Kids' Choice Restaurant Program

The purpose of the study is to assess the efficacy of an intervention to improve access to
healthier foods by introducing or changing child menus in restaurants. We propose recruiting
8 independent full service restaurants, either with or without existing child menus.
Recruitment will occur in waves of two restaurants per wave for a total of four waves.
Restaurants will be matched on key criteria such as whether they have a child menu and
restaurant size based on seating (categorized as small -to- medium or large). Matched
restaurants will be randomized to either an 8--week menu--only intervention or a menu--plus
intervention that will occur at the same time. The menu--only intervention will involve
working with the restaurant to add new healthy child menu items to their menus. The
menu--plus intervention will involve working with the restaurants to add new healthy child
menu items tailored to their menus, along with promotional materials and restaurant employee
trainings to encourage customers to select these menu items. Weekly detailed sales data
(reported by menu item) at baseline for one month, ongoing in all restaurants during 8-week
intervention, and for one month at post intervention for all restaurants will be gathered
and serve as the primary outcome of interest. Additionally, biweekly observations and
customer interviews in each restaurant during one month pre--intervention phase, over
8--week intervention period, and during one month post-intervention phase to capture how
orders are placed and what is ordered and reported to be consumed by the child. We will also
assess the feasibility and fidelity of the intervention using manager interview data
(baseline and post--intervention), restaurants audits (baseline, once during the
intervention, and at post--intervention), and process evaluation measures (weekly during
8-week intervention). The study is not designed to provide a direct benefit to the
participants and no such benefits can be guaranteed; however, participants may learn more
about current public health research and efforts to understand child ordering and
consumption behaviors in restaurants. This study may benefit independent restaurants as the
findings will contribute to designing evidence--based approaches to improving the
nutritional quality of child menu offerings and will help researchers to understand ordering
and consumption behaviors for children in restaurants. This study presents minimal risks to
the participants.

For customer observations and interviews:

Inclusion Criteria:

- Restaurant dining parties having at least one adult 18 or older and one child in
party who appears to be between the ages of 3--17 years

- Dining parties including no more than six people

- Party speaks English and/or Spanish

Exclusion Criteria:

- Party does not speak English and/or Spanish

- Parties larger than six people

For restaurant manager interviews:

Inclusion Criteria:

- At least 18 years of age

- Has worked at restaurant at least 4 months

- Works at least 20 hours per week for the restaurant

- Plans to continue working at the restaurant for at least 6 months

- Speaks and writes English and/or Spanish