Status of Beverages Served to Young Children in Child Care After Implementation of California Policy, 2012–2016

ORIGINAL RESEARCH — Volume 17 — April 9, 2020

Danielle L. Lee, MPH, RD1; Klara Gurzo, MA1,2; Lilly A. Nhan, MPH, RD1,3; Elyse Homel Vitale, MPH4,5; Sallie Yoshida, DrPH6; Ken Hecht, LLB1; Lorrene D. Ritchie, PhD, RD1 (View author affiliations)

Suggested citation for this article: Lee DL, Gurzo K, Nhan LA, Vitale EH, Yoshida S, Hecht K, et al. Status of Beverages Served to Young Children in Child Care After Implementation of California Policy, 2012–2016. Prev Chronic Dis 2020;17:190296. DOI: http://dx.doi.org/10.5888/pcd17.190296.

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Summary

What is already known on this topic?

In 2012, California enacted a policy designating that licensed child care sites serve only healthy beverages. A study conducted later that year showed positive changes. However, only 60% of child care survey respondents knew about the policy and only one-quarter were fully adherent.

What is added by this report?

We assessed the degree of adherence to the policy in 2016, finding continued improvements since 2012 and few implementation barriers reported.

What are the implications for public health practice?

Comprehensive state policy on beverages in child care can be successfully implemented and should be considered by other states.

Abstract

Introduction

Since 2012, licensed California child care centers and homes, per state policy, are required to serve only unflavored low-fat or nonfat milk to children aged 2 years or older, no more than one serving of 100% juice daily, and no beverages with added sweeteners, and they are required to ensure that drinking water is readily accessible throughout the day. We evaluated adherence to the policy after 4 years in comparison to the adherence evaluation conducted shortly after the policy went into effect.

Methods

Licensed California child care sites were randomly selected in 2012 and 2016 and surveyed about beverage practices and provisions to children aged 1–5 years. We used logistic regression to analyze between-year differences for all sites combined and within-year differences by site type and participation in the federal Child and Adult Care Food Program (CACFP) in self-reported policy adherence and beverage provisions.

Results

Respondents in 2016 (n = 680), compared with those in 2012 (n = 435), were more adherent to California’s 2010 Healthy Beverages in Child Care Act overall (45.1% vs 27.2%, P < .001) and with individual provisions for milk (65.0% vs 41.4%, P < .001), 100% juice (91.2% vs 81.5%, P < .001), and sugar-sweetened beverages (97.4% vs 93.4%, P = .006). In 2016, centers compared with homes (48.5% vs 28.0%, P = .001) and CACFP sites compared with non-CACFP sites (51.6% vs 27.9%, P < .001) were more adherent to AB2084 overall.

Discussion

Beverage policy adherence in California child care has improved since 2012 and is higher in CACFP sites and centers. Additional policy promotion and implementation support is encouraged for non-CACFP sites and homes. Other states should consider adopting such policies.