Published: March 2023

ID #: CAS065

Journal: J Acad Nutr Diet

Authors: Jana B, Loefstedt K, Vu M, Ward D, Erinosho T

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The Child and Adult Care Food Program (CACFP) is a federally-regulated feeding program that reimburses early care and education (ECE) programs for providing nutritious meals to low-income children. Participation in CACFP is voluntary and varies widely across states. This study assessed barriers and facilitators of center-based ECE program participation in CACFP and identified potential strategies to promote participation by eligible programs. This was a multi-method (interviews, surveys, document reviews) descriptive study. Participants included stakeholders from 22 national and state agencies that work with ECE programs to promote CACFP, nutrition, and quality care; representatives of 17 sponsor organizations; and 140 center-based ECE program directors from Arizona, North Carolina, New York, and Texas. Barriers, facilitators and recommended strategies to promote CACFP that emerged from interviews were summarized with relevant illustrative quotes. Survey data were analyzed descriptively using frequencies and percentages. Key barriers to center-based ECE program participation in CACFP shared by participants included the cumbersome CACFP paperwork, difficulty meeting eligibility requirements, strict meal patterns, difficulties with meal counts, penalties for non-compliance, low reimbursements, inadequate ECE staff to assist with paperwork, and limited trainings. Facilitators to participation included supports provided by stakeholders and sponsors through outreach, technical assistance, and nutrition education. Potential strategies recommended to promote CACFP participation would require policy change (e.g., streamlining paperwork, modifying eligibility requirements, leniency toward non-compliance) and systems-level change (e.g., more outreach and technical assistance) by stakeholders and sponsor organizations. Stakeholder agencies recognized the need to prioritize CACFP participation and highlighted ongoing efforts. Policy changes are needed at the national and/or state levels to address barriers and ensure consistent CACFP practices among stakeholders, sponsors, and ECE programs.

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