Adaption and reliability of the Nutrition Environment Measures for stores (NEMS-S) instrument for use in urban areas of Chile

Gislaine Granfeldt,Josep A Tur,Katia Sáez,Juan Antonio Carrasco,Montserrat Victoriano,Maria Del Mar Bibiloni

doi:10.1186/s12889-022-12651-w

Abstract

ObjectiveTo adapt and assess reliability of the Chilean version of Nutritional Environment Measurement for Stores (NEMS-S-CHILE) to measure the food environment of stores in urban areas.DesignNEMS-S-CHILE was the NEMS-S tool adapted to the Chilean food patterns; foods were grouped according to level of processing in (a) unprocessed or minimally processed foods, (b) processed culinary ingredients, (c) processed foods, and (d) ultra-processed foods, and scored according to NEMS-S-CHILE tool. Reliability inter evaluators was measured.SettingCity of Concepción, Bio-Bio region, Chile.ParticipantsSeventeen of a total of 25 supermarkets, and 9 out of 10 street markets according to the municipal registry and the street market trade unions, representing 74.3% of both types of food premises in Concepción.ResultsReliability inter evaluators was measured by the following aspects: product availability, price, quality, and variety, through the intraclass correlation coefficient (ICC), percent agreement, and Cohen’s kappa analysis. Reliability was high for availability, where the kappa index and ICC were acceptable, ranging from moderate to high (0.42 to 1.00 for the kappa coefficient and 0.65 to 1.00 for ICC), as well as for prices (ICC: 0.65-1.00 ), variety (kappa: 0.76-1.00) and quality (percent agreement: 68.2- 100%).ConclusionsThe adapted instrument, NEMS-S-CHILE, has a high reliability inter evaluators and can be useful to measure the availability of foods by the level of processing according to the prevalent food system in developing countries.

Highlights

IntroductionThe obesogenic environment, defined as “the built and dietary environment that affects patterns that lead to the accumulation of “body fat”, establishes obesity as the Gislaine et al BMC Public Health (2022) 22:224 quality and quantity of food consumed in the family diet and the intake of nutrients [8].From the socio-ecological perspective, the study of retail food environment includes the community environment, widely studied through the density and proximity of types of premises available in the territory and the consumer environment, characterized by the availability of healthy foods, their price, and variety of options, freshness and nutritional qualities [8].The constructs described to assess the food environment of consumers have generated many instruments based on food checklists that seek to capture environmental stimuli that can influence consumer food choices [9,10,11]
Reliability inter evaluators was measured by the following aspects: product availability, price, quality, and variety, through the intraclass correlation coefficient (ICC), percent agreement, and Cohen’s kappa analysis
The adapted instrument, Nutritional Environment Measurement for Stores (NEMS-S)-CHILE, has a high reliability inter evaluators and can be useful to measure the availability of foods by the level of processing according to the prevalent food system in developing countries

Summary

Introduction

The obesogenic environment, defined as “the built and dietary environment that affects patterns that lead to the accumulation of “body fat”, establishes obesity as the Gislaine et al BMC Public Health (2022) 22:224 quality and quantity of food consumed in the family diet and the intake of nutrients [8].From the socio-ecological perspective, the study of retail food environment includes the community environment, widely studied through the density and proximity of types of premises available in the territory and the consumer environment, characterized by the availability of healthy foods, their price, and variety of options, freshness and nutritional qualities [8].The constructs described to assess the food environment of consumers have generated many instruments based on food checklists that seek to capture environmental stimuli that can influence consumer food choices [9,10,11]. Different versions of NEMS have been proposed, adapted according to representative dietary patterns of the population, adjusted to the reality of food supply chains available in each region or country [14,15,16,17]. This is useful to observe among rural and urban areas [18, 19], ethnic populations [20] and other types of food stores [13, 16]

Methods

Results

Discussion

Conclusion