Consumer Food Environment Healthiness Score: Development, Validation, and Testing between Different Types of Food Retailers.

Camila Aparecida Borges,Kamila Tiemann Gabe,Patricia Constante Jaime

doi:10.3390/ijerph18073690

Camila Aparecida Borges, Kamila Tiemann Gabe + Show 1 more

Open Access

https://doi.org/10.3390/ijerph18073690

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Abstract

The aim of this study was to develop and validate a scoring system, based on AUDITNOVA, to assess the healthiness of the consumer food environment, considering food availability, price, advertising, and placement strategies. Audited data of 650 food retailers were used to develop, validate, and test the consumer food environment healthiness score. To compose the score, the reference was the Dietary Guidelines for the Brazilian Population. The total and subscores were standardized for a scale from 0 to 100. Construct validity was assessed using the Kruskal–Wallis Dunn tests. Cronbach’s alpha coefficients were calculated to determine the consistency of the scores. The median score was 33.7 (p25 = 26.9; p75 = 42.1). The public and private specialized indoor fresh food markets showed the highest medians; otherwise, bakeries and food retailers with the predominant sale of ultra-processed foods showed the lowest. The score was able to satisfactorily classify the extreme food retailer groups by the predominant sale of fresh or minimally processed foods and the predominant sale of ultra-processed foods. The results of Cronbach’s alpha showed excellent internal consistency (α = 0.91). The score helped to provide an overall assessment of consumer food environment healthiness and was able to classify food retailer groups as healthy and unhealthy according to the degree of processing of the available foods.

Highlights

Access to adequate and healthy food is influenced by socioeconomic, behavioral, and cultural factors which are influenced by the environment [1]
To develop and validate the score proposed in this study, a data set from an audit process carried out inside food retailers was used
It is possible to visualize in the box the median, minimum and maximum values, and interquartile ranges for the scores

Summary

Introduction

Access to adequate and healthy food is influenced by socioeconomic, behavioral, and cultural factors which are influenced by the environment [1]. Different theoretical models on food environment have converged in recognizing its complexity, multidimensionality, and potential influence on food choices and practices of individuals and collectivity [2,3,4,5] In this context, the ecological model of Glanz et al (2005) stands out [3], proposing that health-related behavior and, in particular, eating practices, are influenced by political, environmental, and individual components. The ecological model of Glanz et al (2005) stands out [3], proposing that health-related behavior and, in particular, eating practices, are influenced by political, environmental, and individual components According to this model, the food environment encompasses four aspects: community nutrition environment, organizational nutrition environment, consumer nutrition environment, and information environment, which, in turn, are influenced by government policies and the food industry.

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