Validation of an Adapted Version of the Nutrition Environment Measurement Tool for Stores (NEMS-S) in an Urban Area of Brazil

Abstract Objective To validate an adapted instrument that assesses the nutritional environment of food stores in Brazilian urban areas. Methods The instrument measured aspects of food environment such as availability, prices, and quality. The Harvard Healthy Eating Pyramid and the degree of processing were used to define healthy foods. The sample included 44 food stores in 3 census tracts in the city of Santos. Inter-rater reliability and stability coefficient were obtained with measurements performed by different individuals at different times. Internal consistency and construct validity were assessed by Cronbach α and the known-groups comparison method, respectively. Results Inter-rater reliability was high. The mean intra-class correlation coefficient was 0.98 and the mean kappa was 0.77. Cronbach α values ranged from .68 to .93. Conclusions and Implications The instrument can be useful in the development of interventions to promote healthy eating through actions focused on healthy food availability in Brazilian communities.