Assessing Compliance for Proposed CACFP Meal Pattern Changes and Recent Maryland Legislation in Maryland Childcare Centers
(School of Medicine (UMB) Pediatrics Master's Student)
Objective: The Child and Adult Care Food Program (CACFP) provides reimbursement for childcare centers following federal meal pattern guidelines. Maryland childcare centers are required to follow CACFP guidelines. In 2015, USDA proposed CACFP changes, including offering >1 whole grain serving/day and eliminating flavored milk. Maryland passed the Childcare Centers-Healthy Eating and Physical Activity Act (CC-HEPAA), eliminating sugar-sweetened beverages (SSBs). This study aims to assess childcare center compliance regarding proposed changes in CC-HEPAA and CACFP and, to determine if compliance varies by centers who serve low vs. middle-income families. Methods: A statewide survey of all licensed childcare centers serving children under 5 years (610/1564, 39% response rate) was administered via e-mail from November 2014-January 2015. Survey questions included center demographics and foods/beverages served. Compliance with state/federal guidelines was examined using descriptive statistics. T-tests/chi-square analyses were used to examine differences in center compliance by service to low/middle-income families. Results: 549 centers were included in the analysis (serves >1 snack or meal/day). Most centers offered full-time care (93.3.%) and are independent (66.7%). Childcare centers who accept subsidy vouchers (75.4%) or participate in CACFP (24.6%) were considered serving low-income families. Whole grain proposed rule: 38.4% compliant. Flavored milk proposed rule: 86.7% compliant. SSBs state law: 87.6% compliant. Compliance with flavored milk was higher among centers accepting vouchers (88.4% versus 81.5%, χ2 =4.23 (p=0.040)). Compliance with whole grains was higher among CACFP centers (57.5% versus 32.3%, χ2 =27.13 (p<0.001)). Conclusions: MD childcare centers are generally complying with legislative changes regarding flavored milk and SSBs, however over 10% of centers offer these beverages. Compliance for the CACFP whole grain proposed rule is low and improvements are needed. Childcare centers serving low-income families had better compliance than centers serving middle-income families, possibly due to greater state/federal oversight.
Importance to public health: