{"title":"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","authors":"","doi":"10.1016/j.jneb.2024.05.064","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>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.</p></div><div><h3>Objective</h3><p>The study objective was to evaluate the impact of the increase in reimbursement on CACFP participation rates among FCCH in California.</p></div><div><h3>Study Design, Settings, Participants</h3><p>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).</p></div><div><h3>Measurable Outcome/Analysis</h3><p>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).</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusions</h3><p>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.</p></div><div><h3>Funding</h3><p>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)</p></div>","PeriodicalId":50107,"journal":{"name":"Journal of Nutrition Education and Behavior","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Child and Adult Care Food Program Meal Reimbursement Rates and Program Participation by Family Child Care Homes in California\",\"authors\":\"\",\"doi\":\"10.1016/j.jneb.2024.05.064\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>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.</p></div><div><h3>Objective</h3><p>The study objective was to evaluate the impact of the increase in reimbursement on CACFP participation rates among FCCH in California.</p></div><div><h3>Study Design, Settings, Participants</h3><p>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).</p></div><div><h3>Measurable Outcome/Analysis</h3><p>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).</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusions</h3><p>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.</p></div><div><h3>Funding</h3><p>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)</p></div>\",\"PeriodicalId\":50107,\"journal\":{\"name\":\"Journal of Nutrition Education and Behavior\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Nutrition Education and Behavior\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1499404624001647\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"EDUCATION, SCIENTIFIC DISCIPLINES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nutrition Education and Behavior","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1499404624001647","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}
Child and Adult Care Food Program Meal Reimbursement Rates and Program Participation by Family Child Care Homes in California
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)
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.
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