Using the Nutrition Environment Measures Survey to Inform &

Evaluate a Restaurant and Food Store Community Intervention

Josie Golembiewski, MPH CandidateAna P. Martínez-Donate, PhD

Department of Population Health SciencesUniversity of Wisconsin, Madison

Bev Hall, BS CDWaupaca County NuAct Coalition

Healthy Food for All SummitNeenah, WI - 3/27/14

Background

Community nutrition environment: • The number, type, location, and

accessibility of food outlets in a community

Consumer nutrition environment: • What consumers encounter

when they buy food, such as availability, cost, and quality of healthful food choices

Assessing and Improving the Nutrition Environment in Wisconsin Communities

Funded by UW School of Medicine and Public Health Wisconsin Partnership Program 2010 - 2013

ANEWC Project

Assessing the Nutrition Environment in Wisconsin Communities (ANEWC)

ANEWC

Surveillance

Intervention

Dissemination & Policy Implications

Assessing the Nutrition Environment in Wisconsin Communities (ANEWC)

ANEWC

Surveillance

Intervention

Dissemination & Policy Implications

Aim: To develop and test a pilot intervention to improve the nutrition environment in

restaurants and grocery stores

Our intervention:Waupaca Eating Smart (WES)

• Two nutrition and physical activity coalitions• 10 months: Oct 2011- July 2012• 7 restaurants & 2 stores in each community• Broad strategies:– Offer, label, and promote healthier foods

Stevens Point

Waupaca

Activities in Restaurants• Offer more healthy items– WES-approved meal: <700 calories

& 1 cup fruit or vegetables• Label & promote healthy items– Materials, signs, wait staff

Activities in Stores• Offer more healthy items– Recipes for bundled family meals: <700

calories & 1 cup fruit or vegetables• Label & promote healthy items– Promote fruits, vegetables, & family meals – Displays & samples– Signs & flyers

WES Promotion in the Community

• Where’s Jim Eating? articles in Waupaca newspaper

• Local media pieces

• Facebook

• Blog

Our Process

Formative assessment

Build partnership

s with restaurants & grocery

stores

Implement strategies: offer, label, & promote

healthy items

Improve the nutrition

environment

Improve attitudes and behaviors in customers &

owner/ managers

Methods

• Assessment tool:– Nutrition Environment Measures Survey (NEMS)

• Goal:– Measure changes in the food environment

attributable to the intervention• Evaluation design:– Before and after the intervention– Intervention community– Comparison community

Assessment Tool: Nutrition Environment Measurement Survey

• Restaurants• Stores• Convenience Stores• Vending machines

• Other tools– Perceived nutrition

environment– Grocery store

promotions (GroPromo)

• Online training– Free, 20 hours

www.med.upenn.edu/nems/Karen Glanz et al. at the University of Pennsylvania and Emory University

• Availability• Cues, signs, & information• Price• Total score: -27 to 63 points

NEMS for Restaurants

• Availability • Quality• Price• Total score: -9 to 54 points

NEMS for Stores10 food categories that contribute the most fat and calories to the American diet AND those that are most recommended for healthful eating• Fruits, vegetables, milk, ground

beef, hot dogs, frozen dinners, beverages (soda, 100% juice), baked goods, bread, chips

Discussion• NEMS-restaurant

– Availability– Cues, signs, info– Price

• NEMS-store– Availability– Quality– Price

• Adapt NEMS?• Use other tools?

Offer, label, and promote healthy items

Future directions• Analyze statewide data• Disseminate toolkits• Sustain WES • Partner with Thedacare• Expand WES through a larger study

AcknowledgmentsCommunity Partners: • Bev Hall• Anne Menzies• Marilyn Herman• Gary Garske• Waupaca NuAct• Portage County CAN• Thedacare• Wisconsin Partnership for Physical

Activity and Nutrition (WIPAN)• Wisconsin Department of Health

Services Nutrition and Physical Activity Coalition

UW-Madison Team:• Ana Martinez-Donate• Josie Golembiewski• Amy Meinen• Kristen Malecki• Anne Escaron• Norma-Jean Simon• Anne Roubal• Dan Fisher• Sahra Kahin• Natalie Rhoads• Jen Valdivia• Natalie Guerrero• Susan Nitzke• Javier Nieto• And many others

Questions? Please contact Dr. Ana Martinez-Donate: martinezdona@wisc.edu

Questions