Development and testing of two tools to assess point-of-sale food and beverage marketing to children in restaurants

Abstract

Objective: To describe the development and testing of two assessment tools designed to assess exterior (including drive-thru) and interior food and beverage marketing in restaurants with a focus on marketing to children and teens. Design: A scoping review on restaurant marketing to children was undertaken, followed by expert and government consultations to produce a draft assessment tool. The draft tool was mounted online, and further refined into two separate tools: the Canadian Marketing Assessment Tool for Restaurants (CMAT-R) and the CMAT-Photo Coding Tool (CMAT-PCT). The tools were tested to assess inter-rater reliability using Cohen’s Kappa and percent agreement for dichotomous variables, and intra-class correlation coefficients for continuous or rank order variables. Setting: Waterloo, Ontario, Canada. Participants: Restaurants of all types were assessed using the CMAT-R (n = 57), and 30 randomly selected photos were coded using the CMAT-PCT. Results: The CMAT-R collected data on general promotions and restaurant features, drive-thru features, the children’s menu, and the dollar/value menu. The CMAT-PCT collected data on advertisement features, features considered appealing to children and teens, characters. The inter-rater reliability of the CMAT-R tool was strong (mean percent agreement was 92.4%, mean Cohen’s κ = 0.82 for all dichotomous variables and mean ICC = 0.961 for continuous/count variables). Mean percent agreement for the CMAT-PCT across items was 97.3%, and mean Cohen’s κ across items was 0.91, indicating very strong inter-rater reliability. Conclusions: The tools assess restaurant food and beverage marketing. Both showed high inter-rater reliability and can be adapted to better suit other contexts.