{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:42:42Z","timestamp":1785508962394,"version":"3.56.0"},"reference-count":68,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T00:00:00Z","timestamp":1727222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Robert Wood Johnson Foundation Healthy Eating Research Program","award":["269287"],"award-info":[{"award-number":["269287"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Introduction: The U.S. Child and Adult Care Food Program (CACFP) provides tiered reimbursements for healthy foods for children at participating family childcare homes (FCCH). Higher tier 1 reimbursements are for providers who operate in low-income communities or who are themselves living on a low income. All FCCHs received a higher rate to address food insecurity during the COVID-19 pandemic. Methods: A survey was administered in the spring of 2023 to a randomly selected sample of licensed California FCCHs to assess the perceived impacts of the increased reimbursement on CACFP participation and anticipated challenges with reinstated tiered rates. A total of 518 surveys (261 tier 1, 257 tier 2) were analyzed using linear or logistic regression, adjusting for confounders. Results: Among tier 1 and tier 2 providers combined, over half reported lowering out-of-pocket spending for food (59%) and serving greater variety (55%) and quality (54%) of foods. Tier 2 providers reported experiencing more benefits (p &lt; 0.05) and tended to be more likely to implement optional CACFP best practices (although not significantly different between tiers). Most FCCH providers found reimbursement rates were inadequate before (83%) the pandemic; this amount decreased to 54% post-pandemic for tier 1 and tier 2 providers combined. Conclusions: The temporary CACFP reimbursement positively impacted the perceived quality and variety of foods served to children, especially among tier 2 providers. Increased reimbursements for all FCCHs may ensure children have access to the healthy meals and snacks provided by the CACFP.<\/jats:p>","DOI":"10.3390\/nu16193241","type":"journal-article","created":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T16:16:37Z","timestamp":1727280997000},"page":"3241","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Child and Adult Care Food Program: Family Childcare Home Providers\u2019 Perceptions of Impacts of Increased Meal and Snack Reimbursement Rates during the COVID-19 Pandemic"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8038-1821","authenticated-orcid":false,"given":"Lorrene D.","family":"Ritchie","sequence":"first","affiliation":[{"name":"Nutrition Policy Institute, Agriculture and Natural Resources, University of California, 1111 Franklin Street, Eleventh Floor, Oakland, CA 94607, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kassandra A.","family":"Bacon","sequence":"additional","affiliation":[{"name":"Nutrition Policy Institute, Agriculture and Natural Resources, University of California, 1111 Franklin Street, Eleventh Floor, Oakland, CA 94607, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celeste","family":"Felix","sequence":"additional","affiliation":[{"name":"Nutrition Policy Institute, Agriculture and Natural Resources, University of California, 1111 Franklin Street, Eleventh Floor, Oakland, CA 94607, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2138-1087","authenticated-orcid":false,"given":"Danielle L.","family":"Lee","sequence":"additional","affiliation":[{"name":"Nutrition Policy Institute, Agriculture and Natural Resources, University of California, 1111 Franklin Street, Eleventh Floor, Oakland, CA 94607, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha Kay-Daleiden","family":"Marshall","sequence":"additional","affiliation":[{"name":"CACFP Roundtable, San Diego, CA 92172, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elyse","family":"Homel Vitale","sequence":"additional","affiliation":[{"name":"CACFP Roundtable, San Diego, CA 92172, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3635-7445","authenticated-orcid":false,"given":"Susana L.","family":"Matias","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences and Toxicology, University of California, Berkeley, 225 Morgan Hall, Berkeley, CA 94720, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1016\/j.jada.2011.06.007","article-title":"What Role Can Child-Care Settings Play in Obesity Prevention? 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