Introducing Child Menus in Restaurants to Improve Access to Healthier Foods

描述（由申请人提供）：项目摘要儿童肥胖是墨西哥移民/墨西哥裔美国人中最高的，是美国拉丁裔人口中增长最快的部分。大量证据支持健康的饮食环境对于儿童肥胖预防和控制的重要性。最新的干预研究，以改善餐厅的食物环境，为儿童集中在菜单标签，但没有研究已经测试的方法，改善餐厅的食物环境，改变什么是提供给儿童和改变社会环境，通过创新的儿童菜单营销活动和餐厅员工培训，这是医学研究所和白宫儿童肥胖特别工作组推荐的策略。拟议的研究，在餐馆引入儿童菜单，以改善获得更健康的食品，建立在我们的形成性研究和探索性干预研究的基础上。在第一阶段，我们将开发一种方法，观察12家餐馆的儿童的菜单订购和消费行为，这些餐馆与干预阶段的目标餐馆相似，但位于不同的社区。第二阶段将涉及评估以餐馆为基础的干预措施的可行性、忠实性和短期功效。五对配对的独立拥有的餐馆将被随机分配到干预或延迟治疗对照条件。干预措施将包括：（a）制定符合饮食指南的健康儿童菜单，减少热量、脂肪和糖，增加水果和蔬菜;（B）通过创新的儿童菜单营销活动和餐馆员工的鼓励，推广这一菜单。我们对独立餐厅的关注是由我们的形成性研究所确定的缺乏儿童菜单所驱动的;此外，这项工作与餐饮业对连锁餐厅所做的工作相辅相成，并且不重叠。本研究的主要目的是评估干预措施对新的健康儿童菜单项的销售使用餐馆的销售数据的有效性。一个探索性的目标将检查新的健康儿童菜单的添加是否有效地改变订购和消费行为，通过观察评估，以减少热量，脂肪和糖，并增加儿童消费的水果和蔬菜。过程评价的目标包括评估：（a）可行性和干预的保真度的基础上，健康菜单的创建和推广的程度，和（B）客户的反应，包括满意度与健康的孩子菜单。拟议的研究将为未来更大规模的随机对照试验提供必要的数据，以餐馆为基础的干预措施的可行性、短期疗效、潜在的可持续性和普遍性，以评估饮食摄入量的变化。它也有可能有助于国家卫生研究院的要求，研究针对少数民族和研究，寻求预防和控制儿童肥胖。

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.