Challenges in the measurement of the food environment

Background: To discuss the quality of secondary data and the methodological aspects involved in primary measurement of the food environment. Methods: This article deals with the methodological description of an ecological... [ view full abstract ]

Background: To discuss the quality of secondary data and the methodological aspects involved in primary measurement of the food environment.

Methods: This article deals with the methodological description of an ecological study to assess the food environment, defined by food stores selling fruit and vegetables, situated in the public service territories under the Health Academy Program promoted by the Brazilian Primary Care program. Secondary data about stores were provided by the municipal administration. In addition, identified sites were investigated through observations on site. Macro and micro-level variables were investigated, including type and location of the store, as well as availability, variety, and advertising of fruit and vegetables and ultra-processed foods. The kappa coefficient was utilized to verify the adequacy of, and agreement between, the classifications in the analysis.

Results: There was poor agreement between the primary and secondary data: kappa 0.30 (p <0.001). The following were identified as important methodological aspects for proper study design: conducting a pilot study to ensure adequacy of the staff, time and tools, use of a validated direct observation tool, and staff training. Regarding analysis of the food environment, there was a need for the combination of macro and micro-level variables by using indices such as the Healthy Food Store Index-HFSI in stores that sold food for consumption at home.

Conclusion: The quality of publicly available secondary data was low, requiring the validation of the bases used, as well as changes in flow monitoring for quality improvement. Valid databases and their proper analysis by combining macro and micro-variables are fundamental to the understanding and monitoring of the food environment, as well as in carrying out scientific research to foster the development of public policies.