Advancing Measures of Customer Outcomes in Restaurant Interventions Using the COM-B Framework

About This Grant

Project summary Foods away from home (FAFH)—including restaurant meals, takeout, and fast-casual dining—account for more than half of U.S. food spending and nearly one-third of daily calories. Despite the central role of FAFH in shaping diet quality and cardiovascular health, the behavioral drivers of food choices in these settings remain poorly understood. Existing research tools, such as dietary recalls, satisfaction/acceptability surveys, and point-of-sale data, do not fully capture the complex psychological, social, and environmental influences on restaurant-based food decisions. This methodological gap limits our ability to inform, design, and evaluate interventions and policies that promote healthier eating in the real-world restaurant setting. This R03 project aims to address this critical gap by refining and validating a theory-informed psychometric scale grounded in the Capabilities, Opportunities, and Motivations for Behavior (COM-B) model. Preliminary NHLBI K01-funded research informed the initial development of the scale, specific to Latin American restaurant customers, as part of formative research for interventions. The proposed study will strengthen and expand the scale’s application to any restaurant in the United States. Aim 1 will apply a human-centered design and mixed-methods approach to develop and test the Capabilities, Opportunity, and Motivation for Healthier Choices in Restaurants (COM- HCR) scale. The scale will be developed through design workshops with restaurant customers, expert consultation, and cognitive interviews, and tested with a national sample to assess validity and reliability. Aim 2 will further validate the refined scale using a new national sample and the Mini-EAT, a validated dietary screener aligned with the Healthy Eating Index. Confirmatory factor analysis will assess construct validity, while associations with dietary quality will establish criterion validity. The resulting measure will offer researchers, practitioners, and policymakers a validated, easy-to-administer tool to assess the behavioral factors influencing healthy food choices in restaurant environments. This project advances implementation science and public health nutrition by addressing a key measurement gap in one of the most commonly used but understudied food environments. The data and tools produced will directly support a future R01 focused on testing interventions to improve diet quality at the population level.