Lee-Kwan SH, Bleich SN, Kim H, Colantuoni E, Gittelsohn J. Environmental Intervention in Carryout Restaurants Increases Sales of Healthy Menu Items in a Low-Income Urban Setting.
Am J Health Promot 2014;
29:357-64. [PMID:
24968184 DOI:
10.4278/ajhp.130805-quan-408]
[Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE
To investigate how a pilot environmental intervention changed food sales patterns in carryout restaurants.
DESIGN
Quasi-experimental.
SETTING
Low-income neighborhoods of Baltimore, Maryland.
SUBJECTS
Seven carryouts (three intervention, four comparison).
INTERVENTION
Phase 1, menu board revision and healthy menu labeling; phase 2, increase of healthy sides and beverages; and phase 3, promotion of cheaper and healthier combination meals.
MEASURES
Weekly handwritten menu orders collected to assess changes in the proportion of units sold and revenue of healthy items (entrée, sides and beverages, and combined).
ANALYSIS
Logistic and Poisson regression models with generalized estimating equations.
RESULTS
In the intervention group, odds for healthy entrée units and odds for healthy side and beverage units sold significantly increased in phases 2 and 3; odds for healthy entrée revenue significantly increased in phase 1 (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.08-1.26), phase 2 (OR 1.32, 95% CI 1.25-1.41), and phase 3 (OR 1.39, 95% CI 1.14-1.70); and odds for healthy side and beverage revenues increased significantly in phase 2 (OR 1.62, 95% CI 1.33-1.97) and phase 3 (OR 2.73, 95% CI 2.15-3.47) compared to baseline. Total revenue in the intervention group was significantly higher in all phases than in the comparison group (p < .05).
CONCLUSION
Environmental intervention changes such as menu revision, menu labeling, improved healthy food selection, and competitive pricing can increase availability and sales of healthy items in carryouts.
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