Clinical trial NCT02692001: Child Friendly Menu Labelling and Food Choices
Official title: A Randomized Controlled Trial to Evaluate the Impact of Child Friendly Menu Labelling Designs on Food Choices by Parents and Children in an Inpatient Hospital Setting
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Childhood Obesity
Lead sponsor: The Hospital for Sick Children
Sponsor class: OTHER
First posted: 2016-02-25
Enrollment: 163
Sex: ALL
Minimum age (years): 2
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: PREVENTION

Brief summary: Childhood obesity is a major problem in Canada. Children are eating larger portions and have easier access to high-fat, high-sugar foods and drinks. Menu labelling is a promising tool to teach families about healthier choices. The investigators will study the impact of combining child-friendly superhero food labels, fun food names, and a traffic light system on the food choices of children and their parents at SickKids. The investigators will use the hospital inpatient food ordering system (Meal Train) and look at food orders and eating patterns before and after introduction of the revised Meal Train menu. Only the design format of the menu was changed and all menu items remained unchanged. The investigators will also survey the families on their thoughts about the menu. This study will help doctors and dietitians develop strategies to deliver nutrition education to families.

Detailed description: Childhood obesity is recognized as a major public health epidemic in Canada with over 31.5% of all 5- to 17-year-olds being overweight or obese. The etiology of this increase in childhood obesity can be attributed to trends in children's diets that include increasing access to foods high in fats, added sugars, and eating outside the home with routine exposure to large portions of energy-dense, nutrient-poor foods. Menu labelling and point-of-purchase nutrition information is a promising potential cost effective public health strategy and utilized in the adult population. In this study, the investigators plan to evaluate the impact of a combination of labelling techniques including attractive characters, descriptive food names and traffic light system on food choices made by children and their parents in an inpatient hospital setting at the Hospital for Sick Children. The investigators will assess patient ordering and consumption patterns before and after the introduction of a revised educational Meal Train menu. A crossover randomized control trial design will be employed to identify changes in fruit and vegetable intake, healthy ("green light") option intake, number of sweetened beverages and energy-dense nutrient-poor ("red light") foods chosen as well as the number of children that meet the Canadian Food Guide (CFG) daily serving recommendations. As a secondary analysis, the investigators will be collecting participant's age, sex and weight-for-age z-score (as defined by the World Health Organization guidelines) to investigate any potential relationships between these variables and food ordering patterns before and after introduction of the proposed educational menu. A questionnaire will also be distributed to assess parent and child perceptions of the revised Meal Train menu. The investigators hypothesize patient ordering and consumption patterns before and after the introduction of a revised educational Meal Train menu will promote healthier food selections. While this type of intervention has been studied in hypothetical restaurants and cafeteria setting, this will be the first study conducted in a hospital setting with pediatric inpatients and their parents.

Eligibility criteria: Inclusion Criteria:

* Admitted to a general pediatrics or subspecialty wards
* Fluent in written English

Exclusion Criteria:

* NPO or receiving parenteral nutrition at any point in their admission
* Specialized diet e.g. celiac, purée, renal diet, or high energy diet
* Those exposed to educational intervention menu in first 2 weeks who remain on ward following the crossover period

Primary outcomes:
measure: Evaluate patient ordering patterns before and after the introduction of the revised educational Meal Train menu.
timeFrame: 1 month
Secondary outcomes:
measure: Relationship between patient demographics and meal orders
timeFrame: 1 month
measure: Impact of child-friendly menu designs on food orders
timeFrame: 1 month
measure: Evaluation of meal consumption
timeFrame: 1 month
measure: Parent/child perceptions of the revised Meal Train menu
timeFrame: 1 month
Other outcomes:
Locations:
city: Toronto
country: Canada
facility: The Hospital for Sick Children
state: Ontario
Study officials:
affiliation: The Hospital for Sick Children
name: Jill Hamilton, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Basak S, Steinberg A, Campbell A, Dupuis A, Chen S, Dayan AB, Dello S, Hamilton J. All Aboard Meal Train: Can Child-Friendly Menu Labeling Promote Healthier Choices in Hospitals? J Pediatr. 2019 Jan;204:59-65.e3. doi: 10.1016/j.jpeds.2018.08.073. Epub 2018 Sep 28.