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Abstract
Purpose: To determine if enjoyment of cafeteria meals varies by sex, grade-level, school-level socioeconomic status (SES) and reported use of nutrition information in restaurants.
Methods: This is a cross-sectional study using data from cafeteria surveys and focus groups conducted in six secondary schools as part of the Renton Menu Labeling Project. The survey and focus groups assessed exposure to the healthy choice symbol, its impact on enjoyment of cafeteria meals, and use of restaurant nutrition information. Rates of noticing the symbol and enjoyment were compared with two sample t tests. Logistic regression analysis was used to predict the effect of the symbol on enjoyment. Focus group sessions were audio-taped, transcribed and coded.
Results: Of the 81.3% of survey respondents who noticed the symbol, 15.2% of students reported that the symbol decreased their enjoyment of cafeteria meals. The symbol decreased enjoyment more among boys, middle school students and students who use restaurant nutrition information. Male sex (OR = 1.6; 95% CI = 1.2-2.3; p = 0.004), middle school age (OR = 1.6; 95% CI = 1.1-2.3; p = 0.015) and use of restaurant nutrition information (OR = 1.4; 95% CI = 1.1-2.0; p = 0.038) were significant predictors of decreased enjoyment. Focus group participants were confused by the term enjoyment. Students observed the symbol did not generally impact enjoyment, but stated its potential to have a positive or negative effect depending on the student.
Conclusions: This method of menu labeling is unlikely to negatively impact students' enjoyment of school meals, but it has the potential to affect some groups of adolescents. Future research should compare the affective impact of different types of menu labeling, specifically calorie labeling, among adolescents using an assessment tool more specific than questions about 'enjoyment'.