Development of an observational tool to assess availability, portion size, and marketing of beverages in stores and fast food restaurants: NEMS-B

Background:  Attention to food and nutrition environments as contributors to population-level consumption patterns and chronic disease has increased.  Quality measures are necessary to better understand access to different types of food and to evaluate interventions intended to change food environments.  The Nutrition Environment Measures Surveys (NEMS), a validated and widely used tool, assesses nutrition environments.  However, a tool to specifically examine the beverage environment has been lacking.

Methods: A new environmental measure of beverage availability, portion sizes, and marketing, the NEMS-Beverage (NEMS-B), was developed and tested. The goal of the tool was to describe the beverage environment in a variety of retail locations, including fast food restaurants, corner stores, and supermarkets.  The tool was based off previously developed NEMS tools, pretested, and examined for reliability andvalidity.

Results:  We will present the development, scoring and validation of the NEMS-B, used multiple times in 62 restaurants, 55 convenience stores and 40 supermarkets in New York City and New Jersey. Validity and reliability of the instrument will be presented (analysis is underway).  The tool measures portion/package size, pricing and promotion, and allows for direct comparison of locations at a given point in time and assessment of changes over time. Beverages are classified into categories:  SSBs, 100% fruit juice, sugar-free/low-no calorie non-carbonated beverages, diet drinks, and bottled water, smoothies, shakes, and coffee drinks.

Discussion:  NEMS-B is an important addition to the range of NEMS tools. Systematic measurement of the beverage environment enables quantification and comparison of the availability, price, and promotion of beverage types.