A Novel Mobile Phone Application to Assess Nutrition Environment Measures in Low- and Middle-Income Countries

Abstract

Background Consumer nutrition environment measures are important to understanding the food environment, which affects individual dietary intake. A nutrition environment measures survey for supermarkets (NEMS-S) has been designed on paper for use in Guatemala. However, a paper survey is not an inconspicuous data collection method. Objective To design, pilot test, and validate the Guatemala NEMS-S in the form of a mobile phone application (mobile app). Methods CommCare, a free and open-source software application, was used to design the NEMS-S for Guatemala in the form of a mobile app. Two raters tested the mobile app in a single Guatemalan supermarket. Both the interrater and the test—retest reliability of the mobile app were determined using percent agreement and Cohen's kappa score and compared with the interrater and test—retest reliability of the paper version. Results Interrater reliability was very high between the paper survey and the mobile app (Cohen's kappa > 0.90). Test—retest reliability ranged from kappa 0.78 to 0.91. Between two certified NEMS-S raters, survey completion time using the mobile app was 5 minutes less than that with the paper form (35 vs. 40 minutes). Conclusions The NEMS-S mobile app provides for more rapid data collection, with equivalent reliability and validity to the NEMS-S paper version, with advantages over a paper-based survey of multiple language capability and concomitant data entry.