Background:
The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a federally funded food and nutrition education program for pregnant, breastfeeding, and postpartum women, infants and children under the age of five who are low to moderate income (up to 185% of federal poverty level) and at nutritional risk. Approximately 25% of the WIC participants are women, 25% are infants and the remaining 50% are children age one to five.
PHFE-WIC, a nonprofit agency that has been providing WIC services in the Los Angeles and Orange Counties for over 25 years, is the largest local WIC agency in the United States, serving approximately 4% of the nation's total and 25% of California's total WIC participants for over 25 years.
Integrating interconception care into the WIC setting is ideal in improving pregnancy outcomes. Among Los Angeles County WIC participants, the rates of premature births rose from 5.5% to 6.4% between 2003 and 2006 -- a startling increase of 16.4%. Closely spaced pregnancies with conception less than 16 months postpartum, a known risk factor for adverse birth outcomes, hover around 19% among the Los Angeles County WIC population. While WIC is primarily a nutrition education and referral program, PHFE-WIC is in the unique position of being a primary point for the underserved and hard to reach women of reproductive age in Los Angeles County.

Objectives:
By the end of the presentation, participants will be able to: 1. Describe the opportunity for interconception care integration into the WIC Program. 2. Identify at least two components of the WOW Project.

Methods:
The “WIC Offers Wellness” (WOW)Program, funded by the March of Dimes, is a prematurity prevention demonstration project providing care coordination services to low-income mothers who have recently delivered a preterm and/or low birthweight baby. Women who deliver preterm have a greatly increased risk of recurrent poor pregnancy outcomes, and this project is designed to lessen this risk through screening, health promotion and psychosocial intervention services. WOW services will be provided to up to 240 women at one Los Angeles County PHFE-WIC Center in order to optimize their health, support family planning, and maximize their chances for a subsequent full-term healthy pregnancy.

Results:
The WOW Project is designed to show that care coordination of high-risk women who receive WIC services will dramatically increase women's chances of a healthy subsequent pregnancy. The primary objectives of the project are to improve the health status of women who have recently delivered a preterm and/or low birthweight baby, to increase pregnancy intervals and rates of planned pregnancies, thereby reducing the incidence of repeat premature births to low-income women.

Conclusion and implications for practice:
In Los Angeles County, 69% of all infants born are enrolled in WIC, and over 91% of all low-income infants are served by the WIC Program. Families visit WIC through multiple pregnancies and WIC is one of very few services that low-income women access at least four times a year. Success of this project has local and national implications as WIC services are available in every County in the United States.