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Dissemination of the Rural Restaurant Healthy Options Program


Host Institution
University of Iowa: Prevention Research Center

Health Topics

Obesity prevalence is high in Iowa, especially in rural counties. Consumption of high-fat foods, diminished opportunities for physical activity, and limited financial resources can contribute to overweight and obesity. Restaurants and concession stands (at school sporting events) could be places where residents improve their eating habits. Many small-business owners, however, do not have the time or financial budget to offer their customers the most nutritious food choices. Owners may find it difficult to obtain accurate nutritional information about the foods they serve, especially when they must substitute ingredients according to fluctuating availability and cost. Restaurant owners are also concerned that customers’ preferences can affect business success. Concession-stand operators have similar concerns about the financial risks and commitments associated with selling healthy foods.

In a preliminary study funded by the National Institutes of Health, researchers tested the Rural Restaurant Healthy Options Program, which promoted healthy menu choices in three owner-operated, small-town restaurants. Owners received a window poster promoting nutritious foods and table tents listing healthy choices. After a year, owners reported that all customer feedback was positive and that their participation was motivated by customers" interest in healthy foods and the publicity potential through local newspaper coverage.

Currently, researchers are trying to determine the best way to disseminate this intervention to small-town restaurants across Iowa, which were identified through a database of state sanitation inspection records. The researchers want to include 100 restaurants within the state"s 90 rural counties. The researchers are investigating why some owners agree to participate immediately after receiving an initial mailed invitation, why some need a follow-up telephone call before joining the study, and why others decline to participate. Researchers also are noting the number of years the restaurant has been in business, menu details, customer volume, and owner age and education. Owners then receive the study"s materials and are called after 3, 6, 12, and 18 months. Researchers will record whether owners are maintaining the promotional materials and how many reminders they may need to continue the program. Results about how long owners continue to use the intervention will help guide future studies in rural settings. A similar study is being developed to offer healthy foods at sports concession stands.
Research Setting
Rural area
Race or Ethnicity
No specific focus
No specific focus
Age Group
Adults (25-49 years) | Older adults (50 years and older)
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Principal Investigator
Faryle Nothwehr

Project Identifier
Dissemination of the Rural Restaurant Healthy Options Program - Core Project (2009-2014)

Funding Source
PRC Program

Project Status
Not active