Fast Food Environment among Low‐Income Communities in the Pacific Region: Findings from the Children's Healthy Living Program

Abstract

Understanding community fast food environments is important to address obesity, particularly in low‐income populations. This study examines menus of fast food restaurants (FFR) across 4 US Affiliated Pacific Regions in the Children's Healthy Living Program. 
 A total of 91 FFR were surveyed using a modified Fast Food Observation Form from the Bridging the Gap Community Obesity Measures Project, including 40 in Alaska, 9 in the Commonwealth of the Northern Mariana Islands (CNMI), 5 in Guam, and 37 in Hawaii. Burger and Fries, Sandwich/Sub Shop, Plate Lunch/Lunch Truck, and Chinese/Pan‐Asian were the top 4 FFR types.
 Food and beverages offered on the menu were assessed in 80 FFR. The most common foods were salad (48%), sandwich (44%), fries (44%), and cheeseburger (36%). The most common beverages were fountain drink (73%), bottled water (71%), can/bottled soda (56%), and 100% juice (48%). Among 87 FFR assessed for fruit and vegetable (FV) dishes on the menu, 75% had at least one. Among 16 FFR with a dollar menu, 56% had FV, salad, or yogurt (FVSY) items. Among 34 restaurants with a children's menu, 76% had FVSY items and 76% had skim/1% milk, 100% juice, or bottled water. Significant regional differences were found on the availability of FV as sides (p<0.01, with Alaska highest, CNMI lowest) or of FVSY items on a children's menu (p=0.04, with Hawaii highest, CNMI lowest). 
 Intervention messages aimed at changing eating behaviors among families in low‐income communities can focus on availability and identification of healthy food and beverage options among FFR.