title: Lack of healthy food options on children's menus of restaurants in the health-disparate Dan River region of Virginia and North Carolina, 2013.
abstract: BACKGROUND
  Interest has increased in understanding the types and healthfulness of restaurant foods for children, particularly in disadvantaged areas. The purpose of this community-based participatory research study was to describe the quality of restaurant food offered to children in a health-disparate region in Virginia and North Carolina and to determine if the availability of healthy foods differed by location (rural, urban) or by the predominant race (black, white, mixed race) of an area's population.
  
  
  METHODS
  Restaurants offering a children's menu in the 3 counties in Virginia and North Carolina that make up the Dan River Region were identified by using state health department records. Research assistants reviewed menus using the Children's Menu Assessment (CMA), a tool consisting of 29 scored items (possible score range, -4 to 21). Scores were calculated for each restaurant. We obtained information on the predominant race of the population at the block group level for all counties from 2010 US Census data.
  
  
  RESULTS
  For the 137 restaurants studied, mean CMA scores were low (mean, 1.6; standard deviation [SD], 2.7), ranging from -4 to 9 of 21 possible points. Scores were lowest for restaurants in the predominantly black block groups (mean, 0.2; SD, 0.4) and significantly different from the scores for restaurants in the predominantly white (mean, 1.4; SD, 1.6) and mixed-race block groups (mean, 2.6; SD, 2.4) (F = 4.3; P < .05).
  
  
  CONCLUSIONS
  Children's menus available in the Dan River Region lack healthy food options, particularly in predominantly black block groups. These study findings can contribute to regional efforts in policy development or environmental interventions for children's food quality by the community-based participatory research partnership and help local stakeholders to determine possible strategies and solutions for improving local food options for children.
authors: Virginia Tech, Human Nutrition, Foods and Exercise, Integrated Life Sciences Building 23, Room 1033 (0913), 1981 Kraft Drive, Blacksburg, VA 24061. Email: hilljl@vt.edu.
authors: Jennie L
authors: JL
authors: Hill
authors: Virginia Tech, Blacksburg, Virginia.
authors: Nicole C
authors: NC
authors: Olive
authors: National University of Singapore, Singapore.
authors: Clarice N
authors: CN
authors: Waters
authors: Virginia Tech, Blacksburg, Virginia.
authors: Paul A
authors: PA
authors: Estabrooks
authors: Virginia Tech, Blacksburg, Virginia.
authors: Wen
authors: W
authors: You
authors: Virginia Tech, Blacksburg, Virginia.
authors: Jamie M
authors: JM
authors: Zoellner
mesh_terms: D002648:Child; D002664:Child Nutritional Physiological Phenomena; D002755:Choice Behavior; D002908:Chronic Disease / Q000517:prevention & control; D018672:Community Health Planning; D055812:Community-Based Participatory Research; D003159:Community-Institutional Relations; D005247:Feeding Behavior; D005502:Food / Q000145:classification*; D005504:Food Analysis; D006293:Health Promotion / Q000379:methods; D054624:Health Status Disparities; D006801:Humans; D008612:Menu Planning; D009657:North Carolina; D009765:Obesity / Q000517:prevention & control; D012147:Restaurants / Q000145:classification*; D012424:Rural Population / Q000706:statistics & numerical data; D040241:Social Marketing; D014505:Urban Population / Q000706:statistics & numerical data; D014768:Virginia