Dataset Information

Food Purchasing and Preparation at Child Day Care Centers Participating in the Child and Adult Care Food Program in the United States, 2017.

ABSTRACT: BACKGROUND:More than 3.6 million children are served daily by the Child and Adult Care Food Program (CACFP)-participating child day care centers. This study provides a nationwide assessment of center-level responsibilities for menu, meal/snack preparation, meal preparer training, and food and beverage (F&B) purchasing. METHODS:A nationally representative survey of 5483 CACFP child day care centers was conducted between August 22, 2017, and September 30, 2017. One thousand three hundred forty-three centers (25% response) in 47 states and the District of Columbia responded. Descriptive statistics describe center-level menu, meal, and purchasing practices and center characteristics. Multivariate logistic regressions examined characteristics associated with F&B purchasing sources. RESULTS:Menus were primarily prepared by directors/assistant directors and on-site food manager/cooks, while site staff primarily prepared meals/snacks. Fifty-two percent of meal preparers held a food sanitation license, but only 5% had formal nutrition training (e.g., Registered Dietician). Most centers purchased F&B from food service providers (63%), local grocery stores (59%), warehouse stores (40%), or from 2+ sources (50%). Independent centers were more likely to purchase F&B from local grocery stores or 2+, while free or state-subsidized sites were more likely to purchase from a food service provider and less likely to purchase from other sources than were centers charging between $101 and $201.99 per week. Centers where an on-site cook/food manager prepared the menus were significantly more likely to purchase their F&B from local grocery and/or warehouse stores and/or from 2+ sources. CONCLUSIONS:Opportunities exist to target CACFP training to specific roles within and specific types of CACFP-participating child day care centers to facilitate compliance with the updated CACFP standards.

SUBMITTER: Chriqui JF

PROVIDER: S-EPMC6909716 | biostudies-literature | 2018 Aug/Sep

REPOSITORIES: biostudies-literature

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Food Purchasing and Preparation at Child Day Care Centers Participating in the Child and Adult Care Food Program in the United States, 2017.

Chriqui Jamie F JF Schermbeck Rebecca M RM Leider Julien J

Childhood obesity (Print) 20180801 6

<h4>Background</h4>More than 3.6 million children are served daily by the Child and Adult Care Food Program (CACFP)-participating child day care centers. This study provides a nationwide assessment of center-level responsibilities for menu, meal/snack preparation, meal preparer training, and food and beverage (F&B) purchasing.<h4>Methods</h4>A nationally representative survey of 5483 CACFP child day care centers was conducted between August 22, 2017, and September 30, 2017. One thousand three hu ...[more]

PMID: 30199293

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Project description:BackgroundNative American (NA) children have a high prevalence of obesity contributing to lifespan health disparities. Dietary intake is important to promote healthy weight gain, growth, and development. In 2017, the USDA enforced changes to the Child and Adult Care Food Program (CACFP). The CACFP provides reimbursement to qualifying Early Care and Education (ECE) programs that serve foods that uphold the program's nutrition requirements.ObjectiveThis study had the following 2 objectives: 1) Describe a novel index to evaluate ECE menus based on revised CACFP requirements (accounting for food substitutions) and best practices for 3- to-5-y-old children, and 2) analyze CACFP requirement and best practice compliance and nutrient changes in 9 NA ECE programs before and after enforcement of the revised CACFP requirements.MethodsThis longitudinal study is within a larger community-based participatory research study. Menus and meals served were evaluated for 1 wk at each of 9 programs before and after enforcement of the revised meal patterns. Nutrient analysis, CACFP requirement and best practice compliance, and substitution quality were evaluated. Differences were determined using a paired t-test or Wilcoxon matched test. This trial was registered at clinicaltrials.gov as NCT03251950.ResultsTotal grams of fiber consumed increased (5.0 ± 1.2 compared with 5.9 ± 0.8 g, P = 0.04) and total grams of sugar consumed decreased (53.8 ± 12.6 compared with 48.4 ± 7.9 g, P = 0.024), although room for further improvement exists. Although total grams of fat remained unchanged, grams of saturated fat significantly increased (7.8 ± 1.4 compared with 10.5 ± 3.4, P = 0.041). Other nutrients remained unchanged. Overall CACFP requirement and best practice compliance scores improved, although this finding was not statistically significant. No significant changes in food quality associated with substitutions occurred.ConclusionsThis study provides early evidence to support the beneficial impact of the revised CACFP requirements. Understanding barriers to compliance within rural NA communities would be an important next step in enhancing the health of vulnerable children.

Project description:BACKGROUND:North Carolina Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) resources improve child body mass index (BMI) when the resources are introduced by nurses to child care providers, and offered with workshops and incentives. In San Francisco, public health and child care agencies partnered to adapt NAP SACC resources into an annual "Healthy Apple" quality improvement program (HAP). METHODS:This cluster randomized controlled trial pilot-tested integration of the HAP with bi-annual public health screenings by nurses. All child care centers that participated in Child Care Health Program (CCHP) screenings in San Francisco in 2011-2012 were offered routine services plus HAP in 2012-2013 (CCHP?+?HAP, n?=?19) or routine services with delayed HAP in 2014-2015 (CCHP?+?HAP Delayed, n?=?24). Intention-to-treat analyses (robust SE or mixed models) used 4 years of screening data from 12 to 17 CCHP?+?HAP and 17 to 20 CCHP?+?HAP Delayed centers, regarding 791 to 945 children ages 2 to 5y, annually. Year-specific, child level models tested if children in CCHP?+?HAP centers had greater relative odds of exposure to 3 index best practices and smaller Autumn-to-Spring changes in BMI percentile and z-score than children in CCHP?+?HAP Delayed centers, controlling for age, sex, and Autumn status. Multi-year, child care center level models tested if HAP support modified year-to-year changes (2013-2014 and 2014-2015 vs 2011-2012) in child care center annual mean Autumn-to-Spring BMI changes. RESULTS:In 2011-2012, the CCHP?+?HAP and CCHP?+?HAP Delayed centers had similar index practices (<15% of children were exposed to a physical activity curriculum, staff joining in active play, and drinking water pitchers) and annual BMI changes. In 2013-2014: 60% of children in CCHP?+?HAP centers were exposed to the 3 index practices vs 19% in CCHP?+?HAP Delayed centers; Mean (SE) child BMI percentile (-2.6 (0.9), p?=?0.003) and z-score (-0.08 (0.03), p?=?0.007) decreased more in CCHP?+?HAP vs CCHP?+?HAP Delayed centers. In 2014-2015, after all centers were offered HAP, the index practices and BMI changes were improved for all centers vs 2011-2012. CONCLUSIONS:Integration of the HAP with existing public health nursing services was associated with significantly more children exposed to best practices and improvement in child BMI change. The results warrant continued integration of HAP into local public health infrastructure. TRIAL REGISTRATION:ISRCTN18857356 (24/04/2015) Retrospectively registered.

Project description:BackgroundEvidence for an association between the local food environment, diet and diet-related disease is mixed, particularly in the UK. One reason may be the use of more distal outcomes such as weight status and cardiovascular disease, rather than more proximal outcomes such as food purchasing. This study explores associations between food environment exposures and food and drink purchasing for at-home and out-of-home (OOH) consumption.MethodsWe used item-level food and drink purchase data for London and the North of England, UK, drawn from the 2019 Kantar Fast Moving Consumer Goods panel to assess associations between food environment exposures and household-level take-home grocery (n=2,118) and individual-level out-of-home (n=447) food and drink purchasing. Density, proximity and relative composition measures were created for both supermarkets and OOH outlets (restaurants and takeaways) using a 1 km network buffer around the population-weighted centroid of households' home postcode districts. Associations between food environment exposure measures and frequency of take-home food and drink purchasing, total take-home calories, calories from fruits and vegetables, high fat, salt and sugar products, and ultra-processed foods (UPF), volume of take-home alcoholic beverages, and frequency of OOH purchasing were modelled using negative binomial regression adjusted for area deprivation, population density, and individual and household socio-economic characteristics.ResultsThere was some evidence for an inverse association between distance to OOH food outlets and calories purchased from ultra-processed foods (UPF), with a 500 m increase in distance to the nearest OOH outlet associated with a 1.1% reduction in calories from UPF (IR=0.989, 95%CI 0.982-0.997, p=0.040). There was some evidence for region-specific effects relating to purchased volumes of alcohol. However, there was no evidence for an overall association between food environment exposures and take-home and OOH food and drink purchasing.ConclusionsDespite some evidence for exposure to OOH outlets and UPF purchases, this study finds limited evidence for the impact of the food environment on household food and drink purchasing. Nonetheless, region-specific effects regarding alcohol purchasing indicate the importance of geographical context for research and policy.

Dataset Information

Food Purchasing and Preparation at Child Day Care Centers Participating in the Child and Adult Care Food Program in the United States, 2017.

Publications

Food Purchasing and Preparation at Child Day Care Centers Participating in the Child and Adult Care Food Program in the United States, 2017.

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