Challenges, Supports, and Lessons Learned: The Impact of the COVID-19 Pandemic on Efforts to Promote Nutrition and Quality Care at Early Care and Education Programs

The COVID-19 pandemic has wreaked havoc in many settings, including early care and education (ECE) programs. This study describes challenges, supports, and lessons learned from the impact of COVID-19 on efforts to promote nutrition and quality care at ECE programs. A mixed-methods study of 4 states was conducted. Stakeholders from 22 organizations associated with the Child and Adult Care Food Program (CACFP), representatives of 17 CACFP sponsor organizations, and 40 center-based ECE program directors were interviewed; 100 ECE directors completed surveys. Key challenges included difficulty keeping up with continuous changes and inconsistent COVID-19 requirements across federal, state, and local regulatory agencies. ECE directors reported shortages of personal protective equipment, food, and supplies early in the pandemic. To protect their staff, children and families, directors took proactive measures including stopping family-style meals, switching to single use utensils or individually-packaged meals, conducting daily temperature checks, and installing sanitation stations at building entrances. Despite these efforts, many directors reported staff shortages, low enrollment, and center closures due to state mandates and positive cases on-site. Supports highlighted by stakeholders included the emergency relief funds from state agencies (57%), additional funding from other organizations (46%), access to information from state agencies, sponsors, and community organizations about where to find personal protective equipment (30%), and the CACFP waivers from the U.S. Department of Agriculture (16%). Lessons learned included the need to continue to prioritize federal/state funding to support ECE, provide enhanced internet access to rural programs, and make aspects of the CACFP waivers permanent. The pandemic has challenged the ECE system, but has also drawn attention to the essential role of ECE in child nutrition and education. This study highlights potential opportunities for new policies to enhance efforts to promote child nutrition and quality care at ECE. Healthy Eating Research, a national program of the Robert Wood Johnson Foundation (RWJF); and the School of Public Health at Indiana University Bloomington.