| In 2007, Glanz et al. published the Nutrition Environment Measures Survey in Stores (NEMS-S). The 11-item checklist assessed availability and pricing between healthy and less healthy food items available in grocery stores. Based on the 2005 Dietary Guidelines for Americans, there was an emphasis on low-fat and low-calorie foods. The tool has been widely used to assess the nutrition environment across different settings; however, the NEMS-S does not include foods specific to Latino or other ethnic cultures. As a result, the NEMS-S underestimates the presence of healthy food options in Latino stores and other cultural stores.;The study purpose was to create and test a NEMS-S adaptation that would more accurately describe the food environment of Latino grocery stores and have high inter-rater reliability and test-retest validity. Drawing on literature searches, previous pilot research in Arizona, 2009-2012 National Health and Nutrition Examination Survey (Centers for Disease Control and Prevention (CDC)) Hispanic consumption frequencies, the 2015 Dietary Guidelines, and formative evaluation observations in 24 Latino grocery stores, a new instrument was developed and validated.;Trained researchers tested the Latino NEMS-S and original NEMS-S in randomly selected Latino stores across Iowa (n=42). On average, stores scored 41.9 +/- 7.5 points out of 60.0 possible points on the Latino NEMS-S, and 12.0 +/- 4.6 out of 54.0 points on the original NEMS-S. Two raters evaluated each store independently at time 1 (T1) with the Latino NEMS-S. Inter-rater reliability was assessed from these measures. Test-retest reliability was then evaluated by having one rater repeat the store assessment at time 2 (T2) within 1-2 weeks of T1. The second rater completed the original NEMS-S at T2 for comparison purposes. No significant differences in total store scores were found for inter-rater reliability or test-retest reliability using paired t-tests (p=0.535 and p=0.746, respectively). The average total scores for the original NEMS-S versus the Latino NEMS-S were significantly different (p<0.001). Inter-rater agreement for individual food items using Cohen's Kappa values were high, ranging from 0.82-1.00 (p<0.001). Our findings indicate the Latino NEMS-S is a valid and reliable tool to measure the nutrition environment in Iowa's Latino grocery stores. |
