Changes in Child and Adult Care Food Program (CACFP) Practices at Participating Childcare and Education Centers in the United States Following Updated National Standards, 2017–2019

Abstract

The U.S. Department of Agriculture’s (USDA) Child and Adult Care Food Program (CACFP) updated meal pattern standards took effect in October 2017. The aim of this quasi-experimental, pre-post study is to identify changes in food and beverage practices of CACFP-participating centers due to implementation of updated CACFP meal patterns over a 21-month period. Eight hundred and fifty-eight centers located in 47 states and the District of Columbia completed a survey (primarily electronic) at both time points (67.6% follow-up response rate). Multivariable logistic regressions with robust standard errors assessed changes over time, accounting for repeated observations within each site. From baseline to follow-up, centers reported the increased familiarity and implementation, albeit with time, money, and staffing-related challenges. Significant improvements were seen in not serving sugary cereals or flavored milk, in serving 100% whole grains, and serving processed meats less than once a week. While CACFP-participating centers reported making significant progress in meeting the updated meal pattern standards and suggested best practices within 15–19 months of their effective date, reported compliance and adherence to the standards and best practices was not universal. USDA, state agencies, and technical assistance providers should work to provide centers with additional guidance to help them with implementation.

Strengthening US Food Policies and Programs to Promote Equity in Nutrition Security: A Policy Statement From the American Heart Association

“…Provide technical assistance, additional funding, and ongoing assessment to ensure that the implementation of the CACFP nutrition standards results in meals aligned with the DGA for children and adults. 83…”

The Child and Adult Care Food Program: Barriers to Participation and Financial Implications of Underuse

“…The survey was informed by our prior work 12 and research elsewhere. 19 10 A center's location in a high-poverty area was used to approximate the household income of enrolled families. High poverty was based on the city/town designation as eligible for the Community Eligibility Provision (CEP), that is, ≥ 40% of school-aged children qualified for free school meals.…”

“…12 Program application and compliance could be costly and difficult to navigate. 19,20 There is a paucity of data on the motivation of ECE providers to participate in CACFP, including how their decisions affect access to CACFP across states and population groups. 21 This study aimed to identify facilitators and barriers to CACFP participation to expand the CACFP reach and improve the nutrition of young children.…”

Improving child care through healthy eating and physical activity

“…In 2017, the U.S. Department of Agriculture (USDA) updated the CACFP meal pattern to require participants to provide more fruits and vegetables, less solid fats and added sugars, and more whole grains [40]. Since the meal pattern update, research has found significant improvements among participating ECE programs in serving 100% whole grains, serving processed meats less than once a week, and not serving sugary cereals or flavored milk [41]. Overall, ECE facilities participating in CACFP are more likely to provide more nutritious foods and beverages compared to non-CACFP sites [42].…”