Protocol - Healthy Food Environments
Description
The Perceived Availability of Healthy Foods Scale from the Multi-Ethnic Study of Atherosclerosis (MESA) is a three-item, interviewer-administered scale that measures the quality and availability of fresh fruit and vegetables and low-fat products in the local neighborhood. Higher mean scores indicate greater availability of healthy foods in the neighborhood (i.e., low-fat products, fruits, and vegetables).
Specific Instructions
Although used in the context of a personal interview, the questions and response categories are straightforward and can be adapted to a self-administered format.
Availability
Protocol
The respondents are asked to think of their neighborhood as the area within a 20‑minute walk (approximately 1 mile) from their home and then to indicate the extent to which they agree with the following statements:
1. The fresh fruits and vegetables in my neighborhood are of high quality.
1[ ]strongly agree
2[ ]agree
3[ ]neither agree nor disagree
4[ ]disagree
5[ ]strongly disagree
2. A large selection of fresh fruits and vegetables is available in my neighborhood.
1[ ]strongly agree
2[ ]agree
3[ ]neither agree nor disagree
4[ ]disagree
5[ ]strongly disagree
3. A large selection of low-fat products is available in my neighborhood.
1[ ]strongly agree
2[ ]agree
3[ ]neither agree nor disagree
4[ ]disagree
5[ ]strongly disagree
Scoring Instructions
The Perceived Availability of Healthy Foods Scale is estimated by taking the average across the three items (note that only respondents with complete information for all three items can be assigned a scale score).
Lower mean scores indicate better availability of healthy foods (i.e., low-fat products, fruits, and vegetables).
Note that in papers by Moore, Diez Roux, and Brines (2008) and Moore et al. (2008), the five-point Likert scale was reported as follows: 0 = strongly agree; 1 = agree; 2 = neither agree nor disagree; 3 = disagree; and 4 = strongly disagree.
Personnel and Training Required
No specific training is needed if data are collected through a self-administered questionnaire. If interviewers administer the questionnaire, the interviewer must be trained to conduct personal interviews with individuals from the general population and found competent to administer these particular questions (i.e., tested by an expert) at the completion of this training. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided.
Equipment Needs
These questions can be administered in a computerized or noncomputerized format (i.e., paper-and pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer or handheld computer to administer or to allow the respondent to self-administer a computer-assisted questionnaire.
Requirements
| Requirement Category | Required |
|---|---|
| Major equipment | No |
| Specialized training | No |
| Specialized requirements for biospecimen collection | No |
| Average time of greater than 15 minutes in an unaffected individual | No |
Mode of Administration
Interviewer-administered questionnaire
Lifestage
Adult
Participants
Adults, aged 18 years and older.
The respondent should be the primary food shopper in the household.
Selection Rationale
The protocol was selected because it is low burden, has good reported psychometric properties (Mujahid et al., 2007), and has been shown to be associated with higher-burden measures derived from secondary data and Geographic Information System (GIS) characterizations of the local food environments (Moore, Diez Roux, & Brines, 2008).
Language
Chinese, English
Standards
| Standard | Name | ID | Source |
|---|---|---|---|
| Logical Observation Identifiers Names and Codes (LOINC) | Healthy food environments proto | 63024-4 | LOINC |
| caDSR Form | PhenX PX210701 - Healthy Food Environments | 6196387 | caDSR Form |
Derived Variables
None
Process and Review
The Expert Review Panel #2 (ERP 2) reviewed the measures in the Demographics, Environmental Exposures, and Social Environments domains.
Guidance from ERP 2 includes:
• Revised descriptions of the measure
Back-compatible: no changes to Data Dictionary
Previous version in Toolkit archive (link)
Protocol Name from Source
Multi-Ethnic Study of Atherosclerosis (MESA), Neighborhood Section, 2000
Source
U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung and Blood Institute. (2000). Multi-Ethnic Study of Atherosclerosis (MESA). Neighborhood Section. Seattle, WA: Author. www.mesa-nhlbi.org
General References
Charreire, H., Casey, R., Salze, P., Simon, C., Chaix, B., Banos, A., Badariotti, D., Weber, C., & Oppert, J. M. (2010). Measuring the food environment using geographical information systems: A methodological review. Public Health Nutrition, 13(11), 1773-1785.
Davison, K. K., & Birch, L. L. (2001). Childhood overweight: A contextual model and recommendations for future research. Obesity Reviews, 2, 159-171.
Diez Roux, A. V. (1998). Bringing context back into epidemiology: Variables and fallacies in multilevel analysis. American Journal of Public Health, 88(2), 216-222.
Egger, G., & Swinburn, B. (1997). An "ecological" approach to the obesity pandemic. British Medical Journal, 315, 477-480.
Lyttle, L. A. (2009). Measuring the food environment: State of the science. American Journal of Preventive Medicine, 36(4, Suppl.), S134-S144.
McKinnon, R. A., Reedy, J., Morrissette, M. A., Lytle, L. A., & Yaroch, A. L. (2009). Measures of the food environment: A compilation of the literature, 1990-2007. American Journal of Preventive Medicine, 36(4, Suppl.), S124-S133.
Moore, L. V., Diez Roux, A. V., & Brines, S. (2008). Comparing perception-based and Geographic Information System (GIS)-based characterizations of the local food environment. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 85(2), 206-216.
Moore, L. V., Diez Roux, A. V., Nettleton, J. A., & Jacobs, D. R., Jr. (2008). Associations of the local food environment with diet quality: A comparison of assessments based on surveys and Geographic Information Systems. American Journal of Epidemiology, 167(8), 917-924.
Mujahid, M. S., Diez Roux, A. V., Morenoff, J. D., & Raghunathan, T. (2007). Assessing the measurement properties of neighborhood scales: From psychometrics to ecometrics. American Journal of Epidemiology, 165(8), 858-867.
National Cancer Institute. (2010). Risk factor monitoring and methods, measures of the food environment. Bethesda, MD: Author. Available from https://riskfactor.cancer.gov/mfe/.
Walker, S., Poston, C., II, & Foreyt, J. P. (1999) Obesity is an environmental issue. Atherosclerosis, 146, 201-209.
Protocol ID
210701
Variables
Export Variables| Variable Name | Variable ID | Variable Description | dbGaP Mapping | |
|---|---|---|---|---|
| PX210701_Large_Selection_Fresh_Fruits_Vegetables | ||||
| PX210701020000 | A large selection of fresh fruits and more | Variable Mapping | ||
| PX210701_Large_Selection_Low_Fat_Products | ||||
| PX210701030000 | A large selection of low-fat products is more | Variable Mapping | ||
| PX210701_Quality_Fresh_Fruits_Vegetables | ||||
| PX210701010000 | The fresh fruits and vegetables in my more | Variable Mapping | ||
Measure Name
Healthy Food Environments
Release Date
October 8, 2010
Definition
This measure utilizes a questionnaire to assess a respondent’s access to healthy foods and healthy eating alternatives in his or her local neighborhood.
Purpose
Obesity and being overweight are major public health issues, and it is well established that obesity is associated with a wide range of serious health outcomes, such as coronary heart disease, cancer, and diabetes. Until quite recently, food purchasing behavior and diet have been regarded purely as matters of individual free choice, and most intervention studies have targeted changing individual behavior (e.g., encouraging healthy eating). This perspective neglects social and material contexts in which food purchasing and diet decisions are made (Diez Roux, 1998). There is now considerable interest in the role of the built and social environments in promoting obesity and being overweight (Egger & Swinburn, 1997; Walker et al., 1999; Davison & Birth, 2000).
Keywords
Social environments, healthy food availability, fresh foods, food, restaurant, grocery store, neighborhood, community, obesity, Multi-Ethnic Study of Atherosclerosis, MESA, Perceived Availability of Healthy Foods Scale, National Heart, Lung and Blood Institute, NHLBI
Measure Protocols
| Protocol ID | Protocol Name |
|---|---|
| 210701 | Healthy Food Environments |
Publications
Bergstrom, H., et al. (2018) The usefulness of psychopathy in explaining and predicting violence: Discussing the utility of competing perspectives. Aggression and Violent Behavior. 2018 October; 42: 84-95. doi: 10.1016/j.avb.2018.07.006
Steinglass, J. E. and B. T. Walsh. (2016) Neurobiological model of the persistence of anorexia nervosa. J Eat Disord. 2016 May; 4: 19. doi: 10.1186/s40337-016-0106-2