Abstract

Background Implementation of the new Child and Adult Care Food Program (CACFP) nutrition standards may present challenges, especially for in-home child care providers. Objective To elucidate perceived barriers and facilitators faced by in-home child care providers to following the changes in the CACFP food and beverage nutrition standards. Study Design, Settings, Participants Virtual, semi-structured individual interviews elicited qualitative data from a cross section of low-income in-home child care providers in Michigan. Stratified purposive sampling (race, ethnicity, urban and rural residence and licensure) was used to recruit 20 in-home child care providers. Measurable Outcome/Analysis Thematic coding analysis with NVivo (v10.0) was used to organize and interpret data. Results Primary barriers included: food received outside of child care, food preparation time, child food and beverage restrictions, the expense and availability of foods and beverages and child care provider and child preferences. Facilitators included: focus on health and behavior of children, child care provider encouragement and modeling, clear CACFP guidelines and examples, preparation ahead of time, giving children choices and serving the same food for all children. What the children are perceived as more likely to eat, CACFP, WIC, state child care licensing guidelines, what the child care provider chooses to serve and what the provider perceives as healthy help determined their feeding decisions. Perceived support was provided through CACFP program sponsors, social media outlets, and nutrition and early care education and training organizations. Conclusion Early care education and training organizations, such as Extension, should focus on if and how facilities, seasonality, child dietary restrictions as well as budget impact food purchase choices as well as preparation ability on a limited budget. Modeling and family-style meals education may also be beneficial in conjunction with partnering with CACFP program sponsors and using social media as an informational outlet.

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