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How may have the community colleges impacted on your healthy and unhealthy habits? And restaurants

How may have the community colleges impacted on your healthy and unhealthy habits? And restaurants

Case Studies In Health Information Management
Case Studies In Health Information Management
3rd Edition
ISBN:9781337676908
Author:SCHNERING
Publisher:SCHNERING
Chapter7: Healthcare Statistics And Research Methods
Section: Chapter Questions
Problem 7.29.1C
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How may have the community colleges impacted on your healthy and unhealthy habits? And restaurants
Abstract Objective: According to the US Affordable Care Act, restaurant chains are required to provide energy (calorie) and other nutrition information on their menu. The current study examined the impact of menu labelling containing calorie information and recommended daily calorie intake, along with subjective nutrition knowledge, on intention to select lower-calorie foods prior to the implementation of the Affordable Care Act. Design: Full factorial experimental design with participants exposed to four variants of a sample menu in a 2 (presence v. absence of calorie information) x2 (presence v. absence of recommended daily calorie intake). Setting: Large, public university in the Southwest USA. Subjects: Primarily undergraduate college students. Results: Majority of participants were 19-23 years of age (mean 21-8 (sD 3-6) years). Menu information about calorie content and respondents' subjective nutrition knowledge had a significantly positive impact on students' intention to select lower-calorie foods (B=0-24, P<0-001 and ß=0-33, P<0-001, respectively); however, recommended daily calorie intake information on the menu board did not influence students' intention to select lower-calorie foods (B=0-10, P=0-105). Gender played a significant role on purchase intent for lower-calorie menu items, with females more affected by the calorie information than males (p=0-37, P<0.001). Conclusions: Findings support the role menu labelling can play in encouraging a healthier lifestyle for college students. College students who are Generation Y desire healthier menu options and accept nutritional labels on restaurant menus as a way to easily and expediently obtain nutrition information. The consumption of away-from-home meals in the USA has increased dramatically over the years and accounted for 43-1% of consumers' food budget in 2012, compared with only 25.9% in 1970). Increasing interest by con- sumers in changing their diet and in restaurants being more transparent about menu items) has resulted in a desire for restaurants to include nutrition information for patrons. To aid this consumer need, in 2010, the Afford- able Care Act was signed into law in the USA, amending wamchang section 403(q) of the Federal Food and Drug Act. began nug act As amended, section 403(q) requires restaurant chains and similar retail food establishments operating as part of a chain under the same name with twenty or more locations to provide energy (calories, i.e. kilocalories) and other nutrition information for standard menu items, including foods on display, self-service foods, and on menus and menu boards. The law takes effect on 5 May 2017 (5). Its primary purpose is to make nutrition information on w *Corresponding author: Email mroseman@olemiss.edu 798 With Generation Y, the number of college students has risen dramatically in the USA; in 2016, nearly 20-5 million students are expected to attend US colleges. and universities, constituting an increase of about 5 million since 2000(13). The nutrition health of US college students is important; nearly 32% of college students self- report a high BMI (>25-0 kg/m2), classifying them as overweight or obese. College students tend to be physically inactive, have little time or ability to cook nutritious meals, are exposed to large portion sizes at eating facilities (¹5) and like fast foods due to their low cost and convenience (16) Nutrition information on restaurant menus Customers perceive restaurants to be socially responsible when they provide healthful food and nutrition informa- tion, with highly health-conscious customers reacting more strongly to healthy foods than their counterparts(17), Data of menu items from the largest restaurant chains for 2012-2013 found that mean calories among menu items. did not change, while the amount of calories in newly (18.10) Keywords Menu labelling Calorie information Recommended daily calorie intake Nutrition knowledge restaurant foods available to consumers in a direct, accessible and consistent manner, to enable consumers to make informed and healthful dietary choices. Prior to the Affordable Care Act, some cities and states enacted their own laws requiring chain restaurants to post nutrition information on their menu boards and menus6,7), prompting interest in research on restaurant menu label- ling. Initiated in 2010, some major national restaurant chains such as Panera Bread Company and McDonald's to voluntarily post calories on their menu boards at company-owned stores (8,9) Generation Y, also known as Millennials, is loosely defined as young adults who were born between 1980 and 2000(10) with the first Millennials reaching adulthood around the year 2000). While the buying power of Generation Y consumers is projected to eclipse that of Baby Boomers(12), there is limited research focusing on their healthy eating and purchase behaviours in restaurants. The Authors 2016 MG Roseman et al. they eat 36,37). Therefore, to better understand if restaurant menu labelling affects the calorie intake of college (Generation Y) students, the following two hypotheses were proposed: H1. Generation Y students have a higher intention to select lower-calorie foods if they are provided calorie information on restaurant menus. H2. Generation Y students have a higher intention to select lower-calorie foods if they are provided with recommended daily calorie intake information on restaurant menus. Subjective nutrition knowledge Consumer research distinguishes between actual knowl- edge and subjective knowledge (38) where two con- ceptually different constructs are defined as: 'objective knowledge, i.e. the accurate information about the product stored in consumer's long-term memory; and sub- jective knowledge, i.e. people's subjective perceptions of what or how much they know about a product based on J (39)
Transcribed Image Text:Abstract Objective: According to the US Affordable Care Act, restaurant chains are required to provide energy (calorie) and other nutrition information on their menu. The current study examined the impact of menu labelling containing calorie information and recommended daily calorie intake, along with subjective nutrition knowledge, on intention to select lower-calorie foods prior to the implementation of the Affordable Care Act. Design: Full factorial experimental design with participants exposed to four variants of a sample menu in a 2 (presence v. absence of calorie information) x2 (presence v. absence of recommended daily calorie intake). Setting: Large, public university in the Southwest USA. Subjects: Primarily undergraduate college students. Results: Majority of participants were 19-23 years of age (mean 21-8 (sD 3-6) years). Menu information about calorie content and respondents' subjective nutrition knowledge had a significantly positive impact on students' intention to select lower-calorie foods (B=0-24, P<0-001 and ß=0-33, P<0-001, respectively); however, recommended daily calorie intake information on the menu board did not influence students' intention to select lower-calorie foods (B=0-10, P=0-105). Gender played a significant role on purchase intent for lower-calorie menu items, with females more affected by the calorie information than males (p=0-37, P<0.001). Conclusions: Findings support the role menu labelling can play in encouraging a healthier lifestyle for college students. College students who are Generation Y desire healthier menu options and accept nutritional labels on restaurant menus as a way to easily and expediently obtain nutrition information. The consumption of away-from-home meals in the USA has increased dramatically over the years and accounted for 43-1% of consumers' food budget in 2012, compared with only 25.9% in 1970). Increasing interest by con- sumers in changing their diet and in restaurants being more transparent about menu items) has resulted in a desire for restaurants to include nutrition information for patrons. To aid this consumer need, in 2010, the Afford- able Care Act was signed into law in the USA, amending wamchang section 403(q) of the Federal Food and Drug Act. began nug act As amended, section 403(q) requires restaurant chains and similar retail food establishments operating as part of a chain under the same name with twenty or more locations to provide energy (calories, i.e. kilocalories) and other nutrition information for standard menu items, including foods on display, self-service foods, and on menus and menu boards. The law takes effect on 5 May 2017 (5). Its primary purpose is to make nutrition information on w *Corresponding author: Email mroseman@olemiss.edu 798 With Generation Y, the number of college students has risen dramatically in the USA; in 2016, nearly 20-5 million students are expected to attend US colleges. and universities, constituting an increase of about 5 million since 2000(13). The nutrition health of US college students is important; nearly 32% of college students self- report a high BMI (>25-0 kg/m2), classifying them as overweight or obese. College students tend to be physically inactive, have little time or ability to cook nutritious meals, are exposed to large portion sizes at eating facilities (¹5) and like fast foods due to their low cost and convenience (16) Nutrition information on restaurant menus Customers perceive restaurants to be socially responsible when they provide healthful food and nutrition informa- tion, with highly health-conscious customers reacting more strongly to healthy foods than their counterparts(17), Data of menu items from the largest restaurant chains for 2012-2013 found that mean calories among menu items. did not change, while the amount of calories in newly (18.10) Keywords Menu labelling Calorie information Recommended daily calorie intake Nutrition knowledge restaurant foods available to consumers in a direct, accessible and consistent manner, to enable consumers to make informed and healthful dietary choices. Prior to the Affordable Care Act, some cities and states enacted their own laws requiring chain restaurants to post nutrition information on their menu boards and menus6,7), prompting interest in research on restaurant menu label- ling. Initiated in 2010, some major national restaurant chains such as Panera Bread Company and McDonald's to voluntarily post calories on their menu boards at company-owned stores (8,9) Generation Y, also known as Millennials, is loosely defined as young adults who were born between 1980 and 2000(10) with the first Millennials reaching adulthood around the year 2000). While the buying power of Generation Y consumers is projected to eclipse that of Baby Boomers(12), there is limited research focusing on their healthy eating and purchase behaviours in restaurants. The Authors 2016 MG Roseman et al. they eat 36,37). Therefore, to better understand if restaurant menu labelling affects the calorie intake of college (Generation Y) students, the following two hypotheses were proposed: H1. Generation Y students have a higher intention to select lower-calorie foods if they are provided calorie information on restaurant menus. H2. Generation Y students have a higher intention to select lower-calorie foods if they are provided with recommended daily calorie intake information on restaurant menus. Subjective nutrition knowledge Consumer research distinguishes between actual knowl- edge and subjective knowledge (38) where two con- ceptually different constructs are defined as: 'objective knowledge, i.e. the accurate information about the product stored in consumer's long-term memory; and sub- jective knowledge, i.e. people's subjective perceptions of what or how much they know about a product based on J (39)
Nutrition information on restaurant menus Customers perceive restaurants to be socially responsible when they provide healthful food and nutrition informa- tion, with highly health-conscious customers reacting more strongly to healthy foods than their counterparts Data of menu items from the largest restaurant chains for 2012-2013 found that mean calories among menu items did not change, while the amount of calories in newly introduced menu items reduced significantly (1819) Much of the research on the effects of restaurant menu labelling encouraging individuals to choose healthier menu items has been mixed. Some research suggests that consumers may not want to be exposed to a menu item's nutrition information or may overstate their use of nutri- tion labelling Other studies on consumer behaviour before and after the implementation of restaurant menu labelling in the USA find no significant change in the caloric level of menu purchases (21-23), Some studies found a caloric reduction between pre- and post-treatment phases and selections with fewer calories by those viewing nutrition information on menu items when com- pared with those who did not-27). A meta-analysis of six controlled studies in restaurant settings found a non- significant reduction in calories, with some consumers stating that nutrition labelling is a healthful influence over (29) their purchasing decision Restaurant customers have positive attitudes towards lower-calorie items and these patrons are willing to pay a premium if the information provided indicates healthy nutrition Generation Y's healthy eating behaviours Generation Y's health concerns are increasing); "health- conscious' and 'adventurous' Generation Y groups seek green restaurants, healthy menus and quality foods ds (32) Generation Y describe themselves as foodies), with a Gallup poll showing that 57% of Millennials eat at a quick service restaurant at least once weekly, compared with 47% of those aged 40-49 years, 44% of those aged 50-64 years and 41% of those aged 65 years or older, While Millennials eat out more often than non-Millennials (3-4 28 times per week)), they are a part of the growing trend towards consumers becoming concerned about their health and the healthiness and quality of the foods Methods Research design Undergraduate research participants were exposed to four variants of a sample menu in a 2 (presence r. absence of calorie information) x2 (presence r. absence of recom- mended daily calorie intake) full factorial experimental design. Participants saw only one of four versions of stimulus materials in which all possessed consistent menu items, features and descriptions but varied regarding calorie information as follows. Version 1: No calorie or recommended daily calorie intake information. Version 2: Only calorie information. Version 3: Only recommended daily calorie intake information. Version 4: Both calorie and recommended daily calorie intake information. Restaurant nutrition menu labelling on healthy eating behaviours variable (intention to select lower-calorie foods); and potential confounding variables (gender, age, frequency of dining out, BMD). Research participants were recruited at a campus cafeteria of a large, public university in the Southwest USA to voluntarily participate in the study. Prior to conducting the research, the study protocol was approved by Texas Tech University's Internal Review Board. Subjective nutrition knowledge Consumer research distinguishes between actual knowl edge and subjective knowledge where two con- ceptually different constructs are defined as: 'objective knowledge, ie. the accurate information about the product stored in consumer's long-term memory; and sub- jective knowledge, i.e. people's subjective perceptions of what or how much they know about a product based on their own subjective interpretation of what one knows Both forms of knowledge have contributed to the literature; for example, subjective and objective measures of nutrition knowledge are significantly associated with self-reported use of nutrition labels on grocery products. While objective knowledge is related to an increase in healthful eating patterns by college students, subjective knowledge is also a good predictor- or even a better motivator - than objective knowledge in dietary behaviour and food choices when selecting healthier options from food labels. Thus, an additional hypothesis was proposed: Each version of the sample menu contained six menu items selected from a list of Burger King sandwiches using calorie information from its official website. The sand- wiches included BK Veggie Burger: 320 kcal (1339 kJ), Tendergrill Chicken Sandwich: 360 kcal (1506 kJ), Deluxe Cheeseburger: 420 kcal (1757 kJ); Whopper Sandwich: 760 kcal (3180 kJ); Double Whopper Sandwich: 900 kcal (3766 kJ); and Triple Whopper Sandwich, 1140 kcal (4770 kJ). Fifty participants were exposed to the stimulus materials for each version of the menu. Participants were randomly selected regarding the menu version they viewed. To randomize the menus, five field researchers were located in the north, south, east, west and centre of the cafeteria with ten questionnaires of each sample menu, H3. Generation Y students who have higher subjective nutrition knowledge have a higher intention to select lower-calorie foods on restaurant menus. Hypothesized model To better understand the current study, a conceptual fra- mework is depicted in Fig. 1. The hypothesized model includes three independent variables: () calorie informa- tion, (ii) recommended daily calorie intake information and (iii) subjective nutrition knowledge, a dependent Calorie information Recommended daily calorie intake information Subjective nutrition knowledge H1 H₂ H₂ Fig. 1 Hypothesized conceptual framework Intention to select lower-calorie foods Contounding variables Gender -Age Frequency .BMI 799 Measures Independent measures There were three independent variables in the study: (i) calorie information (presence z. absence: CI); (ii) recom mended daily calorie intake information (presence r absence: RDCI); and (iii) respondents' subjective nutrition knowledge (SNK). The operationalization of CI and RDCI is illustrated in Fig. 2. In addition, SNK was measured with multiple statements based on a previous research study using an eleven-point Likert-type scale (0='not at all'; 10= extremely, but modified to fit the current study. The three SNK statements were: (i) In general, how much do you think you know about the topic of nutrition?; (ii) 1 do not really know very much about nutrition in general; and (iii) 'Compared to most people, I am quite knowledgeable about nutrition. Dependent measure The dependent variable was respondents' intention to select lower-calorie foods using an eleven-point Likert- type scale. Participants responded to the statement: "Based on the menu, please rate your purchase intention toward each menu item' (0='very probably not; 10='definitely). In order to empirically operationalize the construct, the following formula was used: Intention to select lower-calorie food Sum of ratings of the three lowest-calorie items x 100. Sum of ratings of all six items The three lowest-calorie sandwiches in the numerator included the Veggie Burger, Tendergrill Chicken Sandwich and Deluxe Cheeseburger. Therefore, the intention to select the lower-calorie food ranged from 0 to 100, 0 meant that respondents selected the higher-calorie menu items and 100 meant that the lower-calorie foods were chosen. Data analysis Prior to model testing, data were tested for univariate and multivariate outliers and normality using the statistical software package IBM SPSS Statistics Version 22.0. There were no univariate outliers detected and no violation of normality. However, eight multivariate outliers were identified using Mahalanobis' distance and were deleted for model testino As a result a sample of 197 was used for
Transcribed Image Text:Nutrition information on restaurant menus Customers perceive restaurants to be socially responsible when they provide healthful food and nutrition informa- tion, with highly health-conscious customers reacting more strongly to healthy foods than their counterparts Data of menu items from the largest restaurant chains for 2012-2013 found that mean calories among menu items did not change, while the amount of calories in newly introduced menu items reduced significantly (1819) Much of the research on the effects of restaurant menu labelling encouraging individuals to choose healthier menu items has been mixed. Some research suggests that consumers may not want to be exposed to a menu item's nutrition information or may overstate their use of nutri- tion labelling Other studies on consumer behaviour before and after the implementation of restaurant menu labelling in the USA find no significant change in the caloric level of menu purchases (21-23), Some studies found a caloric reduction between pre- and post-treatment phases and selections with fewer calories by those viewing nutrition information on menu items when com- pared with those who did not-27). A meta-analysis of six controlled studies in restaurant settings found a non- significant reduction in calories, with some consumers stating that nutrition labelling is a healthful influence over (29) their purchasing decision Restaurant customers have positive attitudes towards lower-calorie items and these patrons are willing to pay a premium if the information provided indicates healthy nutrition Generation Y's healthy eating behaviours Generation Y's health concerns are increasing); "health- conscious' and 'adventurous' Generation Y groups seek green restaurants, healthy menus and quality foods ds (32) Generation Y describe themselves as foodies), with a Gallup poll showing that 57% of Millennials eat at a quick service restaurant at least once weekly, compared with 47% of those aged 40-49 years, 44% of those aged 50-64 years and 41% of those aged 65 years or older, While Millennials eat out more often than non-Millennials (3-4 28 times per week)), they are a part of the growing trend towards consumers becoming concerned about their health and the healthiness and quality of the foods Methods Research design Undergraduate research participants were exposed to four variants of a sample menu in a 2 (presence r. absence of calorie information) x2 (presence r. absence of recom- mended daily calorie intake) full factorial experimental design. Participants saw only one of four versions of stimulus materials in which all possessed consistent menu items, features and descriptions but varied regarding calorie information as follows. Version 1: No calorie or recommended daily calorie intake information. Version 2: Only calorie information. Version 3: Only recommended daily calorie intake information. Version 4: Both calorie and recommended daily calorie intake information. Restaurant nutrition menu labelling on healthy eating behaviours variable (intention to select lower-calorie foods); and potential confounding variables (gender, age, frequency of dining out, BMD). Research participants were recruited at a campus cafeteria of a large, public university in the Southwest USA to voluntarily participate in the study. Prior to conducting the research, the study protocol was approved by Texas Tech University's Internal Review Board. Subjective nutrition knowledge Consumer research distinguishes between actual knowl edge and subjective knowledge where two con- ceptually different constructs are defined as: 'objective knowledge, ie. the accurate information about the product stored in consumer's long-term memory; and sub- jective knowledge, i.e. people's subjective perceptions of what or how much they know about a product based on their own subjective interpretation of what one knows Both forms of knowledge have contributed to the literature; for example, subjective and objective measures of nutrition knowledge are significantly associated with self-reported use of nutrition labels on grocery products. While objective knowledge is related to an increase in healthful eating patterns by college students, subjective knowledge is also a good predictor- or even a better motivator - than objective knowledge in dietary behaviour and food choices when selecting healthier options from food labels. Thus, an additional hypothesis was proposed: Each version of the sample menu contained six menu items selected from a list of Burger King sandwiches using calorie information from its official website. The sand- wiches included BK Veggie Burger: 320 kcal (1339 kJ), Tendergrill Chicken Sandwich: 360 kcal (1506 kJ), Deluxe Cheeseburger: 420 kcal (1757 kJ); Whopper Sandwich: 760 kcal (3180 kJ); Double Whopper Sandwich: 900 kcal (3766 kJ); and Triple Whopper Sandwich, 1140 kcal (4770 kJ). Fifty participants were exposed to the stimulus materials for each version of the menu. Participants were randomly selected regarding the menu version they viewed. To randomize the menus, five field researchers were located in the north, south, east, west and centre of the cafeteria with ten questionnaires of each sample menu, H3. Generation Y students who have higher subjective nutrition knowledge have a higher intention to select lower-calorie foods on restaurant menus. Hypothesized model To better understand the current study, a conceptual fra- mework is depicted in Fig. 1. The hypothesized model includes three independent variables: () calorie informa- tion, (ii) recommended daily calorie intake information and (iii) subjective nutrition knowledge, a dependent Calorie information Recommended daily calorie intake information Subjective nutrition knowledge H1 H₂ H₂ Fig. 1 Hypothesized conceptual framework Intention to select lower-calorie foods Contounding variables Gender -Age Frequency .BMI 799 Measures Independent measures There were three independent variables in the study: (i) calorie information (presence z. absence: CI); (ii) recom mended daily calorie intake information (presence r absence: RDCI); and (iii) respondents' subjective nutrition knowledge (SNK). The operationalization of CI and RDCI is illustrated in Fig. 2. In addition, SNK was measured with multiple statements based on a previous research study using an eleven-point Likert-type scale (0='not at all'; 10= extremely, but modified to fit the current study. The three SNK statements were: (i) In general, how much do you think you know about the topic of nutrition?; (ii) 1 do not really know very much about nutrition in general; and (iii) 'Compared to most people, I am quite knowledgeable about nutrition. Dependent measure The dependent variable was respondents' intention to select lower-calorie foods using an eleven-point Likert- type scale. Participants responded to the statement: "Based on the menu, please rate your purchase intention toward each menu item' (0='very probably not; 10='definitely). In order to empirically operationalize the construct, the following formula was used: Intention to select lower-calorie food Sum of ratings of the three lowest-calorie items x 100. Sum of ratings of all six items The three lowest-calorie sandwiches in the numerator included the Veggie Burger, Tendergrill Chicken Sandwich and Deluxe Cheeseburger. Therefore, the intention to select the lower-calorie food ranged from 0 to 100, 0 meant that respondents selected the higher-calorie menu items and 100 meant that the lower-calorie foods were chosen. Data analysis Prior to model testing, data were tested for univariate and multivariate outliers and normality using the statistical software package IBM SPSS Statistics Version 22.0. There were no univariate outliers detected and no violation of normality. However, eight multivariate outliers were identified using Mahalanobis' distance and were deleted for model testino As a result a sample of 197 was used for
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