Development and Validation of a Set of Instruments to Measure Food Environments

Abstract

Background: There is worldwide interest in measuring local food environments (FEs). The aim of this study was to develop and validate a set of instruments to evaluate FEs in Chile. Methods: Based on the development and validation of four instruments to measure FEs, a literature review, an evaluation by experts, and the implementation of a pilot tool in the FEs of schoolchildren from nine public schools in the commune of Chillán, Chile, were used. Results: A tool to evaluate FEs was provided, based on three dimensions: availability, variety, and advertising of healthy foods. A total of 1928 foods points of purchase were evaluated. The reliability was evaluated by Cronbach’s alpha. Some 74% of the foods’ points of purchase were store locations. The reliability of the four instruments was high to acceptable (store: 0.90; institution: 0.77; street food: 0.74; restaurant: 0.68). Unhealthy foods were highlighted by the scores obtained: store (6.08 ± 4.07; range: 0–13), restaurant (3.95 ± 1.75; range: 0–10), street food (1.18 ± 1.56; range: 0–7), and institution FEs (3.38 ± 2.78; range: 0–9). Conclusions: The results of this tool can provide information to governments for incorporating structural measures to ensure adequate availability, variety, and advertising of healthy foods in different FEs.