Duran Ana Clara, Lock Karen, Latorre Maria do Rosario D O, Jaime Patricia Constante
Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil.
Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, University of London, London, UK.
Rev Saude Publica. 2015;49. doi: 10.1590/S0034-8910.2015049005420. Epub 2015 Oct 30.
To assess inter-rater reliability, test-retest reliability, and construct validity of retail food store, open-air food market, and restaurant observation tools adapted to the Brazilian urban context.
This study is part of a cross-sectional observation survey conducted in 13 districts across the city of Sao Paulo, Brazil in 2010-2011. Food store and restaurant observational tools were developed based on previously available tools, and then tested it. They included measures on the availability, variety, quality, pricing, and promotion of fruits and vegetables and ultra-processed foods. We used Kappa statistics and intra-class correlation coefficients to assess inter-rater and test-retest reliabilities in samples of 142 restaurants, 97 retail food stores (including open-air food markets), and of 62 restaurants and 45 retail food stores (including open-air food markets), respectively. Construct validity as the tool's abilities to discriminate based on store types and different income contexts were assessed in the entire sample: 305 retail food stores, 8 fruits and vegetable markets, and 472 restaurants.
Inter-rater and test-retest reliability were generally high, with most Kappa values greater than 0.70 (range 0.49-1.00). Both tools discriminated between store types and neighborhoods with different median income. Fruits and vegetables were more likely to be found in middle to higher-income neighborhoods, while soda, fruit-flavored drink mixes, cookies, and chips were cheaper and more likely to be found in lower-income neighborhoods.
The measures were reliable and able to reveal significant differences across store types and different contexts. Although some items may require revision, results suggest that the tools may be used to reliably measure the food stores and restaurant food environment in urban settings of middle-income countries. Such studies can help .inform health promotion interventions and policies in these contexts.
评估适用于巴西城市环境的零售食品店、露天食品市场和餐厅观察工具的评分者间信度、重测信度和结构效度。
本研究是2010 - 2011年在巴西圣保罗市13个区进行的横断面观察调查的一部分。食品店和餐厅观察工具是在先前可用工具的基础上开发的，然后进行测试。这些工具包括对水果、蔬菜和超加工食品的可及性、种类、质量、价格和促销的测量。我们分别使用卡方统计量和组内相关系数来评估142家餐厅、97家零售食品店（包括露天食品市场）样本中的评分者间信度和重测信度，以及62家餐厅和45家零售食品店（包括露天食品市场）样本中的评分者间信度和重测信度。在整个样本（305家零售食品店、8个水果和蔬菜市场以及472家餐厅）中评估基于商店类型和不同收入背景进行区分的工具的结构效度。
评分者间信度和重测信度总体较高，大多数卡方值大于0.70（范围为0.49 - 1.00）。两种工具都能区分不同类型的商店和不同收入中位数的社区。水果和蔬菜更有可能在中高收入社区找到，而苏打水、水果味混合饮料、饼干和薯片更便宜，且更有可能在低收入社区找到。
这些测量方法可靠，能够揭示不同商店类型和不同环境之间的显著差异。尽管有些项目可能需要修订，但结果表明这些工具可用于可靠地测量中等收入国家城市环境中的食品店和餐厅食品环境。此类研究有助于为这些环境中的健康促进干预措施和政策提供信息。
