Graduation Year


Document Type




Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Community and Family Health

Major Professor

Carol A. Bryant, Ph.D., M.S.

Committee Member

Russell Kirby, Ph.D., M.S., FACE

Committee Member

Martha L. Coulter, Dr.P.H., M.S.W.

Committee Member

Julie Baldwin, Ph.D.

Committee Member

William Sappenfield, M.D., M.P.H.

Committee Member

Kathleen O’Rourke, Ph.D., M.P.H.


CHAID, Focus Groups, Nonparticipation, Outreach, Survival Analysis


The purpose of this dissertation is to understand why individuals enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) fail to retrieve food vouchers, miss WIC appointments, and become inactive in program components. In Kentucky, mothers who fail to pick up food instruments for 60 days are automatically terminated from the program. The specific research questions that guided this study are: (1) Which segments of enrollees are at greatest and least risks of nonparticipation in the WIC program? (2) How do predisposing, enabling and need characteristics impact WIC nonparticipation among eligible mothers? (3) How do WIC enrollees describe their experiences using WIC? (4) What do WIC enrollees report as reasons for nonparticipation while still eligible? Addressing these research questions will inform the development of practical outreach solutions specifically tailored for the purpose of mitigating nonparticipation in WIC and contribute to our understanding of the factors that deter eligible families from using government assistance programs like WIC.

Included in

Public Health Commons