Encouraging Healthier
Eating When Dining Out

Presented by: Melissa Jacobson, MPH
Steps to a HealthierNY Program Coordinator
Rockland County Department of Health
Rockland County, New York

(image: Just Ask Us! logos)

To describe the achievements and challenges in the design, implementation and evaluation of a countywide program to encourage restaurants to offer and highlight healthier choices on their menus.

(image: Steps to a Healthier NY logo)

• Based on the successful New York State Department of Health "Just Ask Us!" Program, Rockland County's "Just Ask Us! We Bake, Broil, or Grill" Program began July 29, 2005.
• Collaborated with the local chapter of the state restaurant association to determine needs of restaurateurs.

• The goal of the program is to improve nutrition to reduce overweight and obesity.
• The objectives of the program are:
  • To empower consumers to make healthier choices when dining out.
  • To work with restaurants to offer healthier choices.
  • To promote restaurants that offer healthier options on their menus.

• The average American eats at least 4 meals outside the home every week.^*
• Meals consumed outside of the home are less healthy and nutritious than meals prepared at home.^**
• Concerns over high rates of obesity led the Steps to a Healthier Rockland Collaborative to implement a healthy eating campaign.

*National Restaurant Association
** Journal of the American Dietetic Association

• Catchy theme.
• Applicable to most restaurants.
• Educates customers about the healthier ways to prepare food.
• Appropriate for adult and child menus.
• Main dish ordered at restaurants.

• All Licensed Food Services Establishments in Rockland County, 1200 facilities.
• Compliant with Sanitary Code.
• Willing to promote healthier choices for their customers.
• Promote program more aggressively in low-income areas and to restaurants of different ethnicities to reach a larger percentage of county residents.

Initial letter mailed to food service establishments. At least 20 restaurants called as a result of this letter.

(image: copy if mailed letter)

• Members of the Steps to a Healthier Rockland Collaborative.
• Members received a "Just Ask Us! Volunteer Kit".
• Members were trained in speaking with restaurateurs at a quarterly collaborative meeting.
• Each Member of collaborative was requested to promote Just Ask Us! at 2 of their favorite and most frequented restaurants.

Included the following materials

• Support letter from Commissioner of Health
• Support letter from President of the Westchester/Rockland Chapter of the NYS Restaurant Association
• Samples of promotional materials

• Place Just Ask Us! decal on front door or window.
• Highlight healthier menu items with a heart, steps healthy choice sticker or Steps sneakers.
• Allow customers to make substitutions for healthier items.

• free paid advertisement in local publications
• free earned media on local and regional radio, television, and print publications.
• free promotional materials.
• free promotion on the Steps to a HealthierNY website.
• free consultation from public health nutritionist/culinary consultant.
• free menu review.

(image: photo of "Rockland Dineout" magazine)

(image: "Just Ask Us!" ad from "Rockland Dineout" magazine listing restaurants participating in the Just Ask Us! program)

(image: photo of Steps to a Healthier NY advertisement in "Rockland Dineout" magazine displaying decal that "Just Ask Us!" participating restaurants display)

(image: samples of promotional items, including window decal, menu label, cd rom and ad frame insert)

(image: Just Ask Us! Placemat)

(graphic of Just Ask Us! Healthy Choices Tip Sheet)

(image: Just Ask Us! Promotional Materials Order Form)

• 122 food service establishments registered for program and received some promotional items.
• 73 are actively participating and have healthier choices highlighted on their menus.
• Eateries in all Rockland County municipalities.
• Fast food restaurants, take out places, fine dining restaurants, national chain restaurants, workplace cafeterias.

(image: List of participating food service establishments by location.)

• July 2006

• Is the Steps decal prominently displayed in the window?
• Are healthy items marked on the menu?
• It is clear that customers can ask for substitutions?
• Is the restaurant using any of the following? ___ Brochure holders ___ Table tops ___ Buttons ___ Placemats ___ Labeled menu boards or daily specials ___ Other Steps materials

Questions for Restaurateurs

• Have the changes you made as a result of this program impacted what the customers ordered?
• Did customers ask for more substitutions?
• Did customers order the healthy items more often?
• Did you have to order more of a particular item than usual? (e.g. whole wheat bread or pasta, skim milk, vegetables)
• Do you plan to keep the changes you made?
• What did you like about participating in this program?
• Is there anything we could do to improve this program?

• Began in Summer 2006
• Customer survey with free mints.
  • Are you aware of a restaurant campaign in Rockland County that promotes healthier choices?
  • Did you order an item marked with a heart or a sneaker on the menu at this restaurant?
  • Did you ask for any healthy substitutions when you ordered?
  • Did you choose this restaurant because it is part of a healthy restaurant campaign?
  • Would the healthy items and substitutions influence your decision to return to this restaurant?
  • Comments?
  • Zip Code?

(image: front and back of Customer Evaluation Card)

• Receptive to personal approach from HD.
• Enthusiastic about the program.
• Supportive of healthy menu options
• Willing to make adaptations to provide healthier options.
• Appreciate the free publicity and promotional materials.
• Easy program to adopt.
• Would do it even without the free materials and support.

• Del Arte "We want to partner with the HD and the local Farmers Market to offer healthy cooking classes to the community."
• Mia Cucina "This a fantastic program; requests for whole wheat pasta have increased so that now I order one case of whole wheat pasta once a week. Prior to this program I only ordered it once a month."
• Priya "I didn't know how many items could actually qualify for healthier choices. I thought the menu item Aloo Chola (chickpeas and spinach) had too many carbohydrates."

• Ole' Ole' "I am surprised that many parents are choosing to eat at my restaurant since I have highlighted and offer a "healthier choice" on the children's menu."
• LeCroy Corporation "I have made my signature dishes healthier by using reduced fat mayonnaise in my chicken and tuna salad and using part skim ricotta and mozzarella in my lasagna."

• Many restaurateurs don't open their mail or toss it aside.
• Needed to explain the program in detail to each restaurateur several times.
• Not all restaurateurs have access to or used computers – CD ROM usage was limited.
• Many said "yes" – put decal on door – didn't modify menu or highlight their healthier choices.

• Initial barriers included misconceptions, misinformation, mistrust coming from the Health Dept.
• Had to gain the confidence of the restaurateurs, that there was no hidden agenda.
• Avoidance factors-Difficult for volunteers scheduling visits to discuss program with owners.
• Restaurateurs were unsure as to what could be labeled as a "healthier choice". I.e. thought a baked potato was not a healthier choice because of the number of carbohydrates.

• Utilized Public Health Nutritionist and trained Public Health Educator to visit restaurants and personally review menus with restaurateur.
• Showed sample menus of how other restaurants adopted the program.
• Demonstrated "good will" with free professional advertisement in local publications.
• Gained the support of highly reputable restaurants as program champions.
• Sent memorandum of agreement to all participants to establish a uniform code of participation.

(image: photo of Just Ask Us! Decal affixed to the front door of a participating restaurant)

(image: photo of Just Ask Us! Deli Menu Board with red hearts affixed to healthy menu items)

(image: photo of Just Ask Us! Decal on Deli Case with Healthier Selections)

(image: photo of Grilled Honey Mustard Chicken in deli case)

(image: photo of troll figurine with menu board)

(image: photo of Ad frame and table tent on concierge table)

(image: photo of table tent on table)

(image: photos of healthier buffet options)

(image: example of sample menus)

(image: more sample menus)

(image: more sample menus)

(image: more sample menus)

(image: more sample menus)

(image: another sample menu)

• WABC Eyewitness News coverage
• Rockland County Dineout Guide
• The Dining Times Diner Placemats
• Rockland County Times
• Rivertown
• The Journal News
• Looking Forward
• Rockland Review
• Pennysaver
• El Sol
• El Clarin

• Continue promotional efforts.
• Promote different themes, Mayor's Healthy Choice, Rockland's Tasty N' Healthy Pizza Contest.
• Continue to recruit new establishments.
• Work in conjunction with food safety re-certification course.
• Sustain program by working with local Restaurant Association to adopt and assume oversight of the program.

• All participating restaurateurs have been educated about healthier menu options for their customers in order to sustain the program over time.
• Many restaurateurs have embraced this program especially since the media has highlighted the obesity epidemic and the effect of Americans eating out on our waistlines.

Michelle Kleinman, RD
Public Health Nutritionist
Rockland County Department
of Health
50 Sanatorium Road
Building J
Pomona, NY 10970
845-364-3612
Kleinmam@co.rockland.ny.us

(image: photo of Just Ask Us! team)