Adaptation and Validation of the Chinese Version of the Nutrition Environment Measurement Tool for Stores

Yang Liu, Shenzhi Song, Joel Gittelsohn, Nan Jiang, Jiajin Hu, Yanan Ma and Deliang Wen
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Yang Liu: Institute of Health Sciences, China Medical University, Shenyang 110122, China
Shenzhi Song: Institute of Health Sciences, China Medical University, Shenyang 110122, China
Joel Gittelsohn: Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205-2179, USA
Nan Jiang: Institute of Health Sciences, China Medical University, Shenyang 110122, China
Jiajin Hu: Institute of Health Sciences, China Medical University, Shenyang 110122, China
Yanan Ma: Institute of Health Sciences, China Medical University, Shenyang 110122, China
Deliang Wen: Institute of Health Sciences, China Medical University, Shenyang 110122, China

IJERPH, 2019, vol. 16, issue 5, 1-12

Abstract: Changes in lifestyle and food environment have created a heavy burden of obesity and chronic disease in China. However, measurements of the food environment have been rarely reported in China or other countries with similar food cultures; this measurement shortage is partially due to the lack of valid and reliable measurement tools. The aim of the present study was to adapt and validate a Chinese version of the Nutritional Environment Measurement Survey for Stores (C-NEMS-S). Categories and items of the NEMS-S were culturally adapted to fit the Chinese population and included grains, dry beans, starchy tubers, vegetables, fruits, seafood, meat and poultry, dietary oils, milk, bread, instant noodles, and beverages. A scoring sheet for each food category was created to measure availability, quality, and pricing. Then, the C-NEMS-S was validated in 10 large-sized supermarkets and 10 convenience stores in Shenyang, China. Two trained raters performed their evaluations separately at the same store. The intra-class correlation coefficient (ICC) of the availability composite score was 0.98. All food measures had a moderate or good ICC (0.41 to 1.00). The kappa for each food measure ranged from 0.52 to 1.00. C-NEMS-S was able to show the difference in healthy food availability between large-sized supermarkets and convenience stores, as well as the price differences between healthier options and regular options. Large-sized supermarkets had a significantly higher total score ( p < 0.001) and healthier option availability for all food measures (all items were statistically significant ( p < 0.05), except sugar-free beverages). Healthier options cost more than regular options for grains, milk, bread, and instant noodles (from 4% to 153%). The adapted C-NEMS-S can be used to measure the consumer food environment in stores in China.

Keywords: food environment; China; Nutritional Environment Measurement Survey-Stores (NEMS-S) (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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