Table 2.
Summary of the evaluations of interventions to promote healthier ready-to-eat meals (to eat in, take away, or delivered) sold by specifica food outlets in England (Tier 2, n = 30)
| Project name (reference number) | Type of food outlet targeted by the interventionb, and notesc | Process | Acceptability | Cost | Impact/Outcome | Comments related to food outlets 1) working upstream (n = 6), 2) favouring a health by stealth approach (n = 10), and 3) generating customer demand (n = 3), and other information. | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Description | ++ favourable, + favourable overall but included some negative aspects, 0 ambivalent, − negative overall but included some positive aspects, −- negative | |||||||||||
| Food outlet | Project team | Food outlet | Customer | Project team | Food outlet | Customer | Project team | Food outlet | Customer | |||
| Rochdale Borough Council’s Healthier Chips (Award 2) |
Takeaway eateries (1) Notes: specifically outlets near schools |
++ | + | |||||||||
| The Cornwall Healthier Eating and Food Safety (CHEFS) Award (Award 6) |
Takeaways and Sit in eateries (1, 2 and 3) | + | Upstream issues: difficulties sourcing alternative food products | |||||||||
| Kirklees Healthy Choice Award (Award 10) |
Takeaways and Sit in eateries (1, 2 and 3) | Only one business chose not to renew their award | + | |||||||||
| Recipe4Health, Lancashire (Award 15) |
Takeaways and Sit in eateries (1, 2 and 3) | ++ | ++ | ++ | Cost and impact/outcome results based on 1–2 case studies | |||||||
| Tower Hamlets Healthy Towns/Healthy Food Award/Food for Health (Award 20) |
Takeaways and Sit in eateries (1, 2 and 3) | + | 0 |
Health by stealth:
Most businesses found changing to a healthier oil was the easiest criteria to meet |
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| Bristol Better Sandwiches project (Award 25) |
Takeaway eateries (1) Notes: independent outlets only (n = 20 outlets at baseline) |
At 3 years: 4 closed down, 3 changed hands & 13 were still trading as the same business. Some staff changes and new managers resulting in little memory of the intervention. | - | 0 | ++ | The negative view around acceptability was focussed on the fact that the resource for the intervention had ended. | ||||||
| Heartbeat Award (Health Education Authority), England-wide (Award 26) [40, 41] |
Takeaways and Sit in eateries (1, 2 and 3) Notes: intervention aimed at lower SES groups |
+ | ++ |
Generation of customer demand: the majority of respondents agreed that healthy food choices should be available when eating out. Health by stealth: Award premises purchased significantly more brown rice and semi/skimmed milk, and skinned chicken before cooking. |
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| Eat Well Award, Undisclosed PCT in the North West (Award 27) [42] |
Takeaways and Sit in eateries (1, 2 and 3) Notes: outlets in disadvantaged areas |
- | ||||||||||
| Healthy Business Award, Ashton, Leigh, Wigan (Award 29) |
Takeaways and Sit in eateries (1, 2 and 3) Notes: included outlets in deprived areas |
++ | + | Generation of customer demand: 54% of which customers said they were positively influenced by the fact it was a ‘Healthier Choice’ | ||||||||
| Healthier Options Food Awards, Newham (Award 30) |
Takeaways and Sit in eateries (1, 2 and 3) | + | ||||||||||
| London Healthier Catering Commitment (overall) (Award 34) (HCC) [26] |
Takeaways and Sit in eateries (1, 2 and 3) Notes: included outlets in deprived areas |
- | + |
Upstream issues: Difficulties sourcing low fat products from existing suppliers Health by Stealth: Businesses reported fearing that customers would not like the taste of food cooked without any salt |
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| London Healthier Catering Commitment, Hammersmith and Fulham, Kensington and Chelsea and Westminster (Award 40) (HCC) |
Takeaways and Sit in eateries (1, 2 and 3) Notes: Outlets in affluent and deprived areas |
+ | + | 0 | 0 | + | Health by stealth: businesses appreciated the fact that the changes required of them were fairly minor. Changes made to the use of oil and salt were adopted by the largest number of businesses. | |||||
| London Healthy Catering Commitment, Sutton and Merton (incorporated in Sutton and Merton Responsibility Deal) (Award 41) (HCC) |
Takeaways and Sit in eateries (1, 2 and 3) Notes: independent outlets |
+ | + | Generation of customer demand: 43% of 42 business said they are selling more water and diet drinks now they are prominently displayed; 14% of the businesses reported their customers have been asking for smaller portions now they are clearly advertised | ||||||||
| London Healthy Catering Commitment, London Borough of Richmond (Whitton & Heathfield) (Award 42) (HCC) |
Takeaways and Sit in eateries (1, 2 and 3) Notes: independent outlets |
+ | + | + | ||||||||
| London Healthy Catering Commitment, London Borough of Richmond (Ham, Sheen and Twickenham) (Award 43) (HCC) |
Takeaways and Sit in eateries (1, 2 and 3) Notes: outlets near schools |
23 out of 60 achieved award. 17 of 37 restaurants and cafes achieved award, compared with 6 of 23 takeaways. | 0 | Negative views of acceptability expressed by takeaways compared with restaurants and cafes. | ||||||||
| Eatright Liverpool (Non-award 9) |
Takeaways and Sit in eateries (1, 2 and 3) | Trust between the takeaways and support team essential to project. Takeaways, do not document recipes. Some dietary analysis software inappropriate | ||||||||||
| Worcestershire Truckers Tucker (Non-award 15) |
Takeaways and Sit in eateries (1, 2 and 3) | + | + | + | + |
Health by stealth:
Top Tips successfully implemented included using healthier products and cooking practices, of which the customer would be unaware. |
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| Central England Trading Association Truckers Tucker (Non-award 16) |
Takeaways and Sit in eateries (1, 2 and 3) | + | + | + | 0 | 0 | Impact/outcome based on 2 cases Health by stealth: proprietors top tips included changes which their customers (in all except one premise) did not notice any difference in taste. Top Tips easiest to implement included using healthier products and cooking practices, of which the customer would be unaware. |
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| Shropshire Eat Well live Longer - on the road (Non-award 17) |
Takeaways and Sit in eateries (1, 2 and 3) Notes: outlets in areas of social deprivation |
+ | + | ++ |
Upstream issues: Specific healthier products are not always available in wholesalers. Health by stealth: Businesses successfully implemented the use of healthier products and cooking practices, of which the customer would be unaware. |
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| Warwickshire Truckers Tucker (Non-award 18) |
Takeaways and Sit in eateries (1, 2 and 3) | ++ | ||||||||||
| Healthier menu choices for children, South Somerset (Non-award 21) |
Takeaways and Sit in eateries (1, 2 and 3) Notes: independent outlets |
+ | + | Acceptability views by food outlets limited to their views on the training provided | ||||||||
| Box chicken, London (Non-award 23) |
Takeaway eateries (1) Notes: outlets near schools, particularly in low income areas |
++ | + | |||||||||
| Enfield healthier takeaways project (Non-award 24) |
Takeaway eateries (1) | - | - | + | ||||||||
| Stoke-on-Trent Chip shop project (Non-award 25) |
Takeaway eateries (1) | + |
Health by stealth:
Businesses successfully implemented the use of healthier products and cooking practices, of which the customer would be unaware. |
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| Shake Less Salt campaign, Norfolk (Non-award 26) |
Takeaway eateries (1) | + | - | + | + | Health by stealth: findings suggest customers favour a ‘health by stealth’ approach. | ||||||
| Gateshead Salt Shakers (Non-award 27) |
Takeaway eateries (1) | Only 3 businesses approached declined to take part. A large proportion of shops agreed to provide a poster and leaflets. | ++ | + | + | Cost and impact/outcome results based on one case | ||||||
| Sandwich project, Exeter (Non-award 28) |
Takeaway eateries (1) | ++ | ++ | ++ |
Health by stealth:
Businesses successfully implemented the use of healthier products, of which the customer would be unaware. |
|||||||
| Sandwich project, Buckinghamshire (Non-award 29) |
Takeaway eateries (1) | + | + | |||||||||
| My Choice, London (Non-award 30) |
Takeaways and Sit in eateries (1, 2 and 3) Notes: outlets in a deprived area |
+ | ||||||||||
| FSA project - calorie information at the point of choice in catering outlets, UK wide (Non-award 31) |
Takeaways and Sit in eateries (1, 2 and 3) | + | + | 0 | ||||||||
aThe specific food outlets included were those that, as their main business, sold ready-to-eat meals and were openly accessible to the general public
bFood outlets targeted by the intervention were mapped (see Additional file 1 for detail of process) onto one of three categories:
1. Takeaway eateries (takeaways)
2. Sit-in eateries
3. Food outlets that included options to takeaway or sit-in
cInformation on whether the intervention included chain and/or independent outlets, and/or had a particular focus on low SES groups or outlets near schools, where reported