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Community-Based Restaurant Interventions to Promote Healthy Eating: A Systematic Review

The vertical flow chart details the identification of relevant studies, extraction of data, and assessment of the level of evidence for community-based restaurant interventions. The figure shows that 770 articles were identified through the search of terms and authors. After removing duplicates, 740 articles remained. Of these, 5 articles were deemed relevant, and an additional 20 relevant articles were identified through references and lists of cited articles. The 25 relevant articles described 27 interventions. Data were extracted from reports on the 27 interventions and summarized descriptively. The 27 interventions were scored for study design, public awareness of the intervention, and effectiveness. The interventions were also grouped into 9 categories based on a combination of 1 to 6 intervention strategies. The average scores for study design, awareness, and effectiveness were calculated for the 9 categories. Then, the study design, public awareness, and effectiveness scores were summed to indicate the strength of evidence for the 9 categories (first subscore). The 9 categories were also assessed for volume of research according to the number of studies in that category (second subscore). The 2 subscores were then multiplied to produce summary scores for the 9 categories. Of the 9 categories, 8 were insufficient, 1 was sufficient, and 0 categories were strong, based on the summary score. Study design, public awareness, effectiveness, strength of evidence, volume of research, and summary scores were averaged for the 9 categories.

Figure 1. Methods to select studies, extract data, and describe and assess the level of evidence for community-based restaurant interventions to promote healthy eating, United States, 2014.


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Figure 2. Percentage of interventions, within each decade, that implemented the following strategies: point-of-purchase information (POP), promotion and communication (Promotion), increased availability (Availability), reduced prices and coupons (Pricing), catering policies (Catering), and increased access (Access [11]). Data from 27 interventions, described in 25 reports of studies published through January 2014. 

Decade (n) Intervention Strategies, %
POP Promotion Availability Pricing Catering Access
1970s (1) 100.00 100.00 100.00 0 0 0
1980s (6) 83.33 83.33 16.67 16.67 0 0
1990s (6) 66.67 100.00 83.33 0 0 0
2000s (7) 71.43 100.00 42.86 71.43 0 0
2010s (7) 85.71 28.57 100.00 0 0 0

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The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions.

Page last reviewed: May 21, 2015