From "Tacos" to "Black Bean Tacos on Whole Wheat Tortillas": Tools for Effective, Systematic Menu Assessments of Compliance with Updated Child & Adult Care Food Program Child Meal Pattern Requirements.

State agencies (SA) interpret federal regulations for Child and Adult Care Food Program (CACFP) institutions and facilities (I/F). 2016 brought major changes, the first since 1968, to CACFP meal requirements. Beginning October 1, 2019, menus must comply with these updated nutrition standards to qualify for reimbursement. To increase I/Fs menu compliance, North Carolina offered a voluntary, systematic menu assessment statewide. As the USDA recommended, the SA program provided technical assistance (without financial penalty) to l/F on their menus. The SA developed a Menu Assessment Tool (MAT) to assess compliance with meal requirements. l/F were invited to submit menus, review MAT scores, and revise and resubmit. From June 2018-January 2019, 42 institutions submitted revised child menus. A Sign test was used to analyze score differences between initial and revised menus on six metrics: (1) correct milk, (2) one whole grain-rich grain per day, (3) no grain-based desserts, (4) cereal identified, (5) cereal within sugar limits, and (6) 100% juice once per day or less. Revised menus demonstrated increased compliance on five of six metrics. Initial compliance rates were (1) 14.3%, (2) 38.1%, (3) 64.3%, (4) 66.7%, (5) 59.5%, and (6) 38.1%. Revised compliance rates were (1) 88.1% (p≤0.000), (2) 78.6% (p≤0.084), (3) 92.9% (p≤0.004), (4) 90.5% (p≤0.003), (5) 83.3% (p≤0.038), and (6) 90.5% (p≤0.000). Findings suggest I/F that utilized the menu assessment program increased meal requirement compliance and improved menu documentation. Continuing the program may increase the number of reimbursable meals served and enable l/F to avoid financial impacts of noncompliance [ABSTRACT FROM AUTHOR]