Child and Adult Care Food Program Meal Reimbursement Rates and Program Participation by Family Child Care Homes in California

IF 2.3 3区医学 Q2 EDUCATION, SCIENTIFIC DISCIPLINES Journal of Nutrition Education and Behavior Pub Date : 2024-08-01 DOI:10.1016/j.jneb.2024.05.064

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Abstract

Background

The Child and Adult Care Food Program (CACFP) provides tiered reimbursements (I/II) to family childcare homes (FCCH) to serve healthy foods to a large proportion of children from households with low-income. Due to COVID-19, federal waivers allowed all FCCH on CACFP to temporarily receive the higher Tier-I reimbursement rate from Jul. 1 2021-Jun. 30, 2023.

Objective

The study objective was to evaluate the impact of the increase in reimbursement on CACFP participation rates among FCCH in California.

Study Design, Settings, Participants

We conducted a secondary analysis of program data collected by the relevant state agency between Oct. 2018-Dec. 2023. The sample included all licensed FCCH in California (∼28,000).

Measurable Outcome/Analysis

We analyzed trends using Joinpoint regression (segmented regression) to detect monthly percent changes (MPC) and identify significant shifts in CACFP participation (p 90% of CACFP FCCH).

Results

Monthly percent changes (MPC) were detected and significant shifts in CACFP participation (p 90% of CACFP FCCH) identified. A different pattern was observed among Tier-II FCCH, which received a substantial increase in meal reimbursement during the waiver period. CACFP participation in this group increased from Oct. 2018-Sep. 2020 (MCP=0.12), followed by monthly decreases (MCP=-0.51), but only through May 2021, the month following the announcement of the waiver. No significant trend was detected from May 2021–Jun. 2022 (MCP=0.08). Newly analyzed results on trends from Jun. 2022-Dec. 2023 will also be presented.

Conclusions

Among Tier-II FCCH, the temporary increase in meal reimbursement appears to have stopped the decreasing CACFP participation rates that were likely due to the pandemic. This suggests that higher reimbursements could increase CACFP participation among this FCCH group, which currently serves more than 200,000 meals/month to young children in California.

Funding

Robert Wood Johnson Foundation UC San Francisco California Collaborative for Pandemic Recovery and Readiness Research (CPR³), funded by the California Department of Public Health (CDPH)

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加州儿童和成人护理食品计划膳食报销率和家庭托儿所的计划参与情况

背景儿童和成人保育食品计划（CACFP）为家庭托儿所（FCCH）提供分级补偿（I/II），以便为大部分低收入家庭的儿童提供健康食品。由于 COVID-19，联邦豁免允许所有参加 CACFP 的家庭托儿所在 2021 年 7 月 1 日至 2023 年 6 月 30 日期间暂时获得较高的一级补偿率。研究设计、环境、参与者我们对相关州政府机构在 2018 年 10 月至 2023 年 12 月期间收集的项目数据进行了二次分析。样本包括加利福尼亚州所有获得许可的 FCCH（28,000 人）.可衡量的结果/分析我们使用连接点回归（分段回归）分析趋势，以检测每月百分比变化（MPC），并确定 CACFP 参与率的显著变化（P 90% of CACFP FCCH）.结果检测到每月百分比变化（MPC），并确定 CACFP 参与率的显著变化（P 90% of CACFP FCCH）.我们使用连接点回归（分段回归）分析趋势，以检测每月百分比变化（MPC），并确定 CACFP 参与率的显著变化（P 90% of CACFP FCCH）。在豁免期间，膳食补偿大幅增加的第二级 FCCH 观察到了不同的模式。从 2018 年 10 月至 2020 年 9 月，该群体的 CACFP 参与度有所上升（MCP=0.12），随后逐月下降（MCP=-0.51），但仅持续到 2021 年 5 月，即宣布豁免后的次月。2021 年 5 月至 2022 年 6 月（MCP=0.08）未发现明显趋势。结论在二级 FCCH 中，膳食报销额度的临时提高似乎阻止了 CACFP 参与率的下降，而这种下降很可能是由大流行病引起的。这表明，较高的报销额度可提高该 FCCH 群体的 CACFP 参与率，该群体目前每月为加州幼儿提供 20 多万份膳食。

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来源期刊

Journal of Nutrition Education and Behavior 医学-学科教育

CiteScore

4.20

自引率

11.50%

发文量

379

审稿时长

44 days

期刊介绍： The Journal of Nutrition Education and Behavior (JNEB), the official journal of the Society for Nutrition Education and Behavior, is a refereed, scientific periodical that serves as a global resource for all professionals with an interest in nutrition education; nutrition and physical activity behavior theories and intervention outcomes; complementary and alternative medicine related to nutrition behaviors; food environment; food, nutrition, and physical activity communication strategies including technology; nutrition-related economics; food safety education; and scholarship of learning related to these areas. The purpose of JNEB is to document and disseminate original research and emerging issues and practices relevant to these areas worldwide. The Journal of Nutrition Education and Behavior welcomes evidence-based manuscripts that provide new insights and useful findings related to nutrition education research, practice and policy. The content areas of JNEB reflect the diverse interests in nutrition and physical activity related to public health, nutritional sciences, education, behavioral economics, family and consumer sciences, and eHealth, including the interests of community-based nutrition-practitioners. As the Society''s official journal, JNEB also includes policy statements, issue perspectives, position papers, and member communications.