Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2017 Dec 1;14(12):1494.
doi: 10.3390/ijerph14121494.

A Cluster Randomized Trial to Promote Healthy Menu Items for Children: The Kids' Choice Restaurant Program

Guadalupe X Ayala  1 , Iana A Castro  2 , Julie L Pickrel  3 , Shih-Fan Lin  4 , Christine B Williams  5 , Hala Madanat  6 , Hee-Jin Jun  7 , Michelle Zive  8
Affiliations
Randomized Controlled Trial

A Cluster Randomized Trial to Promote Healthy Menu Items for Children: The Kids' Choice Restaurant Program

Guadalupe X Ayala et al. Int J Environ Res Public Health. .

Abstract

Evidence indicates that restaurant-based interventions have the potential to promote healthier purchasing and improve the nutrients consumed. This study adds to this body of research by reporting the results of a trial focused on promoting the sale of healthy child menu items in independently owned restaurants. Eight pair-matched restaurants that met the eligibility criteria were randomized to a menu-only versus a menu-plus intervention condition. Both of the conditions implemented new healthy child menu items and received support for implementation for eight weeks. The menu-plus condition also conducted a marketing campaign involving employee trainings and promotional materials. Process evaluation data captured intervention implementation. Sales of new and existing child menu items were tracked for 16 weeks. Results indicated that the interventions were implemented with moderate to high fidelity depending on the component. Sales of new healthy child menu items occurred immediately, but decreased during the post-intervention period in both conditions. Sales of existing child menu items demonstrated a time by condition effect with restaurants in the menu-plus condition observing significant decreases and menu-only restaurants observing significant increases in sales of existing child menu items. Additional efforts are needed to inform sustainable methods for improving access to healthy foods and beverages in restaurants.

Keywords: child menu; food availability; food marketing; restaurant.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. In addition, the National Institutes of Health had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Figures

Figure 1
Figure 1
CONSORT figure for Kids’ Choice Restaurant Program (KCRP).
Figure 2
Figure 2
Example kids menus. (a) Original menu; (b) New menu from Menu-only condition; and, (c) New menu from Menu-plus condition.
Figure 2
Figure 2
Example kids menus. (a) Original menu; (b) New menu from Menu-only condition; and, (c) New menu from Menu-plus condition.
Figure 3
Figure 3
Total weekly $ sales of new healthy child menu items by condition (N = 8).
Figure 4
Figure 4
Total weekly sales in dollars of existing child menu items by condition (N = 6).
Figure 5
Figure 5
% of healthy child menu items (units) sold by condition (N = 6).
See this image and copyright information in PMC

References

    1. Popkin B.M., Adair L.S., Ng S.W. Global nutrition transition and the pandemic of obesity in developing countries. Nutr. Rev. 2012;70:3–21. doi: 10.1111/j.1753-4887.2011.00456.x. - DOI - PMC - PubMed
    1. Poti J.M., Popkin B.M. Trends in energy intake among U.S. children by eating location and food source, 1977–2006. J. Am. Diet. Assoc. 2011;111:1156–1164. doi: 10.1016/j.jada.2011.05.007. - DOI - PMC - PubMed
    1. Bowen D.J., Barrington W.E., Beresford S.A. Identifying the effects of environmental and policy change interventions on healthy eating. Annu. Rev. Public Health. 2015;36:289–306. doi: 10.1146/annurev-publhealth-032013-182516. - DOI - PMC - PubMed
    1. Rose D., Nicholas Bodor J., Hutchinson P.L., Swalm C.M. The importance of a multi-dimensional approach for studying the links between food access and consumption. J. Nutr. 2010;140:1170–1174. doi: 10.3945/jn.109.113159. - DOI - PMC - PubMed
    1. Lytle L.A., Sokol R.L. Measures of the food environment: A systematic review of the field, 2007–2015. Health Place. 2017;44:18–34. doi: 10.1016/j.healthplace.2016.12.007. - DOI - PubMed

Publication types

LinkOut - more resources