The Nutrition Environment Measurement Survey‐Stores in Guatemala: measurement performance between the standard (USA) and a modified version (1019.7)

Abstract

Background: The nutrition environment measures survey for stores (NEMS‐S) is a way to assess the consumer nutrition environment, which affects individual dietary intake. While NEMS‐S has high validity in the United States, its validity has not been tested in Guatemala. The standard US NEMS‐S was tested, modified and re‐tested in urban Quetzaltenango, Guatemala.Objective: To compare the measurement performance between the standard NEMS‐S (USA) and the modified NEMS‐S (Guatemala), respectively.Methods: Seven trained raters tested the modified NEMS‐S in 3 supermarkets, and returned one week later at the same time. Inter‐rater and test‐retest reliability were assessed using percent agreement and Cohen’s kappa. Measurement validity was based on how well each item was found based on the modified NEMS‐S. The reliability and validity of the modified NEMS‐S were compared to the standard NEMS‐S.Results: Both the inter‐rater and test‐retest reliability were very high (Cohen’s kappa >0.78) and similar to the standard NEMS‐S. The validity of many standard NEMS‐S items improved in the modified NEMS‐S, especially lean meat, milk, hot dogs, and diet soda.Conclusions: The modified NEMS‐S has a better measurement performance as compared to the standard NEMS‐S. Therefore, the modified NEMS‐S is a reliable and valid tool that can be used to measure the nutrient environment in Quetzaltenango, Guatemala.