Abstract
The objectives were to: (1) adapt the Nutrition Environment Measures Survey for Stores (NEMS-S) to better culturally fit small Latino grocery stores (tiendas) in Iowa; (2) assess the newly adapted Latino NEMS-S for inter-rater and test-retest reliability; and (3) compare Latino and original NEMS-S summary scores. This pilot instrument, containing culturally appropriate foods from the original NEMS-S and 2015 US Dietary Guidelines for Americans, underwent two rounds of formative evaluation. The new instrument and scoring protocol were applied to a random sample of 42 of 81 possible tiendas in Iowa. Cohen’s kappa was used to assess inter-rater and test-retest reliability for availability and quality of indicator food items (total scores and food category sub scores). There were no differences in summary scores for inter-rater or test-retest reliability using paired t-tests. Inter-rater agreement was high (range 0.82–1.00; p < 0.001). Tiendas averaged 42.0 ± 7.5 of 57 possible points on the Latino NEMS-S, but only 12.0 ± 4.6 of 54 points on the original NEMS-S (p < 0.001). The Latino NEMS-S is a reliable tool for assessing the food environment within Iowa tiendas. Culturally specific instruments can describe diverse food environments more accurately and guide public health nutrition interventions within communities.
Highlights
The Latino Nutrition Environment Measures Survey for Stores (NEMS-S) represents an evolution and revision of the Mexican/MexicanAmerican NEMS-S (NEMS-S Mex) instrument protocol developed by Szkupinski Quiroga and the principal investigator (PI; D.M.W.) [24]
The NEMS-S Mex was pilot tested in metropolitan Phoenix, Arizona, with 32 Latino stores ranging from large supermarkets to medium and small tiendas [24]
Eighty-one percent (n = 34) of the stores were in an area classified as low-income and with low-access to healthy foods, or food desert, by the United States Department of Agriculture’s (USDA) Food Access
Summary
Access to healthy foods has a primary role in shaping individuals’ diets, which can positively affect life-long health outcomes. The term ‘nutrition environment’ describes the characteristics of food outlets and food items available to consumers in a community [1]. While it is only one element of the complex network governing health and food choices, the nutrition environment enables or restricts eating behaviors. A lack of healthy, quality, and affordable foods accessible to consumers can contribute to chronic disease risk [1]. Affordable foods of suitable quality are not readily available in grocery stores, shoppers, regardless of their intentions, are unable to obtain them. Greater fruit and vegetable availability in stores may increase the likelihood of purchase [2]
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