Perspectives of Home-Based Child Care Providers in New Mexico on Barriers and Facilitators to Participating in the Child and Adult Care Food Program, 2021-2022.

This study examined New Mexico home-based child care provider perspectives (n = 75) on barriers to and facilitators of Child and Adult Care Food Program (CACFP) participation. Two thirds of the sample were Spanish speakers. Providers reported that CACFP reimbursement does not cover actual food costs and the time-and-effort costs of obtaining qualifying foods and completing required documentation. They noted that additional reimbursed meals are needed for children in care for extended hours and that linguistically competent CACFP sponsor staff facilitated their participation. (Am J Public Health. 2023;113(S3):S215-S219. https://doi.org/10.2105/AJPH.2023.307402).

Factors Associated With Self-Reported Family Enrollment in Community Services After Referral by First Born Home Visitors.

OBJECTIVE: To examine factors associated with family enrollment in community services after receiving a referral from First Born home visiting staff in New Mexico. METHODS: Analyses of program administrative data from August 2010 to January 2020 for 1049 families with 5397 referrals were conducted in Stata 15.1 using mixed effects logistic regression; missing data were imputed. We examined the likelihood of a referral outcome being coded as "client enrolled in services" based on family self-report as a function of program, referral type and initiator, and staff and referral recipient characteristics. RESULTS: About one fourth of referrals resulted in enrollment in services, with the highest enrollment rate for early intervention (39%) and lower enrollment rates for behavioral health (18%) and domestic violence (14%) services. Reported enrollment in the referred-to service was significantly higher for older caseholders versus teens (odds ratio [OR]: 1.69, 95% confidence interval [CI] 1.07-2.67) and for children (OR: 1.33, 95% CI 1.06-1.67) and pregnant mothers (OR: 1.45, 95% CI 1.04-2.01) versus non-pregnant mothers and significantly lower for referrals initiated by home visitors (in discussion with family - OR: 0.62, 95% CI 0.49-0.79; based on screening results - OR: 0.52, 95% CI 0.37-0.72) versus family initiated referrals, for fathers versus non-pregnant mothers (OR: 0.49, 95% CI 0.32-0.75) and for Asian, Black, and multi-racial/ethnic group caseholders versus white caseholders (OR: 0.53, 95% CI 0.30-0.97). CONCLUSIONS: Quality improvement efforts and home visitor training on making sensitive referrals, anti-racism, and motivational interviewing could potentially improve family engagement with community services via the First Born home visiting model.

New Mexico Sponsors Identify Time and Money as Factors Affecting Home-Based Provider Child and Adult Care Food Program Engagement.

OBJECTIVE: Describe Child and Adult Care Food Program (CACFP) sponsor perspectives on barriers and facilitators to home-based provider CACFP eligibility, enrollment, and participation and ways to improve provider support. METHODS: Semistructured interviews were conducted with 11 New Mexico CACFP sponsor staff representing 9 out of 13 agencies (69% response rate) from August to September, 2020. Interviews were analyzed using thematic analysis with an essentialist/realist epistemological approach. RESULTS: Sponsor-perceived barriers to provider CACFP: eligibility (costs, background checks, fear/stigma, and delays in becoming state-approved providers); enrollment (lack of translated/low-literacy materials and cumulative systems requirements); and participation (challenges maintaining qualifying menus and documentation and accessing qualifying food, inadequate reimbursements, and unannounced visits). Sponsors suggested systems changes to improve provider support (eg, more assistance with becoming state-approved and for start-up costs and accessible, progressive nutrition training opportunities). CONCLUSIONS AND IMPLICATIONS: Sponsors noted CACFP barriers for home-based providers and identified corresponding systems changes that could be tested.