The impact of a community social marketing campaign on children's meal orders and consumption: main outcomes from a group randomised controlled trial

Objective: Restaurants may be important settings for interventions to reduce children's energy intake. The objective of this study was to test the impact of a parent-focused social marketing campaign to promote healthy children's meals on calories ordered and consumed by children at quick-service restaurants (QSR). Design: Using a repeated cross-sectional study design, two urban communities were randomised to intervention (IN) v. control (C) condition. A community-wide social marketing campaign was implemented in the IN community to empower Black and Latinx mothers who frequent QSR (priority population) to select healthier options for their child. Setting: Data were collected in 2016 at QSR located within the communities pre- and post-IN and analysed in 2017. Participants: Parents (n 1686; n 819 and n 867 for I and C conditions, respectively) were recruited after placing their QSR order; a survey, receipt and their child's leftovers were collected. Results: Calories ordered did not differ significantly between the IN and C conditions (change(adj) = -146 center dot 4 kJ (-35 center dot 0 kcal); 95 % CI -428 center dot 0 kJ (-102 center dot 3 kcal), 134 center dot 6 kJ (32 center dot 2 kcal)). In a sub-analysis of only the priority audience, children in the IN community ordered significantly fewer calories compared to C children in unadjusted models (change(unadj) = -510 center dot 4 kJ (-122 center dot 0 kcal); 95 % CI -1013 center dot 4 kJ (-242 center dot 2 kcal), -7 center dot 5 kJ (-1 center dot 8 kcal)), but the trend did not persist after adjusting for covariates (change(adj) = -437 center dot 2 kJ (-104 center dot 5 kcal); 95 % CI -925 center dot 5 kJ (-221 center dot 2 kcal), 50 center dot 6 kJ (12 center dot 1 kcal)). Calories consumed followed similar trends. Conclusion: The campaign did not significantly reduce children's QSR calories ordered or consumed. However, a quantitatively important mean reduction in calories was suggested among the priority audience, indicating potential for community-wide promotion of healthful children's meals.

Automated summary

This study aimed to test the impact of a parent-focused social marketing campaign on promoting healthy children's meals in quick-service restaurants. The results showed that the campaign did not significantly reduce children's calorie intake at QSR. However, there was a suggestive reduction in calorie intake among the priority audience, indicating potential for community-wide promotion of healthful children's meals.