Impact of Food Marketing and Cross-Promotions on Preschoolers' Dietary Intake

描述(申请人提供)：背景：食品公司每年花费近20亿美元用于儿童导向营销，其中大部分用于推广高脂肪、高能量密度的食品。餐厅快餐(FF)和高糖早餐麦片(SBC)在幼儿中的广告支出和曝光率最高。由于学龄前儿童年龄较小，他们可能极易受到食品营销的影响。目的：本研究的主要目的是确定儿童导向营销对学龄前儿童膳食摄入量和BMI的影响。此外，我们将研究交叉促销联系(CPTI)的额外影响，以及种族/民族是否缓和了这种联系。使用定性方法，我们将确定与父母购买儿童和儿童住房有关的因素，这些因素可以通过政策和家庭层面的干预来修改。方法：对东北地区四个不同民族的800名亲子二人组进行纵向调查。这项调查将在15个月内包括10项评估。基线和最终调查将亲自进行。8项临时调查将通过iPod Touch自行管理。学龄前儿童的饮食摄入量将通过重复7天的FF和SBC消费回忆和4次24小时饮食召回来评估，并以父母为代表。身高和体重将被客观测量。儿童对儿童指导的FF和SBC营销的接触将通过三个来源进行衡量：前6个学龄前儿童电视网络播放的电视广告，票房最高的青年收视率电影中的产品植入，以及位于四个集水区的连锁快餐店和大型超市的购物点促销活动的现场观察。将通过对基金会网站的定期监测和对超市的评估来评估CPTIs。IPod Touch调查将预先编程，以确保调查时间与电视商业广告采样时间框架一致，并进行远程更新，以包括有关新发布的电影和CPTI的提示。总体风险将通过结合家长调查答复和对这三个食品营销来源的内容分析来确定。将使用纵向统计分析，允许饮食摄入量随着儿童导向营销的时间变化而发生变化。在线焦点小组和电话访谈将与有目的的父母样本进行，这些父母是根据他们的孩子接触食品营销和食用FF和SBC的情况而选择的。意义：这是第一项以人群为基础的大规模研究，客观地衡量学龄前儿童食品营销暴露的多种来源，并评估其对饮食和BMI的影响。必须进行严格的研究，量化儿童食品营销的影响，以便制定有效的政策，促进负责任的食品营销做法。这项研究的发现将对预防儿童肥胖具有重要的公共卫生意义。

DESCRIPTION (provided by applicant): Background: Food companies spend nearly $2 billion each year on child-directed marketing, the majority of which is used to promote high-fat energy-dense foods. Restaurant fast foods (FF) and high sugar breakfast cereals (SBC) account for the greatest advertising expenditures and exposure among young children. Because of their young age, preschool children are potentially highly susceptible to food marketing. Aims: The primary goal of this study is to determine the impact of child-directed marketing of FF and SBC on preschool children's dietary intake and BMI. Additionally, we will examine the added impact of cross- promotional tie-ins (CPTIs) and whether race/ethnicity moderates this association. Using qualitative methods, we will identify factors related to parental purchases of FF and SBC that may be modified through policy and family-level interventions. Methods: We will conduct a longitudinal survey of 800 parent-child dyads recruited from four ethnically diverse Northeast cities. The survey will include 10 assessments over a 15-month period. The baseline and final surveys will be administered in-person. Eight interim surveys will be self-administered through an iPod touch. Preschoolers' dietary intake will be assessed through repeated 7-day recalls of FF and SBC consumption and four 24-hour dietary recalls with parents as a proxy. Height and weight will be objectively measured. Children's exposure to child-directed marketing of FF and SBC will be measured through three sources: TV commercials aired on the top 6 preschool TV networks, product placements in the top box-office youth-rated movies, and onsite observations of point-of-purchase promotions at chain fast food restaurants and large supermarkets located in the four catchment areas. CPTIs will be assessed through regular monitoring of FF websites and supermarket assessments. The iPod touch surveys will be pre-programmed to ensure the survey timing corresponds to TV commercial sampling timeframes, and remotely updated to include prompts about newly released movies and CPTIs. Overall exposure will be determined by combining parent survey responses with content analyses of these three sources of food marketing. Longitudinal statistical analyses that allow for changes in dietary intake as a function of time-varying exposure to child-directed marketing will be used. Online focus groups and telephone interviews will be conducted with a purposeful sample of parents, selected based on their children's exposure to food marketing and consumption of FF and SBC. Significance: This is the first large population-based study to objectively measure multiple sources of food marketing exposure among preschoolers' and evaluate its impact on diet and BMI. Rigorous research quantifying the impact of child-directed food marketing is imperative to inform effective policy and promote responsible food marketing practices. Findings from this study will have important public health implications for preventing obesity in children.