Commercial Television Exposure, Fast Food Toy Collecting, and Family Visits to Fast Food Restaurants among Families Living in Rural Communities.

Objective: To assess the associations between children's exposure to television (TV) networks that aired child-directed advertisements for children's fast food meals with the collection of fast food meal toy premiums and frequency of family visits to those restaurants.

Study Design: One hundred parents of children 3-7 years old were recruited from a rural pediatrics clinic during 2011; families receiving Medicaid were oversampled. Parents reported the child's TV viewing habits and family visit frequency to the fast food restaurants participating in child-directed TV marketing at the time, and their child's requests for visits to and the collecting of toy premiums from those restaurants. Logistic regression models assessed adjusted associations between a child's TV viewing with more frequent restaurant visits (≥monthly in this population). Structural equation modeling assessed if child requests or toy collecting mediated that association.

Results: Thirty-seven percent of parents reported ≥monthly visits to the select fast food restaurants. Among children, 54% requested visits to and 29% collected toys from those restaurants. Greater child commercial TV viewing was significantly associated with more frequent family visits to those fast food restaurants (aOR 2.84 for each 1-unit increase in the child's commercial TV viewing scale, P < .001); toy collecting partially mediated that positive association.

Conclusions: Higher exposure among children to commercial TV networks that aired child-directed ads for children's fast food meals was associated with more frequent family visits to those fast food restaurants. Child desire for toy premiums may be a mediating factor.