Adaption and reliability of the Nutrition Environment Measures for stores (NEMS-S) instrument for use in urban areas of Chile

Abstract

Objective To adapt and assess reliability of the Chilean version of Nutritional Environment Measurement for Stores (NEMS-S-CHILE) to measure the food environment of stores in urban areas. Design NEMS-S-CHILE was the NEMS-S tool adapted to the Chilean food patterns; foods were grouped according to level of processing in (a) unprocessed or minimally processed foods, (b) processed culinary ingredients, (c) processed foods, and (d) ultra-processed foods, and scored according to NEMS-S-CHILE tool. Reliability inter evaluators was measured. Setting City of Concepción, Bio-Bio region, Chile. Participants Seventeen of a total of 25 supermarkets, and 9 out of 10 street markets according to the municipal registry and the street market trade unions, representing 74.3% of both types of food premises in Concepción. Results Reliability inter evaluators was measured by the following aspects: product availability, price, quality, and variety, through the intraclass correlation coefficient (ICC), percent agreement, and Cohen’s kappa analysis. Reliability was high for availability, where the kappa index and ICC were acceptable, ranging from moderate to high (0.42 to 1.00 for the kappa coefficient and 0.65 to 1.00 for ICC), as well as for prices (ICC: 0.65-1.00 ), variety (kappa: 0.76-1.00) and quality (percent agreement: 68.2- 100%). Conclusions The adapted instrument, NEMS-S-CHILE, has a high reliability inter evaluators and can be useful to measure the availability of foods by the level of processing according to the prevalent food system in developing countries.

Consumer nutrition environment measurements for nutrient-dense food availability and food sustainability: a scoping review

“…Instruments were developed primarily in the United States (US) ( n = 37), [ 25 – 58 ], Australia ( n = 4), [ 59 – 62 ], New Zealand ( n = 3), [ 63 – 65 ], Canada ( n = 3), [ 66 – 68 ], Brazil ( n = 3), [ 69 – 71 ] the United Kingdom ( n = 2), [ 72 , 73 ], and Chile ( n = 2), [ 74 , 75 ]. Two studies ( n = 2) were developed to be used in multiple countries [ 76 , 77 ].…”

“…The most common assessment method was a checklist or similar format ( n = 36), [ 25 , 26 , 28 , 32 – 37 , 39 – 41 , 44 – 49 , 51 , 52 , 56 – 59 , 61 , 66 – 70 , 72 – 74 , 78 , 79 , 81 , 82 ]. Additional assessment methods included the use of a market basket approach which aims to measure foods commonly consumed ( n = 1), [ 50 ], use of an observational form or tool, [ 29 , 71 ], and assessment of shelf space ( n = 5) [ 29 , 31 , 53 , 64 , 65 , 83 ].…”

“…The majority of measures assessed food availability ( n = 53), [ 25 , 26 , 28 – 33 , 33 , 33 , 34 , 34 , 35 , 35 – 37 , 47 , 48 , 50 – 56 , 58 – 72 , 74 , 76 – 83 ], and food prices ( n = 36) [ 25 , 26 , 29 , 32 – 34 , 39 , 41 , 42 , 46 – 48 , 51 , 53 , 56 , 58 – 60 , 66 – 70 , 72 – 74 , 76 , 78 – 83 ]. Seven studies examined advertisements [ 34 , 55 , 69 , 70 , 76 , 83 ] and 13 examined promotion [ 39 , 43 , 53 , 59 , 60 , 62 , 63 , 65 , 70 , 71 , 73 , 76 ].…”

“…Seven studies examined advertisements [ 34 , 55 , 69 , 70 , 76 , 83 ] and 13 examined promotion [ 39 , 43 , 53 , 59 , 60 , 62 , 63 , 65 , 70 , 71 , 73 , 76 ]. Other constructs assessed included variety ( n = 16) [ 25 , 26 , 33 , 37 , 44 , 59 , 64 – 67 , 71 – 74 , 81 , 83 ], comparison of healthier vs. less healthy options ( n = 7), [ 26 , 33 , 40 , 67 , 72 , 82 ] placement ( n = 9), [ 39 , 43 , 55 , 59 , 60 , 62 , 63 , 69 , 73 ] and accessibility ( n = 5) [ 27 , 31 , 39 , 61 ]. Few studies ( n = 2) assessed food sustainability [ 47 , 68 ].…”

Adaptation and validation of the Perceived Nutrition Environment Measures Survey for the Chilean context (NEMS-P-Ch)

“…A national conceptual framework proposes the existence of five food environments: home, restaurants, institution/organization, street and stores 23 . Only two national studies have focused on adapting and validating instruments to the local context 24,25 , both using objective measurements.…”