Promoting healthy choices in non-chain restaurants: effects of a simple cue to customers.

This study tested a novel intervention to influence restaurant customer ordering behavior, with measurements at baseline and 3, 6, and 12 months postintervention in four owner-operated restaurants in the Midwest. A sample of 141 to 370 customers was surveyed at each time point. The response rate was 70% to 84% with 59% women, 98% White, and a mean age of 53 years. Table signs listed changes customers might consider, for example, asking for meat broiled instead of fried or requesting smaller portions. Customer surveys measured program reach and effectiveness. Owner interviews measured perceptions of program burden and customer response. Order slips were analyzed for evidence of changes in ordering. Window signs were noticed by 40%, 48%, and 45% of customers at each follow-up, respectively. Table signs were noticed by 67%, 71%, and 69% of customers, respectively. Of those, 34% at each time point stated that the signs influenced their order. Examples of how orders were influenced were elicited. Order slip data not only did not show significant changes but was also found to be an inadequate measure for the intervention. Owners reported no concerns or complaints. This intervention resulted in small but positive behavior changes among a portion of customers. Because of its simplicity and acceptability, it has great potential for dissemination.