A Novel Mobile Phone Application to Assess Nutrition Environment Measures in Low- and Middle-Income Countries

Abstract

Consumer nutrition environment measures are important to understanding the food environment, which affects individual dietary intake. A nutrition environment measures survey for supermarkets (NEMS-S) has been designed on paper for use in Guatemala. However, a paper survey is not an inconspicuous data collection method. To design, pilot test, and validate the Guatemala NEMS-S in the form of a mobile phone application (mobile app). CommCare, a free and open-source software application, was used to design the NEMS-S for Guatemala in the form of a mobile app. Two raters tested the mobile app in a single Guatemalan supermarket. Both the interrater and the test-retest reliability of the mobile app were determined using percent agreement and Cohen's kappa score and compared with the interrater and test-retest reliability of the paper version. Interrater reliability was very high between the paper survey and the mobile app (Cohen's kappa > 0.90). Test-retest reliability ranged from kappa 0.78 to 0.91. Between two certified NEMS-S raters, survey completion time using the mobile app was 5 minutes less than that with the paper form (35 vs. 40 minutes). The NEMS-S mobile app provides for more rapid data collection, with equivalent reliability and validity to the NEMS-S paper version, with advantages over a paper-based survey of multiple language capability and concomitant data entry.