P088 A Feasibility Trial of an Asynchronous Web-based Infant Feeding Course for Child and Adult Care Food Program Providers


      The Child and Adult Care Food Program (CACFP) provides meals and snacks to children at eligible, participating locations. Previous nutrition interventions for providers presented improved knowledge of CACFP nutrition standards, behavioral intentions, and confidence about feeding practice. However, few studies focusing on infant feeding for providers have been reported.


      To describe the development and implementation of an asynchronous virtual training course aiming to improve infant feeding practices of providers and report program outcomes.

      Study Design, Settings, Participants

      This study was a single group, pretest-posttest quasi-experimental design. A three-module course was developed and implemented through a partnership between the State Department of Education and an Extension system. Each module consisted of 2-3 sessions and was offered through the Canvas platform. Providers completed pre-survey (n = 51) and/or post-survey (n = 57), respectively. Participants (n = 32) who completed both were included for analysis.

      Measurable Outcome/Analysis

      Self-confidence and knowledge related to infant feeding were measured. Recommended changes were assessed qualitatively. Descriptive statistics and a marginal homogeneity test were used for analysis.


      Approximately 37% of participants were teachers and 24% were center directors or owners. After the course, participants’ self-confidence significantly improved (P <0.001). In particular, they became very confident in describing breast milk storage (P = 0.001), when a child should switch from a bottle to a cup (P = < 0.001), and when a baby is ready to start eating solid foods (P = < 0.001). Also, participants significantly improved knowledge of infant feeding (P < 0.001). Qualitative responses emphasized the importance of educating staff to feed in response to hunger cues, rather than at set times. The participants mentioned that providing refresher training, and posting signage about breast milk and formula feeding and storage guidelines in classrooms would be beneficial. Constant communication with families was perceived to be important as well.


      An asynchronous virtual training course implemented through an Extension was feasible and effective for improving self-efficacy and knowledge related to infant feeding. It also has potential for program sustainability.


      USDA; US Department of Agriculture Child and Adult Care Food Program Meal Service Training Grant through the Maryland State Department of Education.


      Supplementary data related to this article can be found at