Attitudes vary across groups regarding meal choice in restaurants

"Incorporating perspectives of parents, children, and executives allows us to gain insight and develop future interventions. For example, our findings support the promise of targeting health promotion efforts at both parents and children and positioning healthier children's options as normative," said lead author Stephanie Anzman-Frasca, PhD, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo. "Tests of these approaches should also recognize restaurants' priorities, including consumer demand and profitability."

For the study, parent-child pairs dining at one of two participating quick-service restaurants or one of two participating full-service restaurants were recruited. Fifty-nine families agreed to participate, with 59 parents and 58 children answering surveys. Just 8% of children's meals ordered were those matching national Kids LiveWell criteria for healthier kids' meals. A total of 76% of children reported that they had visited the restaurant before, of whom 64% placed their usual order, and 48% of children knew what they would order before arriving at the restaurant. Ninety-five percent of children reported positive responses regarding the taste of their meal and 48% intended to order the same item again.

Parents largely did not know their child's preference (37%) regarding Kids LiveWell options or did not know what these options were (42%). Regarding toys in meals, one third of parents disagreed with the practice and one third agreed, with parents dining in the quick-service restaurants more likely to agree with this practice.

In order to incorporate the views of restaurant executives, researchers interviewed two executives from large chains and two executives from small chains via telephone. Executives communicated greater demand for kids' meals at full-service restaurants, and that meal offerings must be readily accepted by kids. According to the executives, parents view dining out as a special occasion, allowing their children to eat items that are not necessarily available to them every day; thus, healthy options were less popular. Other barriers to healthier meals include the fact that children's menus are more static than regular menus and restaurants have low incentive to invest in healthier kids' meals. Some areas of common ground between families and restaurant executives were uncovered, including the importance of taste and familiarity.

"Our research can inform the development and implementation of efforts to make healthier choices easier for families in quick- or full-service restaurant settings, an important goal given the regularity with which children consume meals from restaurants." Anzman-Frasca said.