Food ordering for children in restaurants: multiple sources of influence on decision making.

Objective: Restaurants are playing an increasingly important role in children's dietary intake. Interventions to promote healthy ordering in restaurants have primarily targeted adults. Much remains unknown about how to influence ordering for and by children. Using an ecological lens, the present study sought to identify sources of influence on ordering behaviour for and by children in restaurants.

Design: A mixed-methods study was conducted using unobtrusive observations of dining parties with children and post-order interviews. Observational data included: child's gender, person ordering for the child and server interactions with the dining party. Interview data included: child's age, restaurant visit frequency, timing of child's decision making, and factors influencing decision making.

Setting: Ten independent, table-service restaurants in San Diego, CA, USA participated.

Subjects: Complete observational and interview data were obtained from 102 dining parties with 150 children (aged 3-14 years).

Results: Taste preferences, family influences and menus impacted ordering. However, most children knew what they intended to order before arriving at the restaurant, especially if they dined there at least monthly. Furthermore, about one-third of children shared their meals with others and all shared meals were ordered from adult (v. children's) menus. Parents placed most orders, although parental involvement in ordering was less frequent with older children. Servers interacted frequently with children but generally did not recommend menu items or prompt use of the children's menu.

Conclusions: Interventions to promote healthy ordering should consider the multiple sources of influence that are operating when ordering for and by children in restaurants.