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Dahl AA, Fandetti SM, Ademu LO, Harris R, Racine EF. Assessing the Healthfulness of University Food Environments: A Systematic Review of Methods and Tools. Nutrients 2024; 16:1426. [PMID: 38794664 PMCID: PMC11123862 DOI: 10.3390/nu16101426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/04/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
The availability, promotion, and price of healthy foods within the university food environment may impact students' dietary choices. This systematic review summarizes the tools and methods used to assess the healthfulness of university food environments where many students spend a significant portion of their emerging adulthood. Thirty-six global studies published between 2012 and 2022 were sourced from PubMed (NNLM), Cochrane Library (Wiley), Web of Science (Clarivate), APA PsycInfo (EBSCO), CINHAL Complete (EBSCO), ProQuest Nursing, and Allied Health, following PRISMA 2020 guidelines. Of the included studies, 58% were institutional-level audits, 17% examined individual-level perceptions, and 25% combined both. Most institutional-level audits focused on one aspect of the food environment (e.g., eateries, vending machines). For studies examining multiple spaces within the campus environment (38%), comprehensive assessments were limited, and most studies had to employ a combination of assessment tools. Surveys were most often used to gather individual perceptions about the food environment. The Nutrition Environment Measures Survey (NEMS) was the most commonly used tool across all studies. This review highlights the need for a standardized tool, method, or a "healthy" benchmark for specific use at universities to improve methodological rigor and comparability of findings across institutions.
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Affiliation(s)
- Alicia Anne Dahl
- Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | - Stacy M. Fandetti
- Department of Public Health Sciences, College of Health and Human Services, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | - Lilian O. Ademu
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife Research Center at El Paso, Texas A&M University, El Paso, TX 79927, USA
| | - Ryan Harris
- J. Murrey Atkins Library, University of North Carolina at Charlotte, Charlotte, NC 28223, USA;
| | - Elizabeth F. Racine
- Texas A&M AgriLife Research Center at El Paso, Texas A&M University, El Paso, TX 79927, USA;
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Baker K, Burd L, Figueroa R. Consumer nutrition environment measurements for nutrient-dense food availability and food sustainability: a scoping review. Arch Public Health 2024; 82:7. [PMID: 38225657 PMCID: PMC10789067 DOI: 10.1186/s13690-023-01231-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/19/2023] [Indexed: 01/17/2024] Open
Abstract
Consumer nutrition environments are defined as places in which consumers interact with the food they eat; these food choices can impact human and planetary health. Assessment measures for consumer nutrition environments are numerous, and vary widely on what, and how, they assess the food environment. The objective of this scoping review was to synthesize existing evidence on nutrition environment measurements and their capacity to assess nutrient-dense food access and food sustainability capacity. Eligibility criteria were developed to capture relevant peer-reviewed literature about auditing measures designed to assess nutrient-dense foods and food sustainability capacity in the consumer nutrition environment. A search strategy was conducted to collect articles published between January 1, 2002-June 4, 2022, using PubMed, Web of Science, Scopus, PsycINFO and the Cochrane library electronic databases. After screening 2457 manuscripts, 58 met inclusion criteria. Study aims, funding source(s), types of retailers assessed, assessment format and name, constructs measured, food categories measured, assessment of validity and/or reliability, and other relevant data were extracted from each manuscript. Results showed that most measures use checklists, surveys, questionnaires or similar methods to assess availability, quality, and price of select food items as assessment constructs. Most do not assess nutrient-dense food availability, and even fewer assess food sustainability. Development of comprehensive, reliable, and valid consumer nutrition environment measures that assess nutrient-dense food availability and food sustainability is important for research, planning, evaluation and advocacy aimed at improving consumer food environments for human and planetary health.
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Affiliation(s)
- Katherine Baker
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
- Sol Price School of Public Policy, University of Southern California, Los Angeles, CA, USA.
| | - Laura Burd
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
| | - Roger Figueroa
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA
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Hill AB, Kaur R, Sundermeir SM, Kasprzak C, Winkler M, John S, Dombrowski RD, Bode B, Gittelsohn J. Refining the Nutrition Environment Measures Survey (NEMS) for Healthy Community Stores: Adaptations to Capture Alternative Food Retailers and Align with Dietary Guidelines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912875. [PMID: 36232175 PMCID: PMC9566451 DOI: 10.3390/ijerph191912875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/28/2022] [Accepted: 10/04/2022] [Indexed: 05/27/2023]
Abstract
Inadequate consumption of healthy food is an ongoing public health issue in the United States. Food availability measures of supply versus consumption of healthy foods are disconnected in many studies. There is a need for an objective assessment of the food environment in order to assess how the food supply aligns with the Healthy Eating Index (HEI). Data were collected as part of the Healthy Community Stores Case Study Project, including a refined Nutrition Environment Measures Survey for Healthy Community Stores (NEMS-HCS) and an updated Healthy Food Availability Index that aligns with the Healthy Eating Index (HFAHEI). This paper will focus on the NEMS-HCS development process, findings, and HFAHEI application. All food items were more likely to be found at grocery stores rather than corner stores. Food pricing was often above the Consumer Price Index averages for six food items. The NEMS-HCS assessment better aligned with the HEI because it included a wider variety of meats, frozen fruits and vegetables, and an increased selection of whole grains. HFAHEI scoring was inclusive of non-traditional and alternative community stores with a health focus, making it suitable for use at the local level, especially in neighborhoods where supermarkets and large chain stores are less common.
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Affiliation(s)
- Alex B. Hill
- Detroit Food Map Initiative and Department of Urban Studies and Planning, College of Liberal Arts and Sciences, Wayne State University, Detroit, MI 48202, USA
| | - Ravneet Kaur
- Division of Health Research and Evaluation, Department of Family and Community Medicine, College of Medicine, University of Illinois, Rockford, IL 61107, USA
| | - Samantha M. Sundermeir
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Christina Kasprzak
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY 14260, USA
| | - Megan Winkler
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Sara John
- Center for Science in the Public Interest, Washington, DC 20005, USA
| | - Rachael D. Dombrowski
- Departments of Public Health and Kinesiology, College of Education, Health and Human Services, California State University San Marcos, San Marcos, CA 92096, USA
| | - Bree Bode
- Division of Kinesiology, Heath and Sport Studies, College of Education, Detroit, MI 48202, USA
| | - Joel Gittelsohn
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
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Tavares LF, Perez PMP, dos Passos MEA, de Castro Junior PCP, da Silva Franco A, de Oliveira Cardoso L, de Castro IRR. Development and Application of Healthiness Indicators for Commercial Establishments That Sell Foods for Immediate Consumption. Foods 2021; 10:1434. [PMID: 34205645 PMCID: PMC8235135 DOI: 10.3390/foods10061434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 12/21/2022] Open
Abstract
Studies of food environments lack easy-to-apply indicators for their characterization and monitoring. This study aimed to create and assess the applicability of an a priori classification of establishments that sell foods for immediate consumption and to develop and apply indicators for assessment of the establishments' healthiness. The indicators were grouped by the types of foods sold most frequently at these establishments, according to the extent and purpose of the foods' industrial processing. Four indicators were developed, based on the availability of unprocessed/minimally processed foods (MPF) and ultra-processed foods (UPF) in the establishments. The classification and indicators were applied to commercial food establishments at two Brazilian universities. Descriptive analyses were performed to characterize the food environment for all the establishments and by university. Two proportion indicators assess the relative availability of subgroups of MPF and UPF. The UPF/MPF ratio expresses the relative advantage/disadvantage of the availability of MPF compared to that of UPF. The Healthiness Index or summary score expresses the availability of MPF and the unavailability of UPF. The classification and indicators present good discriminatory power and are easy to operationalize, interpret, and adapt.
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Affiliation(s)
- Letícia Ferreira Tavares
- Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (L.F.T.); (M.E.A.d.P.); (P.C.P.d.C.J.)
| | - Patrícia Maria Périco Perez
- Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro 20559-900, Brazil; (P.M.P.P.); (I.R.R.d.C.)
| | - Maria Eliza Assis dos Passos
- Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (L.F.T.); (M.E.A.d.P.); (P.C.P.d.C.J.)
| | - Paulo Cesar Pereira de Castro Junior
- Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (L.F.T.); (M.E.A.d.P.); (P.C.P.d.C.J.)
| | - Amanda da Silva Franco
- Nutrition Coordination, Health Sciences Center, Centro Universitário Serra dos Órgãos (UNIFESO), Rio de Janeiro 25964-000, Brazil;
| | | | - Inês Rugani Ribeiro de Castro
- Institute of Nutrition, State University of Rio de Janeiro, Rio de Janeiro 20559-900, Brazil; (P.M.P.P.); (I.R.R.d.C.)
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Hawkes C, Fox E, Downs SM, Fanzo J, Neve K. Child-centered food systems: Reorienting food systems towards healthy diets for children. GLOBAL FOOD SECURITY 2020. [DOI: 10.1016/j.gfs.2020.100414] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Paquet C. Environmental Influences on Food Behaviour. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152763. [PMID: 31382447 PMCID: PMC6696422 DOI: 10.3390/ijerph16152763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 08/01/2019] [Indexed: 11/16/2022]
Abstract
The ubiquitous presence of food cues in our modern environment is believed to contribute to the rising trends in overconsumption and associated obesity observed over the last few decades [...].
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Affiliation(s)
- Catherine Paquet
- Australian Centre for Precision Health, University of South Australia Cancer Research Institute, Adelaide, SA 5001, Australia.
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia.
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Redesign, Field-Testing, and Validation of the Physical Activity Campus Environmental Supports (PACES) Audit. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2019; 2019:5819752. [PMID: 31236118 PMCID: PMC6545773 DOI: 10.1155/2019/5819752] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 04/04/2019] [Accepted: 05/05/2019] [Indexed: 11/18/2022]
Abstract
This paper describes the redesign, field-testing, and convergent validity of a practical tool-Physical Activity Campus Environmental Supports (PACES) audit. Methods. The audit includes two parts: (1) PACES-Programs, which is comprised of questions regarding populations served, fees, programs (recreation/fitness classes and intramurals), proximity, adequacy of facilities, and marketing, and (2) PACES-Facilities, which is comprised of questions regarding built environment (aesthetics, bike racks, stairs, and universal design), recreation equipment, staff, amenities, and access. Each item criterion is specifically scored using a five-point, semantic-differential scale ranging from limited to extensive environmental support. A few questions utilize select all that apply for a summed score. PACES training, interrater reliability, and data collection are all accessible via an online portal. PACES was tested on 76 college campuses. Convergent validity was examined by comparing the PACES-Programs questions to Healthy Campus Initiatives-Programs questions (HCI-Programs) and comparing the PACES-Facilities questions to questions contained in the Physical Activity Resource Assessment (PARA) Instrument. Statistical analyses included Cronbach's alpha, ANOVA, latent profile analysis, and Spearman correlations. Results. The PACES-Programs audit includes 10 items for a potential total of 73 points (α = 0.72) and PACES-Facilities audit includes 15 items for a potential total of 77 points (α = 0.837). Most (77.8%) of the 153 facilities assessed scored in the most healthful range (20-42), which was mainly due to the extensiveness of the aerobic equipment/amenities and the competence/accessibility of staff. Significant differences in PACES-Total and PACES-Programs scores were associated with campus size and PACES-Facilities across regions. For the paired validation assessments, correlations were significant between PACES-Programs and HCI-Programs ((n=41) r=0.498, p < 0.001) and PACES-Facilities and PARA (n=29) for both features (r=0.417, p=0.024) and amenities (r=0.612, p < 0.001), indicating moderate convergent validity. Conclusion. The PACES audit is a valid, reliable tool for assessing the quality of recreation facilities and programs in a variety of college campus environments.
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