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

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 per cent agreement for dichotomous variables, and intra-class correlation coefficients (ICCs) for continuous or rank-order variables.Setting: Waterloo, Ontario, Canada.Participants: Restaurants of all types were assessed using the CMAT-R (n 57), and thirty 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, and characters. The inter-rater reliability of the CMAT-R tool was strong (mean per cent agreement was 92<middle dot>4 %, mean Cohen's kappa = 0<middle dot>82 for all dichotomous variables and mean ICC = 0<middle dot>961 for continuous/count variables). The mean per cent agreement for the CMAT-PCT across items was 97<middle dot>3 %, and mean Cohen's kappa across items was 0<middle dot>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.