摘要：Objectives. We examined population-level impact on customer awareness and use and explored potential disparities in outcomes regarding the King County, Washington, regulation requiring chain restaurants to provide calorie information. Methods. We analyzed 2008 to 2010 Behavioral Risk Factor Surveillance System data from 3132 English-speaking King County residents aged 18 years and older who reported eating at a regulated chain. We used regression models to assess changes in calorie information awareness and use from prepolicy to postpolicy implementation by customer demographics, health status, and restaurant type. Results. Calorie information awareness and use increased significantly from 2008 to 2010. Unadjusted analyses indicated that the proportion who saw and used calorie information tripled, from 8.1% to 24.8%. Fully adjusted analyses confirmed significant increases. After policy implementation, White, higher income, and obese respondents had greater odds of seeing calorie information. Women, higher income groups, and those eating at a fast-food versus a sit-down chain restaurant were more likely to use this information. Conclusions. Significant increases in calorie information awareness and use following regulation support the population-wide value of this policy. However, improvements varied across race, income, and gender. In recent years, policymakers and public health practitioners have implemented policies such as posting calorie and other nutrition information at restaurants to help curb epidemic levels of obesity. 1,2 King County, Washington, implemented its menu-labeling regulation on January 1, 2009—the second jurisdiction in the United States to do so after New York City. The regulation requires chain restaurants to provide calorie, saturated fat, carbohydrate, and sodium information. 3 To date, research on the impact of menu-labeling policies has focused on pre–post changes in calorie information awareness and calories in food purchased among patrons intercepted at regulated chain restaurants using surveys, receipt data, or both. 4–10 These studies may not provide an accurate population-level estimate of menu-labeling awareness and use and are not ideal for examining whether impact varies across demographic subgroups. We report on countywide and subpopulation changes in menu-labeling awareness (i.e., seeing calorie information) and use (i.e., using calorie information) before and after policy implementation and examine heterogeneity in outcomes across subpopulations.
