Health inequities related to poor diet, food insecurity, and obesity negatively affect children from low-income minority families. The USDA administers Food and Nutrition Assistance Programs (FNAPs) in Early Care and Education settings (ECEs) to safeguard the health of vulnerable children. However, the extent to which FNAPs provide an equitable food environment in ECEs remains unclear. Examine FNAPs’ association with young children's (2–6 years) food environment in ECE through a systematic review using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. The primary focus is to operationalize RE-AIM in ECE context and evaluate FNAPs' association with the ECE food environment using an equity lens. Food environment dimensions were assessed at three levels: ECE setting (availability, accessibility, affordability, acceptability, accommodation); ECE provider (feeding practices); and child (dietary intake, food insecurity, BMI percentile). The review included 38 articles (cross-sectional=30, mixed method=1, pre-post=5, longitudinal=2) with Child and Adult Care Food Program (CACFP; = 35), Farm to ECE ( = 2), and Food Bank-ECE program partnership ( = 1). No study addressed all RE-AIM indicators. CACFP participation showed positive association with healthy food availability ( = 28), feeding practices ( = 12), child dietary intake ( = 6), and reduced risk of being overweight ( = 1). Farm to ECE interventions showed increased local food affordability ( = 1) and children's acceptance of healthy foods ( = 1). No study addressed foods served in ECEs to accommodate cultural diversity, special dietary needs, developmental disabilities, or reported child food insecurity. CACFP emerges as the most prevalent FNAP nationally for having potential to improve ECE food availability and feeding practices, but further research is needed to address equity gaps by examining its impact on child outcomes (dietary intake, BMI percentile) across diverse geographic locations (urban vs. rural), ECE organizational structures (center-based vs. home-based), and demographic characteristics of ECE providers and children.

中文翻译：

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食品和营养援助计划是否促进了公平的早期保育和教育 (ECE) 食品环境？利用 RE-AIM 框架进行系统审查


与不良饮食、粮食不安全和肥胖相关的健康不平等对低收入少数族裔家庭的儿童产生负面影响。美国农业部在早期保育和教育机构 (ECE) 中管理食品和营养援助计划 (FNAP)，以保障弱势儿童的健康。然而，FNAP 在多大程度上为欧洲经委会提供公平的粮食环境仍不清楚。通过使用 RE-AIM（覆盖范围、有效性、采用、实施和维护）框架进行系统审查，检查 FNAP 与 ECE 幼儿（2-6 岁）食品环境的关联。主要重点是在 ECE 背景下实施 RE-AIM，并使用公平视角评估 FNAP 与 ECE 食品环境的关联。食品环境维度在三个层面进行评估： ECE 环境（可用性、可达性、负担能力、可接受性、住宿）；儿童早教提供者（喂养方法）；和儿童（膳食摄入量、食品不安全、BMI 百分位）。该综述包括 38 篇文章（横断面=30，混合方法=1，前后=5，纵向=2），涉及儿童和成人护理食品计划（CACFP；= 35）、农场到 ECE（= 2）和食品银行-欧洲经委会计划伙伴关系 (= 1)。没有研究涉及所有 RE-AIM 指标。 CACFP 参与显示与健康食品供应 (= 28)、喂养方式 (= 12)、儿童膳食摄入量 (= 6) 以及超重风险降低 (= 1) 呈正相关。农场到 ECE 的干预措施表明当地食品的承受能力 (= 1) 和儿童对健康食品的接受度有所提高 (= 1)。没有研究针对儿童早教中心提供的食品来适应文化多样性、特殊饮食需求、发育障碍或报告的儿童食品不安全问题。 CACFP 成为全国最普遍的 FNAP，因为它有可能改善儿童早教食品供应和喂养方式，但需要进一步研究，通过检查其对不同地理位置（城市与地区）儿童结果（膳食摄入量、BMI 百分位数）的影响来解决公平差距. 农村）、幼儿教育组织结构（以中心为基础与以家庭为基础）以及幼儿教育提供者和儿童的人口特征。