Dataset Information

Facilitators and barriers to family child care home participation in the U.S. Child and Adult Care Food Program (CACFP).

ABSTRACT: This paper describes facilitators, barriers, and potential strategies to promote participation in the Child and Adult Care Food Program (CACFP) by family child care homes (FCCHs). This descriptive study occurred from January-May 2022 in Arizona and New York, two states with varying levels of CACFP participation. Stakeholders from three state-level CACFP-administering agencies, representatives of six sponsor organizations, and 23 FCCH providers (70% CACFP, 30% non-CACFP) participated in interviews. Facilitators of CACFP participation included the simple enrollment, technical assistance from sponsors, software provided by sponsors, and incentives from state agencies. Barriers included perceptions that CACFP paperwork would be burdensome, lack of access to sponsors, and challenges with meal pattern requirements. Recommended strategies to promote CACFP uptake included educating providers about CACFP, expanding outreach, and additional funding. Efforts to address state-level disparities in FCCH participation in CACFP are needed. This study provides some insight into policy and systems changes that could be beneficial.

SUBMITTER: Erinosho T

PROVIDER: S-EPMC9593702 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Facilitators and barriers to family child care home participation in the U.S. Child and Adult Care Food Program (CACFP).

Erinosho Temitope T Jana Bethany B Loefstedt Kaitlyn K Vu Maihan M Ward Dianne D

Preventive medicine reports 20221017

This paper describes facilitators, barriers, and potential strategies to promote participation in the Child and Adult Care Food Program (CACFP) by family child care homes (FCCHs). This descriptive study occurred from January-May 2022 in Arizona and New York, two states with varying levels of CACFP participation. Stakeholders from three state-level CACFP-administering agencies, representatives of six sponsor organizations, and 23 FCCH providers (70% CACFP, 30% non-CACFP) participated in interview ...[more]

PMID: 36304077

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Project description:BackgroundPredischarge home assessments (PDHA) aim to support safe discharge from hospital or rehabilitation. There is insufficient evidence on the effectiveness of PDHA. For adults with any diagnosis, we aimed to determine (1) the effects of PDHA on outcomes associated with the successful return to community living (e.g., Activities of Daily Living, falls) and (2) the associated barriers and facilitators in order to derive recommendations for clinical practice.MethodsWe searched Medline, EMBASE, CINAHL, five additional databases and other sources. We included individual and cluster randomized (RCT/cRCT) and controlled clinical trials comparing PDHA versus usual care/other intervention, as well as qualitative/mixed methods studies dealing with PDHA. Critical appraisal was performed according to the Cochrane risk-of-bias tool in quantitative studies and the Critical Appraisal Skills Programme (CASP) as well as the McMaster University Guidelines for Critical Review Form for qualitative studies and data extraction. Meta-analysis, thematic synthesis and integrative synthesis were performed.ResultsEight RCTs (n = 1072) and ten qualitative studies (n = 336) met the inclusion criteria. RCTs reported a variety of outcomes (n = 17). We are uncertain if PDHA has any effect on patient outcomes in Activities of Daily Living, quality of life, mobility and fear of falling, falls and hospital readmissions (with moderate to very low quality of the evidence). The qualitative studies revealed facilitators and barriers which should be considered by therapists when conducting PDHA. These were related to the following topics: patient safety education, patient information, patients' acceptance of modifications and aids, functional assessment, standardization of procedures as well as the consideration of relevant patient conditions and contextual factors in PDHA.ConclusionThere is no evidence from the meta-analysis for the effectiveness of PDHA. Further robust studies are needed to adapt and evaluate PDHA interventions, taking the identified stakeholders' views on PDHA into account and following the current recommendations for the development and evaluation of complex interventions.Trial registrationThe review was registered and methods were reported on PROSPERO on 18th July 2018 ( CRD42018100636 ).

Project description:BackgroundSince 2015, the New York State Office of Mental Health has provided state primary care clinics with outreach, free training and technical assistance, and the opportunity to bill Medicaid for the Collaborative Care Model (CoCM) as part of its Collaborative Care Medicaid Program. This study aims to describe the characteristics of New York State primary care clinics at each step of CoCM implementation, and the barriers and facilitators to CoCM implementation for the New York State Collaborative Care Medicaid Program.MethodsIn this mixed-methods study, clinics were categorized into RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) steps. Clinics were sent a survey, which included questions related to payer mix, funding sources, billing codes used, and patient population demographics. Qualitative interviews were conducted with clinic representatives, focusing on barriers or facilitators clinics experienced affecting their progression to the next RE-AIM step.ResultsOne thousand ninety-nine surveys were sent to primary care clinics across New York State, with 107 (9.7%) completing a survey. Significant differences were observed among the different RE-AIM steps for multiple demographic variables including primary payer, percentage of patients with a diagnose of depression or anxiety, and percent of behavioral health services that are reimbursed, in addition to others. Three main themes regarding barriers and facilitators to implementing CoCM for New York State Medicaid billing emerged from 31 qualitative interviews: (1) Billing requirements, (2) Reimbursement rates, and (3) Buy-in to CoCM.ConclusionsSurvey data align with what we would expect to see demographically in NYS primary care clinics. Qualitative data indicated that CoCM billing requirements/structure and reimbursement rates were perceived as barriers to providing CoCM, particularly with New York State Medicaid, and that buy-in, which included active involvement from organizational leaders and providers that understand the Collaborative Care model were facilitators. Having dedicated staff to manage billing and data reporting is one way clinics minimize barriers, however, there appeared to be a disconnect between what clinics can bill for and the reimbursed amount several clinics are receiving, illustrating the need for stronger billing workflows and continued refinement of billing options across different payers.

Dataset Information

Facilitators and barriers to family child care home participation in the U.S. Child and Adult Care Food Program (CACFP).

Publications

Facilitators and barriers to family child care home participation in the U.S. Child and Adult Care Food Program (CACFP).

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