Adaptation and Evaluation of the Nutrition Environment Measures Survey in Stores to Assess Mediterranean Food Environments (NEMS-S-MED)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Sample
2.2. Measurement
2.2.1. Development of the NEMS-S-MED
2.2.2. Audits
2.3. Statistical Analyses
3. Results
3.1. Reliability
3.2. Construct Validity
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Afshin, A.; Forouzanfar, M.H.; Reitsma, M.B.; Sur, P.; Estep, K.; Lee, A.; Marczak, L.; Mokdad, A.H.; Moradi-Lakeh, M.; Naghavi, M.; et al. Health effects of overweight and obesity in 195 countries over 25 years. N. Engl. J. Med. 2017, 377, 13–27. [Google Scholar] [PubMed]
- Swinburn, B.A.; Kraak, V.I.; Allender, S.; Atkins, V.J.; Baker, P.I.; Bogard, J.R.; Brinsden, H.; Calvillo, A.; De Schutter, O.; Devarajan, R.; et al. The Global Syndemic of Obesity, Undernutrition, and Climate Change: The Lancet Commission report. Lancet 2019, 393, 791–846. [Google Scholar] [CrossRef]
- Hawkes, C.; Jewell, J.; Allen, K. A food policy package for healthy diets and the prevention of obesity and diet-related non-communicable diseases: The NOURISHING framework. Obes. Rev. 2013, 14, 159–168. [Google Scholar] [CrossRef] [PubMed]
- Lakerveld, J.; Mackenbach, J. The Upstream Determinants of Adult Obesity. Obes. Facts 2017, 10, 216–222. [Google Scholar] [CrossRef]
- Glanz, K.; Sallis, J.F.; Saelens, B.E.; Frank, L.D. Healthy Nutrition Environments: Concepts and Measures. Am. J. Health Promot. 2005, 19, 330–333. [Google Scholar] [CrossRef]
- Cobb, L.K.; Appel, L.J.; Franco, M.; Jones-Smith, J.C.; Nur, A.; Anderson, C.A.M. The relationship of the local food environment with obesity: A systematic review of methods, study quality, and results. Obesity 2015, 23, 1331–1344. [Google Scholar] [CrossRef] [Green Version]
- Caspi, C.E.; Sorensen, G.; Subramanian, S.V.; Kawachi, I. The local food environment and diet: A systematic review. Health Place 2012, 18, 1172–1187. [Google Scholar] [CrossRef] [Green Version]
- Gustafson, A.; Hankins, S.; Jilcott, S. Measures of the consumer food store environment: A systematic review of the evidence 2000–2011. J. Community Health 2012, 37, 897–911. [Google Scholar] [CrossRef] [Green Version]
- Black, C.; Moon, G.; Baird, J. Dietary inequalities: What is the evidence for the effect of the neighbourhood food environment? Health Place 2014, 27, 229–242. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Friel, S.; Hattersley, L.; Ford, L.; O’Rourke, K. Addressing inequities in healthy eating. Health Promot. Int. 2015, 30, ii77–ii88. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Glanz, K.; Johnson, L.; Yaroch, A.L.; Phillips, M.; Ayala, G.X.; Davis, E.L. Measures of Retail Food Store Environments and Sales: Review and Implications for Healthy Eating Initiatives. J. Nutr. Educ. Behav. 2016, 48, 280–288. [Google Scholar] [CrossRef] [PubMed]
- Honeycutt, S.; Davis, E.; Clawson, M.; Glanz, K. Training for and dissemination of the Nutrition Environment Measures Surveys (NEMS). Prev. Chronic Dis. 2010, 7, A126. [Google Scholar] [PubMed]
- Glanz, K.; Sallis, J.F.; Saelens, B.E.; Frank, L.D. Nutrition Environment Measures Survey in Stores (NEMS-S). Development and Evaluation. Am. J. Prev. Med. 2007, 32, 282–289. [Google Scholar] [CrossRef] [PubMed]
- Ghirardelli, A.; Quinn, V.; Sugerman, S. Reliability of a retail food store survey and development of an accompanying retail scoring system to communicate survey findings and identify vendors for healthful food and marketing initiatives. J. Nutr. Educ. Behav. 2011, 43, S104–S112. [Google Scholar] [CrossRef]
- Pinho, M.; Mackenbach, J.; Oppert, J.-M.; Charreire, H.; Bárdos, H.; Rutter, H.; Compernolle, S.; Beulens, J.; Brug, J.; Lakerveld, J. Exploring absolute and relative measures of exposure to food environments in relation to dietary patterns among European adults. Public Health Nutr. 2019, 22, 1037–1047. [Google Scholar] [CrossRef] [Green Version]
- Carins, J.E.; Rundle-Thiele, S.; Storr, R.J. Appraisal of short and long versions of the Nutrition Environment Measures Survey (NEMS-S and NEMS-R) in Australia. Public Health Nutr. 2019, 22, 564–570. [Google Scholar] [CrossRef]
- Lo, B.K.; Minaker, L.M.; Mah, C.L.; Cook, B. Development and Testing of the Toronto Nutrition Environment Measures Survey–Store (ToNEMS-S). J. Nutr. Educ. Behav. 2016, 48, 723–729. [Google Scholar] [CrossRef]
- Liu, Y.; Song, S.; Gittelsohn, J.; Jiang, N.; Hu, J.; Ma, Y.; Wen, D. Adaptation and validation of the chinese version of the nutrition environment measurement tool for stores. Int. J. Environ. Res. Public Health 2019, 16, 782. [Google Scholar] [CrossRef] [Green Version]
- Martins, P.A.; Cremm, E.C.; Leite, F.H.M.; Maron, L.R.; Scagliusi, F.B.; Oliveira, M.A. Validation of an adapted version of the nutrition environment measurement tool for stores (NEMS-S) in an Urban Area of Brazil. J. Nutr. Educ. Behav. 2013, 45, 785–792. [Google Scholar] [CrossRef]
- Gartin, M. Food deserts and nutritional risk in paraguay. Am. J. Hum. Biol. 2012, 24, 296–301. [Google Scholar] [CrossRef]
- Díez, J.; Bilal, U.; Franco, M. Unique features of the Mediterranean food environment: Implications for the prevention of chronic diseases Rh: Mediterranean food environments. Eur. J. Clin. Nutr. 2018, 72, 71–75. [Google Scholar] [CrossRef] [PubMed]
- Pettinger, C.; Holdsworth, M.; Gerber, M. “All under one roof?” Differences in food availability and shopping patterns in Southern France and Central England. Eur. J. Public Health 2008, 18, 109–114. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Achón, M.; Serrano, M.; García-González, Á.; Alonso-Aperte, E.; Varela-Moreiras, G. Present food shopping habits in the Spanish adult population: A cross-sectional study. Nutrients 2017, 9, 508. [Google Scholar] [CrossRef] [PubMed]
- Bilal, U.; Díez, J.; Alfayate, S.; Gullón, P.; Del Cura, I.; Escobar, F.; Sandín, M.; Franco, M. Population cardiovascular health and urban environments: The Heart Healthy Hoods exploratory study in Madrid, Spain. BMC Med. Res. Methodol. 2016, 16, 104. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Díez, J.; Cebrecos, A.; Galán, I.; Pérez-Freixo, H.; Franco, M.; Bilal, U. Assessing the Retail Food Environment in Madrid: An Evaluation of Administrative Data against Ground Truthing. Int. J. Environ. Res. Public Health 2019, 16, 3538. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Aranceta-Bartrina, J.; Partearroyo, T.; López-Sobaler, A.M.; Ortega, R.M.; Varela-Moreiras, G.; Serra-Majem, L.; Pérez-Rodrigo, C. Updating the food-based dietary guidelines for the Spanish population: The Spanish society of community nutrition (senc) proposal. Nutrients 2019, 11, 2675. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Bach-Faig, A.; Berry, E.M.; Lairon, D.; Reguant, J.; Trichopoulou, A.; Dernini, S.; Medina, F.X.; Battino, M.; Belahsen, R.; Miranda, G.; et al. Mediterranean diet pyramid today. Science and cultural updates. Public Health Nutr. 2011, 14, 2274–2284. [Google Scholar] [CrossRef] [Green Version]
- Landis, J.R.; Koch, G.G. The Measurement of Observer Agreement for Categorical Data Data for Categorical of Observer Agreement the Measurement. Biometrics 1977, 33, 159–174. [Google Scholar] [CrossRef] [Green Version]
- Bartko, J.J. The intraclass correlation coefficient as a measure of reliability. Psychol. Rep. 1966, 19, 3–11. [Google Scholar] [CrossRef]
- Bilal, U.; Jones-Smith, J.; Diez, J.; Lawrence, R.S.; Celentano, D.D.; Franco, M. Neighborhood social and economic change and retail food environment change in Madrid (Spain): The heart healthy hoods study. Health Place 2018, 51, 107–117. [Google Scholar] [CrossRef]
- Gullón, P.; Bilal, U.; Sánchez, P.; Díez, J.; Lovasi, G.S.; Franco, M. A comparative case study of walking environment in Madrid and Philadelphia using multiple sampling methods and street virtual audits. Cities Health 2020, 1–9. [Google Scholar] [CrossRef]
Variables | |||
---|---|---|---|
Food Category | Availability | Price 1 | |
Absolute | Comparative | ||
1. Fresh fruits | |||
- Apples | X | X | |
2. Vegetables (fresh/frozen) | |||
- Tomatoes | X | X | |
- Frozen spinach | X | X | |
- Potatoes | X | ||
3. Nuts | |||
- Raw vs. processed | X | ||
4. Non-alcoholic beverages | |||
- Soda: Diet Coke vs. regular Coke | X | X | |
- Fruit juice: 100% juice vs. juice drinks | X | X | |
5. Bread, cereals, and baked goods | |||
- 100% whole grain bread | X | ||
- Baked goods | X | ||
- Plain cereals vs. >5 g of sugar per 100 g | X | X | |
6. Milk and dairy products | |||
- Skim/low-fat vs. whole milk | X | X | |
- White cheese vs. aged cheese | X | ||
- Low-fat yoghurts | X | ||
7. Eggs | X | ||
8. Oil and butter | |||
- Extra virgin olive oil | X | X | |
- Sunflower oil | X | X | |
- Butter vs. non-added salt butter | X | ||
9. Rice | |||
- Whole rice vs. white rice | X | X | |
10. Legumes | X | ||
11. Meat and meat products (red and poultry) | |||
- Red meat (beef) vs. poultry (chicken) | X | X | |
- Processed meat | X | ||
12. Fish | |||
- Fresh fish varieties | X | X | |
- Unprocessed vs. processed seafood | X | ||
- Canned Tuna | X |
Food Group | Availability | Price |
---|---|---|
Fresh fruits | If ≤5 varieties = 2 pt If 6–10 varieties = 3 pt If >10 varieties = 4 pt | No score, to compare between store types |
Vegetables | Fresh vegetables If ≤ 5 varieties = 2 pt If 6–10 varieties = 3 pt If >10 varieties = 4 pt Frozen vegetables If ≤ 5 varieties = 2 pt If 6–10 varieties = 3 pt If >10 varieties = 4 pt | No score, to compare between store types |
Nuts | If raw nuts = 1 pt | No score, to compare between store types |
Non-alcoholic beverages | If 100% juice = 1 pt | If diet soda ≤ regular = 2 pt If 100% juice ≤ juice drinks = 2 pt |
Bread, cereals, and baked goods | If 100% whole grain bread = 1 pt If low-sugar cereals = 1 pt | If low-sugar cereals ≤ regular = 2pt |
Milk and dairy products | If any milk = 1 pt If skimmed yoghurt = 1 pt If cheese available = 1 pt | If skimmed- or low-fat milk < whole milk = 2 pt If skimmed- or low-fat milk = whole milk = 1 pt |
Eggs | If eggs = 1 pt | No score, to compare between store types |
Oil and butter | If extra virgin olive oil = 1 pt | No score, to compare between store types |
Rice | If whole rice = 2 pt If white rice = 1 pt | If whole rice ≤ white rice = 2 pt |
Legumes | If legumes = 1 pt | No score, to compare between store types |
Meat and meat products | If red meat = 1 pt If poultry = 2 pt | If poultry meat ≤ red meat = 2 pt |
Fish | Fresh fish If ≤ 5 varieties = 2 pt If 6–10 varieties = 3 pt If >10 varieties = 4 pt Frozen fish If ≤ 5 varieties = 2 pt If 6–10 varieties = 3 pt If >10 varieties = 4 pt Canned Tuna = 1pt | No score, to compare between store types |
Score (0–49) | Availability: 0–37 | Price: 0–12 |
Inter-Rater Reliability (n = 43) | Intra-Rater Reliability (n = 42) | |||
---|---|---|---|---|
Food Item | Percent Agreement [95% CI] | Cohen Kappa 1 [95% CI] | Percent Agreement [95% CI] | Cohen Kappa 1 [95% CI] |
Fresh fruits | 0.95 [0.88–1.00] | 0.87 [0.70–1.00] | 0.85 [0.74–0.97] | 0.65 [0.40–0.91] |
Fresh vegetables | 0.93 [0.85–1.00] | 0.82 [0.62–1.00] | 0.85 [0.73–0.97] | 0.67 [0.42–0.91] |
Frozen vegetables | 0.93 [0.85–1.00] | 0.85 [0.69–1.00] | 0.90 [0.80–1.00] | 0.79 [0.58–0.99] |
Raw nuts | 0.83 [0.72–0.95] | 0.67 [0.45–0.89] | 0.90 [0.80–1.00] | 0.76 [0.53–0.98] |
Processed nuts | 0.93 [0.85–1.00] | 0.83 [0.65–1.00] | 0.89 [0.81–0.97] | 0.75 [0.55–0.94] |
Diet Coke | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 0.97 [0.90–1.00] | 0.93 [0.79–1.00] |
Coke | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] |
100% juice | 0.97 [0.92–1.00] | 0.91 [0.75–1.00] | 0.97 [0.90–1.00] | 0.91 [0.74–1.00] |
Juice drinks | 0.97 [0.93–1.00] | 0.93 [0.80–1.00] | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] |
Whole grain bread | 0.95 [0.88–1.00] | 0.91 [0.79–1.00] | 0.85 [0.74–0.97] | 0.71 [0.50–0.93] |
Baked goods | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 1.00 [0.95–1.00] | 1.00 [0.95–1.00] |
Low-sugar cereals | 0.95 [0.88–1.00] | 0.88 [0.72–1.00] | 0.93 [0.83–0.99] | 0.82 [0.62–1.00] |
Plain cereals | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 0.83 [0.70–0.95] | 0.66 [0.42–0.90] |
Skimmed milk | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 1.00 [0.95–1.00] | 1.00 [0.95–1.00] |
Low-fat milk | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 1.00 [0.95–1.00] | 1.00 [0.95–1.00] |
Whole milk | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 1.00 [0.95–1.00] | 1.00 [0.95–1.00] |
Low-fat yoghurt | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 0.85 [0.73–0.97] | 0.71 [0.48–0.93] |
White cheese | 0.86 [0.75–0.97] | 0.72 [0.52–0.92] | 0.90 [0.80–1.00] | 0.80 [0.62–0.99] |
Semi-aged cheese | 0.97 [0.92–1.00] | 0.95 [0.85–1.00] | 0.83 [0.70–0.95] | 0.65 [0.41–0.89] |
Eggs | 0.97 [0.92–1.00] | 0.92 [0.77–1.00] | 0.97 [0.90–1.00] | 0.92 [0.76–1.00] |
Whole rice | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 0.97 [0.90–1.00] | 0.91 [0.74–1.00] |
White rice | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 1.00 [0.95–1.00] | 1.00 [0.95–1.00] |
Legumes | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 1.00 [0.95–1.00] | 1.00 [0.95–1.00] |
Olive oil | 0.95 [0.88–1.00] | 0.93 [0.83–1.00] | 0.97 [0.91–1.00] | 0.94 [0.84–1.00] |
Sunflower oil | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 0.92 [0.83–0.99] | 0.83 [0.64–1.00] |
Butter | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 0.90 [0.80–1.00] | 0.81 [0.62–0.99] |
Red meat | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 1.00 [0.95–1.00] | 1.00 [0.95–1.00] |
Poultry meat | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 1.00 [0.95–1.00] | 1.00 [0.95–1.00] |
Processed meat | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 0.97 [0.90–1.00] | 0.94 [0.81–1.00] |
Fish | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 1.00 [0.95–1.00] | 1.00 [0.95–1.00] |
Frozen fish | 0.95 [0.88–1.00] | 0.87 [0.70–1.00] | 0.90 [0.80–1.00] | 0.77 [0.55–0.99] |
Canned tuna | 1.00 [1.00–1.00] | 1.00 [1.00–1.00] | 1.00 [0.95–1.00] | 1.00 [0.95–1.00] |
Item | Inter-Rater Reliability (n = 43) | Intra-Rater Reliability (n = 42) | ||
---|---|---|---|---|
ICC 1 | 95% CI | ICC 1 | 95% CI | |
Apple | 0.95 | [0.92–0.98] | 0.95 | [0.92–0.98] |
Tomato | 1.00 | [1.00–1.00] | 1.00 | [1.00–1.00] |
Frozen spinach | 1.00 | [1.00–1.00] | 0.86 | [0.76–0.92] |
Diet Coke | 0.95 | [0.92–0.98] | 0.86 | [0.75–0.89] |
Coke | 0.95 | [0.92–0.98] | 0.91 | [0.83–0.95] |
100% juice | 0.91 | [0.84–0.95] | 0.91 | [0.84–0.95] |
Juice drinks | 0.91 | [0.83–0.95] | 0.90 | [0.82–0.94] |
Whole bread | 0.95 | [0.91–0.97] | 0.71 | [0.53–0.84] |
Low-sugar cereals | 0.83 | [0.70–0.90] | 0.78 | [0.61–0.87] |
Plain cereals | 0.95 | [0.92–0.97] | 0.77 | [0.61–0.87] |
Skimmed milk | 1.00 | [1.00–1.00] | 0.95 | [0.91–0.97] |
Whole milk | 1.00 | [1.00–1.00] | 0.95 | [0.91–0.97] |
Whole rice | 0.92 | [0.86–0.95] | 0.92 | [0.86–0.96] |
White rice | 0.85 | [0.74–0.92] | 0.85 | [0.73–0.91] |
Olive oil | 1.00 | [1.00–1.00] | 0.86 | [0.75–0.92] |
Sunflower oil | 0.95 | [0.92–0.97] | 0.81 | [0.67–0.89] |
Red meat | 0.99 | [0.99–1.00] | 0.84 | [0.72–0.91] |
Poultry meat | 1.00 | [0.99–1.00] | 0.92 | [0.86–0.96] |
Fish | 1.00 | [0.99–1.00] | 1.00 | [0.99–1.00] |
Item | Store Type | |||
---|---|---|---|---|
Supermarkets 1 (n = 10) | Convenience Stores 1 (n = 22) | Fruit and Vegetables 1 (n = 5) | p-Value 2 | |
Fruit and Vegetables | 11 [2] | 5 [3] | 9 [0] | 0.0001 |
Availability | 29 [11] | 16 [4] | 12 [1] | 0.0001 |
Price | 5 [2] | 3 [0] | 1 [0] | 0.0007 |
Total score | 35.5 [15] | 19 [5] | 13 [1] | 0.0001 |
Item | Area-Level SES | |||
---|---|---|---|---|
Low-SES 1 | Middle-SES 1 | High-SES 1 | p-Value 2 | |
Fruit and Vegetables | 5 [6] | 6 [5] | 6.5 [5] | 0.3849 |
Availability | 12 [3] | 19 [12] | 18 [10] | 0.0128 |
Price | 1 [2] | 3 [2] | 3 [2] | 0.0471 |
Total score | 14 [5] | 22 [14] | 19.5 [10] | 0.0095 |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Martínez-García, A.; Díez, J.; Fernández-Escobar, C.; Trescastro-López, E.M.; Pereyra-Zamora, P.; Ariza, C.; Bilal, U.; Franco, M. Adaptation and Evaluation of the Nutrition Environment Measures Survey in Stores to Assess Mediterranean Food Environments (NEMS-S-MED). Int. J. Environ. Res. Public Health 2020, 17, 7031. https://doi.org/10.3390/ijerph17197031
Martínez-García A, Díez J, Fernández-Escobar C, Trescastro-López EM, Pereyra-Zamora P, Ariza C, Bilal U, Franco M. Adaptation and Evaluation of the Nutrition Environment Measures Survey in Stores to Assess Mediterranean Food Environments (NEMS-S-MED). International Journal of Environmental Research and Public Health. 2020; 17(19):7031. https://doi.org/10.3390/ijerph17197031
Chicago/Turabian StyleMartínez-García, Alba, Julia Díez, Carlos Fernández-Escobar, Eva María Trescastro-López, Pamela Pereyra-Zamora, Carles Ariza, Usama Bilal, and Manuel Franco. 2020. "Adaptation and Evaluation of the Nutrition Environment Measures Survey in Stores to Assess Mediterranean Food Environments (NEMS-S-MED)" International Journal of Environmental Research and Public Health 17, no. 19: 7031. https://doi.org/10.3390/ijerph17197031