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

Study Overview
=================
Brief Summary
-----------------
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.

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

Conditions
-----------------
Food Security

Intervention / Treatment
-----------------
* Behavioral: Proposed Meal Changes for CACFP: Impact on Child Food Intake and Costs


Participation Criteria
=================
Eligibility Criteria
-----------------
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

Ages Eligible for Study
-----------------
Minimum Age: 3 Years
Maximum Age: 80 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

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


Arms and Interventions

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

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | 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 | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Child care food costs, Meal participation rates, Child and Adult Care Food Program