NEMS Applications

We would like to share with others all of the exciting applications of the NEMS tools and make this a useful webpage to other NEMS users.  We need your help in order to do that by letting us know about your NEMS projects and developments! Please keep us in the loop and send us an email at nems@zimbra.upenn.edu. 

Click on the links below to learn more.

 Project Updates and Applications        Webinars           

Project Updates and Applications

The LiveWell EatWell Restaurant Challenge in Lawrence, KS (April 2013)

LiveWell Lawrence began the LiveWell EatWell Restaurant Challenge in late 2010. To date, 17 restaurants have accepted the challenge to offer healthy options for restaurant patrons. The program is managed and sustained by a WIC nutritionist at the Lawrence-Douglas County Health Department. The initiative rewards participating restaurants by promoting them and featuring their menu offerings in short stories posted on WellCommons, an award-winning community-journalism website that empowers local consumers and community health advocates reporting on and communicating about health and well-being issues that impact residents of Douglas County, Kansas.

To understand the relationship of food environments to eating and weight patterns, researchers need to examine accessibility of restaurants, but also factors that are believed to contribute to food choices in restaurants, including availability of more healthful foods, factors that facilitate or hinder healthful eating, pricing, and signage or promotion of healthful and unhealthful foods. As the program was originally designed, restaurants qualify for recognition by LiveWell required meeting several criteria including but not limited to the following: offering fresh, frozen or canned fruit; entrées prepared with lower-fat method (baked, steamed, poached, broiled or barbecued); offering smaller servings of entrées; offering lower fat or sugar free dessert options on menu; and providing a substitute for fried side dishes (e.g., side salad, vegetables, pasta salad or fresh fruit). This original program design is being modified as a result of an evaluation activity supported by the 2012-2013 CDRR grant. That activity resulted in the assessment of 56 Douglas County restaurants, including 17 that are currently participating in the LiveWell EatWell Restaurant Challenge. The assessment was completed using the nationally recognized Nutrition Environment Measures Survey for Restaurants (NEMS-R), which was recommended by the Dr. Anthony Randles, KDHE Physical Activity and Nutrition Program Manager. The NEMS-R assessment activity targeted current and prospective participants in the LiveWell EatWell Restaurant Challenge. As part of the 2012-2013 CDRR NEMS-R activity, a NEMS-R assessment report will be produced and provided to the 56 Douglas County restaurants evaluated in 2012. The analysis will summarize restaurant practices that facilitate or create barriers to healthful dining. The report will also identify opportunities for improvement in healthy dining.

Among EatWell restaurants, scores on the NEMS-R assessment ranged from a high of 17 to a low of 3 (excluding points allowable for kids’ menus, which not all participating restaurants had). Higher NEMS-R scores are associated with health promoting restaurant environments. 24% (4 of 17) of EatWell restaurants scored 10 or higher: Jason's Deli (17), Carlos O’Kelly’s (15), Applebee's (13) and Bambino's (10).

New NEMS smart phone app related to NEMS-R scores being developed for Cerro Gordo County in Iowa!  (March 2013)

The Cerro Gordo County Department of Public Health, located in north central Iowa, has been using the NEMS assessment tools for many years now. They have recently used the NEMS-R tool to assess every restaurant in the county in an effort to encourage restaurant managers to enhance their restaurant environment through healthy strategies. They have put together a book explaining the NEMS-R tool, the restaurant’s respective NEMS-R score, and highlighted a few strategies the restaurants could implement to improve their score and consequently provide a healthier eating environment for residents.  Click here to see the NEMS-R Strategy Guide for Improvement that they would like to distribute to the restaurant managers.

To complement the NEMS-R Scores, they will also be releasing a Smart Phone App that will utilize NEMS-R scores in the county for public use when deciding where to dine throughout Cerro Gordo County. As restaurants improve, their scores will be updated. The public health department received funding through the Iowa Department of Public Health Community Transformation Grant.  Click here to view Powerpoint presentation.

Once the app is in use, we will provide the link!

NEMS-Related Video from NEMS User

Sarah Moen, a student in Wisconsin who worked on a NEMS project over the summer of 2011, created a video of her NEMS experience.  To see her video, click here.

NEMS Vending Machine Tool (NEMS-V) Website   

Susan Klein and Carol Voss of Iowa State University Extension and Iowans Fit for Life Program received a grant from The Wellmark Foundation to develop a Nutrition Environment Measures Tool to assess the contents of vending machines (NEMS-V).  Dr. Glanz and Margaret Clawson consulted on the development of the tool.  Read the published article to learn more. Or, visit the website  www.nems-v.com

On the website, you'll find a tutorial on how to use the tool and the healthy choices calculator and tips on how to take action to add some healthier options if needed.

They have received a second grant from The Wellmark Foundation to continue to build on NEMS-V.  They will be assessing all the vending machines located in the buildings owned by the state of Iowa and work to get them to be filled with some healthier options, if the assessment shows it is needed.  They also just handed out mini-grants to groups all over the state of Iowa that are interested in using any of the NEMS tools in their community or at their workplace.

Please go to webinars section to learn more about NEMS-V and their interesting work!

Hospital Food/Beverage and Physical Activity Environment Scans

Dr. Belay is hopeful that the scan will be released this year, 2013.

Researchers at the Centers for Disease Control and Prevention have adapted a version of NEMS-R, NEMS-S and NEMS-V  to assess the nutrition environment in hospitals.  Collaborators on this project completed the Nutrition Environment Measures Survey  (NEMS) training, which includes didactics on the process of enumeration and fieldwork assessments of restaurants, grocery stores, and convenience stores. NEMS-Vending were also adapted to reflect components of the food/beverage and physical environments, respectively.

They collaborated with hospitals across the country to conduct validity testing of these tools. The objectives of their project were to adapt a food & beverage retail environment assessment tool for hospitals and to disseminate these tools such that hospitals can increase knowledge about and monitor healthy hospital environments.

If you are interested in learning more about this project, please contact Dr. Brook Belay at hup1@cdc.gov.

NEMS Tool for Assessing the Nutrition Environment on College Campuses

Fifteen post-secondary institutions assessed their near and on-campus eating environment using NEMS-S and NEMS-R tools modified by Dr. Tanya Horacek from Syracuse University. In the study, Dr. Horacek concluded that a college campus provides an eating environment with an array of dining and shopping venues,­­­­ most of which are not consistent with dietary recommendations for good health and obesity prevention. The findings of this study provide evidence in support of campus initiatives to evaluate and improve the quality of their own and surrounding eating environments.

The modifications made to NEMS-R to assess Campus Dining venues included the addition of a detailed evaluation of salad bars, vegetarian options, non-dairy milk alternatives, and cereals.  NEMS-S was expanded to evaluate canned and frozen fruits and vegetables (F/V), other ground lean meats, vegetarian (meat alternative) products, and the cereal (by fiber criteria).

NEMS-R.Campus Dining and protocol.

If you'd like to access all of Dr. Horacek's customization materials, please go to the NEMS materials webpage.  Also, please go to the publications page, to view Dr. Horacek's published articles on the project.

Working with Local Restaurants in New Ulm, Minnesota (2011)

The Minneapolis Heart Institute Foundation has been doing some exciting work. First, they conducted a NEMS assessment of the nutrition community in New Ulm, Minnesota.  Based on the results, they created a report for restaurants using NEMS data.  Now, they are working with them to try to modify their menus. Here is a link to more information on their website: http://www.heartsbeatback.org/restaurant-program

For their next steps, they are hoping to begin work in the next few months on a baseline assessment of the entire community (restaurants, grocery stores and convenience stores). Also, they had a poster on the convenience store program at the American Dietetic Association meeting this past September in San Diego. Click here to view the poster.

Chenango Health Network NEMS Assessment (Nov. 2011)

The Chenango Health Network who is the lead organization of a local health planning group conducted NEMS assessments of restaurants in their area in Chenango County in rural New York in late 2010. If you'd like to read about their results, click here.

After reviewing the results, the group members developed The Restaurant project which is an ecological approach to healthy eating, uses evidence-based chronic disease prevention strategies, builds on community strengths and resources and, uses a logic model which enables partners to assess and evaluate progress.  If you'd like to see their logic model, click here.

They launched The Restaurant Project which involves seven locally owned restaurants in different parts of this rural county. They have been working with the restaurants--adding and promoting healthy food choices and have started to promote these restaurants locally. These restaurants also have a strong community connection. The next step is to begin a broad community education campaign about eating out and ordering choices. They have been partnering with worksites/employers who have wellness activities underway.  Other restaurants would like to participate but due to funding and staffing, they will have to wait.

If you'd like to learn more about this project, you can contact Tina Utley Edwards, Executive Director of the Chenango Health Network at tina@chenangohealth.org

Leon County, Florida (2010)

Angela Leone, a graduate student at UGA analyzed the NEMS data collected in Leon County, Florida.  To read the abstract of her results, please click here. You can also see her publication of the results on the publications webpage.

Seattle, WA (2010)

Graduate student Sara Coulter wrote her thesis on her NEMS-S data collected in a low-income racially diverse neighborhood in Seattle, WA.  To read the abstract of her results, please click here.  To read the entire thesis, click here.

 

For more information about any of these projects, please send an email to nems@zimbra.upenn.edu

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Webinars

Using NEMS-S in a Latino Neighborhood in Milwaukee, WI (about 45 minutes) (2012)

Stephanie Calloway and Tatiana Maida of CORE/El Centro in Milwaukee, WI trained some promotoras to collect NEMS-S data. Learn about their project and results in this webinar. If you would like to contact them to learn more, email Stephanie at stephaniec@core-elcentro.org.

If you'd like to view the webinar, click here.  If you would like to read more in-depth about their project, please go to the publications page.

The Chenango Health Network's the Restaurant Project              (about 25 mins) (2012)

The Chenango Health Network based in Norwich, NY conducted NEMS-R assessments almost two years ago. Based on the results, they along with their collaborators designed The Restaurant Project, an intervention with some of the restaurants. Chris McAvoy, the program coordinator would like to share more details about their project and their successes in this webinar on March 2, 2012.

If you'd like to view the webinar, click here.

The Children's Menu Assessment (CMA) Tool and how it is being used to track policy change in California (2012)

On January 31, 2012, Becca Krukowski, PhD, University of Arkansas for Medical Sciences and Jennifer Otten, PhD, RD, Stanford Prevention Research Center presented on the use and scoring of the Children's Menu Assessment tool and how the tool is being used to track the impacts of toy giveaway legislation in California.

Background: The Children's Menu Assessment tool was adapted from the NEMS-R, to focus attention on restaurant children's menus. This tutorial will provide training on the use of the tool, how to score it and an example of how it is being used in the field to track the impacts of California's toy giveaway legislation - legislation prohibiting restaurants from distributing toy giveaways with meals, foods, and beverages not meeting minimal nutrition criteria. The tool and the instructions are attached and can also be found at: https://riskfactor.cancer.gov/mfe/instruments/krukowski-childrens-lunch-dinner-menu-assessment

• If you'd like to view the webinar, click here.
• CMA tool and the scoring
  

NEMS-V: What is it and how it is changing Iowa and beyond!” (2012)

On January 26, 2012, Carol Voss of the Iowa Department of Public Health and Susan Klein of Iowans Fit for Life presented on Iowa's experiences in using the NEMS vending machine assessment tool and its website development and how their project is leading to policy and environmental change in Iowa. If you'd like to contact Carol and Susan with questions, their emails are carol.voss@idph.iowa.gov  and susanklein50@gmail.com.

• If you'd like to view the webinar, click here.
• If you'd like to go to the NEMS-V website, click here.

Omaha's use of NEMS-S for their WIC Poject (March 12, 2010)

During the March 12, 2010 State Nutrition Environment Workgroup webinar, Mary Baluff, MS, RD, LMNT, Chief of the Community and Health Nutrition Services from the Douglas County Health Department in Omaha, NE, presented on a community specific tool that was developed by the DCHD to better understand the adequacy of the retail food network and its capacity system to meet the demands of the new WIC food packages.

• To view the webinar, please click here.
• A more detailed description of Omaha's work can be found here. 

Assessing Kid's Menus in Restaurants in Thurston County, Washington (April 16, 2010)

Making a Better Choice for Kids:  What Restaurants Have to Offer

Washington State University Extension partnered with Thurston County Public Health and Social Services to investigate the availability of healthier children’s menu options at restaurants.  An adapted Nutrition Environment Measures Survey (NEMS) was used to assess availability of healthier entrees, sides, and beverages listed on children’s menus.  All but nineteen potentially eligible restaurants in Thurston County, Washington were visited. After pre-testing and revising, surveys were completed by trained surveyors.  A total of 129 quick service and 161 sit down restaurants were visited between April-May 2008.  A children’s menu was present at 187 or 64% of all restaurants.  Menu text, meal names, and food items were sometimes ambiguous or difficult to read.   Zena Edwards, WSU Thurston County Extension Food Safety & Nutrition faculty will share lessons learned for conducting this type of assessment and plans for use of the data. 

• To view the webinar, please click here.
• To read a brief summary of their findings, click here. 
• To view their sit-down assessment tool, click here.  
• To view their quick service assessment tool, click here.
  

NCI's Measures of the Food Environment Web-based Compilation(June 4, 2010)

https://riskfactor.cancer.gov/mfe

Jill Reedy and Sharon Kirkpatrick will provide an overview of NCI's Measures of the Food Environment web-based compilation, which includes citations for peer-reviewed research encompassing the measurement of food environments, as well as many of the instruments used in the research.  The compilation currently includes articles (and associated instruments) published since 1990 related to food environments in stores, restaurants, schools, and worksites, and is being expanded to include measures of the home food environment.

• The webinar was recorded in two parts. To view the part one of the webinar, please click here. To view part two of the webinar, please click here.
• To view just the slides without the audio, click here.
• Jill and Sharon would appreciate any comments or feedback.  Their emails are kirkpatricksi@mail.nih.gov and reedyj@mail.nih.gov

 

To be a webinar speaker or to be added to the contact list for information on future webinars, email us at: nems@zimbra.upenn.edu.

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