Measuring cues for healthy choices on restaurant menus: Development and testing of a measurement instrument

Purpose. To develop and test the Menu Checklist, an instrument to be used by community members to assess cues for healthy choices in restaurants. Design. Menus from 14 restaurants were coded independently by two trained community reviewers to test the interrater reliability of the instrument. Setting. A low-income, urban, African-American community in Los Angeles, California. Subjects. Restaurants were selected based on community perceptions of their potential to be included in a nutrition education and advocacy program to improve the availability of healthy foods. Measures. The Menu Checklist was adapted from previously tested measurement tools developed by the Prevention Research Center at Saint Louis University. Intraclass correlation coefficients (ICCS), K statistics, and percent agreements were calculated to assess interrater reliability. Descriptive statistics were calculated to show the availability of cues for healthy foods. Results. The interrater reliability coefficients for the majority of items were high (.93-1.0). Labeling on restaurant menus was rare, as were low-fat choices. Fruits and vegetables were readily available: 31% of all entrees included one serving and 39% of all appetizers were primarily fruits and vegetables. Conclusions. The Menu Checklist is a reliable, low-cost means for community members to collect data on influences on food choices in restaurants.