Eat Well El Paso!: Lessons Learned From a Community-Level Restaurant Initiative to Increase Availability of Healthy Options While Celebrating Local Cuisine.

Purpose: Restaurants have the potential to improve nutrition and positively shape social norms. We describe lessons learned and recommended strategies from Eat Well El Paso! (EWEP), a local restaurant initiative.

Design: Descriptive case study.

Setting: EWEP partnered with local restaurants from 2012-2017 in El Paso, Texas, along the US/Mexico border.

Sample: Our sampling frame included EWEP staff and managers/owners at participating restaurants, of which the majority participated (80% and 85%, respectively).

Intervention: EWEP was a local restaurant initiative led by the city public health department. EWEP contracted registered dietitians to assist locally-owned restaurants to increase availability of healthy menu options.

Measures: Observation, key informant interviews, and document review assessed participation, barriers, and facilitators to restaurant participation and program sustainability.

Analysis: Thematic and descriptive analyses.

Results: 57% of restaurants completed the full on-boarding process, but long-term retention was low (24% of completers). Restaurant managers/owners perceived value in marketing, nutritional analysis, and menu design. Barriers included scheduling, complexity of restaurant culture, fear of food inspections, restaurant turnover, competing responsibilities, and lack of dedicated funding.

Conclusion: Although local context and sample size may limit generalizability, lessons learned and recommended strategies are relevant and informative for communities working to increase restaurants' healthy menu options.