Keywords
Beverage
Children’s Meals
Policy
Childhood Obesity
How to Cite
Abstract
In January 2020, Hawai‘i became the second state with a healthy default beverage (HDB) law, requiring restaurants to offer HDBs with their children’s meals. This observational study presents baseline characteristics of restaurants with a children’s menu and meal, and describes pre-law beverage options to inform future HDB policy language, implementation, and evaluation. Between November and December 2019, data were collected from a statewide sample of unique restaurants (n=383) with health inspection permits. Restaurants were assessed separately for a children’s menu and meal using website reviews, telephone calls, and in-person visits. Meals were evaluated in February 2020 for pre-law beverage type and compliance. Logistic regression was used to estimate the likelihood of having a children’s menu and meal. Most of the restaurants were full-service (70.2%) and non-chains (67.9%). While 49.3% of restaurants had a children’s menu, only 16.7% had a meal. Significant predictors of having a children’s menu were being full-service (OR=2.09; p=0.004), national/international (OR=5.32; p<0.001) or local chains (OR=1.99; p=0.03), neighbor island (non-Honolulu) locations (OR=2.49; p<0.001), and hotel locations (OR=3.77; p<0.001). Only being a national/international chain significantly predicted having a children’s meal (OR=7.57; p<0.001). Although 35.9% of children’s meals offered a non-sugar-sweetened beverage (SSB) option, only 3.1% offered law-compliant beverages. Inclusion of an SSB default option (60.9%) and not specifying the type of default beverage were the predominant factors for pre-law non-compliance. Results support the need for HDB regulations, especially for national/international chains, which were most likely to have children’s meals, and provide data to inform policies in other jurisdictions.
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Copyright (c) 2021 Meghan D. McGurk, Stephanie L. Cacal, Uyen Vu, Tetine Sentell, Toby Beckelman, Jessica Lee, Alyssa Yang, Catherine M. Pirkle