Center for Epidemiological Research in Nutrition and Health, Department of Nutrition, Faculty of Public Health-University of Sao Paulo, Av. Dr. Arnaldo, 715-Cerqueira César, Sao Paulo 01246-904, Brazil.
Int J Environ Res Public Health. 2021 Apr 1;18(7):3690. doi: 10.3390/ijerph18073690.
The aim of this study was to develop and validate a scoring system, based on AUDITNOVA, to assess the healthiness of the consumer food environment, considering food availability, price, advertising, and placement strategies. Audited data of 650 food retailers were used to develop, validate, and test the consumer food environment healthiness score. To compose the score, the reference was the Dietary Guidelines for the Brazilian Population. The total and subscores were standardized for a scale from 0 to 100. Construct validity was assessed using the Kruskal-Wallis Dunn tests. Cronbach's alpha coefficients were calculated to determine the consistency of the scores. The median score was 33.7 (p25 = 26.9; p75 = 42.1). The public and private specialized indoor fresh food markets showed the highest medians; otherwise, bakeries and food retailers with the predominant sale of ultra-processed foods showed the lowest. The score was able to satisfactorily classify the extreme food retailer groups by the predominant sale of fresh or minimally processed foods and the predominant sale of ultra-processed foods. The results of Cronbach's alpha showed excellent internal consistency (α = 0.91). The score helped to provide an overall assessment of consumer food environment healthiness and was able to classify food retailer groups as healthy and unhealthy according to the degree of processing of the available foods.
本研究旨在开发和验证一种基于 AUDITNOVA 的评分系统，以评估消费者食品环境的健康程度，同时考虑食品的可得性、价格、广告和放置策略。使用 650 家食品零售商的审核数据来开发、验证和测试消费者食品环境健康评分。为了组成评分，参考了巴西人口的饮食指南。总得分和子得分均进行了标准化，范围为 0 至 100。使用 Kruskal-Wallis Dunn 检验评估结构有效性。计算 Cronbach's alpha 系数以确定分数的一致性。中位数评分为 33.7（p25 = 26.9；p75 = 42.1）。公立和私立专业室内新鲜食品市场的中位数最高；另一方面，以销售超加工食品为主的面包店和食品零售商的中位数最低。该评分能够根据新鲜或最低限度加工食品的主要销售和超加工食品的主要销售，对极端食品零售商群体进行满意的分类。Cronbach's alpha 的结果显示出极好的内部一致性（α = 0.91）。该评分有助于对消费者食品环境健康状况进行全面评估，并能够根据现有食品的加工程度对食品零售商群体进行健康和不健康的分类。
