in Delaware to adopt new state best practice standards and policies.) First, maintaining and investing in regular assessments of the population is important so that population-level changes can be monitored. In the case of CACFP, ongoing assessment will be critical to evaluating the role that CACFP participation plays in children’s dietary intake. According to Weber, Nemours encourages the collection of baseline data before the recommended CACFP meal standards are implemented. Second, certainly there is a need for data on the food and nutrient content of meals and snacks served in CACFP homes and centers, as well as participants’ overall food and nutrient intakes and their alignment with current dietary guidance. In addition, Nemours also encourages the collection of information on provider characteristics and other factors that might influence the impact of CACFP on children’s nutritional well-being. As examples, Weber listed caregivers’ knowledge, awareness, attitudes, beliefs about changes to the nutrition standards, and beliefs about nutrition standards overall. Third, Nemours encourages the collection of data that can assess systems-level changes (i.e., policy, program, and practice changes) that, in turn, could lead to changes in population health outcomes. As examples of this type of data, Weber listed the number of child care providers who implement new standards and the speed at which they do so.

QUESTION 1

What baseline measures are particularly needed to track the impact of change to CACFP, such as those that were recommended in the recent Institute of Medicine (IOM) report?

The CACFP report (IOM, 2011) recommended substantial changes to CACFP meal requirements in an effort to bring the requirements into alignment with the best available dietary guidance and to improve consistency with the requirements of other USDA food assistance programs. The report also recommended steps for ongoing evaluation and periodic reassessment to determine the impact of the meal requirement changes on participants’ nutritional well-being. As part of that process, the report recommended that “USDA should take appropriate actions to establish the current baselines prior to implementation of the new Meal Requirements for comparison purposes” (Program Evaluation Recommendation 2, IOM, 2011). Thus, the question was raised: Which of the measures discussed throughout the course of the workshop would be especially informative to collect before the meal requirement changes are implemented?



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