title: A community-based restaurant initiative to increase availability of healthy menu options in Somerville, Massachusetts: Shape Up Somerville.
abstract: BACKGROUND
  Environmental factors at the community level may play a role in the development and maintenance of obesity. Because many US families frequently eat meals outside of the home, restaurants are an environmental factor that can affect their health. The purpose of this project was to test the feasibility of a community-based restaurant initiative that targets families and young children.
  
  
  BACKGROUND
  Somerville, Massachusetts, is an ethnically diverse, densely populated city. Approximately 44% of elementary school children in Somerville are overweight or obese. The restaurant initiative described here was conducted as part of a larger community-based environmental intervention, Shape Up Somerville: Eat Smart, Play Hard (SUS), designed to improve energy balance by making small changes in all aspects of a child's environment.
  
  
  METHODS
  Restaurant initiative activities were establishing criteria for approval as an SUS restaurant; conducting brief one-on-one interviews with 15 restaurant owners and managers; recruiting restaurants; and monitoring and evaluating restaurants' ability to adhere to the criteria, using questionnaires and site visits.
  
  
  CONCLUSIONS
  Establishing approval criteria for restaurants required several iterations and ongoing flexibility. Barriers to participation included lack of time and interest and concerns about potential profit losses. The strategy of publicizing approved restaurants facilitated participation in the program. Twenty-eight percent of actively recruited restaurants participated in the initiative. Approximately one-half of restaurants fully complied with all approval criteria.
  
  
  CONCLUSIONS
  Despite limited feasibility, the initiative provided valuable visibility and branding of the intervention within the community as well as lessons for working with restaurants to improve health.
authors.affiliation: New Balance Chair in Childhood Nutrition, John Hancock Center for Physical Activity and Nutrition, Friedman School of Nutrition Science and Policy, 150 Harrison Ave, Tufts University, Boston, MA 02111, USA. christina.economos@tufts.edu
authors.forename: Christina D
authors.initials: CD
authors.lastname: Economos
authors.forename: Sara C
authors.initials: SC
authors.lastname: Folta
authors.forename: Jeanne
authors.initials: J
authors.lastname: Goldberg
authors.forename: David
authors.initials: D
authors.lastname: Hudson
authors.forename: Jessica
authors.initials: J
authors.lastname: Collins
authors.forename: Zachariah
authors.initials: Z
authors.lastname: Baker
authors.forename: Eliza
authors.initials: E
authors.lastname: Lawson
authors.forename: Miriam
authors.initials: M
authors.lastname: Nelson
mesh_terms: D003256:Community Participation; D005247:Feeding Behavior; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008404:Massachusetts; D011204:Poverty Areas; D012147:Restaurants; D040241:Social Marketing; D014505:Urban Population