2021 Pediatric Research Forum Poster Session

Child and Adult Care Food Program Sponsor Perspectives on Barriers and Facilitators to Program Access for Home-based Child Care Providers

Lucia Vulcan
Hailey Heinz
Dana Bell
Julia Martinez
Margaret Cunningham
Darlene Castillo
Elizabeth Yakes Jimenez


Intro: The Child and Adult Care Food Program (CACFP) helps child care providers serve nutritious foods and is part of the food and nutrition security safety net for children nationwide. Sponsors are regionally located agencies that assist home-based child care providers with participating in CACFP.

Aim: To describe New Mexico (NM) CACFP sponsor staff perspectives on barriers and facilitators to program access for home-based childcare providers.

Methods: We interviewed 11 NM CACFP sponsor staff representing 9 out of 13 agencies (69% response rate) from August-September 2020. Interviews were recorded, transcribed and coded. Thematic analysis was conducted by a mixture of constructivist and modified grounded theory.

Results: Most sponsors described their home-based provider population as Hispanic older adults or grandparents who speak English or Spanish. Perceived barriers to CACFP access include financial costs to become a registered provider (e.g., background checks, safety classes and equipment), the program administrative burden, and low reimbursements. Perceived challenges after providers enroll include the need to document attendance and maintain menus, inability to attend required nutrition trainings and to pay for safety training, as well as inadequate reimbursement to justify the additional effort. Many sponsors felt that providing bilingual technical assistance was essential to provider participation in CACFP. Recommendations to enhance the CACFP participation were to improve the quality, quantity and access to required nutrition trainings, increase reimbursement rates and provide funds to cover enrollment costs, and improve state or sponsor capacity to conduct home inspections required to become a registered provider. A home inspection pause during the COVID-19 pandemic limited the new CACFP enrollments and technology and communication barriers have interfered with virtual trainings and visits.

Conclusion: Sponsors identified several potential solutions to increase home-based providers’ participation in CACFP. Next, we will interview home-based child care providers who are or are not enrolled in CACFP.