School of Public Health, University of Alberta, Edmonton, AB, Canada.
School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada.
Int J Behav Nutr Phys Act. 2018 May 31;15(1):38. doi: 10.1186/s12966-018-0667-3.
Current methods for evaluating food marketing to children often study a single marketing channel or approach. As the World Health Organization urges the removal of unhealthy food marketing in children's settings, methods that comprehensively explore the exposure and power of food marketing within a setting from multiple marketing channels and approaches are needed. The purpose of this study was to test the inter-rater reliability and the validity of a novel settings-based food marketing audit tool.
The Food and beverage Marketing Assessment Tool for Settings (FoodMATS) was developed and its psychometric properties evaluated in five public recreation and sport facilities (sites) and subsequently used in 51 sites across Canada for a cross-sectional analysis of food marketing. Raters recorded the count of food marketing occasions, presence of child-targeted and sports-related marketing techniques, and the physical size of marketing occasions. Marketing occasions were classified by healthfulness. Inter-rater reliability was tested using Cohen's kappa (κ) and intra-class correlations (ICC). FoodMATS scores for each site were calculated using an algorithm that represented the theoretical impact of the marketing environment on food preferences, purchases, and consumption. Higher FoodMATS scores represented sites with higher exposure to, and more powerful (unhealthy, child-targeted, sports-related, large) food marketing. Validity of the scoring algorithm was tested through (1) Pearson's correlations between FoodMATS scores and facility sponsorship dollars, and (2) sequential multiple regression for predicting "Least Healthy" food sales from FoodMATS scores.
Inter-rater reliability was very good to excellent (κ = 0.88-1.00, p < 0.001; ICC = 0.97, p < 0.001). There was a strong positive correlation between FoodMATS scores and food sponsorship dollars, after controlling for facility size (r = 0.86, p < 0.001). The FoodMATS score explained 14% of the variability in "Least Healthy" concession sales (p = 0.012) and 24% of the variability total concession and vending "Least Healthy" food sales (p = 0.003).
FoodMATS has high inter-rater reliability and good validity. As the first validated tool to evaluate the exposure and power of food marketing in recreation facilities, the FoodMATS provides a novel means to comprehensively track changes in food marketing environments that can assist in developing and monitoring the impact of policies and interventions.
目前评估针对儿童的食品营销的方法通常研究单一的营销渠道或方法。随着世界卫生组织敦促在儿童环境中消除不健康的食品营销，需要一种能够综合探索来自多个营销渠道和方法的环境中的食品营销的暴露和影响力的方法。本研究的目的是测试一种新颖的基于场所的食品营销审计工具的重测信度和有效性。
开发了食品和饮料营销评估工具（FoodMATS），并在五个公共娱乐和体育设施（场所）中评估其心理测量学特性，随后在加拿大的 51 个场所进行横断面分析，以评估食品营销情况。评估员记录食品营销的次数、存在的针对儿童和与运动相关的营销技巧以及营销的实际规模。通过健康状况对营销活动进行分类。使用 Cohen's kappa（κ）和组内相关系数（ICC）测试重测信度。使用一种算法计算每个场所的 FoodMATS 得分，该算法代表营销环境对食品偏好、购买和消费的理论影响。更高的 FoodMATS 分数代表着暴露于更多（不健康、针对儿童、与运动相关、大型）食品营销的场所。通过（1）FoodMATS 分数与设施赞助金额之间的 Pearson 相关关系，以及（2）从 FoodMATS 分数预测“最不健康”食品销售的顺序多重回归，测试评分算法的有效性。
重测信度非常好到极好（κ=0.88-1.00，p<0.001；ICC=0.97，p<0.001）。在控制设施规模后，FoodMATS 分数与食品赞助金额之间存在很强的正相关关系（r=0.86，p<0.001）。FoodMATS 分数解释了“最不健康”特许经营权销售额（p=0.012）和总特许经营权和自动售货“最不健康”食品销售额（p=0.003）14%的变异性。
FoodMATS 具有很高的重测信度和良好的有效性。作为第一个验证评估娱乐设施中食品营销暴露和影响力的工具，FoodMATS 提供了一种全面跟踪食品营销环境变化的新方法，有助于制定和监测政策和干预措施的影响。
