Development of an Assessment Tool to Measure the Latino Market Nutrition Environment

Abstract

The Nutrition Environment Measures Survey for grocery stores (NEMS‐S) was designed to assess availability and pricing between healthy and less healthy food items available in grocery stores based on the 2005 Dietary Guidelines for Americans (DGA). The tool has been widely used to assess the nutrition environment, yet it does not include foods specific to Latino or other ethnic cultures. As a result, the original NEMS‐S underestimates the presence of healthy food options in Latino stores. The study purpose was to create and test a NEMS‐S adaptation that would more accurately describe the true food environment of Latino grocery stores and have high inter‐rater reliability and test‐retest validity. Drawing on literature searches, previous research in Arizona, 2010–2012 NHANES consumption frequencies for Hispanics, the 2015 DGA, and formative evaluation observations in 24 Latino grocery stores or tiendas in Iowa, we developed and validated a new instrument.Trained researchers tested the Latino NEMS‐S and the original NEMS‐S at 35 randomly selected Latino stores across Iowa. Two different raters evaluated each store independently at time 1 (T1) with the Latino NEMS‐S. Inter‐rater reliability was assessed from these measures. Test‐retest validity was evaluated by having one of the T1 raters repeat the store assessment at time 2 (T2) within 1–2 weeks of T1. The second rater completed the original NEMS‐S at T2. On average, stores scored 42 out of 61 points on the Latino NEMS‐S, and 12 out of 54 points on the original NEMS‐S. No significant differences were found in inter‐rater reliability or test‐retest validity using paired t‐tests (p=0.37 and p=0.29, respectively). Inter‐rater agreement using Cohen's Kappa values for individual items on the instrument were high, e.g., milk (1.00), tortillas (1.00), and bananas (0.89). Our findings indicate that the Latino NEMS‐S is a valid and reliable tool to measure the nutrition environment in these culturally specific grocery stores.Support or Funding InformationThis study was supported in part by the Cooperative Agreement Number, DP004807, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Centers for Disease Control and Prevention or the Department of Health and Human Services.