Cultural Adaptation and Evaluation of the Perceived Nutrition Environment Measures Survey to the Mediterranean Spanish Context (NEMS-P-MED)

Abstract

Individuals’ perceptions of their food environments are a mediator between exposure to the environment and people’s interaction with it. The Nutrition Environment Measures Surveys (NEMS) are valid and reliable measures to assess food environments. In Spain, there is no adapted instrument to measure the perceived obesogenic environment. This article aims to adapt and evaluate the Perceived Nutrition Environment Measures Survey for a Spanish context (NEMS-P-MED). The Spanish version has 32 questions to measure the perception about availability, accessibility and marketing of 3 types of environment: home, shops and restaurants. We assess feasibility, construct validity and internal consistency reliability through a sample of 95 individuals. The internal consistency was acceptable for most items (Cronbach’s alpha coefficients range from 0.6 to 0.9), similar to that of the original scale. The NEMS-P-MED has been shown to be valid and, on certain items reliable, and was useful to assess the population’s perceptions of the food environment in the home, restaurants and food stores in a Spanish context. Adapting standardized measurement tools to specific contexts to assess the perceived and observed characteristics of food environments may facilitate the development of effective policy interventions to reduce excess weight.

Cross-cultural adaptation of the Brazilian-Portuguese version of the Perceived Nutrition Environment Measures Survey

“…With regard to changes in the instrument, in the study that carried out the translation and adaptation of the NEMS-P into Spanish, [40] some types of food were included and excluded and the types of food stores and restaurants were changed, for the instrument to maintain the local reality.…”

“…A pilot test was run with a group of 10 people. The instrument had a content validity index of 0.729 which, according to the authors, is acceptable as it is close to 1 [40]. The name of the instrument was also changed to NEMS-P-MED due to its application being carried out in the context of the Mediterranean.…”

Individual and food environment determinants of Mediterranean diet adherence among Lebanese adults: a cross-sectional study

“…Perception of food environment in two different settings, home and stores, was assessed using an adapted version of the NEMS-P-MED questionnaire composed of 5 main sections: (1) Home Food Environment, (2) Perceived Food Environment in Stores, (3) Perceived Food Environment in Restaurants, (4) Your Food Habits and Thoughts About Food, and (5) General/Background Information Questions [14].…”

Development and Validation of Nutrition Environment Scoring for Chinese Style University/Work-Site Canteens (NESC-CC) and Oil–Salt Visual Analogue Scale (OS-VAS)

“…Nutrition environment is a conceptual model first proposed in 2005 [ 2 ] with a perspective of the possible impact of food environment on personal food consumption. There is evidence that the nutritional environment plays a key role in dietary patterns, food choices, and energy intake [ 3 , 4 ], and thus influences the risk of obesity and chronic diseases. In recent years, many studies on obesity prevention have also focused attention on environmental factors, contributing to the formulation and publication of relevant health policies [ 5 , 6 , 7 ].…”