Table 2a.
Summary of included studies with customer‐level outcomes (n = 23)
| Study ID | Study design | Food outlet type | Nuffield intervention ladder | Intervention function | Policy category | Implementation score* | Summary impact (↓↑↔↕) (global quality assessment score)† |
|---|---|---|---|---|---|---|---|
| Trans fat law (n = 1) | |||||||
| Angell 2012 38, ‡ | Repeat cross‐sectional | 11 fast food chains, New York City, USA | Restrict choice | Environmental restructuring | Environmental/social planning; legislation | 5 | ↑ (moderate) |
| Changing pre‐packed children's meal content (n = 1) | |||||||
| Wansink 2014 48 | Repeat cross‐sectional | McDonald's restaurants (fast food chain), USA | Restrict choice | Environmental restructuring | Environmental/social planning; communication/marketing | 3 | ↑ (weak) |
| Price increases for unhealthier choices (n = 2) | |||||||
| Price increases for unhealthier choices only | |||||||
| Shah 2014 60 (sin tax menu arm) | Controlled clinical trial | One moderately priced restaurant, which specialized in ‘small plates’ to share, USA | Guide choice (disincentives) | Coercion | Fiscal | 5 | ↓ (strong) unhealthy items ordered by men and women |
| Price increases for unhealthy choices + signposting | |||||||
| Shah 2014 60 (unhealthy label + sin tax menu arm) | Controlled clinical trial | One moderately priced restaurant, which specialized in ‘small plates’ to share, USA | Guide choice (disincentives) | Environmental restructuring; education; coercion | Communication/marketing; environmental/social planning; fiscal | 5 | ↑ (strong) decrease in unhealthy items ordered by men and women |
| Incentives (contingent rewards) (n = 1) | |||||||
| Reimann 2015 54 | Cohort | Chain sandwich restaurant, USA | Guide choice (incentives) | Incentives | Unclear (customers offered half portions for same price as full portion, plus a lottery ticket) | 7 | ↑ (moderate) customers choosing half‐sized portions |
| Price reductions for healthier choices (n = 2) | |||||||
| Price reduction for healthier choices only | |||||||
| Horgen and Brownell 2002 58 | Controlled clinical trial | Delicatessen‐style restaurant (cafeteria), USA | Guide choice (incentives) | Incentives | Fiscal | 6 | ↑ (weak) healthy food purchase |
| Price reduction for healthier choices + health promotion | |||||||
| Horgen and Brownell 2002 58 | Controlled clinical trial | Delicatessen‐style restaurant (cafeteria), USA | Guide choice (incentives) | Environmental restructuring; education; incentives; persuasion; enablement | Communication/marketing; environmental/social planning; fiscal | 6 | ↑ (weak) healthy food purchase |
| Signposting (n = 8) | |||||||
| Signposting only | |||||||
| Shah 2014 60 (unhealthy label menu arm) | Controlled clinical trial | One moderately priced restaurant, which specialized in ‘small plates’ to share, USA | Enable choice | Environmental restructuring; education | Communication/marketing; environmental/social planning; | 5 | ↕ (strong) decrease in unhealthy items ordered |
| Eldridge 1997 41 | Repeat cross‐sectional | Food service areas of large discount department store chain, USA | Enable choice | Environmental restructuring; education | Communication/marketing; environmental/social planning | 6 | ↕ (weak) sales of ‘healthier’ food items |
| Pandya 2013 46 | Repeat cross‐sectional | Latino family‐owned restaurants, KS, USA | Enable choice | Environmental restructuring; education | Communication/marketing; environmental/social planning | 7 | ↓ (weak) healthy food purchases |
| Signposting + menu changes | |||||||
| Nothwehr 2013 45 | Repeat cross‐sectional | Non‐chain owner‐operated full menu, sit‐down restaurants with typical Midwestern fare, Iowa, USA | Enable choice | Environmental restructuring; education | Communication/marketing; environmental/social planning | 8 | ↓ (weak) healthy food purchases |
| Lee‐Kwan 2013 59 | Controlled clinical trial | Non‐franchised small local food establishments that sell ready‐to‐eat food and beverages for off‐premise consumption, Baltimore, USA | Enable choice | Environmental restructuring; education; incentives | Communication/marketing; environmental/social planning | 8 | ↑ (moderate) healthy food purchases |
| Signposting + health promotion/social marketing campaign | |||||||
| Fitzgerald 2004 42 | Repeat cross‐sectional | Community restaurants varied from counter service to table service, USA | Enable choice | Environmental restructuring; education; persuasion | Communication/marketing; environmental/social planning | 6 | ↓ (weak) sales of ‘heart healthy’ menu items |
| Acharya 2006 31 | Repeat cross‐sectional with control | Restaurant chains (fine dining and moderately priced, family‐style restaurants) (Mexican, upscale pizza, and 40s‐style diner), CA, USA | Enable choice | Environmental restructuring; education; incentives; persuasion | Communication/marketing; environmental/social planning | 6 | ↑ (moderate) healthy food purchases |
| Horgen and Brownell 2002 58 (health promotion condition) | Controlled clinical trial | Delicatessen‐style restaurant (cafeteria), USA | Enable choice | Environmental restructuring; education; persuasion; enablement | Communication/marketing; environmental/social planning | 6 | ↑ (weak) healthy food purchase |
| Calorie labelling law (n = 10) | |||||||
| Calorie labelling law only | |||||||
| Bollinger 2011 33 | Repeat cross‐sectional with control plus subgroup cohort | Starbucks Cafes, New York City, USA | Provide information | Environmental restructuring; education | Communication/marketing; environmental/social planning; legislation | 5 | ↑ (strong) |
| Chen 2015 39 | Repeat cross‐sectional | Regulated chain or fast food restaurants in King County, USA | Provide information | Environmental restructuring; education | Communication/marketing; environmental/social planning; legislation | 5 | ↑ (weak) saw and used calorie information |
| Dumanovsky 2011 40, ‡ | Repeat cross‐sectional | 11 fast‐food chains, New York City, USA | Provide information | Environmental restructuring; education | Communication/marketing; environmental/social planning; legislation | 5 | ↓ (moderate) |
| Krieger 2013 43, § | Repeat cross‐sectional, retrospective | Restaurants from 10 chains: Subway, McDonald's, Taco del Mar, Taco Time, Starbuck's, Quizno's, Tully's; Jack in the Box, Burger King, Taco Bell, King County, USA | Provide information | Environmental restructuring; education | Communication/marketing; environmental/social planning; legislation | 4 | ↓ (moderate) |
| Namba 2013 37 | Repeat cross‐sectional with control | Large chain fast food restaurants, USA | Provide information | Environmental restructuring; education | Communication/marketing; environmental/social planning; legislation | 3 | ↔ (strong) adults and children |
| Elbel 2009 34 | Repeat cross‐sectional with control | Chain restaurants with >15 establishments – McDonald's, Burger King, Wendy's, KFC in New York City, USA | Provide information | Environmental restructuring; education | Communication/marketing; environmental/social planning; legislation | 4 | ↔ (moderate) adults and children |
| Elbel 2013 35 | Repeat cross‐sectional (before and after legislation) with control cohort (difference in difference design) | Fast food restaurants (McDonald's and Burger King) in Philadelphia (which implemented calorie labelling policies) and Baltimore (which did not and acted as a matched comparison city), USA | Provide information | Environmental restructuring; education | Communication/marketing; environmental/social planning; legislation | 5 | ↔ (moderate) |
| Finkelstein 2011 36 | Repeat cross‐sectional with control | Mexican fast food restaurant chain – Taco Time Northwest, King County, USA | Provide information | Environmental restructuring; education | Communication/marketing; environmental/social planning; legislation | 3 | ↔ (moderate) |
| Tandon 2011 55 | Controlled before‐and‐after study (same participants) | Chain restaurants, King County, USA | Provide information | Environmental restructuring; education | Communication/marketing; environmental/social planning; legislation | 4 | ↔ (weak) children |
| Calorie labelling law + nutritional recommendation information | |||||||
| Downs 2013 57 | Controlled clinical trial | 2 McDonalds restaurants in New York City, USA | Provide information | Environmental restructuring; education | Communication/marketing; environmental/social planning | 4 | ↔ (moderate) |
| Voluntary calorie labelling (n = 1) | |||||||
| Pulos and Leng 2010 47 | Repeat cross‐sectional | Full‐service locally owned (non‐chain) restaurants; ‘casual, midrange’, USA | Provide information | Environmental restructuring; education | Communication/marketing; environmental/social planning | 6 | ↑ (weak) energy, fat and sodium levels of foods purchased |
| Personalized receipts (n = 1) | |||||||
| Bedard and Kuhn 2013 32 | Repeat cross‐sectional with control | Burgerville restaurants (fast‐food chain), California, USA | Provide information | Environmental restructuring; education; persuasion | Communication/marketing | 4 | ↔ (weak) |
*
Implementation score was determined using a checklist for obesity‐related interventions 25 adapted from workplace interventions 26.
†
Energy purchased unless otherwise stated; key: effective (↑), equally effective as a comparison group (↔), effectiveness mixed by outcome or gender (↕), or not effective (↓).
‡
Dumanovsky 2011 and Angell 2012 used the same data set.
§
Krieger 2013 used the same data set as Saelens 2012 (food‐outlet‐level outcomes, Table 2b).