Trial Outcomes & Findings for Promoting Healthier Eating Among Children in Restaurants (NCT NCT04334525)
NCT ID: NCT04334525
Last Updated: 2026-06-10
Results Overview
Whether a healthier children's meal or other children's meal was ordered (bundled meal including promoted healthy main dish, healthy side, and healthy beverage). Counts reported indicate the number of children who ordered a healthy bundled meal.
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
554 participants
Primary outcome timeframe
Post-test (about 4 months after recruitment)
Results posted on
2026-06-10
Participant Flow
For the RCT, 240 parents and 240 children were recruited and enrolled in restaurants over four cohorts (Summer 2021-Summer 2024). 236 of the families were randomized as described herein. Recruitment occurred across the restaurants' 6 locations, 2 per year. Prior to this, 74 participants (37 parents, 37 children) participated in a pilot phase to finalize the promoted meals for the study. Those in the pilot phase were not involved in the RCT and were never randomized.
Four participants were excluded from randomization to groups because they did not complete necessary baseline procedures (providing complete data on child's order at baseline). Generally this was because families changed their minds about participating between consenting and providing this information.
Unit of analysis: Restaurant locations
Participant milestones
| Measure |
Generic Placemats and Frequent Diner Cards
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
Pilot Phase
Taste testing in a separate arm that occurred prior to randomization
|
|---|---|---|---|
|
1. Pilot Phase
STARTED
|
0 0
|
0 0
|
74 2
|
|
1. Pilot Phase
COMPLETED
|
0 0
|
0 0
|
74 2
|
|
1. Pilot Phase
NOT COMPLETED
|
0 0
|
0 0
|
0 0
|
|
2. Main Phase (RCT)
STARTED
|
214 3
|
258 3
|
0 0
|
|
2. Main Phase (RCT)
COMPLETED
|
156 3
|
160 3
|
0 0
|
|
2. Main Phase (RCT)
NOT COMPLETED
|
58 0
|
98 0
|
0 0
|
Reasons for withdrawal
| Measure |
Generic Placemats and Frequent Diner Cards
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
Pilot Phase
Taste testing in a separate arm that occurred prior to randomization
|
|---|---|---|---|
|
2. Main Phase (RCT)
Withdrawal by Subject
|
18
|
30
|
0
|
|
2. Main Phase (RCT)
Lost to Follow-up
|
40
|
68
|
0
|
Baseline Characteristics
Age here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
Baseline characteristics by cohort
| Measure |
Generic Placemats and Frequent Diner Cards
n=210 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=258 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
Pilot Phase
n=74 Participants
Families recruiting for taste testing prior to the main RCT
|
Total
n=542 Participants
Total of all reporting groups
|
|---|---|---|---|---|
|
Age, Continuous
|
6.4 years
STANDARD_DEVIATION 1.3 • n=105 Participants • Age here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
6.5 years
STANDARD_DEVIATION 1.4 • n=129 Participants • Age here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
—
|
6.5 years
STANDARD_DEVIATION 1.3 • n=234 Participants • Age here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
|
Sex: Female, Male
Female
|
56 Participants
n=105 Participants • Sex here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
77 Participants
n=129 Participants • Sex here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
—
|
133 Participants
n=234 Participants • Sex here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
|
Sex: Female, Male
Male
|
49 Participants
n=105 Participants • Sex here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
52 Participants
n=129 Participants • Sex here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
—
|
101 Participants
n=234 Participants • Sex here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
|
Race/Ethnicity, Customized
Refused to answer
|
1 Participants
n=105 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
1 Participants
n=129 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
0 Participants
n=37 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
2 Participants
n=271 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
|
Race/Ethnicity, Customized
White
|
85 Participants
n=105 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
111 Participants
n=129 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
34 Participants
n=37 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
230 Participants
n=271 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
|
Race/Ethnicity, Customized
Black
|
3 Participants
n=105 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
7 Participants
n=129 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
0 Participants
n=37 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
10 Participants
n=271 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
|
Race/Ethnicity, Customized
Asian
|
0 Participants
n=105 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
1 Participants
n=129 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
0 Participants
n=37 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
1 Participants
n=271 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
|
Race/Ethnicity, Customized
American Indian Alaska Native
|
0 Participants
n=105 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
1 Participants
n=129 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
0 Participants
n=37 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
1 Participants
n=271 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
|
Race/Ethnicity, Customized
Multiracial
|
16 Participants
n=105 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
8 Participants
n=129 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
3 Participants
n=37 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
27 Participants
n=271 Participants • Race/ethnicity here refers to the child, which is why the sample size differs from overall number of participants (parent and child). Parent demographics were entered subsequently. Two randomized families did not provide demographic information.
|
|
Region of Enrollment
United States
|
210 participants
n=210 Participants
|
258 participants
n=258 Participants
|
74 participants
n=74 Participants
|
468 participants
n=542 Participants
|
|
Parent age (continuous)
|
38.6 years
STANDARD_DEVIATION 5.6 • n=105 Participants • Age here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
40.0 years
STANDARD_DEVIATION 8.8 • n=129 Participants • Age here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
—
|
39.4 years
STANDARD_DEVIATION 7.5 • n=234 Participants • Age here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
|
Parent sex (male/female)
Female
|
88 Participants
n=105 Participants • Sex here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
96 Participants
n=129 Participants • Sex here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
25 Participants
n=37 Participants • Sex here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
209 Participants
n=271 Participants • Sex here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
|
Parent sex (male/female)
Male
|
17 Participants
n=105 Participants • Sex here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
33 Participants
n=129 Participants • Sex here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
12 Participants
n=37 Participants • Sex here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
62 Participants
n=271 Participants • Sex here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
|
Parent race/ethnicity, customized
Refused to answer
|
0 Participants
n=105 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
1 Participants
n=129 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
—
|
1 Participants
n=234 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
|
Parent race/ethnicity, customized
White
|
94 Participants
n=105 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
118 Participants
n=129 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
—
|
212 Participants
n=234 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
|
Parent race/ethnicity, customized
Black
|
6 Participants
n=105 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
6 Participants
n=129 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
—
|
12 Participants
n=234 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
|
Parent race/ethnicity, customized
Asian
|
1 Participants
n=105 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
2 Participants
n=129 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
—
|
3 Participants
n=234 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
|
Parent race/ethnicity, customized
American Indian Alaska Native
|
0 Participants
n=105 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
1 Participants
n=129 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
—
|
1 Participants
n=234 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
|
Parent race/ethnicity, customized
Multiracial
|
4 Participants
n=105 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
1 Participants
n=129 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
—
|
5 Participants
n=234 Participants • Race/ethnicity here refers to the parent, which is why the sample size differs from overall number of participants (parent and child). Two randomized families did not provide demographic information.
|
PRIMARY outcome
Timeframe: Post-test (about 4 months after recruitment)Population: Sample is those with post-test order data. Results for all pre-registered outcomes are from initial models without additional covariates. Please note that the pre-registered outcomes (all of them) were only collected in the intervention (placemats and frequent diner cards promoting healthier meals) and control (generic placemats and frequent diner cards) groups and not during the pilot phase.
Whether a healthier children's meal or other children's meal was ordered (bundled meal including promoted healthy main dish, healthy side, and healthy beverage). Counts reported indicate the number of children who ordered a healthy bundled meal.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=77 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=81 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Meal Type Ordered for Child in Restaurant
|
0 Participants
|
2 Participants
|
PRIMARY outcome
Timeframe: Baseline, midpoints 1-9 (weekly assessments about 2 months after recruitment), post-test (about 4 months after recruitment)Population: Because generalized linear mixed model (planned analysis) would not converge for this outcome (due to quasi separation of data) we present, among those with post-test data, the raw change in number of participants ordering the healthy meal from baseline to post-test, by group.
Whether a healthier children's meal or other children's meal was ordered. Counts reflect the raw change in number of participants ordering the bundled healthy meal from baseline to post-test, by group.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=77 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=81 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Change in Meal Type Ordered for Child in Restaurant
|
0 Participants
|
2 Participants
|
PRIMARY outcome
Timeframe: Post-test (about 4 months after recruitment)Population: Sample sizes reflect number of participants included overall in the repeated measures model that includes all available data from all randomized participants at each time point.
Nutrition information provided by the restaurant will be combined with parent report of children's orders to calculate total calories ordered
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=107 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=129 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Total Calories Ordered for Child in Restaurant
|
1077.56 calories
Standard Error 29.97
|
1031.63 calories
Standard Error 29.55
|
PRIMARY outcome
Timeframe: Baseline, midpoints 1-9 (weekly assessments about 2 months after recruitment), post-test (about 4 months after recruitment)Population: LS means reflect the average change from baseline to post-test in the context of the model including all data from all randomized participants at all time points (full information maximum likelihood). Sample sizes reflect overall sample size in this model.
Nutrition information provided by the restaurant will be combined with parent report of children's orders to calculate total calories ordered
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=107 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=129 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Change in Total Calories Ordered for Child in Restaurant
|
0.33 calories
Standard Error 33.66
|
-27.28 calories
Standard Error 31.97
|
PRIMARY outcome
Timeframe: Post-test (about 4 months after recruitment)Population: Sample sizes reflects number of families in the overall mixed model which includes all available data from all randomized families at all time points.
Nutrition information provided by the restaurant will be combined with parent report of children's orders to calculate total saturated fat ordered.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=107 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=129 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Total Saturated Fat Ordered for Child in Restaurant
|
19.59 grams
Standard Error 0.86
|
18.81 grams
Standard Error 0.84
|
PRIMARY outcome
Timeframe: Baseline, midpoints 1-9 (weekly assessments about 2 months after recruitment), post-test (about 4 months after recruitment)Population: Least squares means reflect the change from baseline to post-test in the context of the model including all data from all randomized participants at all study time points. Sample sizes reflect overall sample size in this model.
Nutrition information provided by the restaurant will be combined with parent report of children's orders to calculate total saturated fat ordered.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=107 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=129 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Change in Total Saturated Fat Ordered for Child in Restaurant
|
-1.18 grams
Standard Error 1.13
|
-1.55 grams
Standard Error 1.07
|
PRIMARY outcome
Timeframe: Post-test (about 4 months after recruitment)Population: Sample sizes reflects number of families in the overall mixed model which includes all available data from all randomized families at all time points.
Nutrition information provided by the restaurant will be combined with parent report of children's orders to calculate total sugar ordered.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=107 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=129 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Total Sugar Ordered for Child in Restaurant
|
67.84 grams
Standard Error 2.47
|
66.94 grams
Standard Error 2.44
|
PRIMARY outcome
Timeframe: Baseline, midpoints 1-9 (weekly assessments about 2 months after recruitment), post-test (about 4 months after recruitment)Population: LSmeans reflect the average change from baseline to post-test in the context of the model including all data from all randomized participants at all time points (full information maximum likelihood). Sample sizes reflect overall sample size in this model.
Nutrition information provided by the restaurant will be combined with parent report of children's orders to calculate total sugar ordered.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=107 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=129 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Change in Total Sugar Ordered for Child in Restaurant
|
3.74 grams
Standard Error 3.09
|
3.08 grams
Standard Error 2.93
|
PRIMARY outcome
Timeframe: Post-test (about 4 months after recruitment)Population: Sample sizes reflects number of families in the overall mixed model which includes all available data from all randomized families at all time points.
Nutrition information provided by the restaurant will be combined with parent report of children's orders to calculate total sodium ordered.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=107 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=129 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Total Sodium Ordered for Child in Restaurant
|
1364.29 milligrams
Standard Error 49.32
|
1363.69 milligrams
Standard Error 48.35
|
PRIMARY outcome
Timeframe: Baseline, midpoints 1-9 (weekly assessments about 2 months after recruitment), post-test (about 4 months after recruitment)Population: LS means reflect the change from baseline to post-test in the context of the model including all data from all randomized participants at all time points (full information maximum likelihood). Sample sizes reflect overall sample size in this model.
Nutrition information provided by the restaurant will be combined with parent report of children's orders to calculate total sodium ordered.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=107 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=129 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Change in Total Sodium Ordered for Child in Restaurant
|
28.08 milligrams
Standard Error 64.40
|
50.97 milligrams
Standard Error 60.68
|
PRIMARY outcome
Timeframe: Post-test (about 4 months after recruitment)Population: Sample size reflects those with post-test order data
Whether or not a dessert was ordered. Counts below reflect the number of children ordering a dessert at post-test.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=77 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=81 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Dessert Ordered for Child in Restaurant
|
66 Participants
|
64 Participants
|
PRIMARY outcome
Timeframe: Baseline, midpoints 1-9 (weekly assessments about 2 months after recruitment), post-test (about 4 months after recruitment)Population: Sample size reflects sample with order data (n=236). Numbers below reflect change in likelihood of ordering dessert from baseline to post-test in the context of the generalized linear mixed model with all time points (baseline, midpoints 1-9, post-test).
Whether or not a dessert was ordered. Numbers below reflect change in likelihood of ordering dessert from baseline to post-test in the context of the generalized linear mixed model with all time points (baseline, midpoints 1-9, post-test).
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=107 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=129 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Change in Dessert Ordered for Child in Restaurant
|
0.17 change in probability
Standard Error 0.51
|
0.83 change in probability
Standard Error 0.51
|
SECONDARY outcome
Timeframe: Post-test (about 4 months after recruitment)Population: Sample size includes those with intake data at post-test. The first cohort did not have intake assessed due to COVID-19, so these cases are excluded as well as any Cohort 2-4 cases for whom it was not possible to collect all intake data. LS means are in the context of the model with data from all randomized participants at all time points as which intake data were collected (baseline and post-test only, among the aforementioned sample. Intake was not assessed at the midpoints).
Children's dietary intake will be measured using plate waste methodology. Grams consumed will be converted to percentages using total grams from pre-weights, and these percentages will be multiplied by the total calories in the full item to calculate calories consumed.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=63 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=67 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Calories Consumed at Restaurant by Child in Restaurant
|
670.93 calories
Standard Error 26.44
|
716.13 calories
Standard Error 26.52
|
SECONDARY outcome
Timeframe: Baseline, post-test (about 4 months after recruitment)Population: Sample size includes all those with in intake data analysis models. The first cohort did not have intake assessed due to COVID-19, so these cases are excluded as well as any Cohort 2-4 cases for whom it was not possible to collect all intake data. LS means are in the context of the model with data from all randomized participants at all time points as which intake data were collected (baseline and post-test only, among the aforementioned sample. Intake was not assessed at the midpoints).
Children's dietary intake will be measured using plate waste methodology. Grams consumed will be converted to percentages using total grams from pre-weights, and these percentages will be multiplied by the total calories in the full item to calculate calories consumed.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=93 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=98 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Changes in Calories Consumed at Restaurant by Child in Restaurant
|
-3.53 calories
Standard Error 30.42
|
70.23 calories
Standard Error 29.82
|
SECONDARY outcome
Timeframe: Post-test (about 4 months after recruitment)Population: Sample size includes those with intake data at post-test. The first cohort did not have intake assessed due to COVID-19, so these cases are excluded as well as any Cohort 2-4 cases for whom it was not possible to collect all intake data. LS means are in the context of the model with data from all randomized participants at all time points as which intake data were collected (baseline and post-test only, among the aforementioned sample. Intake was not assessed at the midpoints).
Children's dietary intake will be measured using plate waste methodology. Grams consumed will be converted to percentages using total grams from pre-weights, and these percentages will be multiplied by the total saturated fat in the full item to calculate saturated fat consumed.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=63 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=67 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Saturated Fat Consumed at Restaurant by Child in Restaurant
|
12.07 grams
Standard Error 0.67
|
13.75 grams
Standard Error 0.67
|
SECONDARY outcome
Timeframe: Baseline, post-test (about 4 months after recruitment)Population: Sample size includes all those with in intake data analysis models. The first cohort did not have intake assessed due to COVID-19, so these cases are excluded as well as any Cohort 2-4 cases for whom it was not possible to collect all intake data. LS means are in the context of the model with data from all randomized participants at all time points as which intake data were collected (baseline and post-test only, among the aforementioned sample. Intake was not assessed at the midpoints).
Children's dietary intake will be measured using plate waste methodology. Grams consumed will be converted to percentages using total grams from pre-weights, and these percentages will be multiplied by the total saturated fat in the full item to calculate saturated fat consumed.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=93 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=98 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Changes in Saturated Fat Consumed at Restaurant by Child in Restaurant
|
-0.55 grams
Standard Error 0.81
|
1.76 grams
Standard Error 0.79
|
SECONDARY outcome
Timeframe: Post-test (about 4 months after recruitment)Population: Sample size includes those with intake data at post-test. The first cohort did not have intake assessed due to COVID-19, so these cases are excluded as well as any Cohort 2-4 cases for whom it was not possible to collect all intake data. LS means are in the context of the model with data from all randomized participants at all time points as which intake data were collected (baseline and post-test only, among the aforementioned sample. Intake was not assessed at the midpoints).
Children's dietary intake will be measured using plate waste methodology. Grams consumed will be converted to percentages using total grams from pre-weights, and these percentages will be multiplied by the total sugar in the full item to calculate sugar consumed.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=63 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=67 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Sugar Consumed at Restaurant by Child in Restaurant
|
40.17 grams
Standard Error 1.88
|
48.65 grams
Standard Error 1.85
|
SECONDARY outcome
Timeframe: Baseline, post-test (about 4 months after recruitment)Population: Sample size includes all those with in intake data analysis models. The first cohort did not have intake assessed due to COVID-19, so these cases are excluded as well as any Cohort 2-4 cases for whom it was not possible to collect all intake data. LS means are in the context of the model with data from all randomized participants at all time points as which intake data were collected (baseline and post-test only, among the aforementioned sample. Intake was not assessed at the midpoints).
Children's dietary intake will be measured using plate waste methodology. Grams consumed will be converted to percentages using total grams from pre-weights, and these percentages will be multiplied by the total sugar in the full item to calculate sugar consumed.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=93 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=98 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Changes in Sugar Consumed at Restaurant by Child in Restaurant
|
-0.51 grams
Standard Error 2.62
|
9.68 grams
Standard Error 2.54
|
SECONDARY outcome
Timeframe: Post-test (about 4 months after recruitment)Population: Sample size includes those with intake data at post-test. The first cohort did not have intake assessed due to COVID-19, so these cases are excluded as well as any Cohort 2-4 cases for whom it was not possible to collect all intake data. LS means are in the context of the model with data from all randomized participants at all time points as which intake data were collected (baseline and post-test only, among the aforementioned sample. Intake was not assessed at the midpoints).
Children's dietary intake will be measured using plate waste methodology. Grams consumed will be converted to percentages using total grams from pre-weights, and these percentages will be multiplied by the total sodium in the full item to calculate sodium consumed.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=63 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=67 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Sodium Consumed at Restaurant by Child in Restaurant
|
837.81 milligrams
Standard Error 41.66
|
860.31 milligrams
Standard Error 41.21
|
SECONDARY outcome
Timeframe: Baseline, post-test (about 4 months after recruitment)Population: Sample size includes all those with in intake data analysis models. The first cohort did not have intake assessed due to COVID-19, so these cases are excluded as well as any Cohort 2-4 cases for whom it was not possible to collect all intake data. LS means are in the context of the model with data from all randomized participants at all time points as which intake data were collected (baseline and post-test only, among the aforementioned sample. Intake was not assessed at the midpoints).
Children's dietary intake will be measured using plate waste methodology. Grams consumed will be converted to percentages using total grams from pre-weights, and these percentages will be multiplied by the total sodium in the full item to calculate sodium consumed.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=93 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=98 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Changes in Sodium Consumed at Restaurant by Child in Restaurant
|
-10.4 milligrams
Standard Error 49.09
|
44.34 milligrams
Standard Error 47.39
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Through study completion, an average of 3 yearsPopulation: These are sales data (all children's menu sales in the restaurant during the study period), which is why the numbers are larger than the total sample sizes for the enrolled study population. Sample size reflects all children's orders during the study period, given outcome here is percentage of all children's orders during study period (all time points, all cohorts) that were for promoted healthier items.
Aggregated sales data from the restaurant will be collected to monitor sales of healthier kids' meals across all patrons in Anderson's restaurants by study group during the study period. Children's orders were studied in aggregate; thus individual study participants were not studied here.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=62209 Children's orders
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=91265 Children's orders
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Healthier Children's Meals Ordered at Aggregate Level
|
4111 healthy orders
|
5591 healthy orders
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Exposure period (lasting from about 2 to about 4 months after participant recruitment)Population: These are sales data (all children's menu sales in the restaurant during the exposure period), which is why the numbers are larger than the total sample sizes for the enrolled study population.
Aggregated sales data from the restaurant will be collected to monitor sales of healthier kids' meals across all patrons in Anderson's restaurants by study group during the exposure period. Given that the intervention experienced by the general population (as opposed to study participants) is the same during midpoints and post-test, note that here exposure refers to midpoints plus post-test as described in a priori published protocol paper. Children's orders were studied in aggregate; thus individual study participants were not studied here.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=25097 Children's orders
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=39540 Children's orders
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Healthier Children's Meals Ordered at Aggregate Level
|
1661 healthy orders
|
2921 healthy orders
|
OTHER_PRE_SPECIFIED outcome
Timeframe: BaselinePopulation: These are sales data (all children's menu sales in the restaurant during the baseline period), which is why the numbers are larger than the total sample sizes for the enrolled study population. Analysis of group differences during this period can serve as a point of comparison for differences during the exposure (intervention) period.
Aggregated sales data from the restaurant will be collected to monitor sales of healthier kids' meals across all patrons in Anderson's restaurants by study group during the baseline period. Only aggregate data were recorded here; no data for individual child participants are available.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=37112 Children's orders
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=51725 Children's orders
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
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Healthier Children's Meals Ordered at Aggregate Level
|
2450 healthy orders
|
2670 healthy orders
|
OTHER_PRE_SPECIFIED outcome
Timeframe: 1 and 2 years prior to study exposure periodPopulation: These are sales data (all children's menu sales in the restaurant during the indicated period), which is why the numbers are larger than the total sample sizes for the enrolled study population.
Aggregated sales data from the restaurant will be collected to monitor sales of kids' meals across all patrons in Anderson's restaurants during time points parallel to the exposure period, 1 and 2 years prior to the study (for historical comparison). 2 years was added after original study planning but before study completion, given that 1 year prior to the study was 2020, a year impacted by the COVID-19 pandemic. Only aggregate data were recorded here (no individual participant data). Values from the two time points (1 year prior and 2 years prior) are summed.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=36933 Children's orders
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=36671 Children's orders
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Changes in Kids' Meals Ordered at Aggregate Level
|
1400 healthy orders
|
1250 healthy orders
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Post-test (about 4 months after recruitment)Population: This analysis examines study group differences among all families with 24-hour dietary recall data at post-test (n=153).
Parents will report children's daily dietary intake using the Automated Self-administered 24-hour Dietary Assessment Tool (ASA24) the day after the in-restaurant part of the post-test assessment.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=74 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=79 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Total Daily Calories Consumed by Child
|
1693.26 calories
Standard Error 103.93
|
1615.32 calories
Standard Error 103.88
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Post-test (about 4 months after recruitment)Population: This analysis examines study group differences among all families with 24-hour dietary recall data at post-test (n=153).
Parents will report children's daily dietary intake using the Automated Self-administered 24-hour Dietary Assessment Tool (ASA24) the day after the in-restaurant part of the post-test assessment.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=74 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=79 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Total Saturated Fat Consumed by Child
|
23.60 grams
Standard Error 1.61
|
23.17 grams
Standard Error 1.60
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Post-test (about 4 months after recruitment)Population: This analysis examines study group differences among all families with 24-hour dietary recall data at post-test (n=153).
Parents will report children's daily dietary intake using the Automated Self-administered 24-hour Dietary Assessment Tool (ASA24) the day after the in-restaurant part of the post-test assessment.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=74 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=79 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Total Sugar Consumed by Child
|
96.14 grams
Standard Error 8.54
|
90.55 grams
Standard Error 8.54
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Post-test (about 4 months after recruitment)Population: This analysis examines study group differences among all families with 24-hour dietary recall data at post-test (n=153).
Parents will report children's daily dietary intake using the Automated Self-administered 24-hour Dietary Assessment Tool (ASA24) the day after the in-restaurant part of the post-test assessment.
Outcome measures
| Measure |
Generic Placemats and Frequent Diner Cards
n=74 Participants
Participants will receive generic placemats listing all of the restaurant's kids' meals. Families will also receive a generic frequent diner card, which after purchasing (any) kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
|
Placemats and Frequent Diner Cards Promoting Healthier Meals
n=79 Participants
Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period. Corresponding signage will be displayed in the restaurant.
Choice architecture + repeated exposure: Participants will receive placemats promoting healthier featured kids' meals and the opportunity to redeem their kids' meal token for a toy instead of dessert. Families will also receive a frequent diner card, which after purchasing one of the featured healthier kids' meals across 6 occasions, makes them eligible for a free kids' meal of their choice during a predetermined redemption period.
|
|---|---|---|
|
Total Sodium Consumed by Child
|
2604.36 grams
Standard Error 142.88
|
2451.99 grams
Standard Error 141.64
|
Adverse Events
Generic Placemats and Frequent Diner Cards
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Placemats and Frequent Diner Cards Promoting Healthier Meals
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Pilot Phase
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place