Health Promotion Practice
March 2016 Vol. 17, No. (2) 265–277
DOI: 10.1177/1524839915612742
© 2015 Society for Public Health Education
265
Purpose. Restaurants and food stores are suitable settings
for healthy eating interventions. A community–academic
partnership developed and implemented “Waupaca
Eating Smart” (WES), a healthy eating program in restau-
rants and supermarkets of a rural, Midwest community.
Previous interventions targeted either restaurants or small
food stores nearly all in urban areas. Intervention design
and implementation is rarely documented, making repli-
cation difficult for interested researchers and communi-
ties. In this article, we report the activities we undertook to
develop and implement WES. Methods. Working with a
local nutrition and activity coalition, we used evidence-
based strategies guided by the social ecological model and
social marketing principles to inform the content of WES.
Formative assessment included a review of the literature,
statewide key informant interviews and focus groups with
restaurant and food store operators and patrons, a local
community survey, and interviews with prospective WES
businesses. WES was implemented in seven restaurants
and two supermarkets and evaluated for feasibility and
acceptance using surveys and direct observation of WES
implementation. Findings. Prior to this intervention, only
one of seven restaurants had three or more meals that met
WES nutrition criteria. By the end of the program, 38
meals were labeled and promoted to restaurant custom-
ers, and the team had staffed four side salad taste tests for
supermarket customers. Four and 10 months after inter-
vention launch, the majority of the program’s strategies
were observed in participating outlets, suggesting that
these program’s strategies are feasible and can be sus-
tained. Operators reported strong satisfaction overall.
Conclusions. A combined restaurant- and supermarket-
based healthy eating intervention is feasible and positively
valued in rural communities. Further research is needed
to better understand how to foster sustainability of these
interventions and their impact on customer food choices.
Keywords: formative research; intervention planning;
restaurants; food stores; healthy eating;
obesity
612742HPP XX X 10.1177/1524839915612742Health Promotion PracticeEscaron et al. / DEVELOPING AND IMPLEMENTING “WAUPACA EATING SMART”
research-article 2015
1
AltaMed Health Services Corporation, Los Angeles, CA, USA
2
University of Wisconsin–Madison, Madison, WI, USA
3
Drexel University, Philadelphia, PA, USA
4
Yakima Valley Farm Workers Clinic, Portland, OR, USA
5
Wisconsin Obesity Prevention Network in Madison, WI, USA
6
Waupaca County WIC Program in Waupaca, WI, USA
Authors’ Note: Anne Menzies, Norma Jean Simon, Sara Soka,
and Gary Garske contributed to the project’s development and/or
implementation. We also acknowledge the outlet operators for
partnering with us on this project. Funding for this project was
provided by the University of Wisconsin School of Medicine and
Public Health through the Wisconsin Partnership Program
(Principal Investigators: Ana P. Martinez-Donate, F. Javier Nieto).
At the time of the research and writing of this article, Anne
Escaron and Ann Josie Riggall were with University of Wisconsin-
Madison. Address correspondence to Ana P. Martinez-Donate,
Dornsife School of Public Health, Drexel University, Philadelphia,
PA, USA; e-mail: martinez-donate@drexel.edu.
Developing and Implementing “Waupaca Eating
Smart”: A Restaurant and Supermarket
Intervention to Promote Healthy Eating Through
Changes in the Food Environment
Anne L. Escaron, PhD, MPH
1
Ana P. Martinez-Donate, PhD
2,3
Ann Josie Riggall, MPH, RD
4
Amy Meinen, MPH, RD, CD
2,5
Beverly Hall, BS, CD
6
F. Javier Nieto, PhD, MD
2
Susan Nitzke, PhD, RD, CD
2
Building Coalitions and Partnerships for Health Promotion