Food served in family day care homes as part of USDA’s Child & Adult Food Program (CACFP) influences children’s nutritional health. Currently CACFP does not reward providers for serving foods that are high in nutrients, low in energy and relatively expensive. Changing CACFP policies to include nutrient standards and increased reimbursement for food could improve children’s diets and reduce risk of obesity.Taking advantage of a unique policy-analysis opportunity to assess the effects of different subsidy levels for providers in CACFP’s “Tier 2” category, we will work closely with 60 CACFP family day care home providers to examine the relationship between food costs and dietary quality. We aim to:

• Compare food quality and food expenditures between providers who receive supplemental reimbursement from the City of Seattle and similar providers in King County who do not receive supplemental reimbursement
• Examine the relationship between food expenditures and food quality and determine if this relationship is impacted by reimbursement level
• Explore the influences of time scarcity, children’s food preferences, geographic access to foods, and provider characteristics on CACFP providers’ decisions about menus, food shopping, and food preparation

Using research protocols developed at the UW Center for Public Health Nutrition, we will calculate mean nutrient density, energy density, expenditures and costs/kcal for CACFP foods, and use appropriate statistical tests (descriptive statistics, t tests, linear regression models) to achieve each research aim. We will call upon the expertise of nutrition professionals from state and local agencies that sponsor CACFP and the president of a home care provider organization.