Childcare and Meal Provision: A Systematic Literature Review

Background The Child and Adult Care Food Program (CACFP) provides reimbursement for meals and snacks that meet nutrition standards served to children enrolled at participating childcare centers and family daycare homes. This program plays an important role in the health and well-being of children and families. Despite the benefits, many eligible childcare providers do not participate in CACFP. The barriers to participation have not been fully examined.Objectives The objectives of this review are to describe meal service operations and practices of childcare providers who participate and those who do not participate in CACFP and to describe characteristics of childcare settings, including differences by CACFP participation status.Methods The study team searched databases, including PubMed, Academic Search Ultimate, and Web of Science, for relevant literature published from 2013 to 2023. Studies were included if they described any type of meal service operation or practice in a childcare setting that served children from birth to age 5. A member of the review team extracted data on study characteristics, target populations, meal service and operations, childcare characteristics, staffing information, and barriers to and facilitators of CACFP participation. Results were synthesized thematically.Results Thirty-seven articles were included in this review. Thirty of the studies used a cross-sectional design. Thirty of the studies were published between 2018 and 2022. The majority of studies identified in this review (n = 30) presented information on childcare characteristics. Nineteen studies discussed meal service operations and practices by CACFP participation status, and 18 studies identified barriers to and/or facilitators of CACFP participation.Conclusion The information on barriers to CACFP participation and childcare meal service operations in this systematic literature review identified potential opportunities to increase CACFP participation. However, more geographically representative research is needed, in addition to research focused on providers who do not participate in CACFP.