1 University of Washington School of Public Health, Nutritional Sciences Program , Center for Public Health Nutrition, Seattle, Seattle, WA.
2 Seattle Children's Research Institute, Center for Child Health, Behavior, and Development, University of Washington General Pediatrics, School of Medicine, Seattle, Seattle, WA.
Child Obes. 2018 Aug/Sep;14(6):429-439. doi: 10.1089/chi.2018.0090.
Sixty percent of US children 5 years old and under receive up to two-thirds of their daily nutrition in early care and education (ECE) settings. Although participation in the federal Child and Adult Care Food Program (CACFP) is shown to improve nutrition, little is known about the relationship between procurement practices (where and how child care programs purchase food) and nutrition in ECE settings or whether these practices differ depending on participation in CACFP.
We assessed self-reported nutrition practices and procurement practices by CACFP participation using a 2013 cross-sectional survey of 690 Washington ECE centers ("Centers") and 1260 family homes (family home child care [FHCCs]) serving children aged 2-5 years old using validated survey tools. We examined the relationship between procurement variables (i.e., main store and main mode) and nutrition scores using multinomial logistic regression models that adjusted for sociodemographic and program characteristics.
In-person shopping was the primary mode of shopping for all programs, regardless of CACFP participation. Some Centers but very few FHCCs reported online shopping as their primary mode. Centers and non-CACFP FHCCs shopped primarily at megastores (Costco, Target, etc.). CACFP FHCCs used both megastores and grocery stores (Albertsons, QFC, etc.) at similar rates. Adjusted multinomial models found that shopping online or at two or more stores was associated with higher nutritional quality of foods served by programs.
Understanding the procurement behaviors of ECE programs helps to illuminate and prioritize potential interventions that would support healthy food purchases.
美国 5 岁及以下的儿童中有 60%在日托和教育机构（ECE）中获得了其日常营养的 2/3 以上。尽管参与联邦儿童和成人护理食品计划（CACFP）已被证明可以改善营养，但对于 ECE 环境中采购实践（儿童保育计划在哪里以及如何购买食物）与营养之间的关系以及这些实践是否因参与 CACFP 而有所不同，人们知之甚少。
我们使用经过验证的调查工具，评估了 2013 年对 690 家华盛顿 ECE 中心（“中心”）和 1260 个家庭式儿童保育中心（家庭式儿童保育[FHCC]）的参与情况，采用了 2013 年对华盛顿 ECE 中心和家庭式儿童保育中心的一项横断面调查，使用了经过验证的调查工具，评估了 CACFP 参与情况对营养实践和采购实践的影响。我们使用多项逻辑回归模型来检验采购变量（即主要商店和主要模式）与营养得分之间的关系，该模型调整了社会人口统计学和计划特征。
无论是否参与 CACFP，所有计划均以亲自购物为主要购物方式。一些中心但很少有 FHCC 报告以在线购物为主要购物方式。中心和非 CACFP FHCC 主要在大型商店（Costco、Target 等）购物。CACFP FHCC 以相似的比例使用大型商店和杂货店（Albertsons、QFC 等）。调整后的多项逻辑回归模型发现，在线购物或在两个或更多商店购物与所提供的食物营养质量更高相关。
了解 ECE 计划的采购行为有助于阐明和优先考虑支持健康食品采购的潜在干预措施。
