Food environments affect people's food-related decisions, consumption, and health outcomes. This paper critiques instruments available for assessing food environments to help researchers, practitioners, and community organizations select those that best meet their needs, resources, and level of expertise. Gaps and recommendations for future instrument development are discussed.
Method.
Instruments were selected by reviewing the literature and contacting researchers and practitioners. Using the social-ecological model, the instruments were classified according to the type of food environments they assess. Each instrument is rated according to criteria for ease of use, detail, resources required, and psychometric testing.
Results.
Of the 48 instruments identified, only 39% were tested for validity or reliability. Observational tools were the largest category of instruments developed. Fifty-two percent of the instruments provide some level of technical assistance and 37% are considered appropriate for community members.
Conclusion.
Three distinct groups want to assess food environments: researchers, practitioners, and community organizations. These groups have different information needs and different capacities to undertake assessments. At this time there is a tradeoff between simplicity and low cost on the one hand, and detail and accuracy on the other. To choose the most suitable instrument, users should consider the pros and cons of each instrument and base their selection on purpose of their assessment, resources and expertise at hand, and validity, reliability, and ease of use of the instrument.
StoryMKaphingstKMRobinson-O'BrienRGalnzK. Creating healthy food and eating environments: Policy and environmental approaches. Annu Rev Public Health. 2008;29:253–272.
2.
PowellLAuldMCChaloupkaFJ. Associations between access to food stores and adolescent body mass index. Am J Prev Med. 2007;33(4S):301–307.
3.
FordPBDzewaltowskiDA. Disparities in obesity prevalence due to variation in the retail food environment: Three testable hypotheses. Nutr Rev. 2008;66:216–228.
4.
MaziakWWardKDStocktonMB. Childhood obesity: Are we missing the big picture?Obes Rev. 2008;9:35–42.
5.
SallisJFGlanzK. The role of built environments in physical activity, eating, and obesity in childhood. Future Child. 2006;16:89–108.
6.
MorlandKWingSRouxA Diez. The contextual effect of the local food environment on residents' diets: The atherosclerosis risk in communities study. Am J Public Health. 2002;92:1761–1768.
7.
RoseDRichardsR. Food store access and household fruit and vegetable use among participants in the US Food Stamp Program. Public Health Nutr. 2004;7:1081–1088.
8.
JagoRBaranowskiTBaranowskiJC. Fruit and vegetable availability: A micro environmental mediating variable?Public Health Nutr. 2007;10:681–689.
9.
BrownsonRCHoehnerCMDayK. Measuring the Built Environment for Physical Activity: State of the Science. St Louis, Mo: Prevention Research Center, School of Public Health, Saint Louis University; 2008. In press.
10.
MoudonAVLeeC. Walking and bicycling: An evaluation of environmental audit instruments. Am J Health Promot. 2003;18:21–37.
ShenotC. Local government approaches to active living—2007. In: Municipal Yearbook 2008. Available at: http://icma.org/main/ns.asp?t=0&nsid=3695. Accessed June 16, 2008.
Cornell University, Program on Breast Cancer and Environmental Risk Factors. Assessment tools—a guide for custom community intervention planning. Available at: http://envirocancer.cornell.edu/obesity/tools.cfm. Accessed December 10, 2007.
NunnallyJCBernsteinI. Psychometric Theory. 3rd ed.New York, NY: McGraw-Hill; 1994.
20.
GlanzK. Personal communication, 2008.
21.
MercerSLDeVinneyBJFineLJ. Study designs for effectiveness and translation research: Identifying tradeoffs. Am J Prev Med. 2007;33:139–154.
22.
StecklerAMcLeroyKR. The importance of external validity. Am J Public Health. 2008;98:9–10.
23.
CronbachLJMeehlPE. Construct validity in psychological tests. Psychol Bull. 1955;52:281–302.
24.
California Center for Public Health Advocacy. Searching for healthy food—the food landscape in California cities and counties. Policy Brief No. 5, January 2007. Available at: http://www.publichealthadvocacy.org/RFEI/policybrief_final.pdf. Accessed November 7, 2007.
25.
New York City Dept of City Planning. Going to the market: New York City's neighborhood grocery store and supermarket shortage. May 2008. Available at: http://www.nyc.gov/html/dcp/html/supermarket/index.shtml. Accessed August 17, 2008.
Samuels and Associates. Neighborhood Food and Beverage Environment Assessment Tool. Available at: www.samuelsandassociates.com. Accessed May 28, 2008.
30.
MooreQ. Nutrition Environment Assessment Tool (NEAT). Michigan Dept of Health. 2005. Available at: http://www.mihealthtools.org/neat/. Accessed May 28, 2008.
31.
ScrimshawSCHeinrichJChavezN. Food & Fitness for Children and Families: A Rapid Assessment Tool. UIC, School of Public Health. Available at: http://www.cade.uic.edu/rap/default.aspx. Accessed May 28, 2008.
GlanzKSalisJ. Personal written communication, 2008.
34.
HousemannRABrownsonRCGonzalesGYMcGuireAM. Perceptions of the Environment: Do They Play a Role in Chronic Disease Risk Behaviors?St Louis, Mo: Department of Community Health and Prevention Research Center, School of Public Health, Saint Louis University; 2003.
California Adolescent Nutrition & Fitness. Cultural needs assessment guide—sample questions for community mapping. 2002. Available at: http://www.canfit.org/pdf/guide.pdf. Accessed May 28, 2008.
SchwartzMLundAGrevesMMcDonnellEProbartCSamuelsonALytleL. A comprehensive coding system to measure the quality of school wellness policies, 2009;109(7):1256–1262.
41.
ChaloupkaF. Food and Fitness School Administrator Survey. Chicago, Ill: University of Illinois at Chicago; 2008.
42.
LytleLKubikMA. IDEA/ECHO A La Carte, School Stores and Vending Inventory. Minneapolis, Minn: University of Minnesota; 2006.
43.
LytleLKubikMA. IDEA/ECHO Principal Survey. Minneapolis: University of Minnesota; 2006.
44.
KubikMALytleLAStoryM. School-wide food practices are associated with middle school students' body mass index. Arch Pediatr Adolesc Med. 2005;159:1111–1114.
45.
LytleLAKubikMYPerryCL. Influencing healthful food choices in school and home environments: Results from the TEENS study. Prev Med. 2006;43:8–13.
46.
KubikMYLytleLAHannanPJ. The association of the school food environment with dietary behaviors of young adolescents. Am J Public Health. 2003;93:1168–1173.
47.
HarnackLSnyderPStoryM. Availability of a la carte food items in junior and senior high schools: A needs assessment. J Am Diet Assoc. 2000;100:701–703.
48.
FrenchSAStoryMFulkersonJA. School food policies and practices: A state-wide survey of secondary school principals. J Am Diet Assoc. 2002;102:1785–1789.
49.
FrenchSAStoryMFulkersonJAGerlachAF. Food environment in secondary schools: A la carte, vending machines, and food policies and practices. Am J Public Health. 2003;93:1161–1167.
50.
FrenchSAStoryMFulkersonJAHannanP. An environmental intervention to promote lower fat food choices in secondary schools: Outcomes of the TACOS study (Trying Alternative Cafeteria Options in Schools). Am J Public Health. 2004;94:1507–1512.
Center for Science in the Public Interest. Dispensing Junk: How School Vending Undermines Efforts to Feed Children Well. Washington, DC: Center for Science in the Public Interest; 2004.
AgronPTakadaEPurcellA. California Project LEAN's Food on the Run program: An evaluation of a high school-based student advocacy nutrition and physical activity program. J Am Diet Assoc. 2002;102 (adolescent nutrition suppl):103–105.
WhitakerR. Survey of Healthy Activity and Eating Practices and Environments in Head Start (SHAPES). Philadelphia, Pa: Temple University Center of Obesity Research and Education; 2008.
59.
WardDSHalesDHaverlyK. An instrument to assess the obesogenic environments at child care centers. Am J Health Behav. 2008;32:380–386.
60.
WardDSBenjaminSEAmmermanAS. Nutrition and physical activity in child care settings: Results from an environmental intervention. Am J Prev Med. 2008;35:352–356.
61.
BenjaminSENeelonBBallSC. Reliability and validity of a nutrition and physical activity environmental self assessment for child care. Int J Behav Nutr Phys Act. 2007;4:29.
62.
AmmermanASBenjaminSESommersJKWardDS. 2004. The Nutrition and Physical Activity Self Assessment for Child Care (NAP SACC) Environmental Self-Assessment Instrument. Rev ed.Raleigh, NC: Division of Public Health, NC DHHS; and Chapel Hill: Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill; 2007.
BaranowskiTWatsonKMissaghianM. Social support is a primary influence on home fruit, 100% juice, and vegetable availability. J Am Diet Assoc. 2008;108:1231–1235.
65.
BaranowskiTMissaghianMWatsonK. Home fruit, juice, and vegetable pantry management and availability scales: A validation. Appetite. 2008;50:266–277. Epub September 1, 2007.
66.
BaranowskiTWatsonKMissaghianM. Parent outcome expectancies for purchasing fruit and vegetables: A validation. Public Health Nutr. 2007;10:280–291.
67.
BaranowskiTMissaghianMBroadfootA. Fruit and vegetable shopping practices and social support scales: A validation. J Nutr Educ Behav. 2006;38:340–351.
68.
YooSBaranowskiTMissaghianM. Food-purchasing patterns for home: A grocery store-intercept survey. Public Health Nutr. 2006;9:384–393.
69.
FormanHKerrJNormanGJ. Reliability and validity of destination-specific barriers to walking and cycling for youth. Prev Med. 2008;46:311–316.
70.
MayerJPLovegreenSHousemannRAOrensteinD. Church-Level and Pastor-Level Correlates of Interventions Addressing Nutrition and Physical Activity at Urban Churches. St Louis, Mo: School of Public Health Saint Louis University: And St Louis, Mo: Division of Adult and Community Health, Centers for Disease Control and Prevention; 2001.
ShimotsuSTFrenchSAGerlachAFHannanPJ. Worksite environment. Int J Behav Nutr Phys Act. 2007;4:17. Available at: http://www.ijbnpa.org/content/4/1/17. Accessed May 30, 2008.
74.
OldenburgBSallisJHarrisDOwenN. Checklist of Health Promotion Environments at Worksites (CHEW): Development and measurement characteristics. Am J Health Promot. 2002;16:288–299.
Samuels and Associates. Food and Beverage Marketing on California High School Campuses Survey: Findings and Recommendations. Oakland, Calif: Public Health Institute; 2006.
77.
Samuels and Associates. School Food and Beverage Marketing Inventory Tool. Available at: www.samuelsandassociates.com/. Accessed May 30, 2008.
78.
Citizen's Campaign for Commercial-Free Schools. A Commercialism Walk Through. Available at: http://www.scn.org/cccs/walkthru.pdf. Accessed May 30, 2008.
79.
GlanzKSallisJFSaelensBEFrankLD. Nutrition Environment Measures Survey in stores (NEMS-S): Development and evaluation. Am J Prev Med. 2007;32:282–289.
80.
GlanzKSallisJFSaelensBEFrankLD. Nutrition Environment Measures Survey in stores (NEMS-S). Available at: www.sph.emory.edu/NEMS. Accessed May 30, 2008.
Samuels and Associates. In-store Food and Beverage Availability and Advertisement Assessment Tool. Available at: www.samuelsandassociates.com/. Accessed May 30, 2008.
83.
VarelaOJHaider-MarkelDPPercySL. Perceptions and Experiences of Consumer Access to Food in Milwaukee's Inner-City Neighborhoods. Milwaukee, WI: Hunger Task Force of Milwaukee; 1998.
GittelsohnJFranceschiniMCRasoolyI. Understanding the food environment in a low income urban setting: Implications for food store interventions. J Hunger Environ Nutr, 2(2/3):33–50.
86.
StoryMSherwoodNEHimesJH. An after-school obesity prevention program for African-American girls: The Minnesota GEMS pilot study. Ethn Dis. 2003;13(suppl 1):S54–S64.
SaelensBEGlanzKSallisJFFrankLD. Nutrition Environment Measures Study in restaurants (NEMS-R): Development and evaluation. Am J Prev Med. 2007;32:273–281.
89.
GlanzKSallisJFSaelensBEFrankLD. Nutrition Environment Measures Survey in restaurants (NEMS-R). Available at: www.sph.emory.edu/NEMS. Accessed May 30, 2008.
90.
CassadyDHousemannRDagherC. Measuring cues for healthy choices on restaurant menus: Development and testing of a measurement instrument. Am J Health Promot. 2004;18:444–449.
