Development and evaluation of food environment audit instrument: AUDITNOVA

Abstract

OBJECTIVE:To develop and assess the reliability of an instrument that enables auditing information on consumer food environment indicators, such as availability, price, promotional and advertising strategies, and quantity of brands available, using the food recommendations adopted by the Dietary Guidelines for the Brazilian Population as a theoretical basis. METHODS:This is a methodological study in two phases: 1. development of the audit instrument and 2. assessment of its reliability and reproducibility. The Content Validity Index was estimated for each instrument item (>0.80 satisfactory). Inter-rater and test-retest reliability were assessed by percentage agreement and Kappa coefficients. Pearson's correlation coefficient and Scatter-plots were used to measure the degree of linear correlation between two quantitative variables. RESULTS:The Content Validity Index was 0.91. Inter-rater and test-retest reliability were mostly high (Kappa> 0.80), for food availability indicators. Among the items that measure advertising, Kappa values for inter-rater reliability ranged from 0.57 to 1.00 and for the test-retest ranged from 0.18 to 0.90. Prices and quantity of brands showed a positive linear correlation between measurements performed by researcher 1 and 2 and between visits 1 and 2. CONCLUSIONS: AUDITNOVA is reliable for measuring aspects such as availability, price, quantity of brands, and advertising of foods available in the consumer food environment.

Development and Application of Healthiness Indicators for Commercial Establishments that Sell Foods for Immediate Consumption

“…Other instruments and indicators have been adopted to measure the consumer food environment with a focus on the assessment of facilitators for the consumption of healthy foods, with availability, prices, and information of healthy foods in establishments such as convenience stores, markets, and grocery stores [ 45 , 46 , 47 ]. More recently, an audit tool based on the NOVA classification (AUDITNOVA) was developed for the assessment of the retail food trade [ 21 , 23 ]. All the above-mentioned instruments were developed to characterize the retail food establishments (supermarkets, grocery stores) and they are, thus, not adequate for the assessment of establishments that sell foods for immediate consumption.…”

“…There are still few studies that present summary measures for the assessment of the consumer food environment [ 13 ]. Most summary indicators proposed in these studies are only applicable in certain types of establishments that sell foods to be consumed later, such as supermarkets [ 20 , 21 , 22 , 23 , 24 ]. Besides, the construction of these measures is quite complex [ 21 , 23 , 25 ], which hinders their large-scale use and/or application to specific realities [ 18 ].…”

“…The lack of simple, reliable, and valid summary indicators for characterizing the consumer food environment in establishments that sell foods for immediate consumption limits the interpretation of results from increasingly frequent initiatives to characterize and monitor these settings. The development of such summary indicators would allow comparison of studies within the same country and between countries, besides favoring the study of relations between the consumer food environment and food purchases or food consumption behaviors [ 21 , 26 , 27 ]. The application of such summary indicators can also assist institutional diagnoses (in schools, universities, hospitals, and other workplaces) and community diagnoses at different levels (neighborhood, city, and even country), besides monitoring these environments over time.…”

A Multidisciplinary Perspective of Ultra-Processed Foods and Associated Food Processing Technologies: A View of the Sustainable Road Ahead

“…The complexity of industrially produced foods is such that without precise category definitions and mutually exclusive categories, the potential for misclassification is high [13], so that agreement between independent reviewers in the ranking of a food as UPF or not is only moderate (particularly when it comes to mixed dishes) [18]. These observations indicate that there is room for improvement, for instance, by developing standardized food audit tools to identify UPFs with improved test validity (inter-rater reliability and test-retest reproducibility) [19]; but also highlight the need for ongoing development of the food processing evaluation and classification systems themselves. Some common UPFs are: carbonated soft drinks; sweet, fatty or salty packaged snacks; candies (confectionery); mass produced packaged breads and buns, cookies (biscuits), pastries, cakes and cake mixes; margarine and other spreads; sweetened breakfast cereals and fruit yoghurt and energy drinks; pre-prepared meat, cheese, pasta and pizza dishes; poultry and fish nuggets and sticks; sausages, burgers, hot dogs and other reconstituted meat products; powdered and packaged instant soups, noodles and desserts; and baby formula [14].…”

Disponibilidade de alimentos ultraprocessados no ambiente alimentar do consumidor em um município de médio porte no estado de SP

“…Analisar a distribuição espacial da disponibilidade de alimentos ultraprocessados relacionada as variáveis sociodemográficas do território. 103 .…”