Validity and Reliability of the Facility List Coder, a New Tool to Evaluate Community Food Environments.

Ana María Arcila-Agudelo,Juan Carlos Muñoz-Mora,Andreu Farran-Codina

doi:10.3390/ijerph16193578

Abstract

A community food environment plays an essential role in explaining the healthy lifestyle patterns of its community members. However, there is a lack of compelling quantitative approaches to evaluate these environments. This study introduces and validates a new tool named the facility list coder (FLC), whose purpose is to assess food environments based on data sources and classification algorithms. Using the case of Mataró (Spain), we randomly selected 301 grids areas (100 m2), in which we conducted street audits in order to physically identify all the facilities by name, address, and type. Then, audit-identified facilities were matched with those automatically-identified and were classified using the FLC to determine its quality. Our results suggest that automatically-identified and audit-identified food environments have a high level of agreement. The intra-class correlation coefficient (ICC) estimates and their respective 95% confidence intervals for the overall sample yield the result “excellent” (ICC ≥ 0.9) for the level of reliability of the FLC.

Highlights

There is growing interest in understanding how the physical environment affects health outcomes, either directly or by creating a context in which people make health-related decisions [1]
Despite much qualitative evidence showing the influence of these new community food environments on food behaviors and health outcomes such as obesity, quantitative studies have found counter-intuitive or inconsistent results that suggest that the relationship between food environments and eating patterns is still far from being understood [2,4,5]
We found that the facility list coder (FLC) performed well compared with the street audit

Summary

Introduction

There is growing interest in understanding how the physical environment affects health outcomes, either directly or by creating a context in which people make health-related decisions [1]. Among the various different environs (e.g., sports facilities), community food environments have received increasing attention in the public health sector and from policy makers owing to their effects on diet and health outcomes such as obesity [2]. Despite much qualitative evidence showing the influence of these new community food environments on food behaviors and health outcomes such as obesity, quantitative studies have found counter-intuitive or inconsistent results that suggest that the relationship between food environments and eating patterns is still far from being understood [2,4,5]. In a recent systematic review of the relationship between local food environments and obesity [3], they found limited evidence of the existence of this relationship despite the large number of studies included. The authors point out that the observed preeminence of null associations should be interpreted cautiously because of the

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