Rural restaurant healthy options program: A simple intervention to improve dietary intake

Restaurants present a possible venue to improve the availability of healthy food choices in the environment. In owner-operated rural restaurants, owners are hesitant to make significant menu changes because of their small profit margin and fear of losing customers. A low-cost, low-risk intervention was tested in three rural restaurants in the Midwest. A baseline customer survey (n=250) indicated strong interest in having healthy options available such as fish or meat that is baked or broiled, whole wheat bread, and fruit or vegetable side dishes. Women were more likely than men to express interest in healthy options as were older adults. Table tents and window signs were placed in the restaurants advertising healthy options that owners were willing to provide. A follow-up customer survey (n=264) indicated a significant positive change (p=.02) in the perceptions of the availability of healthy options in the restaurants. In addition, 39% of customers stated that they noticed the window signs, and 64% noticed the table tents. Of those who noticed at least one of these, 34% stated that it had influenced their food order. Process measures showed that the table tents and signs remained in place over at least several months time. Owners stated that the program enhanced their relationship with their customers, and caused them to consider offering additional healthy options in the future. This simple, low-cost intervention had a small but positive effect on customer perceptions and behavior. Long term evaluation of the intervention and plans for dissemination of the program are underway.