Introduction
In the U.S., children regularly consume foods from quick-service restaurants, but
little is known about the marketing strategies currently used inside quick-service
restaurants. This study aims to validate a child-focused Environmental Assessment
Tool for quick-service restaurants, evaluate marketing strategies inside and on the
exterior of quick-service restaurants, and examine differences by community race/ethnicity
or income.
Methods
The inter-rater and test–retest reliability of the Environmental Assessment Tool were
assessed across the top 5 national quick-service restaurant chains. Marketing techniques
in 165 quick-service restaurants (33 per national chain) in socioeconomically and
racially/ethnically diverse communities throughout New England were examined in 2018–2019.
Mixed methods ANOVA examined the differences in marketing techniques in 2020.
Results
The inter-rater and test–retest reliability of the Environmental Assessment Tool were
high (Cohen's κ>0.80). Approximately 95% of quick-service restaurants marketed less
healthy foods, whereas only 6.5% marketed healthy options. When examining the differences
by community demographics, there were significantly more price promotion advertisements
inside and on the exterior of quick-service restaurants in lower-income communities.
In addition, there was a greater number of child-directed advertisements with cartoon
or TV/movie characters as well as fewer healthy entrée options and more sugar-sweetened
beverage and dessert options on the children's menu inside quick-service restaurants
in communities with higher minority populations.
Conclusions
Environmental Assessment Tool is a valid tool to evaluate marketing inside quick-service
restaurants. Results suggest that there is a substantial amount of unhealthy food
and beverage marketing inside quick-service restaurants, with differences in the number
and types of techniques used in lower-income and minority communities. Policies that
limit quick-service restaurant marketing to children should be considered.
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Article Info
Publication History
Published online: May 11, 2021
Identification
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© 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
