Introducing Child Menus in Restaurants to Improve Access to Healthier Foods

描述（由申请人提供）：项目概述儿童肥胖率在墨西哥移民/墨西哥裔美国人中最高，这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食品环境对预防和控制儿童肥胖的重要性。最新的干预研究，以改善餐厅的食品环境为儿童集中在菜单标签，然而，没有研究测试的方法，通过改变提供给儿童的食物，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，由医学研究所和白宫儿童肥胖特别工作组推荐的策略。在我们的形成性研究和探索性干预研究的基础上，提出了一项研究，在餐馆引入儿童菜单以改善健康食品的获取。在第一阶段，我们将开发一种方法来观察12家餐馆的儿童点餐和消费行为，这些餐馆与干预阶段的目标餐馆相似，但位于不同的社区。第二阶段将包括评估餐馆干预的可行性、保真度和短期效果。五家配对的独立餐厅将被随机分为干预组和延迟治疗组。干预将包括(a)制定符合饮食指南的健康儿童菜单，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该菜单。我们对独立餐厅的关注是由我们的形成性研究确定的，因为缺乏儿童菜单；此外，这项工作与餐饮业正在做的连锁餐厅工作是互补的，而不是重叠的。本研究的主要目的是利用餐厅销售数据来评估干预对新健康儿童菜单项目销售的效果。一个探索性的目标是检验新增的健康儿童菜单是否能有效地改变点菜和消费行为，通过观察评估，减少卡路里、脂肪和糖，增加儿童消费的水果和蔬菜。流程评估目标包括评估：(a)基于健康菜单创建和推广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更大规模的随机对照试验提供可行性、短期疗效、潜在的可持续性和推广性的必要数据，以评估饮食摄入量的变化。它也有可能有助于NIH针对少数民族的研究和寻求预防和控制儿童肥胖的研究的要求。

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.