Ayala Guadalupe X, Castro Iana A, Pickrel Julie L, Williams Christine B, Lin Shih-Fan, Madanat Hala, Jun Hee-Jin, Zive Michelle
San Diego State University, 5500 Campanile Drive, San Diego, CA, 92182, USA.
Institute for Behavioral and Community Health, 9245 Sky Park Court, Suite 221, San Diego, CA, 92123, USA.
BMC Public Health. 2016 Mar 10;16:250. doi: 10.1186/s12889-016-2892-5.
Away-from-home eating is an important dietary behavior with implications on diet quality. Thus, it is an important behavior to target to prevent and control childhood obesity and other chronic health conditions. Numerous studies have been conducted to improve children's dietary intake at home, in early care and education, and in schools; however, few studies have sought to modify the restaurant food environment for children. This study adds to this body of research by describing the development and launch of an innovative intervention to promote sales of healthy children's menu items in independent restaurants in Southern California, United States.
This is a cluster randomized trial with eight pair-matched restaurants in San Diego, California. Restaurants were randomized to a menu-only versus menu-plus intervention condition. The menu-only intervention condition involves manager/owner collaboration on the addition of pre-determined healthy children's menu items and kitchen manager/owner collaboration to prepare and plate these items and train kitchen staff. The menu-plus intervention condition involves more extensive manager/owner collaboration and kitchen staff training to select, prepare, and plate new healthy children's menu items, and a healthy children's menu campaign that includes marketing materials and server training to promote the items. The primary outcome is sales of healthy children's menu items over an 18-week period. In addition, dining parties consisting of adults with children under 18 years of age are being observed unobtrusively while ordering and then interviewed throughout the 18-week study period to determine the impact of the intervention on ordering behaviors. Manager/owner interviews and restaurant audits provide additional evidence of impact on customers, employees, and the restaurant environment. Our process evaluation assesses dose delivered, dose received, and intervention fidelity.
Successful recruitment of the restaurants has been completed, providing evidence that the restaurant industry is open to working on the public health challenge of childhood obesity. Determining whether a restaurant intervention can promote sales of healthy children's menu items will provide evidence for how to create environments that support the healthy choices needed to prevent and control obesity. Despite these strengths, collection of sales data that will allow comprehensive analysis of intervention effects remains a challenge.
NCT02511938.
外出就餐是一种重要的饮食行为，对饮食质量有影响。因此，这是预防和控制儿童肥胖及其他慢性健康问题的一个重要行为目标。已有大量研究致力于改善儿童在家中、早期护理和教育机构以及学校的饮食摄入；然而，很少有研究试图改变面向儿童的餐厅食品环境。本研究通过描述一项创新干预措施的开发和实施，为这一研究领域增添了内容，该干预措施旨在促进美国南加州独立餐厅中健康儿童餐品的销售。
这是一项整群随机试验，在加利福尼亚州圣地亚哥的八家配对餐厅进行。餐厅被随机分配到仅菜单干预组和菜单加干预组。仅菜单干预组包括经理/业主合作添加预先确定的健康儿童餐品，以及厨房经理/业主合作准备和装盘这些餐品并培训厨房员工。菜单加干预组涉及更广泛的经理/业主合作和厨房员工培训，以选择、准备和装盘新的健康儿童餐品，以及开展一项健康儿童菜单推广活动，其中包括营销材料和服务员培训以促销这些餐品。主要结果是18周内健康儿童餐品的销售额。此外，在18周的研究期间，对由18岁以下儿童和成人组成的用餐群体在点餐时进行不显眼的观察，然后进行访谈，以确定干预对点餐行为的影响。经理/业主访谈和餐厅审计为干预对顾客、员工和餐厅环境的影响提供了额外证据。我们的过程评估评估了提供的剂量、接受的剂量和干预的保真度。
餐厅的成功招募已经完成，这表明餐饮行业愿意应对儿童肥胖这一公共卫生挑战。确定餐厅干预措施是否能促进健康儿童餐品的销售，将为如何营造支持预防和控制肥胖所需健康选择的环境提供证据。尽管有这些优势，但收集能够全面分析干预效果的销售数据仍然是一项挑战。
NCT02511938。
