Evaluating a Healthy Restaurant Kids Meals Policy

This study uses a quasi-experimental approach to evaluate the effects of a healthy default kids' beverage policy on children's fast-food restaurant meal purchases and dietary intake. Annotated receipt and survey data will be collected from parents purchasing a food or beverage for a child 2-10 years of age at fast-food restaurants. Eligible participants will be asked to participate in a telephone dietary recall the following day. Data will be collected from a repeated cross-section of children in two intervention cities implementing a healthy default kids' beverage policy (New York City and Philadelphia) and a control area not implementing the policy (northern New Jersey) before the policy is implemented and after the policy goes into effect. A difference-in-differences analytic approach will be used to compare the change in children's fast-food restaurant meal orders and dietary intake pre- to post-implementation in the intervention versus control groups. A Holm-Bonferroni correction for multiple comparisons will be applied to p-values for secondary outcomes.

Inclusion criteria

• Adult 18 years of age or older
• Parent or legal guardian of a child 2-10 years of age
• Purchasing at least one food or beverage item for the child at the restaurant (if purchasing foods or beverages for multiple children, only items purchased for the youngest child 2-10 years of age will be included)
• Able to speak and understand English or Spanish

Additional criteria for dietary recalls:

• Parent or legal guardian 18 years of age or older is present for the recall
• If child for whom the restaurant meal was purchased is 6 years of age or older, child is present for the recall
• If child for whom the restaurant meal was purchased is 9 years of age or older, the child is present for the recall and is able to speak and understand English or Spanish

Exclusion criteria

• Younger than 18 years of age
• Is not a parent or legal guardian to a child 2-10 years of age
• Is not purchasing one or more food or beverage items for the child at the restaurant
• Does not speak or understand English or Spanish

Additional criteria for dietary recalls:

• Parent or legal guardian is not present for the recall
• The restaurant meal was purchased for a child 6 years of age or older, who is not present for the recall
• Child 9 years of age or older, for whom the restaurant meal was purchased, is not able to speak or understand English or Spanish