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Section 6.7: Additional Nutrition Education 08/2026 References: 7CFR 246.11(e)(2) Policy: Provide additional nutrition education during the certification period. Purpose: To ensure that additional nutrition education is made available to all participants throughout their certification period. Definitions Additional Nutrition Education: Education contacts that occur at a time other than the certification appointment. Contact: A contact is an interaction between the nutrition educator and the participant to explore opportunities for behavior change, provide anticipatory guidance, and address areas of nutrition risk. Procedures Procedures for providing high risk care are not included in this policy. Participants with a high risk nutrition related condition receive additional care and follow up as outlined in Section 6.6: High Risk Individual Nutrition Care Plans. Content of additional nutrition education contacts: ▪ Is based on the participant’s nutritional needs and category (i.e., risks, participant concerns, and anticipatory guidance). ▪ Includes follow-up to medical referrals and other referrals as needed. See Section 5.7: Referrals. Number of additional nutrition education contacts is based on the length of the certification period. ▪ For participants certified for a period greater than 6 months, nutrition education contacts shall be made available at a rate equivalent to quarterly. This includes the education provided at the initial certification, see Section 6.3: Initial Education, and mid-certification appointments, see Section 5.10: Mid-certification.

S E C T I O N 6 . 7 : A D D I T I O N A L N U T R I T I O N E D U C A T I O N 2 ▪ For example: A child certified for one year will receive an initial contact at certification, an educational contact at mid-certification and two additional nutrition education contacts. This provides four contacts in the one year certification period. ▪ Participants certified for a period of six months or less should be provided a minimum of one additional nutrition education contact, in addition to the initial contact at certification. ▪ For example: Pregnant women certified for more than one month must be offered additional nutrition education before their due date. Delivery methods/mediums for additional nutrition education should be interactive and accommodate individual learning styles and needs. Types may include: ▪ Individual: Nutrition education provided to the participant/parent/guardian or proxy based on the unique needs of the participant and/or interests. Individual contacts may be provided in person, by phone or video calls. ▪ Group: A class or facilitated discussion with a qualified instructor. The group contact should be relevant to the participant’s category. ▪ Self-Guided: Pre-approved web-based nutrition education or other interactive media. This option requires that the participant be given the opportunity to interact with a CPA to discuss the content of the self-guided contact and to ask questions. The CPA should follow- up on any goals or strategies that the participant identified at the end of the self-guided contact. See Guidance for wichealth.org. ▪ Other methods as described and approved in the local agency Nutrition Education Plan. Documentation Documentation of additional nutrition education should promote continuity of care. Follow documentation procedures as outlined in the local agency Nutrition Education Plan. See Section 6.8: Nutrition Education Documentation. Maintain confidentiality Individual contacts should be conducted in a private area rather than in a public waiting room. Participants should not be asked to share private, confidential information in a public or group setting. Missed Contacts If an additional nutrition education contact is missed and not be rescheduled during the current benefit period due to the participant/parent/guardian’s availability, issue one month of benefits and schedule the contact for the following month. If the participant/parent/guardian refused nutrition education, document that in their record.

S E C T I O N 6 . 7 : A D D I T I O N A L N U T R I T I O N E D U C A T I O N 3 Guidance Create and offer options to reduce barriers to nutrition education. Transportation, childcare, and work obligations can make it difficult for families to participate in nutrition education activities. Participants can choose how they would like to receive nutrition education at follow up visits. Options include education by telephone, video call, self-guided modules, or in WIC clinic. Remote Nutrition Education provides guidance on strategies to offer nutrition education outside of the WIC clinic setting. Timing of contacts Additional nutrition education contacts should be provided at a rate equivalent to quarterly, but not necessarily every 3 months. Consider the needs of the participant when scheduling their follow-up. For example, a CPA may choose to provide an additional nutrition education contact one month after an infant’s initial certification to support continued breastfeeding, rather than waiting three months. Wichealth.org wichealth.org: is a pre-approved web-based program available to local WIC participants in Minnesota for self-guided nutrition education. It is intended for participants considered low- risk, with no high risk conditions. For guidance on using wichealth.org visit Remote Nutrition Education. For households with multiple members, the family may complete one lesson. However, as with in-person educational contacts, education should be relevant and individualized to the category and needs of each family member. ▪ Follow up to the on-line lesson should include discussion of any family member’s nutrition/health in a category not covered by the on-line lesson. Example: A family includes breastfeeding mother, 5 month old infant and a 4 year old child. Mom completed a wichealth.org lesson about snacking for children. When contacting the household for follow-up, the CPA should follow up on mom and infant’s nutrition and health needs/concerns and provide education as needed. Document education in each member’s record. ▪ Follow-up on self-guided nutrition education may be by phone, video call or text/email. When using texting/emailing, assure the same opportunities for follow-up are offered to the participant as with phone/video calls. This includes an interaction between the CPA and participant to allow the participant to ask questions and to schedule their next WIC recertification, mid-certification, or additional nutrition education contact. Assure Data Privacy is maintained, see Section 1.7: Data Privacy.

S E C T I O N 6 . 7 : A D D I T I O N A L N U T R I T I O N E D U C A T I O N 4 Additional Education provided by an outside entity An outside entity may provide additional nutrition education for participants if the following criteria are met: ▪ The additional nutrition education content is appropriate for the individual’s nutritional risks and nutritional interests, the encounter is within the current WIC certification period and the education is documented. ▪ Services provided by staff from an outside entity must be within their scope of practice. ▪ WIC CPA staff should be present in the area to respond to questions that are beyond the scope of knowledge/practice of the outside entity staff person. ▪ Lesson plans written by the outside entity for the additional nutrition education contacts should be reviewed and approved by the local agency Nutrition Education Coordinator. ▪ If an outside entity staff person is used for providing additional nutrition education, local agencies are encouraged to enter into an annual agreement with the entity addressing the following roles/expectations: ▪ Time period the agreement covers. ▪ Responsibilities of the staff from the outside entity: e.g., day(s) of month staff will provide contacts; topic(s); length of clinic day; arrangements for backup, if staff is unable to attend the WIC clinic; and assurance that participant confidentiality will be maintained. ▪ WIC responsibilities: providing space, setting up the room, communication regarding schedule changes and materials, and CPA staff present to answer participant questions. ▪ The contacts should be documented per the local agency documentation procedures. See Section 6.8: Nutrition Education Documentation. Exit Counseling ▪ Exit counseling is encouraged as part of an additional education individual contact for all breastfeeding and non-breastfeeding postpartum women before their certification ends. Exit Counseling helps build a solid foundation for good nutritional health, beyond a woman’s eligibility for WIC benefits. ▪ Exit counseling can include verbal education and/or written information (hard copy or electronic) on the topics listed below. The purpose of Exit Counseling is to reinforce the nutrition education and breastfeeding promotion provided during WIC participation. Document the exit counseling education and written information provided in the participant record: ▪ The importance of preconceptual folic acid intake in reducing neural tube defects. Share the message that folic acid supplementation before a future pregnancy can lower the risk of neural tube defects.

S E C T I O N 6 . 7 : A D D I T I O N A L N U T R I T I O N E D U C A T I O N 5 ▪ Encourage breastfeeding as the preferred method of infant feeding ▪ The importance of immunizations ▪ The health risks associated with the use of alcohol, tobacco, and other drugs ▪ The need for a well balanced diet ▪ Referrals as appropriate Reference – Complete Listing of Hyperlinks Section 6.6: High Risk Individual Nutrition Care Plans (https://www.health.state.mn.us/docs/people/wic/localagency/program/mom/chsctns/ch6/sct n6_6.pdf) Section 5.7: Referrals (https://www.health.state.mn.us/docs/people/wic/localagency/program/mom/chsctns/ch5/sct n5_7.pdf) Section 6.3: Initial Education (https://www.health.state.mn.us/docs/people/wic/localagency/program/mom/chsctns/ch6/sct n6_3.pdf) Section 5.10: Mid-Certification (https://www.health.state.mn.us/docs/people/wic/localagency/program/mom/chsctns/ch5/sct n5_10.pdf) Remote Nutrition Education (https://www.health.state.mn.us/people/wic/localagency/edchoice/index.html) Section 6.8: Nutrition Education Documentation (https://www.health.state.mn.us/docs/people/wic/localagency/program/mom/chsctns/ch6/sct n6_8.pdf) 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.