(P07-45-26) Process Evaluation Results for Phase 1 Implementation for FRESH: A Restaurant-Based Intervention in Washington, DC and Baltimore

Objectives: The FRESH (Focus on Restaurant Engagement to Strengthen Health) intervention trial tests a novel, multilevel three phase intervention to improve access to healthier prepared food options among small, independently owned restaurants located in DC and Baltimore. The objective of this abstract is to present how the intervention components were implemented to engage restaurant owners in choosing promotion and healthier beverage options for Phase1. 

Methods: A manual of operating procedures was prepared, and implementation data were collected over 14 months using interventionists visit forms (completed each visit) and restaurant tracking forms (at seven time-points). Process measures included dose delivered/received (tracked intervention components and the extent to which (owners/staff) received intervention components); reach (proportion of owners/staff exposed to intervention components); fidelity (extent to which intervention components were delivered as intended). Restaurants will be categorized into low, moderate, and high based on composite implementation scores.

Results: Restaurants selected FRESH beverages that were low in sugar content ( < 5 g/serving) and affordably priced: freshly squeezed juices, low/no-sugar lemonades, house-made fruit smoothies, agua frescas from pre-approved lists, etc. Interventionists conducted a total of 186 visits over the period of 14 months for each enrolled restaurant (8 Baltimore, 7 DC restaurants) (73 Baltimore; 113 in DC, average 3 visits per week for each site). Most visits included three or more rapport-building activities (e.g., greeting staff: 78.1% in Baltimore, 74% in DC). Most restaurants chose social media (64.7%), followed by promotions in-restaurants (i.e. menu redesign and table tents) print marketing (41%) and promotion by social media influencer (35%). In 77.6% of Baltimore visits and 94.8% of DC visits, owners understood the interventionist role. Interventionists reported owners demonstrating increasing engagement over 14 months, 60.3% in Baltimore and 81.6 % in DC.

Conclusions: Both sites met dose delivered/received, fidelity, and reach requirements. Going forward, process data will be used for development of a systems science simulation model to track changes in customer demand, profitability, ingredient prices etc. over time.

Funding Sources: NIH