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Objectives: To investigate differences between children ages one to five enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the state of Texas whose anemia status improved and those whose anemia status did not improve. Methods: The study involved administration of a survey to a randomly selected stratified sample of parents and guardians of WIC children residing in the eleven public health regions in Texas. Subjects volunteered to complete the survey during a scheduled WIC appointment. A total of 459 usable surveys were completed. Fifty-one percent of the surveys were completed by parents/guardians of children classified as anemia improvers and 49% were completed by parents/guardians of children classified as anemia non-improvers. Results and Conclusions: A majority of the respondents were the child's parent (97%). Most of the children were Hispanic/Latino (77%). More non-improvers than improvers were of young age ( p < 0.01), had a parent/guardian who was 18–30 years of age ( p < 0.01), lived in a household with four or more other children ( p = 0.05) and were from households with a very low income ( p = 0.03). Compared to improvers, non-improvers ate fewer snacks ( p = 0.01) and a greater percentage never consumed dried fruits ( p < 0.01). Knowledge level of the parents/guardians was similar for the two groups. A high percentage of parents/guardians of non-improvers incorrectly believed that their child's condition had improved. WIC staff and other public health educators can utilize these findings to identify those children with anemia who are at higher risk for non-improvement. [ABSTRACT FROM AUTHOR]