Figure 3.

Using theories to inform the Child and Adult Care Food Program (CACFP).⁵⁰

Child and Adult Care Food Program policy	Theory			Policy/research considerations
	Getting to Equity Framework	Family Ecological Model	Stigma and Food Inequity Framework
Expanded eligibilitya	Social and Economic Resources: Expanded eligibility as part of a nutrition assistance program (CACFP) Increase Access to Healthy Options: Expanded eligibility provides healthy meals to more young adults, especially those living at homeless and youth-serving shelters	Community Factors: Expanded eligibility increases access to healthy foods Social Disparities and Chronic Stress: Expanded eligibility alleviates household economic stress and reduces food insecurity	Structural Manifestation of Stigma: Expanded eligibility provides increased access to healthy foods that may mitigate structural inequities (eg, lack of access to affordable, nutritious food) often faced by impoverished communities	(1)Allowing child care centers in low-income areas to automatically receive the highest CACFP reimbursement rates if at least 40% of children qualify for free or reduced-price meals (2)Innovative solutions for collecting data on CACFP participants (eg, partnerships with state programs offices [WICb or transitional assistance departments]) and actions at the federal level to upgrade state data systems for participation in federal programs to facilitate the ability to link data (3)Research that examines comprehensive, long-term follow-up on child, parent, and family outcomes
Increased reimbursementa	Build Community Capacity: Increased reimbursement improves community economic resources by supporting child care centers	Community Factors: Increased reimbursement increases access to healthy foods	Structural Manifestation of Stigma: Greater allocation of funds can help address inequities in existing childcare food environments
Providing afternoon snack and/or supper to children in full-day child care	Increase Access to Healthy Options: Providing afternoon snacks/supper provides healthy meals to children, especially those living in food swamps and food deserts	Community Factors: Providing afternoon snacks/supper increases access to healthy foods Social Disparities and Chronic Stress: Providing afternoon snacks/supper alleviates household economic stress and reduces food insecurity	Structural Manifestation of Stigma: Providing afternoon snack/dinner may mitigate structural inequities (eg, lack of access to affordable, nutritious food) often faced by impoverished communities

^aTemporary policy implemented as a result of the coronavirus disease 2019 pandemic that expanded CACFP eligibility to young adults up to age 24 years at homeless and youth-serving shelters.

^bWIC = Special Supplemental Nutrition Program for Women, Infants, and Children.