Promoting healthier meal selection and intake among children in restaurants

摘要 美国儿童的饮食是不健康的，这是在肥胖症流行的背景下需要解决的一个关键问题。餐饮业 是一种环境变化可以促进儿童健康饮食的环境。三分之一的人 孩子们在特定的一天吃快餐店的食物，消费餐馆的食物 与能量摄入增加和较差的饮食质量有关。口感是影响食物的关键因素 儿童在餐馆的选择，因此增加儿童对更健康选择的喜好的方法提供 承诺在这些环境中和更广泛的情况下改善他们的饮食行为。建议的目标是 研究是通过餐厅内的干预使更健康的选择更有吸引力，更容易选择 它结合了精选的架构和重复曝光策略。选择架构元素将是 Placemat的设计是为了更容易地选择更健康的儿童膳食项目，而不是甜点。重复的 曝光元素将是经常用餐的卡片，旨在增加对目标的暴露和享受 食物。广泛的基础研究支持反复曝光是提高儿童品味的有效策略 偏好。此外，在一家快餐店对58个家庭进行的初步研究中，我们展示了我们的承诺 计划干预：为儿童提供餐垫以促进更健康的儿童膳食 与对照组相比，一些更健康的食物，点了推广主菜的孩子吃得更少 比那些没有饱和脂肪的人要多。我们的长期目标是建立内部餐厅的有效性 可在餐厅实施和传播的健康饮食干预措施。这样做的目的是 格兰特将通过严格测试联合干预的效果来扩展我们的初步研究 快餐儿童食物选择结构与重复暴露策略研究 餐馆和一整天的时间。我们将把餐厅的地点随机分配给团体和光顾的儿童 定期(n=930；每组310家)的餐馆将接触到餐垫和经常用餐卡，以促进 更健康的饮食或这些材料的通用(对照)版本。频繁的用餐卡将激励 在干预组中，选择更健康的特色饮食超过6次。中心假设是 在这些暴露之后，干预组儿童将更有可能选择更健康的饮食。儿童餐 餐厅和全天的选择和饮食摄入量将在最初和之后的测试中进行评估 时间指向测试假设，即这种干预促进更健康的饮食选择(具体目标1)和 饮食摄入量(具体目标2)。家庭在过渡时间点的行为及其对餐馆的潜在影响 也将受到监控。考虑到孩子们吃餐馆食物的频率，典型的消费 在那里的模式，以及反复暴露于广泛影响饮食行为的承诺，这 干预措施有可能对公共卫生产生重大影响。目前的方法是新颖的，因为它 行为策略的应用，并可能对儿童的饮食和健康产生持久影响。

ABSTRACT US children’s diets are unhealthy, a critical issue to address in the context of the obesity epidemic. Restaurants are one setting in which environmental shifts could promote healthier eating among children. One-third of children eat food from quick-service (fast food) restaurants on a given day, and consumption of restaurant food has been linked with increased energy intake and poorer diet quality. Taste is a key factor influencing food choices for children in restaurants, so approaches that increase children’s liking of healthier options offer promise to improve their eating behavior in these settings and more broadly. The goal of the proposed research is to make healthier options more appealing and easier to choose via an in-restaurant intervention that combines choice architecture and repeated exposure strategies. The choice architecture element will be a placemat designed to make it easier to choose healthier kids’ meal items and omit dessert. The repeated exposure element will be frequent diner cards, designed to increase exposure to and enjoyment of target foods. Extensive basic research supports repeated exposure as a powerful strategy to improve children’s taste preferences. Further, in a pilot study of 58 families in a quick-service restaurant, we showed the promise of our planned intervention: Children provided with placemats promoting healthier kids’ meals ordered a greater number of healthier foods than controls, and children who ordered promoted main dishes consumed less saturated fat than those who did not. Our long-term goal is to establish the effectiveness of an in-restaurant healthy eating intervention that can be implemented and disseminated across restaurants. The objective of this grant is to expand on our preliminary research by rigorously testing effects of an intervention that combines choice architecture and repeated exposure strategies on children’s food selection and intake in quick-service restaurants and throughout the day. We will randomize restaurant locations to groups, and children who visit restaurants regularly (n=930; 310 per cohort) will be exposed to placemats and frequent diner cards promoting healthier meals or generic (control) versions of these materials. The frequent diner cards will incentivize selection of a healthier featured meal over 6 occasions in the intervention group. The central hypothesis is that after these exposures, intervention group children will be more likely to select a healthier meal. Children’s meal selection and dietary intake in the restaurant and throughout the day will be assessed at initial and post-test time points to test hypotheses that this intervention promotes healthier meal selection (Specific Aim 1) and dietary intake (Specific Aim 2). Families’ behaviors at interim time points and potential impacts on restaurants will also be monitored. Given how frequently children eat food from restaurants, the typical consumption patterns while there, and the promise of repeated exposure to impact eating behaviors broadly, this intervention has the potential for meaningful public health impact. The present approach is novel in its application of behavioral strategies and offers the potential for lasting impacts on children’s diets and health.