Introducing Child Menus in Restaurants to Improve Access to Healthier Foods

描述(申请人提供)：儿童肥胖是墨西哥移民/墨西哥裔美国人中肥胖率最高的群体之一，也是美国拉美裔人口增长最快的部分。大量证据支持健康的饮食环境对儿童肥胖预防和控制的重要性。最新的改善儿童餐厅食物环境的干预研究主要集中在菜单标签上，然而还没有研究测试通过改变提供给儿童的食物和通过创新的儿童菜单营销活动和餐馆员工培训来改变社会环境的方法，这些策略是由医学研究所和白宫儿童肥胖特别工作组推荐的。这项拟议的研究，在我们的形成性研究和探索性干预研究的基础上，在餐厅引入儿童菜单，以改善获得更健康食品的机会。在第一阶段，我们将开发一种方法来观察12家餐厅的儿童菜单订购和消费行为，与干预阶段的目标相似，尽管位于不同的社区。第二阶段将包括评估以餐馆为基础的干预措施的可行性、保真度和短期效果。五家配对的独立经营餐厅将被随机分为干预或延迟治疗控制条件。干预措施将包括：(A)制作符合饮食指南的健康儿童菜单，以减少卡路里、脂肪和糖，增加水果和蔬菜，以及(B)通过创新的儿童菜单营销活动和餐厅员工的提示来推广这一菜单。我们对独立餐厅的关注是因为我们的形成性研究确定了缺乏儿童菜单；此外，这项工作是对餐饮业对连锁餐厅所做的赞扬，而不是重叠。本研究的主要目的是利用餐厅的销售数据来评估干预对新健康儿童菜单项目销售的效果。一个探索性的目的是检查增加新的健康儿童菜单是否有效地改变点餐和消费行为，通过观察评估，以减少卡路里、脂肪和糖，增加儿童消费的水果和蔬菜。过程评估目标包括评估：(A)基于创建和推广健康菜单的程度的可行性和干预保真度，以及(B)客户反应，包括对健康儿童菜单的满意度。这项拟议的研究将为未来评估饮食摄入量变化的更大规模的随机对照试验提供以餐馆为基础的干预的可行性、短期有效性、潜在可持续性和普遍性的必要数据。它还有可能为NIH提出的针对少数民族的研究以及寻求预防和控制儿童肥胖症的研究做出贡献。

DESCRIPTION (provided by applicant): Project Summary Childhood obesity is among the highest in the Mexican immigrant/Mexican-American population, the fastest growing segment of the U.S. Latino population. Substantial evidence supports the importance of a healthy food environment for childhood obesity prevention and control. The latest intervention research to improve the restaurant food environment for children has focused on menu labeling, however no study has tested methods for improving the restaurant food environment by changing what is offered to children and altering the social environment through an innovative children's menu marketing campaign and restaurant employee training, strategies recommended by the Institute of Medicine and the White House Task Force on Childhood Obesity. The proposed study, Introducing Child Menus in Restaurants to Improve Access to Healthier Foods builds on our formative research and an exploratory intervention study. During Phase I we will develop a method for observing menu ordering and consumption behaviors among children in 12 restaurants similar to those targeted during the intervention phase though located in a different community. Phase II will involve assessing the feasibility, fidelity and short-term efficacy of a restaurant-based intervention. Five pair-matched independently-owned restaurants will be randomized to an intervention or a delayed treatment control condition. The intervention will involve (a) creating healthy child menus that meet dietary guidelines for reducing calories, fat, and sugar and increasing fruits and vegetables, and (b) promoting this menu through an innovative children's menu marketing campaign and prompting by restaurant employees. Our focus on independent restaurants is driven by the lack of child menus as determined by our formative research; in addition, this work compliments and does not overlap with what the restaurant industry is doing with chain restaurants. The primary aim of this study is to evaluate the efficacy of the intervention on sales of new healthy child menu items using restaurant sales data. An exploratory aim will examine whether the addition of new healthy child menus is effective at altering ordering and consumption behaviors, assessed observationally, to decrease the calories, fat, and sugar, and increase the fruits and vegetables that children consume. Process evaluation aims include assessing the: (a) feasibility and intervention fidelity based on the extent to which healthy menus are created and promoted, and (b) customer reactions including satisfaction with the healthy child menus. The proposed study will provide the necessary data on feasibility, short-term efficacy, and potential sustainability and generalizabiliy of a restaurant-based intervention for a future larger scale randomized controlled trial assessing changes in dietary intake. It also has the potential to contribute to NIH's request for research targeting ethnic minorities and studies that seek to prevent and control childhood obesity.