Development of a Nutrition Environment Assessment Tool for Latino Ethnic Stores

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.

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

“…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 ].…”

“…Among foods assessed, the most common food categories included fruits ( n = 45), [ 25 – 30 , 32 – 37 , 40 , 42 – 47 , 49 – 54 , 56 – 60 , 63 , 66 – 71 , 73 , 75 , 77 , 78 , 80 , 82 , 83 ], vegetables ( n = 44), [ 25 – 30 , 32 – 37 , 40 , 42 – 47 , 49 – 54 , 56 – 60 , 63 , 66 – 69 , 71 , 73 , 75 , 77 , 78 , 80 , 82 , 83 ], cow’s milk/dairy, ( n = 32) [ 25 , 26 , 28 , 30 , 33 – 35 , 37 , 39 – 42 , 44 , 45 , 47 , 48 , 50 – 53 , 56 , 59 , 60 , 63 , 66 , 67 , 69 , 75 , 78 , 80 – …”

“…Fruits and vegetables were among the most commonly assessed food items or food categories. Eighteen studies measured both fresh fruits and fresh vegetables [ 25 , 26 , 28 , 30 , 35 – 37 , 40 , 42 , 45 , 46 , 51 , 53 , 54 , 56 , 67 , 81 , 82 ]. Twenty-two studies assessed fruits, [ 27 , 29 , 32 – 34 , 39 , 43 , 47 , 50 , 52 , 57 – 60 , 66 , 68 , 71 , 73 , 77 , 78 , 80 , 83 ] and vegetables, [ 27 , 29 , 32 – 34 , 39 , 43 , 47 , 50 , 52 , 57 – 60 , 66 , 68 , 71 , 73 , 77 , 78 , 80 , 83 ], without specifying the type (fresh, frozen, canned, etc.).…”