Inter-Rater Reliability of the Food Environment Audit for Diverse Neighborhoods (FEAD-N)

Abstract

Studies have shown that neighborhood food environments are important influences on dietary intake and may contribute to health disparities. While instruments with high reliability have been developed to assess food availability, price, and quality, few measures to assess items associated with the physical and social features of food stores have been developed. Yet, recent qualitative studies have documented aspects associated with such features of urban food stores that are barriers to food acquisition. We assessed the reliability of measures to assess multiple components of the food environment-including physical and social store features--in three geographically distinct and diverse communities in Detroit, Michigan, using the Food Environment Audit for Diverse Neighborhoods (FEAD-N). Using the FEAD-N, four trained observers conducted observations of 167 food stores over a 10-week period between October and December 2008. To assess inter-rater reliability, two trained observers independently visited, on the same day, a random subset of 44 food stores. Kappa statistics and percent agreement were used to evaluate inter-rater reliability. Overall, the instrument had mostly high inter-rater reliability with more than 75% of items with kappa scores between 0.80 and 1.00, indicating almost perfect reliability. More than half of the physical store features and 47% of the social store features had almost perfect reliability and about 37% and 47%, respectively, had substantial reliability. Measuring factors associated with the physical and social environment of food stores with mostly high reliability is feasible. Systematic documentation of the physical and social features of food stores using objective measures may promote a more comprehensive understanding of how neighborhood food environments influence health.

Does opening a supermarket in a food desert change the food environment?

“…Orderliness (Izumi et al, 2012), was a count of nine binary items: (i) no people loitering or hanging out, (ii) no panhandling, (iii) no shopping cart guard rails, (iv) no security guard, (v) no bars on doors or windows, (vi) no bullet-proof or plexiglass at check out; (vii) no security mirror; (viii) no graffiti on building; and (ix) no garbage at store entrance. Values range from 0 to 9 with higher scores indicating more order.…”

Ambiente alimentar urbano em São Paulo, Brasil: avaliação, desigualdades e associação com consumo alimentar

“…They, then, categorized business into the following categories adapted for the Brazilian context from Saelens et al (19) :1) A la carte full service restaurants, 2) All-you-eat buffet restaurants 3 Kappa statistics were used to evaluate the level of agreement among the scores based on categorical data on the following scale: 0.81-1.00, almost perfect; 0.61-0.80, substantial; 0.41-0.60, moderate; 0.21-0.40, fair; 0-0.20, slight; < 0, poor (31) . For items with low availability frequency, we used percent agreement as a more accurate reflection of reliability (22,32) . Intraclass Correlation Coefficients (ICCs) were used to test both inter-rater and test-retest reliability for continuous variables, and we considered them excellent if above 0.75 and poor if below 0.40 (22,33) .…”

“…For items with low availability frequency, we used percent agreement as a more accurate reflection of reliability (22,32) . Intraclass Correlation Coefficients (ICCs) were used to test both inter-rater and test-retest reliability for continuous variables, and we considered them excellent if above 0.75 and poor if below 0.40 (22,33) . Tools' ability to discriminate across different contexts/situations -store types in the case of this study -was analyzed by comparing the instruments' indicators, such as availability, quality, price and signage/promotion/advertising of fresh produce and highly processed foods, and barriers and facilitators to healthier choices in two different types of restaurants: full-service and fast food restaurants; and retail food stores:…”

“…Among previously developed instruments to measure the micro-level food environment, some have proposed good to excellent test-retest and inter-rater reliability measures (18)(19)(20)(21)(22) , while others did not report the reliability of their tools (23,24) .…”

“…Noteworthy though, most of them come from the United States (18,19,21,22) . Local food retail settings and food environments are likely to be different to those previously assessed in the United States or Europe and warrant reliable and context-specific 85 measures.…”