with WIC certifiers and RDs and distribute surveys among WIC participants to ensure all perspectives are heard before enacting change.

Community Partner: WA State Department of Health, Division of Prevention and Community Health

Materials Available

Project Type(s): MPH Practicum

Author(s): Megan Fisher

Program(s): Master of Public Health, RDN Training

Year: 2023