"Now I feel like participants really want to be here. They are more interested in what is happening in the WIC office."
How Did WIC Participants and Staff React to Emotion-Based Approaches?
Touching Hearts, Touching Minds (THTM) project leaders dreamed of transforming nutrition education. They believed emotion-based approaches had the potential to connect WIC staff and families in new ways. And they were passionate change agents in pursuit of creative solutions. But their dreams, beliefs and passion, unless shared by others, would be meaningless.
Using focus groups and online surveys, THTM project leaders listened to WIC staff and WIC mothers before, during and after project implementation. This section contains their reactions to THTM emotion-based materials and approaches.
Reactions of WIC Staff to Touching Hearts Touching Minds Emotion-Based Materials
The Massachusetts WIC program selected six pilot WIC agencies to use emotion-based materials and approaches. Staff from the pilot agencies attended formal training to become familiar with the materials and approach before using them for 15 months. They were encouraged to use materials in groups and individual counseling situations.
In general, WIC educators responded positively to emotion-based materials. Emotion-based materials resonated with their vision of what nutrition education should be. WIC educators were excited to use them with individuals and groups.
Although most were eager to use the THTM techniques, a few educators found traditional, factual approaches more in tune with their training and perceptions and therefore preferred straightforward materials focused on facts rather than emotions. They felt more comfortable in the role of information provider.
Most WIC staff liked emotion-based materials
After adjusting to the materials, most WIC staff preferred emotion-based materials.
"I like the handouts. We are not bombarding them with nutrition information anymore. The recipes are great!"
"I am very enthusiastic about the materials and approach. But you have to like them to make it work. If you are unsure or dislike them, it wonít go well. If it doesnít flow for me, it wonít flow for my clients. If I am easy and natural, then they will be too."
"I would not want to go back to the way things were before the Touching Hearts, Touching Minds project. I like seeing the parents open up more. I use the handouts as "stepping stones."
"There is less nutrition rigidity."
The emotional tone of the materials set the stage for emotion-based conversations
"They provide a mode of approaching people with more ease."
"Before I was the only one talking and explaining materials. Now everyone gives feedback about everything to the point where I no longer talk."
"I try to connect with them more."
"I find my counseling to be more conversational now than 'teaching.'"
"It is easier to find things to talk about and it doesnít feel like we are telling them what to do."
"I use more emotional messages. I make an extra effort to recognize their needs."
"I think that they have helped me to key in to the clientsí emotions."
"I approach counseling in a different way and ask questions differently."
Many WIC staff enjoyed using emotion-based materials in groups
Most WIC staff enjoyed using emotion-based materials in groups. Those who responded favorably to group interaction reported being comfortable with this approach and said their groups were comfortable and relaxed. This allowed participants to "open up" in new ways and reveal personal experiences. Some staff thought the participants preferred education in groups more because they could talk to other mothers and add individual input.
"I absolutely love doing this!"
"My clients enjoy the groups. I always tell them they are not obligated to talk but ask them to give it a chance. A lot of times, they get started talking and a group can last for 30-45 minutes. I have to force them to go and get their checks."
"The connection between participants and staff has strengthened because we are not preaching to them anymore. They seem to value what we say more because of that. Without a doubt, I would not want to go back to the way things were before Touching Hearts, Touching Minds! Everyone at this clinic loves it."
"At first, WIC participants were uncomfortable. Now, everyone talks and good conversation is generated. Groups take a little longer than usual but they like them and after awhile they donít mind the length. Connections are stronger and education is valued more. They get personal experiences from other participants and they value those more than lectures."
To assist WIC staff concerned about group sessions, the Massachusetts WIC program developed The WIC Parent Connections, a training video on emotion-based group facilitation. You can view this training video by going to the "Implementation tools" heading on this website and clicking on "Training Video." In addition, practical tips for group facilitation can be found under the same "Implementation tools" heading; click on "Tips for Emotion-Based Counseling."
WIC Participant Reactions to Touching Hearts Touching Minds Emotion-Based Approaches
Participants greatly preferred emotion-based materials over traditional fact-based materials. This summary provides insights into how WIC mothers felt about emotion-based materials:
Participants react positively to images featured in emotion-based materials
"Itís literally better quality, like a fancy magazine. It feels good to the touch. More personal too."
"They are smiling and they are real people. Not cartoon drawings."
"Something a mother would pick up. Someone who has been there and done that."
"This looks like something you would find in your pediatricianís office. Or a magazine."
"This (traditional WIC brochure) makes me feel like Iím poor and I canít afford milk or whatever. When I look at this, (emotion-based approach), it just looks normal, like any parent would get. ...Just because weíre poor doesnít mean weíre dumb."
"The information might be the same, but itís true that there is a feeling that goes along with itÖ.When you go to a restaurant and you get a piece of paper with a menu, itís just not as nice as when you go to a nice restaurant and itís more colorful, there are pictures and itís just a nicer place to eat. The food might taste the same in both restaurants, but it feels nicer to have it look better."
Participants react positively to emotion-based graphics and copy
Parents are unlikely to attend to or act on messages that make them feel bad about themselves, their parenting, their children or their choices. Traditional, logic-based materials were associated with negative feelings while emotion-based materials made participants feel better about themselves and their participation in WIC. Participants reported being engaged and attentive to the writing style and graphics.
"It catches you because the phrases pop out at you so you want to be interested in what the rest says. So you just want to read it."
"They were written for someone who has intelligence."
"I think this is written for all ages actually."
"I would pick it up."
"They tell you how it really is."
"You learn without knowing it."
"Itís more real to your life situation."
"I didnít even know they came from WIC..."
"Good conversation starter."
Participants find personal testimony moving, interesting and helpful
Mothers were moved by the personal experiences and stories of other WIC mothers featured on the backs of the emotion-based materials. Reading the honest, often painful stories of those who "walk in their shoes" made the information more relevant, captured their hearts, and made them think differently about familiar topics.
"I think itís good to see that somebody talked about it (baby bottle tooth decay) . Because this is me and my daughter, except that I didnít have another child. She just wanted that bottle so bad. And I donít even talk about it that much because itís not something a lot of people talk about. My daughter has no front teeth. There is nothing there and she had her school picture today and I cried all morning because I know she has no teeth in that smile, only these little nub things. And this is the first time I have ever said that out loud, how bad it bothers me."
"I like the fact that sheís not afraid to say I messed up and say we can fix that. Every mother feels like she messes up, Iím not the only one who is having this. Itís nice when you finally see others are human."
"Just like we get in parenting magazines that are cool to a parent. They will say, Jeanne, mother of Sam, age 5 and Kim, age 2, and then say what worked for themÖ. I read some of those things and it makes me feel like Iím not the only parent who is struggling with thisÖI like to hear what other moms have to say."
Emotion-based materials encourage participants to think differently and deeply
Traditional nutrition education writing is straightforward, accurate and direct. But clear, accurate and direct writing isnít always engaging, provocative or memorable. Emotion-based materials have added depth, an attribute appreciated by parents.
"Itís your conscience. I mean you read it and then you may be thinking about it and, well yeah. You know and you can relate a little bit more."
"They leave room for your own opinions. ÖIt leaves room for you to decide for yourself what the meaning of it is."
"Iíd save them because I always like to save things like this, to refer back to them."
Participants enjoy group interaction
Emotion-based counseling techniques consist of interactive ways of establishing a warm climate for sharing at an authentic or core rather than a superficial, role playing or defensive level. These activities can be used in group or individual sessions, but group discussion groups were suggested and promoted because earlier focus groups findings suggested that mothers often preferred to learn from each other rather than from educators.
Many parents welcomed the group discussions as fun ways to learn and share, saying that they enjoyed the experience, and left with practical "mom tested" tips. Those who had positive experiences with discussion groups liked sharing ideas with other parents and getting practical suggestions from moms who shared similar challenges. They felt that conversations were just long enough and that they were a good investment of their time. The groups jelled quickly, leaving moms with the comfort of knowing they were not alone with their challenges.
"It was great. I got a few ideas that I never would have thought of and it was short, but you know, enough that you didnít feel like you wasted your time. They didnít keep you there forever. So I had a good time doing this."
"I love to meet other moms and I love to know that Iím not by myself."
"I like the WIC group just because it was a chance to get out and meet other moms. Itís hard for me to get out. I have a child thatís been diagnosed with severe ADHD... ."
Participants identify other factors essential to success when using emotion-based approaches
WIC counselingóemotion-based or traditionalóis still greatly impacted by the person facilitating it. Participants recommended these changes as ways to improve WIC services: