i USDA

Nutrition, Physical Activity, 

and Electronic Media Use 

in the Child and Adult Care 

Food Program

RESEARCH REPORT ON 

PRACTICES, CHALLENGES, 

AND TECHNICAL 

ASSISTANCE NEEDS

United States Department of Agriculture
ii USDA

The Healthy, Hunger-Free 

Kids Act of 2010 

required sweeping changes 

to the USDA child nutrition 

programs, including the 

Child and Adult Care 

Food Program. 
ABOUT THIS RESEARCH

Background & Purpose

The Healthy, Hunger-Free Kids Act of 2010 (HHFKA) required sweeping 

changes to the USDA child nutrition programs, including the Child and Adult 

Care Food Program (CACFP). The Act expanded the purpose of CACFP to 

promote health and wellness in child care settings and instructed the USDA 

to provide training and technical assistance to help child care centers and 

day care homes comply with current nutrition, physical activity, and electronic 

media use recommendations. Under the HHFKA, CACFP centers and homes 

are encouraged to follow the most recent Dietary Guidelines for Americans

to serve healthful foods (like vegetables, fruits, whole grains, and fat-free and 

low-fat milk products), reduce sedentary behaviors, and provide opportunities 

for regular physical activity.

In 2013, USDA’s Food and Nutrition Service (FNS) contracted with FCB 

Garfinkel, KRC Research, and Weber Shandwick to conduct research among 

CACFP audiences in the areas of nutrition, physical activity, and electronic 

media use. The purpose of the research was to determine: perceived 

challenges in implementing recommendations in the three areas, training and 

technical assistance needs, and preferred formats for training and resources.

Method

The study was conducted by KRC Research in two phases during 2014. 

In Phase 1, KRC conducted a national survey, administered both online and 

by telephone, among the following CACFP audiences: providers (child care 

centers and family day care homes), sponsoring organizations, and State 

agencies. The study was conducted in both English and Spanish. The 

25-minute survey asked detailed questions about nutrition, physical activity, 

and electronic media use—including awareness, knowledge, reported 

behaviors, challenges, needs, and preferred communications methods. 

The following are represented in the study:

• Full day child care to children ages 

0 to 5;

• Varying provider education and 

income levels; 

• Urban, suburban, and rural 

communities; and 

• Both large and small organizations. 

Phase 2 consisted of seven followup telephone focus groups, randomly 

recruited from the Phase 1 participants who volunteered to participate in 

further research (62percent of Phase 1 participants). Each of the CACFP 

audiences was represented in the focus groups, which elaborated on the 

findings of the Phase 1 survey and explored unanswered questions.

By the numbers:

1,402

Total research 

participants

representing,

48 States, the 

District of 

Columbia, 

and U.S. Territories

across,

7 FNS Regions
2 USDA

SNAPSHOT OF FINDINGS

Nutrition

All groups are at least somewhat 

familiar with the 2010 Dietary 

Guidelines for Americans (DGAs)

• Interest in meeting the DGA 

recommendations is high!

• All audiences appreciate nutrition 

guidelines specific to age groups.

Many providers are serving healthful 

and nutritious food and beverages, 

including:

• Whole grains

• Fruits

• Vegetables

• Milk

• Water

Providers would like help 

with their biggest challenges:

• Meal planning

• Recipe ideas

• Managing food costs

Providers want to learn from peers 

about best practices in promoting 

healthy habits

• Not only among children,

• But also among the parents of children 

in their care.

Providers are engaged – especially 

on the topic of nutrition.

Physical Activity

All groups recognize the value of 

age-specific physical activity guidelines

• Guidelines can help create structure.

• Some providers are less familiar with what 

children can do at different ages.

Time for physical activity reported by 

providers is what they perceive to be 

best practices, but not always consistent 

with actual recommendations.

Key factors providers consider when 

deciding on physical activity:

• Safety

• Caregiver-to-child ratio

• Children’s clothing and footwear

• Space or equipment limitations

Key barriers to promoting physical 

activity:

• Weather

• Finding activities conducive to smaller, 

indoor spaces
RESEARCH REPORT FOR CHILD AND ADULT CARE FOOD PROGRAM 3

SNAPSHOT OF FINDINGS

Electronic Media Use

Audiences differ in perceived 

appropriateness of use in child 

care settings:

• State agency staff are more likely to say 

young children should not be exposed to 

electronic media.

• Most providers and sponsoring organizations 

see electronic media as an asset if both 

limited and appropriately used.

Providers discuss primarily using 

electronic media for educational 

purposes

• Some report having well-defined strategies 

for limiting electronic media use.

Use is associated with age

• Younger children are allowed less screen 

time per day than older children.

A top challenge to limiting use in 

child care settings:

• Finding activities for mixed-age groups

There is less interest in training on 

electronic media use than on nutrition 

and physical education.

Needs Assessment

All audiences want information 

and training on a range of topics

• The greatest number of topics concern 

nutrition.

• Technical assistance and training needs 

and interests are aligned most clearly around 

nutrition over physical activity and electronic 

media use.

Multiple formats for delivering the 

same content are needed—one size 

will not fit all!

Preferences vary around the delivery 

of information and training

• Interactive training methods and peer 

learning, when possible, are preferred.

• Videos, webinars, and in-person training are 

all considered useful.

• Print materials can be shared with parents 

and provide expert reference for decisions 

and behaviors.

• Social media can play a role in helping 

providers communicate to parents.
4 USDA

Food Service

Percent Saying Each Factor is “Very Important” in Deciding What Types of Food and 

Beverages are Served

State Agency 

Staff

Sponsoring 

Organizations

Child Care 

Centers

Family Day 

Care Homes

Nutritional/health value 69% 89% 95% 97%

Access to nutritious 

foods and beverages 65% 89% 91% 93%

Provider/staff knowledge 

about types of foods to 

prepare/serve

73% 78% 79% 89%

Cost 83% 73% 60% 66%

Child preferences 48% 42% 43% 53%

Parental preference 13% 28% 33% 47%

Percent Reporting How Meals 

and Snacks are Served

Providers who preplate meals express in focus 

groups that they want to know more about how 

to successfully implement family style service. 

Recommended training and tools include:

• Measuring tools that can be used for the first 

serving while allowing children to take the second 

on their own;

• Encouraging providers to model eating so that 

children try new foods; and 

• Helping providers accept that messes may occur as 

children become familiar with serving themselves.
RESEARCH REPORT FOR CHILD AND ADULT CARE FOOD PROGRAM 5

A Closer Look at Key Findings

NUTRITION

Percent Reporting the Frequency of Food Groups 

Served to Children Ages 0 to 5 the Previous Day

Percent Reporting the Frequency of Beverages 

Served to Children Ages 0 to 5 the Previous Day

Just under half specifically serve 

water all or most of the time, but 

focus group participants confirm that 

water is available throughout the day.
6 USDA

Challenges to Meeting Guidelines 

• Across audiences, cost is identified as a top 

challenge to meeting nutritional guidelines. In 

focus groups, however, cost is not raised until 

participants are prompted. 

• Participants say that training on cost-effective 

recipes and food-buying strategies may help 

them overcome this challenge. 

Percent Reporting Top Challenges to Meeting Nutrition Guidelines

State Agency Staff 75%

Cost of Food

52%

Staff Knowledge

Sponsoring 

Organizations 68%

Cost of Food

45%

Preparation Time

Child Care Centers 54%

Cost of Food

43%

Child Preferences

Family Day Care Homes 56%

Cost of Food

48%

Child Preferences
RESEARCH REPORT FOR CHILD AND ADULT CARE FOOD PROGRAM 7

NUTRITION

Other challenges discussed 

in focus groups include:

• The availability of fresh food;

• Gaining support from parents; and 

• Managing food vendors. 

“ I think different ideas for when 

we do cooking projects, quick 

and simple that would help 

educate the children as well, 

that would be great.” 

Child Care Center, mixed 

familiarity with Dietary Guidelines

Suggestions to overcome nutrition challenges: 

• Give providers the opportunity to share strategies 

among themselves that have been successful 

with picky eaters.

• Improve staff knowledge with increased and 

more targeted trainings.

• Provide cost-effective and seasonal produce 

options as well as resources and strategies for 

child care gardens.

• Make menu planning both easier and less 

time-consuming by:

- Supplying new, easy recipes for meals and 

snacks with explanations of how ingredients 

meet CACFP requirements,

- Developing a mobile- or tablet-based 

application that builds recipes based on 

available foods inputted by the provider, and

- Providing recipes that reflect cultural influences.

“ You can feed almost a whole class with a bag of apples for 

$3...a box of blueberries to introduce them to something new 

would be, like, $3 or $4, and you can only serve one or two 

kids with that box of blueberries.” 

Sponsoring Organization
8 USDA

Physical Activity

• Actual time spent on physical activity mirrors 

perceptions about what is recommended.

• However, there is a gap—these amounts tend 

not to match with existing physical activity

recommendations.

Percent Reporting Actual Active Time per Day by Age
RESEARCH REPORT FOR CHILD AND ADULT CARE FOOD PROGRAM 9

PHYSICAL ACTIVITY

Influences

Percent Saying Each Factor is “Very Important” in Deciding the Amount of Time Children 

Have for Physical Activity in a Typical Day

State Agency 

Staff

Sponsoring 

Organizations

Child Care 

Centers

Family Day 

Care Homes

Safety concerns 73% 75% 83% 89%

Caregiver to child ratio 58% 65% 74% 73%

Children wearing 

inappropriate clothing 

and/or footwear

56% 59% 66% 78%

Weather 46% 53% 66% 77%

Space or equipment 

limitations 56% 56% 56% 69%

Staff interest in physical 

activity 52% 57% 49% 58%

Child preferences 12% 39% 40% 52%

Parental preferences 

about children’s 

activities in child care

15% 30% 31% 48%

Electronic media use 27% 20% 12% 23%
10 USDA

Challenges to Providing 

Opportunities for Physical Activity 

Challenges to providing opportunities for physical activity vary by audience, although weather and space 

limitations are raised as key issues during focus groups.

Percent Reporting Top Challenges to Ensuring There are Enough Opportunities 

for Physical Activity

State Agency Staff 65%

Staff Knowledge

63%

Space Limitations

Sponsoring 

Organizations 41%

Space Limitations

34%

Cost of Equipment

Child Care Centers 36%

Cost of Equipment

33%

Space Limitations

Family Day Care Homes 44%

Mixed Age Groups

41%

Cost of Equipment
RESEARCH REPORT FOR CHILD AND ADULT CARE FOOD PROGRAM 11

• To overcome challenges of providing opportunity 

for physical activity in inclement weather and in 

small spaces:

- Examples of how structured and unstructured 

play can be adapted to situations in which 

space or equipment is limited, and 

- Ideas for more indoor activities can be 

distributed. 

- Dancing was cited by providers as one popular 

indoor activity.

• Identifying activities that can occur without 

expensive equipment will help overcome the 

challenge of cost.

• Information about how to adapt common 

activities for different age groups will be 

particularly useful to family day care homes.

• During focus groups, providers also note that 

parental involvement in incorporating physical 

activity into children’s lifestyles can be a 

challenge. 

- Increasing communication with parents 

about physical activity practices at child 

care facilities,

- Sharing health information with parents to 

generate awareness of the importance of 

physical activity, and 

- Sharing ideas about easy ways to incorporate 

more physical activity at home may help 

overcome this barrier.

“ I think what would help more is giving actual examples of 

structured activity that the kids can do and of course...we 

don’t want the kids to get hurt or they might be afraid to do 

it. But if it’s something age appropriate to where we can 

find a way to get the kids all involved, then that way, we’re 

incorporating the physical activity as part of their routine, as 

something that they just do normally.” 

Sponsoring Organization

PHYSICAL ACTIVITY
12 USDA

Electronic Media

• Electronic media use is widespread in childcare 

settings.

• In focus groups, providers discuss primarily 

using electronic media for educational purposes 

and say that it is limited. 

• Providers do, however, see a benefit to some 

screen time.

Percent Perceived Prevalence of Electronic 

Media Use in Child Care Settings

State Agency Staff

94%

Sponsoring 

Organization

87%

Percent Reporting Electronic Media Use

Child Care Centers

82%

Family Day 

Care Homes

91%

For the purposes of this research, “electronic media use” included any TV, video, and DVD watching, 

electronic games, computer use, and use of other electronic devices (like cell phones).
RESEARCH REPORT FOR CHILD AND ADULT CARE FOOD PROGRAM 13

ELECTRONIC MEDIA

Limited Use

Percent Saying Each Factor is “Very Important’ in Deciding the Amount of Time 

Children Spend Using Electronic Media in Child Care Settings

State Agency 

Staff

Sponsoring 

Organizations

Child Care 

Centers

Family Day 

Care Homes

Caregiver to child ratio 31% 37% 40% 45%

Lack of staff knowledge 

about the need to 

limit electronic media 

use and/or more age 

appropriate activities

52% 47% 39% 39%

Weather 31% 31% 29% 46%

Staff breaks/need 

to leave child without 

supervision*

37% 37% 29% 39%

Parental preferences 17% 27% 29% 41%

*need for children to be self-occupied while staff attends to other tasks.

“ Even though I think [electronic media is] wonderful and very 

useful, I don’t think they should be the emphasis of learning. I 

think that children still need those old-fashioned experiences 

of hands-on, to go out and get dirty and to touch things and to 

experience things.”

Sponsoring Organization
14 USDA

Electronic Media

• The majority of State agency staff, sponsoring 

organizations, and child care centers say that 

children under 2 years of age should have no 

screen time each day.

• In focus groups, those representing State 

agencies insist that children age 5 and under 

should have no screen time, but in provider 

settings, the majority of children ages 2 and older 

are getting at least some screen time per day.

Percent Reporting Actual Electronic Media Use per Day by Age
RESEARCH REPORT FOR CHILD AND ADULT CARE FOOD PROGRAM 15

ELECTRONIC MEDIA

Challenges to Limiting Use

• Providers in the focus groups confirm that they do 

not face many obstacles to limiting screen time. 

• State agency staff and sponsoring organizations 

see the perception that electronic media is 

educational as a barrier to limiting it. Suggestions 

to ease this barrier: 

- Sharing recommendations for screen time that 

take into account differing levels of access to 

electronic media outside the child care setting.

- Providing examples of electronic media that 

are educational.

• Parental involvement is raised as a challenge 

during focus groups. Information and training 

to overcome this challenge may include:

- Communicating with parents on the need to limit 

electronic media use with their children, and 

- Providing information and warnings about the 

risks associated with too much screen time.

Percent Reporting Top Challenges to Limiting Electronic Media Use

State Agency Staff 52%

Lack of Staff 

Training

52%

Perception that 

Use is Educational

Sponsoring 

Organizations

27%

Lack of Staff 

Training

38%

Perception that 

Use is Educational

Child Care Centers 35%

None

 18%

Mixed Age 

Groups

Family Day Care Homes 34%

None

31%

Mixed Age 

Groups
16 USDA

NEEDS ASSESSMENT

Technical Assistance and Training: 

Preferred Delivery Channels

Providers prefer to receive training and information in different ways depending on the topic. 

Nutrition

Child care centers prefer social media, peer-to-peer interaction, video, and 

mobile/tablet apps for training and information about nutrition, while family 

day care homes prefer in-person training, video, and webinars.

Physical Activity

For physical activity, child care centers identify video or in-person training 

as preferences while family day care homes identify peer-to-peer interaction, 

webinars, and printed posters. Child care centers also like print or email to 

communicate with parents.

Electronic Media Use

Child care centers prefer information or training on electronic media use 

provided by video, while family day care homes prefer in-person training 

or a webinar. Child care centers would also like print or email materials to 

give to parents.
17 USDA
U.S. Department of Agriculture 

Food and Nutrition Service

FNS-484

For more information, contact 

TeamNutrition@fns.usda.gov, 

or go to teamnutrition.usda.gov

April 2015

USDA is an equal opportunity 

provider and employer.

United States Department of Agriculture