Assessing restaurant staff perceptions of New Orleans, Louisiana, United States children's healthy default beverage ordinance: A qualitative study one year post-implementation.

Objective: Healthy Default Beverage (HDB) ordinances have been implemented across the United States to reduce sugar sweetened beverage (SSB) intake by making healthier options the default for children's meals. This study explored restaurant staff knowledge and perceptions of the HDB ordinance and its potential impact one year after its implementation in New Orleans, Louisiana, United States. Methods: We conducted 21 in-person interviews with restaurant staff across 20 restaurants from March to May 2024, including independent, national chain, and local chain establishments. The interviews focused on the popularity of children's meals, beverages offered, restaurant staff knowledge and perceptions of the ordinance, and potential policy-related health benefits. Results: The majority of restaurant staff supported the policy but expressed concerns about its implementation. Restaurant staff estimated that most children's meals were still ordered with SSBs. Staff felt the policy alone may not change behavior. They highlighted the need for broader public education on the health risks of SSBs. Conclusion: This study identified key factors that may impact the effectiveness of the HDB ordinance, including the need for clearer guidelines, stronger enforcement mechanisms, and better support from public health authorities. Findings suggest that both restaurant staff and parents require further education to ensure the policy's success, especially in marginalized communities. Future research should focus on societal, cultural, and enforcement factors to optimize the impact of HDB policies in improving children's health outcomes.