Methods Fast food menus and nutritional quality - Fast Food FACTS

point rewards for overall participation. All participants in this
survey were anonymous, and the procedures were approved
by Yale University's Human Subjects Committee..
Participants accessed the survey on the computer through
an email link. The internet was used to distribute the survey
because it provides access to a large, well-represented
sample of the national population, including Hispanics and
African Americans. Furthermore, internet surveys generally
produce responses of equal or better quality compared to
telephone surveys. 48
Survey questions. After completing an informed consent
form, participants first confirmed that they were the parent of
at least one child (2-11 years). Parents then indicated whether
they had purchased lunch or dinner from McDonald’s, Burger
King, Subway, or Wendy’s for one or more of their children
within the past week. Parents who answered “yes” continued
to provide information about their most recent visit to one of
the fast food restaurants. Those who had not visited one of
these restaurants in the past week then answered questions
about how often they usually buy fast food for their children
from the twelve restaurants in our analysis and provided
demographic information.
Parents who had purchased lunch or dinner from one of the
four fast food restaurants in the past week for their children
were then asked about their most recent visit, including on
which day of the week the visit occurred, where the restaurant
was located, how they ordered the food, where they consumed
the food, and why they chose that restaurant. Respondents
then provided information about the youngest child for whom
they purchased food during that visit. They indicated if and
why that child wanted to visit the restaurant and what type
of menu they ordered for the child (i.e., kids’ meal, dollar/
value menu, combo meal or other). If they ordered from the
kids’ meal or the dollar/value menu, they were then shown a
list of items available on each menu for the restaurant they
visited and selected the items they ordered for their youngest
child. They also indicated why they chose to order from that
menu and why they chose each of the items they ordered.
Respondents then answered the questions about frequency
of fast food restaurant visits and demographic information.
Group comparisons. In addition to comparing survey
responses by restaurant visited most recently, we also
compared responses for parents of 2- to 5-year-olds versus
6- to 11-year-olds, and white, African American and Hispanic
parents when sample size permitted. We used chi-square
analyses and Z-tests for proportions to identify significant
differences between restaurants and demographic groups.
Menu items purchased at fast food
restaurants
To identify and evaluate the menu items ordered at fast food
restaurants we obtained data from NPD, one of the world’s
Methods
largest privately owned market research companies. 49 NPD
provides restaurant behavior data obtained through online
surveys taken by panelists about their meals and snacks
prepared away from home “yesterday.” 50 NPD’s panel consists
of more than 1.8 million registered adults and teens who have
agreed to participate in its surveys, and the panel is updated
daily to add new recruits and exclude poor-quality respondents.
The company recruits panelists using only opt-in sources (e.g.,
email, website banner ads, etc). Once they register, panelists
must opt-in two more times, demonstrating their commitment,
before they are added to the panel and receive surveys.
Every day, NPD receives approximately 2,000 surveys from
panelists, including 1,900 adults and 100 teens (13- to 17-yearolds).
51 Parents report the behavior of their children under 13.
Of all respondents, approximately 45% indicate purchasing a
meal or snack (which could include a beverage-only occasion)
the day before taking the survey. 52 NPD reports approximately
285,000 quick-serve restaurant visits annually (including orders
at the restaurant and orders from other locations such as by
phone or the internet), including 62,000 for children and teens.
Panelists provide the name and location of the restaurant
they visited the previous day, and note the time of visit and
how the food was obtained, such as by drive-thru, delivery,
or carry-out. 53 They also answer questions about the food
they purchased such as total price paid, promotions used,
special menu, and meal type (e.g., combo meal, kids’ meal
or dollar/value menu), and whether the food items purchased
were described as healthy. 54 For major chain restaurants, the
survey then displays a current menu for the restaurant visited,
and respondents select the items they purchased the previous
day. A few specific questions about menu items are asked
such as size of french fry orders and beverages, specific
toppings on pizzas, and condiments on sandwiches. 55
NPD projects the survey panel data to the U.S. population,
using geographic and demographic targets from the U.S.
Census Bureau. 56 The data are also calibrated according
to individual restaurant sales and traffic data, to accurately
represent each restaurant’s presence within the industry.
We purchased NPD CREST menu item data for each restaurant
in our analysis and for all major fast food restaurants combined.
NPD defines a major fast food restaurant as one with at least
250 transactions in its sample during a given year. In 2009,
79 restaurants fell into this category. We report measures
for the following demographic groups: Under 6 years, 6-12
years, under 13 years, 13-17 years, 18-24 years, 25-49 years,
all respondents, African American under 18 years, Hispanic
under 18 years, and Caucasian under 18 years.
Descriptive information about fast food
orders by demographic group
We report the following measures by demographic group for
all fast food restaurant orders during 2009:
Fast Food FACTS 34