The development of child and adult care food program best-practice menu and training for Native American head start programs: The FRESH study

Abstract

New Child and Adult Care Food Program (CACFP) meal patterns and best practices were implemented nationally in 2017 to address the shift in dietary need from ensuring essential nutrient consumption to chronic disease prevention. Young American Indian (AI) children have disproportionately higher risk of chronic disease. Some AI tribes operate early care and education (ECE) programs and have the opportunity to participate in the CACFP. The purpose of this paper is to describe a CACFP best-practice menu and training developed and implemented as part of the Food Resource Equity and Sustainability for Health (FRESH) study, a community-based participatory research (CBPR) intervention implemented within ECE programs in the Osage Nation of Oklahoma. Site managers and cooks from each of the nine ECE programs attended meetings and provided investigators with feedback that shaped the best-practice menu and training. Each site participated in a three-hour training in January 2018 to discuss the best-practice menu and ways to overcome implementation barriers. Goals of the menu aimed to increase intake of fruit and vegetables and whole grains and reduce pre-fried and processed foods without increasing cook burden. Training included application activities individually and in small and large groups. Though the project is still underway, lessons learned, including the need for technical assistance, improved communication between ECE program staff and food supply vendors, and infrastructure barriers (e.g., limited space, lack of supplies) that challenge workflow, have emerged. Efforts to improve menus in rural and low-income ECE programs must consider these issues in developing feasible intervention strategies.

Impact of a Farm-to-School Nutrition and Gardening Intervention for Native American Families from the FRESH Study: A Randomized Wait-List Controlled Trial

“…The last component included menu modifications at the ECE programs. Further description of the menu modifications from the FRESH study can be found elsewhere [26][27][28]. In short, fresh vegetables from Osage Nation's Harvest Land farm were harvested and delivered to the ECEs to be incorporated into the ECE menus.…”

Design and Methods of a Participatory Healthy Eating Intervention for Indigenous Children: The FRESH Study

“…A menu was developed for all of the ECE programs moving the community toward best practices identified by the Child and Adult Care Food Program (CACFP) ( 50 ) and has been described in detail elsewhere ( 51 ). In short, menus were designed to add fruits and vegetables as snacks, replace refined grains with whole grains, serve lean meats, nuts, and legumes, reduce fried foods, and eliminate sugary beverages and juices.…”

“…The menu changes were determined based on the amounts of produce Bird Creek Farm could grow and deliver regularly and the ECE staffing and space needs. Once the menu was finalized the teachers and cooks participated in a three-hour interactive training session to introduce the menu modifications ( 51 ), discuss the importance of the CACFP best practices, and address any challenges raised during the interactive session.…”

Development of a Tribally-led Gardening Curriculum for Indigenous Preschool Children: The FRESH Study

“…The FRESH study used a communitybased participatory research process that involved Osage Nation tribal leaders from the early childhood education and agricultural sectors in every aspect of the research, from the development of the research questions and study implementation to the data collection, analysis, and dissemination of the findings. As 1 element of a multicomponent intervention for ECE families, the FRESH preschool curriculum was accompanied by a school menu best practices redesign 16 and a supplemental teacher training on responsive feeding practices 17 described elsewhere. Intervention ECE school menus incorporated local, fresh, and culturally tailored foods from the tribe's newly launched farm.…”