B_Summary of SNACS-II Data Collection Plan
B_Summary of SNACS-II Data Collection Plan.docx
Study of Nutrition and Activity in Child Care Settings II (SNACS-II)
B_Summary of SNACS-II Data Collection Plan
OMB: 0584-0669
B. Summary of SNACS-II Data Collection Plan
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The SNACS-II planned data collection approach largely mirrors the approach used in SNACS-I. However, we made some adjustments to data collection modes to enhance data quality and maximize response rates. In addition, we will adjust existing instruments to meet the needs of SNACS-II. Because of the importance of comparisons between SNACS-I and SNACS-II, the planned adjustments have been carefully considered to ensure they will not compromise the validity of these comparisons. The SNACS-II data collection plan is summarized in Table B.1. The remainder of this appendix describes the study team’s plans for collecting data. Appendices for FDCH operators, parents, and teens that are available in both English and Spanish are referenced throughout, with a slash denoting the two corresponding versions.
Table B.1. Summary of the SNACS-II data collection plan
Note: POCs in child care centers, Head Start centers, AR centers, and OSHCCs will receive a $350 stipend. FDCH providers will receive a $150 stipend.
a Target response rates are among recruited providers and consenting parents (and their child, infant, or teen).
b The Menu Survey will also be used to address research questions under Objectives 3a, 4, and 6.
c The Meal Observation Booklet includes the Reference Portion Measurement Form, Meal Observation Forms (“Meals Served by Provider” and “Foods Brought from Home”), and Classroom Waste Measurement Form. The Classroom Waste Measurement Form will be used to address research questions under Objective 6.
d Two mutually exclusive 10 percent subsamples (216 each) will be drawn from interviewed children to provide a third day of intake data; one group will provide a second ICD and the other a second OCD.
e For parents of teens in the Objective 3a/3b sample, parent data will be collected through the main Parent Interview.
f The response rate for the Parent Interview is higher than the response rate for the 24-hour dietary recall because it reflects parents completing the Parent Interview but not the dietary recall. The window for collecting the 24-hour recall will be 48 hours after the meal observation day, but we will continue to attempt to complete the Parent Interview for up to two weeks after the observation.
g For example, a string backpack or water bottle.
h We expect to collect a total of 3,346 meal observations (daily observations that will include all meals and snacks consumed in care). This includes 2,160 observations for children with complete data for one ICD, 216 observations for a subsample of children with complete data for a second ICD, 926 observations for children missing parent-reported data for one ICD, and 44 observations for a subsample of children missing parent-reported data for a second ICD.
i Infants in child care centers and family day care homes.
j Food preparers in sites where infants are sampled will receive $50 for completing both the Menu Survey and the Infant Menu Survey.
k Excludes FDCHs.
AR = at-risk; CACFP = Child and Adult Care Food Program; FDCH = family day care home; ICD = in-care day; n.a. = not applicable; OCD = out-of-care day; OSHCC = outside-school-hours care centers; SNACS = Study of Nutrition and Activity in Child Care Settings.
Objective 1: Describe characteristics of Child and Adult Care Food Program (CACFP) providers and the CACFP environment.
Provider Survey
The web-based Provider Survey (Appendices F7/F8) asks a variety of questions about CACFP food service operations, infant feeding practices, and physical activity in child care settings. The SNACS-II Provider Survey is updated from the SNACS-I instrument to align the content with SNACS-II research questions (RQs). Although the Provider Survey primarily addresses Objective 1 RQs, the infant feeding and physical activity module addresses Objective 5 RQs.
The study team will send personalized emails to family day care home (FDCH) providers and directors of Head Start centers, other child care centers, at-risk (AR) after-school centers, and outside-school-hours care centers (OSHCCs) to invite them to complete the study (Appendices C15–C20). The study team will follow up with nonrespondents using email and telephone reminders (Appendices C21–C24).
Environmental Observation Form
The Environmental Observation Form (EOF; Appendix F19) will provide objective measures of the amount of time children spend in physical activity, sedentary activity, and screen time, as well as the types of activities and screen time children engage in while they are in care. The tool will also document key aspects of the physical activity environment, including attributes of available indoor and outdoor play spaces, weather conditions on the day of observation, types of play equipment available, the presence and type of teacher-led physical activities, and potential barriers to physical activity.
Although the content of the Environment and Policy Assessment Observation (EPAO-2019)1 is largely unchanged from that of the SNACS-I form, the form has been modified to make it easier to use and code and streamline data entry. Dr. Dianne Ward and her colleagues also developed a version of the form for use in family childcare homes (FCCHs), EPAO-FCCH.2 The content and organization of the EPAO-2019 and EPAO-FCCH are comparable, but minor adjustments reflecting the home environment have been made to the EPAO-FCCH. The EPAO-2019 and EPAO-FCCH are the foundation for the SNACS-II EOF.
Trained field interviewers (FIs) will track the activity of children in a sampled group or classroom in each provider selected for onsite data collection, and will use a stopwatch to time and record the amount of time children spend in different activities (excluding eating occasions and naps). During nap times, FIs will assess environmental characteristics of indoor and outdoor spaces. Other characteristics, such as staff interactions with children, will be recorded as they are observed.
Objective 2: Describe the food and nutrient content and overall nutritional quality of CACFP meals and snacks.
Menu Survey
The Menu Survey (Appendices F11/F12) collects information about the foods and beverages served in each meal and snack for one week, referred to as the target week. In each sampled provider, the food preparer (or person most knowledgeable about the foods provided in CACFP meals and snacks) will complete the Menu Survey. The Menu Survey booklet contains instructions, Daily Menu pages for each type of meal and snack, the Foods You Prepared form, and the Food Description Guide (F13/F14). For each CACFP meal and snack served during the target week, respondents will use the Daily Menu pages to report information about the food and beverage served, including food details (the type, preparation method, and brand), whether the food was prepared by combining two or more ingredients, and the CACFP meal pattern age group(s) to which each food and beverage was served. Respondents will use the Food Description Guide for guidance on what details to report for each food and beverage, and will be asked to complete the Foods You Prepared form for any foods prepared by combining two or more ingredients. On each Daily Menu page, respondents will also report information about the type of meal service used, which will be used to address a RQ under Objective 1. Data on the portion size of each food and beverage served in CACFP meals and snacks is needed to address some RQs under Objective 2. Respondents will also be asked to provide a copy of their posted menus for foods served during the target week.
SNACS-II made several targeted changes to the SNACS-I Menu Survey to reflect the more recent CACFP meal patterns, as well as to enhance data completeness and quality. In addition, to reduce respondent burden, the study team will create customized Menu Survey booklets for providers that also have to complete the Infant Menu Survey (discussed under Objective 5) so that instructions are streamlined and less duplicative.
Providers will receive the hardcopy Menu Survey booklet in the mail before their target week, along with a video that provides training on how to complete the Menu Survey. Trained technical assistants (TAs) will contact respondents before their target week to ensure they received their materials and to answer any initial questions. TAs will also be available to answer questions posed through a toll-free number and by email and will encourage respondents to complete the Menu Survey during their scheduled target week. In sites with onsite data collection, FIs will also be available to answer questions and encourage completion. Because some providers—in particular, FDCH providers—may have limited availability to complete the Menu Survey during daytime hours when they are caring for children, TAs will be available not only during the day but also during evening and weekend hours. TAs will follow a standardized schedule for contacting respondents before, during, and after the target week.
Objective 3a: Describe children’s usual food, calorie, and nutrient intakes on child care days and non-child-care days.
Data to address Objective 3a will come from two main sources—onsite meal observations to obtain information about foods and beverages that children (ages 1 to 12 years) consumed while in care, and interviewer-administered 24-hour dietary recall interviews with parents to obtain information about foods and beverages children consumed outside of care. Parents will provide consent by mailing the consent form (Appendices G15/G16) to the study team in the provided postage-paid envelope or by submitting a consent form on the study’s website (Appendices D1/D2). FIs will conduct onsite meal observations in each center and FDCH selected for onsite data collection. Each FI will observe up to three children at a time, using the Meal Observation Booklet (described in the next section under Objective 4).
Automated Self-Administered 24-Hour Recalls
The study team will collect dietary data from parents using an interviewer-administered dietary recall interview (rather than parents completing a child food diary as done in SNACS-I). The interview will be conducted via telephone using the National Cancer Institute Automated Self-Administered 24-Hour Recall system (ASA24), which will be integrated into the Parent Interviews (Appendices H3/H4, H.11/H12). This approach offers four key advantages relative to the approach used for SNACS-I: (1) a streamlined process and reduced burden for parents; (2) a data collection process that is driven by the study team and less reliant on parents’ self-motivation to complete data collection activities on their own; (3) improved data quality because the probes in ASA24 ensure that the details needed for an accurate nutrient analysis are collected; and (4) a more efficient process for coding the dietary intake data because foods are automatically coded in ASA24.
All parents are invited to complete the ASA24 for one in-care day and one out-of-care day. Independent subsamples of 10 percent of parents will be invited to complete a third ASA24 for either an in-care or an out-of-care day so that children’s usual dietary intakes can be described.
Child Food Diary and Food Model Booklet
Parents will be provided with a Child Food Diary (Appendices H7/H8) for recording notes about their child’s intake to help facilitate each ASA24 interview. The diary includes multiple pages so that parents can use it for multiple interviews. Parents will also be provided with the USDA Food Model Booklet (FMB; Appendix H9/H10) to assist in reporting portion sizes during each ASA24 interview.3 The study team will mail parents the Child Food Diary and FMB (Appendix H5–H10), along with instructions (Appendices H5/H6), one week before the first dietary recall interview.
Objective 3b: Describe characteristics of children and their families.
Parent Interviews
Trained telephone interviewers will administer two versions of the Parent Interview for Objective 3b. The In-Care Day Parent Interview collects data on parent demographics and child and family characteristics, as well as the child’s food, activity, and child care schedule (Appendices H3/H4). All parents/guardians of children (ages 1 to 12 years) will be asked to complete this interview. It will be administered immediately after the first ASA24 interview. The ASA24-Only Parent Interview (Appendices H11/H12) is administered to parents/guardians for one out-of-care day for their child, and to the two subsamples of parents/guardians invited to complete a third ASA24 interview. Because these parents/guardians must complete the In-Care Day Parent Interview first, the ASA24-Only Parent Interview does not collect demographic or other data that were already collected.
The SNACS-II In-Care Day Parent Interview updates the SNACS-I instrument by adding the full 18-item U.S. Household Food Security Survey Module developed by the U.S. Department of Agriculture (USDA) Economic Research Service; questions to capture time spent using computers, smart phones and other electronics (that is, screen time); time spent on sedentary activities; and time spent on indoor physical activities. Other questions from the SNACS-I instrument that are not needed to address SNACS-II RQs were deleted.
Height and Weight Form
The SNACS-II Height and Weight Form (Appendix H15) combines the Standing Height and Weight Form and the Standing and Holding Weight Form from SNACS-I into a single instrument. Following the same procedures used in SNACS-I, trained FIs will take two height and weight measurements for each child age 2 and older. If the difference between the two measurements exceeds 0.1 kilogram (kg) (for weight) or 0.5 centimeters (for height), they will take a third measurement. For children up to 2 years of age or any child who cannot stand without assistance, the point-of-contact, teacher, or other provider staff the child is familiar with will assist with the standing and holding weight method. The adult is weighed first, then the scale is tared, and the child is weighed in the arms of the adult. As with the children age 2 and older, FIs will obtain two weight measurements for each child and take a third measurement if the difference between the first two measurements exceeds 0.1 kg. Length will not be measured for these children.
Objective 3c: Describe characteristics of teens and meals and snacks offered to teens.
Food and Physical Activity Experiences Survey
The purpose of the Food and Physical Activity Experiences Survey (Appendices F21/F22) is to collect information about the physical and sedentary activities and food security status of youth ages 10 to 18 years. The survey adapts questions used in other national studies. It includes questions from the Youth Risk Behavior Survey (OMB Number 0920-0493, expires 11/30/2023) about screen time and asks about the most modern technology currently favored by youth, including smartphones and social media; a food security module developed by USDA’s Economic Research Service,4 which was included in the adolescent food security methodological substudy in the second School Nutrition and Meal Cost Study (OMB Number 0584-0648, expires 09/22/2022); and demographic questions about teens’ age, gender identity, grade level, and race/ethnicity, including the gender identity question from the Health Center Patient Survey (OMB Number 0915-0368, expires 03/31/2023).
The Food and Physical Activity Experiences Survey is a self-administered, hardcopy questionnaire. The survey includes an assent statement aimed at ensuring that youth understand the study purpose, how their data will be used, and that they have the option to not participate. (The parents/guardians of sampled youth will have already provided written consent before the youth are invited to participate.) FIs will tailor administration procedures to the needs of each site selected for onsite data collection. If possible, they will administer the surveys in a group setting that allows the youth to spread out for privacy. If group administration is not possible, the FIs will work with the point of contact to administer the surveys individually. Youth ages 10 to 12 who are included in the sample for Objectives 3a, 3b, and 4 will complete the survey while they are also completing height and weight measurements.5
Parent Interview for Teen Sample
For parents of youth ages 10 to 18 who are sampled specifically for Objective 3c, the study team will administer the Parent Interview for Teen Sample (Appendices H13/H14). This version of the Parent Interview is similar to the In-Care Day Parent Interview (Appendices H3/H4) discussed above but is limited to only the questions needed to answer Objective 3c RQs. This includes the U.S. Household Food Security Survey Module, questions about participation in nutrition assistance and other support programs, and sociodemographic characteristics. Administration procedures will be similar for the two parent interviews.
Objective 4: Assess and describe plate waste in the CACFP.
Meal Observation Booklet
To address Objectives 3a and 4, FIs will conduct in-person observations of CACFP meals and snacks served to participating children during their visit to each site over the scheduled target week. Parents will provide written consent to allow observation of their child’s meals. The Meal Observation Booklet (Appendix F20) consists of the Reference Portion Measurement Form, the Meal Observation Form, and the Classroom Waste Observation Form; it is a slightly modified version of the Meal Observation Booklet used in SNACS-I. The Reference Portion Measurement Form has been modified from SNACS-I to collect measurements on two samples of the menu items offered rather than the five collected in SNACS-I.
The FIs will coordinate with the provider’s food preparers to estimate the reference portions for meal and snack items using the Reference Portion Measurement Form. They will record the quantity (in weight or fluid ounces) or portion size for a single serving of each food item, using either measurements or visual estimation. The visual estimations will be based on models from the USDA FMB (Appendix H9/H10).
The FIs will then use the reference portions to visually estimate the amount served to each sampled child, any amounts added or removed (that is, dropped), and the amount remaining at the end of the meal, both on the child’s tray and amounts remaining on the table that will be discarded. These amounts will be recorded on the Meal Observation Form. FIs will also use the Classroom Waste Observation Form to record the types and amounts of foods left at the table for discard.
Objective 5: Examine infant feeding practices, infant food intake, and infant activity levels in child care.
Infant Menu Survey
The Infant Menu Survey (Appendices F15/F16) is similar to the main Menu Survey, except that it (1) collects information on foods served by specific times of day—before 10:00 a.m., 10:00 a.m. to 1:00 p.m., 1:00 p.m. to 4:00 p.m., and after 4:00 p.m.—instead of by meal and snack occasions, as infants are often fed on demand instead of following a specific meal schedule; (2) lists different food categories/components; and (3) lists different CACFP meal pattern age groups.
SNACS-II updated the SNACS-I Infant Menu Survey to reflect the age groups specified in the updated CACFP meal patterns for infants (0–5 months and 6–11 months). For providers that serve infants, the study team will package the Infant Menu Survey with the main Menu Survey and integrate the instructions for both, so the two surveys are streamlined and less duplicative.
Infant Intake Form
Teachers or caregivers of sampled infants will use the Infant Intake Form (Appendices F17/F18) to record the types of foods and beverages consumed at each feeding while the infant is in care, including the start time of each feeding, a description of the food or beverage, and the source (from home, from provider, or the mother nursed on site). At the middle and end of the day when they are visiting sites during each scheduled target week, FIs will check in with the respondents to answer questions and encourage completion.
SNACS-II made targeted changes to the SNACS-I Infant Intake Form to better align it with SNACS-II RQs, improve data quality, and reduce respondent burden. Among the changes are removing the column for recording portion sizes of solid foods and making corresponding measurement guides for bowls and spoons in the instructions. This information is not needed to address any of the SNACS-II RQs, and removing these data elements will eliminate unnecessary burden on providers. The study team also streamlined the form to eliminate unnecessary information and clutter and revised the pre-filled examples to show intakes that follow current CACFP infant meal patterns.
Objective 6: Determine the cost to produce an average CACFP breakfast, lunch, supper, and snack.
Pre-Visit Cost Interview and Pre-Visit Cost Form
The Pre-Visit Cost Interview (Appendix E1) will identify the staff at the sponsor agency or center who are responsible for key functions related to the CACFP; these staff will be invited to respond to other cost data collection instruments described below. This interview will also gather information on key characteristics of the sponsor agency, such as where meals are produced, and how food is transported and by whom. These details will provide context to help tailor subsequent data collection activities. After the Pre-Visit Cost Interview is completed, the study team will send the Pre-Visit Cost Form (Appendix E2) for the respondent to complete and upload to a secure file transfer site along with a recent CACFP financial statement.
SNACS-II modified the content of the SNACS-I Pre-Visit Cost Form to increase the efficiency of the data collection and to reflect the data needed to replicate the SNACS-I cost analysis. For example, rather than asking respondents to enter preliminary data on CACFP revenues, which may be imprecise and can be addressed in detail in other instruments, the study team will ask respondents to submit their most recent statements of CACFP revenues and organizational income.
Using the Pre-Visit Cost Interview, the study coordinator will collect contact information for cost study respondents on hardcopy and enter that information into the study management system. The study coordinator will send a follow-up email to the Pre-Visit Cost Interview respondent reminding them of the request to provide their financial statements to the study team via a secure file transfer site and providing them with the Pre-Visit Cost Form to complete and upload to the site, along with the financial statements.
Sponsor/Center Cost Interview
The Sponsor/Center Cost Interview (Appendix E4) will collect data on sponsor-incurred labor and food costs and revenues. Respondents for this interview will be sponsor or center staff who are knowledgeable about CACFP and sponsor/center finances. The streamlined instruments will enable FIs to collect all data on site. FIs will collect and scan any documents they receive during the interview; if some documents, such as vendor records, are not provided during the interview, FIs will ask respondents to upload the documents to the secure file transfer site.
The study team believes the data collection will proceed most efficiently and accurately if the content of the Sponsor/Center Cost Interview reflects the various sponsor-center relationships that sampled centers may represent: (1) centers affiliated with or operated by a sponsor, (2) centers not affiliated with a sponsor (that is, the sponsor provides only CACFP services to the center), and (3) centers that operate the CACFP independently. Therefore, in fielding the instrument, the study team will create individual versions that are tailored to these structures. This approach will provide more structure for the complex data collection effort to be implemented by field staff and minimize the potential for missing or erroneous data. To prevent duplication of information collection across interviews, the study team will update introductory language to remind respondents not to include staff working primarily at the center level in this interview. FIs will also be trained to probe and provide these types of reminders so that labor is not double counted across instruments.
Because some sponsors may not be located near where other onsite data collection activities will be taking place, the Sponsor/Center Cost Interview may not always be completed in person during the site visit. To accommodate these situations, study coordinators will attempt to schedule the Sponsor/Center Cost Interview during the visit so that only one person—the FI—collects all cost information for the site. This approach, implemented while the interviews are still fresh in the FI’s mind, reduces the risk of under- and overcounting staff across interviews. We will mail sponsors the relevant handouts before the interview, which will allow them to visualize the information to be collected, and we will train FIs to conduct the interview in a private space during the visit. Doing so ensures that other staff at the site will not overhear potentially sensitive salary information. The private space may be a room at the site, a hotel, or at home if the FI is visiting a local site.
Center Food Service Cost Interview
The Center Food Service Cost Interview (Appendix E6) will collect data on the time allocation and compensation of center staff who work primarily on food service. The study team will collect the time allocation information from food preparers at each site during the visits scheduled for each target week. However, because respondents may consider information on compensation to be sensitive data, we plan to gather data on the salaries of center or sponsor food service staff, when needed, from the sponsor or center director. Where possible, the salary information will be collected in person during the site visit. If that is not possible, the FI will follow up by telephone after the site visit has been completed.
If any providers receive meals and snacks from production kitchens (off-site kitchens that prepare food for one or more receiving kitchens), FIs will conduct additional Center Food Service Cost Interviews with production kitchen staff. The additional interviews will allow production kitchen labor to be attributed to the cost of producing meals and snacks for the sampled providers.
Center Director Cost Interview
The Center Director Cost Interview (Appendix E5) will collect data on the time allocation and compensation of center staff who support the CACFP but do not work primarily on food service. These staff may include teachers or aides who help with meal service.
The order in which the center-level interviews—the Center Food Service Cost Interview and the Center Director Cost Interview—are administered will be important in preventing duplication of staff time and salary information. FIs will complete the Center Food Service Cost Interview first, followed by the Center Director Cost Interview. In addition to preventing duplication, this will also provide an opportunity for the center director to provide salary information needed to complete the Center Food Service Cost Interview when necessary.
In some cases, the center director will be asked to complete all or some of the Sponsor/Center Cost Interview, as well as the Center Director Cost Interview. This will happen if the center is independent, as well as in some sponsored centers where the sponsor did not complete any or all modules of the Sponsor/Center Cost Interview. FIs will follow up with the respondents to complete any missing portions of the interviews after the site visit has concluded. This may be especially important in cases in which one respondent is responsible for completing multiple instruments and may not have enough time to complete them all during the site visit.
Self-Administered Cost Questionnaire
The Self-Administered Cost Questionnaire (Appendix E3) will collect data on sponsor and center characteristics, meal and snack counts for the prior Federal fiscal year and the current target week, operating days, and average daily attendance.
We plan to send the Self-Administered Cost Questionnaire to sponsors and independent centers before the site visit and collect it during administration of the Sponsor/Center Cost Interview. Because the Self-Administered Cost Questionnaire contains questions that can be completed by the respondent on their own, sending it in advance limits the amount of in-person time required for the data collection. The FI will collect the Self-Administered Cost Questionnaire during the visit but will instruct the respondent to transmit the target week meal and snack counts section to Mathematica at the conclusion of the target week. The counts must be sent separately because visits will generally be completed before the end of the target week. Respondents may return the meal and snack counts with the hardcopy Menu Survey or upload the data to a secure file transfer site.
For all the instruments and procedures described above, the study team will send materials to sample members in advance of telephone and onsite interviews. These materials will include a summary of topics to be covered, a list of documents that may be requested or that may be helpful to have available during the interview, and handouts with definitions of key terms and tables that can be used to organize information before the interview. Sending these materials will help prepare respondents for the cost interviews, and if they are prepared, the data they provide is more likely to be complete and accurate. Post-visit, FIs will retain responsibility for any interviews with incomplete sections and will be expected to follow up to collect any missing data.
1 Tovar, A., A.E. Vaughn, J.O. Fisher, S.E.B. Neelon, R. Burney, K. Webster, L. Tao, T. Østbye, and D.S. Ward. “Modifying the Environment and Policy Assessment and Observation (EPAO) to Better Capture Feeding Practices of Family Childcare Home Providers.” Public Health Nutrition, vol. 22, no. 2, February 2019, pp. 223–234.
2 Vaughn, A.E., S. Mazzucca, R. Burney, T. Østbye, S.E.B. Neelon, A. Tovar, and D.S. Ward. “Assessment of Nutrition and Physical Activity Environments in Family Child Care Homes: Modification and Psychometric Testing of the Environment and Policy Assessment and Observation.” BMC Public Health, vol. 17, no. 1, August 2017, p. 680.
3 The FMB was developed for the National Health and Nutrition Examination Survey. Available at https://www.cdc.gov/nchs/nhanes/measuring_guides_dri/2002/fmb.htm.
4 Connell, C. L., Nord, M., Lofton, K. L., & Yadrick, K. (2004). Food security of older children can be assessed using a standardized survey instrument. The Journal of Nutrition, 134(10), 2566-2572.
5 Sampling plans for the study objectives are described in Supporting Statement B.
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