A Community-Based Restaurant Initiative to Increase Availability of Healthy Menu Options in Somerville, Massachusetts: Shape Up Somerville

New Balance Chair in Childhood Nutrition, John Hancock Center for Physical Activity and Nutrition, Friedman School of Nutrition Science and Policy, 150 Harrison Ave, Tufts University, Boston, MA 02111, USA.
Preventing chronic disease (Impact Factor: 2.12). 08/2009; 6(3):A102.
Source: PubMed


Environmental factors at the community level may play a role in the development and maintenance of obesity. Because many US families frequently eat meals outside of the home, restaurants are an environmental factor that can affect their health. The purpose of this project was to test the feasibility of a community-based restaurant initiative that targets families and young children.
Somerville, Massachusetts, is an ethnically diverse, densely populated city. Approximately 44% of elementary school children in Somerville are overweight or obese. The restaurant initiative described here was conducted as part of a larger community-based environmental intervention, Shape Up Somerville: Eat Smart, Play Hard (SUS), designed to improve energy balance by making small changes in all aspects of a child's environment.
Restaurant initiative activities were establishing criteria for approval as an SUS restaurant; conducting brief one-on-one interviews with 15 restaurant owners and managers; recruiting restaurants; and monitoring and evaluating restaurants' ability to adhere to the criteria, using questionnaires and site visits.
Establishing approval criteria for restaurants required several iterations and ongoing flexibility. Barriers to participation included lack of time and interest and concerns about potential profit losses. The strategy of publicizing approved restaurants facilitated participation in the program. Twenty-eight percent of actively recruited restaurants participated in the initiative. Approximately one-half of restaurants fully complied with all approval criteria.
Despite limited feasibility, the initiative provided valuable visibility and branding of the intervention within the community as well as lessons for working with restaurants to improve health.

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    • "However, the results found here may not be generalizable to food vendors in other countries, higher-income areas, or to mainstream shops such as supermarkets and food outlet chains, which are also frequented by schoolchildren and may have different strategies, priorities, and concerns in regards to menus, pricing, and profit margins. Further, because the shop owners in this study (and others [38]) were willing to spend only a short period of time in the interviews, it is possible that data saturation was reached quickly due to feasibility limitations on depth. Our study was conducted in three Scottish cities, which may vary in their local culture, norms and values but what was striking about our findings was the extent to which the same issues were mentioned by vendors we interviewed across the three cities. "
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    ABSTRACT: Background Preventing and reducing childhood and adolescent obesity is a growing priority in many countries. Recent UK data suggest that children in more deprived areas have higher rates of obesity and poorer diet quality than those in less deprived areas. As adolescents spend a large proportion of time in school, interventions to improve the food environment in and around schools are being considered. Nutrient standards for school meals are mandatory in the UK, but many secondary pupils purchase foods outside schools at break or lunchtime that may not meet these standards. Methods Qualitative interviews were conducted with fast food shop managers to explore barriers to offering healthier menu options. Recruitment targeted independently-owned shops near secondary schools (pupils aged c.12-17) in low-income areas of three Scottish cities. Ten interviews were completed, recorded, and transcribed for analysis. An inductive qualitative approach was used to analyse the data in NVivo 10. Results Five themes emerged from the data: pride in what is sold; individual autonomy and responsibility; customer demand; profit margin; and neighbourhood context. Interviewees consistently expressed pride in the foods they sold, most of which were homemade. They felt that healthy eating and general wellbeing are the responsibility of the individual and that offering what customers want to eat, not necessarily what they should eat, was the only way to stay in business. Most vendors felt they were struggling to maintain a profit, and that many aspects of the low-income neighbourhood context would make change difficult or impossible. Conclusions Independent food shops in low-income areas face barriers to offering healthy food choices, and interventions and policies that target the food environment around schools should take the neighbourhood context into consideration.
    BMC Public Health 08/2014; 14(1):793. DOI:10.1186/1471-2458-14-793 · 2.26 Impact Factor
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    • "Creating a socially responsible image is one way restaurants can profit by providing healthy alternatives. Economos et al. (2009) showed that restaurants want to be perceived as socially responsible when providing healthful menus and highlighting healthier options on a menu board. Royne and Levy (2008) suggested that companies provide healthy products as an effective marketing strategy so that customers have positive reactions through a socially responsible image. "
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    ABSTRACT: As customers become more health conscious and governments create legislation requiring restaurants to provide nutrition information, the restaurant industry can no longer ignore demands for healthful eating environments. This study considers providing healthful food options and nutrition information as strategies for creating healthful eating environments at restaurants, and aims to develop a theoretical explanation of consumer reactions to such actions that incorporates perceived corporate social responsibility. Data were collected using a between-subjects experimental design with scenarios. The results show that customers perceive restaurants to be socially responsible when they are provided with healthful foods and nutrition information; highly health-conscious customers react more strongly to provision of healthful foods than their counterparts. Consequently, customers have favorable attitude toward and high willingness to visit restaurants providing healthful foods and nutrition information. Restaurateurs should consider taking such initiatives to entice more customers and develop a socially responsible image.
    International Journal of Hospitality Management 02/2014; 37:29–37. DOI:10.1016/j.ijhm.2013.10.005 · 1.94 Impact Factor
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    • "In addition, the home environment was targeted through parent nutrition forums and newsletters that raised awareness about the potential health detriments caused by sugar-sweetened beverages. In the community environment, restaurants were required to offer low-fat dairy as an alternative to sugar-sweetened beverages to become a Shape Up Somerville approved restaurant [29]. The APPLE intervention [36], that likewise used a multi-level approach included curriculum lessons highlighting the negative effects of sugar-sweetened beverages, increased availability of water at schools, and provision of a community-wide healthy eating guide. "
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    ABSTRACT: The purpose of this study is to describe the behavioral changes in children resulting from Shape Up Somerville (SUS), a community-based, participatory obesity prevention intervention that used a multi-level, systems-based approach. It was set in Somerville, an urban, culturally diverse community in Massachusetts, USA. This was a non-randomized, controlled 2-year community-based intervention trial with children enrolled in grades 1 to 3 (ages 6-8 years). Overall, the SUS intervention was designed to create environmental and policy change to impact all aspects of a child's day. Pre-post outcomes were compared between Somerville and two control communities that were chosen based on socio-demographic similarities. Behavioral outcomes were fruit and vegetable and sugar-sweetened beverage consumption; number of organized sports and physical activities per year; walking to and from school; screen and television time; television in bedroom; and dinner in room with television on. These measures were assessed by parent/caregiver report using a 68-item Family Survey Form. Data were analyzed using multiple linear regression, accounting for covariates and clustering by community. Intervention group children, compared to the control group, significantly reduced sugar-sweetened beverage consumption (-2.0 ounces per day; 95% CI -3.8 to -0.2), increased participation in organized sports and physical activities (0.20 sports or activities per year; 95% CI 0.06 to 0.33), and reduced their screen time (-0.24 hours per day; 95% CI -0.42 to -0.06). Results of this study, particularly intake of sugar-sweetened beverages and screen time, are similar to others that used a multi-level approach to realize change in behavior. These results support the efficacy of a multi-level and systems-based approach for promoting the behavioral changes necessary for childhood obesity prevention. This study is registered at ClinicalTrials.gov as NCT00153322.
    BMC Pediatrics 10/2013; 13(1):157. DOI:10.1186/1471-2431-13-157 · 1.93 Impact Factor
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