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Adaptation and Evaluation of the Nutrition Environment Measures Survey in Stores to Assess Mediterranean Food Environments (NEMS-S-MED)

Equity Focus

This study focuses on an audit tool for assessing and monitoring the food environment of consumers in urban contexts in the Mediterranean region, in this case Madrid, Spain.

Case Summary

This project describes the adaptation and evaluation of the Nutrition Environment Measures Survey in Stores (NEMS-S) for Mediterranean urban contexts (NEMS-S-MED). Trained raters used the adapted NEMS-S-MED tool to observe and rate food outlets in 21 census tracts and 43 food stores across the city of Madrid, Spain. Overall, the mean NEMS-S-MED score was 20.7 (SD = 9.8), which ranged from 7 to 43. Most food items displayed substantial or almost perfect inter-rater and intra-rater agreements; the percentage agreement across availability items was almost perfect and kappa statistics were also very high Furthermore, the NEMS-S-MED tool was able to discriminate between store types and census tracts of different SES.

Lessons Learned

• The adapted NEMS-S-MED instrument is a reliable and valid audit tool to assess the consumer food environment in Mediterranean urban contexts. Well-constructed measurement tools, such as the NEMS-S-MED, may facilitate the development of effective policy interventions to increase healthy food access and affordability.
  

LINK TO CASE STUDY