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Section 5.3: Nutrition Risk Assessment 2/2021 Section 5.3: Nutrition Risk Assessment Overview References: WIC Policy Memo #98-9, 7 CFR 246.7(e) (1)-(3) Policy: Local Agency CPAs must conduct a thorough assessment of nutrition risk during the certification process. Purpose: Nutrition risk assessment is the process of obtaining and synthesizing information about a participant’s nutrition and, as appropriate, breastfeeding status in order to provide the most appropriate individualized WIC services. The nutrition assessment is the foundation on which all subsequent nutrition services are based: nutrition education, an individualized food package, and referrals to other health and/or social services providers. The nutrition risk assessment includes an evaluation of: ▪ Anthropometric information ▪ Hematologic information ▪ Health and medical history ▪ Dietary information ▪ Breastfeeding information, as appropriate Procedures The assessment process is meant to be a conversation between the CPA and participant/caregiver. To conduct a WIC nutrition assessment, CPAs must: 1. Accurately collect anthropometric, hematologic, health and dietary information. Anthropometric and hematologic assessments should be done first. Identifying any height, weight, or blood-iron concerns first, provides a context for assessment information collected in the Information System. ▪ Anthropometric and hematologic information should be obtained using standard procedures outlined in the anthropometric and hematologic assessment policies. ▪ Health and dietary information must be collected using the questions in the Information System. Probing questions should be used as appropriate to collect relevant, accurate information. This helps the CPA assess a participant’s health, nutrition practices, cultural values, preferences, and other pertinent areas.

S E C T I O N 5 . 3 : N U T R I T I O N R I S K A S S E S S M E N T O V E R V I E W 2 2. Clarify and synthesize the information that has been collected. 3. Identify and assign all applicable risk codes and any other relevant concerns. 4. Document the assessment in the Information System, including all applicable risk codes. 5. Follow up on previous assessments, as appropriate. 6. After all components of the WIC assessment are completed, provide education based on highest priority risk conditions and participant’s interests. Note: it is not expected, nor is it recommended, that all nutrition risks be addressed (i.e., counseled/educated on) at the initial certification. See Guidance. Guidance A value-enhanced nutrition assessment (VENA) requires: ▪ A systematic approach to collecting and evaluating information provided by participants ▪ Good communication skills and an ability to establish rapport with each participant ▪ Knowledge of nutrition and breastfeeding ▪ Critical thinking 1. It is best practice to review previous assessments and relevant notes in the participant’s record prior to beginning the new assessment. 2. To enhance the value of the assessment, it is critical the assessment be conducted in space that provides privacy to participants. 3. Only after all information has been reviewed and all nutrition risks identified, should education or counseling be provided. ▪ Conclusions based on incomplete information might be incorrect. ▪ Education based on incorrect conclusions is likely to be inappropriate. It is important to understand the underlying causes before exploring possible solutions with participants. For example, it would be inappropriate to discuss dietary recommendations for addressing low hemoglobin before completing all aspects of the assessment. Until the nutrition assessment has been completed, the CPA would not know what dietary factors may be related to the low blood iron. CPAs should prioritize the nutrition issues to be addressed, in collaboration with each participant. Those of greatest importance and/or interest should be addressed first. Other concerns can be addressed at subsequent WIC nutrition visits. Minnesota Department of Health - WIC Program 625 Robert St N, PO BOX 64975, ST PAUL MN 55164-0975; 1-800-657-3942, health.wic@state.mn.us, www.health.state.mn.us. To obtain this information in a different format, call: 1-800-657-3942 This institution is an equal opportunity provider.