Proposed Meal Changes for CACFP: Impact on Child Food Intake and Costs

Child and Adult Care Food Program (CACFP) meals are an important influence on diets of children from low-income families enrolled in the CACFP and should meet children's nutrient needs while fostering healthy eating habits that enable them to maintain energy balance. Recent national data revealed that children consumed low intakes of foods that support healthy dietary patterns (whole grains, fruit and vegetables other than potatoes), but high intakes of low nutrient, energy dense foods. The 2011 USDA-commissioned Institute of Medicine (IOM) report for CACFP meals provided new recommendations that include new meal pattern requirements for the meals programs, aligning them with the U.S. Dietary Guidelines to ensure that the meals promote health and reduce inadequate and excessive intakes. The report recommended inclusion of more whole grains, fruit, vegetables, and meat/meat alternatives which will likely increase meal costs. Two of the IOM report recommendations call for research to better understand how the new meal requirements would change children's CACFP meal dietary intakes and food service costs. These are important questions, and answers are needed to inform policy and future technical and educational assistance needs. The overall objective of this project is to implement the IOM meal pattern requirements for CACFP meals in day homes and centers in Texas. The multidisciplinary team will focus on nutrition, economics, and provider outcomes. The specific aims are to assess the impact of the new meal pattern requirements on 1) Meal participation rates; 2) Provider food service costs (food, labor, total meals); and 3) Child dietary intake at CACFP homes and centers. It is hypothesized that, compared with control sites, intervention site children will select and consume healthier diets (more fruit, vegetables and whole grains) at school. A total of 32 day care sites will be recruited for the study. It is hypothesized that, compared with control sites, children at the intervention sites will select and consume healthier diets (more fruit, vegetable and whole grains) at the center. It is also hypothesized that the increase in food costs will be less than that projected in the IOM report. The results on the costs associated with creating the desired meals will be very important as these data have not been systematically collected in previous studies. This significant study targets underserved minority populations with health promoting intervention to reduce health disparities, and in addition, will inform policy on the influence of a healthy food environment on children's diet, as well as provide critical information on costs.

Study Overview

• Status: Completed
• Conditions: Food Security
• Intervention / Treatment: Behavioral: Proposed Meal Changes for CACFP: Impact on Child Food Intake and Costs

• Study Type: Interventional
• Enrollment (Actual): 32
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Texas
    • Houston, Texas, United States, 77030
      • Baylor College of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 3 years to 80 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Must be day care sites
• Must be parents of children attending the day care sites

Exclusion:

• Parents of children not attending one of the 32 day care sites

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention; Receive new CACFP menu pattern	Behavioral: Proposed Meal Changes for CACFP: Impact on Child Food Intake and Costs
No Intervention: Control; Follow existing CACFP menu pattern

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Change from Baseline Child Dietary Intake at 6 months and 12 months	Up to 12 months
Change from Baseline Meal Participation Rates at 6 months and 12 months	Up to 12 months
Change from Baseline Provider Food Service Costs (food, labor, total meals) at 6 months and 12 months	Up to 12 months

Collaborators and Investigators

• Sponsor: Baylor College of Medicine
• Collaborators: National Heart, Lung, and Blood Institute (NHLBI)

Publications and helpful links

General Publications

• Dave JM, Cullen KW. Foods Served in Child Care Facilities Participating in the Child and Adult Care Food Program: Menu Match and Agreement with the New Meal Patterns and Best Practices. J Nutr Educ Behav. 2018 Jun;50(6):582-588. doi: 10.1016/j.jneb.2018.01.010. Epub 2018 Feb 21.

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2015
• Primary Completion (Actual): May 1, 2017
• Study Completion (Actual): May 31, 2019

Study Registration Dates

• First Submitted: May 25, 2016
• First Submitted That Met QC Criteria: June 1, 2016
• First Posted (Estimate): June 2, 2016

Study Record Updates

• Last Update Posted (Actual): January 14, 2020
• Last Update Submitted That Met QC Criteria: January 13, 2020
• Last Verified: January 1, 2020

More Information

Terms related to this study

• Keywords: Child care food costs; Meal participation rates; Child and Adult Care Food Program
• Other Study ID Numbers: H-35784; R01HL119520 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The Baylor College of Medicine understands and agrees to comply with the NIH policy on Sharing Research Data and on Sharing Model Organisms (as outlined in the NIH Guide, February 26, 2003 and May 7, 2004.) The principal investigator and co-investigators acknowledge their willingness to share data and materials with other eligible investigators through academically established means. Data will be shared with collaborators as soon as available, with local colleagues at seminars and talks, and with the scientific community at large by posters and presentations at local, regional, national and international scientific meetings. Finally, data will be presented by publication to the widest audience possible. Press interviews on important publications are arranged through the Baylor College of Medicine Office of Public Affairs.