Elsevier

Health & Place

Volume 21, May 2013, Pages 65-69
Health & Place

Short Report
Test–retest reliability of a questionnaire measuring perceptions of neighborhood food environment

https://doi.org/10.1016/j.healthplace.2013.01.008Get rights and content

Abstract

There is a lack of validated and reliable instruments on perception of the food environment, in particular for rural environments. We estimated the test–retest reliability of a questionnaire assessing perceptions of the food environment. A total of 101 primary food shoppers in South Carolina were interviewed by phone to assess their perceptions of the food environment and presence of different food outlet types in their neighborhood. The survey was repeated approximately one month after the initial administration. The intra-class correlation (ICC) and Phi coefficient are reported as measures of reliability. The majority of questions on perceptions of the neighborhood food environment appear highly reliable (ICCs range from 0.55 to 0.71), including the 3-item scale on healthy food availability (ICC 0.71). Compared to participants in rural areas, those in urban areas demonstrated better reliability for questions on opportunities to purchase fast food and perceived presence of a supercenter. More research is needed to evaluate potential rural–urban differences in reliability.

Introduction

Recent research suggests that an individual's perception of the food environment is associated with dietary intake (Hearst et al., 2012, Keita et al., 2011, Sharkey et al., 2010, Zenk et al., 2005). Several measures have been developed to characterize the food environment including observations of local neighborhoods, geographic information system (GIS)—based measurements, and self-reported perceptions of the food environment. Studies have shown that perceptions of food environment are reliable but not identical compared to GIS-based measurements (Echeverria et al., 2004, Moore et al., 2008a, Freedman and Bell, 2009). Subjective reports may provide information on the foods actually available and of interest to residents which are not captured by data on the locations of facilities.

The most well-known self-report instrument on the food environment was developed for the Multi-Ethnic Study of Atherosclerosis (MESA) to measure the perceived availability of healthy food options and lack of access to adequate food shopping within a person's neighborhood (Echeverria et al., 2004, Mujahid et al., 2007). Test–retest reliability of a 6-item healthy food access scale was assessed by Echeverria et al. (2004) in a pilot study of 48 volunteers living in New York City. The scale was subsequently refined to include only three items by Mujahid et al. (2007) in a subsample of the MESA study, which included 120 individuals in three study sites (Maryland, North Carolina, and New York).

Both aforementioned studies (Echeverria et al., 2004, Mujahid et al., 2007), as well as several others (Moore et al., 2008a, Moore et al., 2008b, Freedman and Bell, 2009, Keita et al., 2011) have been conducted in urban environments. To the best of our knowledge, only one has compared the perceptions of food environments of rural, suburban, and urban food pantry clients in Iowa and found that rural clients were significantly more likely to perceive their community as having an inadequate number of grocery stores or supermarkets (Garasky et al., 2004).

Several studies have collected data on perceived presence of specific food store outlet types in the neighborhood to evaluate the food environment (Gustafson et al., 2011, Zenk et al., 2009). However, no studies have been performed to assess the reliability of questions on perceived presence of specific food store outlet types.

This study sought to estimate the test–retest reliability of a questionnaire assessing self-reported perceptions of the food environment including the access, availability, and quality of healthy food options, and the perceived presence of specific food outlets in the neighborhood. We examined the test–retest reliability overall and examined whether there were any differences by urban-rural classification.

Section snippets

Study population and sub-study sample

In 2010, we conducted a cross-sectional study of residents of an eight-county region in South Carolina. Using a geographically-based sampling scheme, we randomly sampled 2477 residential listed landline phone numbers and sent out introductory letters. Recruitment calls were made between April and July 2010 and a total of 968 adults participated in the telephone survey. For the reliability sub-study, we randomly selected 155 respondents from the main sample and repeated the phone interview about

Results

Sample characteristics are presented in Table 2. The mean age of our sample was about 60 years and approximately 80% of the respondents were female. Two-thirds were non-Hispanic Whites and one third of respondents were African Americans and other minority race/ethnic groups. Approximately 75.5% of the respondents lived in rural areas. Difference on demographic variables was examined using the T-test for age and Chi Square analysis for the sex and race by urban-rural classification. The p values

Discussion

Our study builds on two previous publications on psychometric characteristics of perceptions of food environment questionnaires (Echeverria et al., 2004, Mujahid et al., 2007). The validity of the questionnaire compared to direct measures of food environment has been reported (Moore et al., 2012). The sensitivity and specificity were reported as 79.6% and 46.8%, respectively. When it comes to reliability, in the study by Echeverria et al. (2004), excellent test–retest reliability of a 6-item

Acknowledgement

This project was supported by Grant R21CA132133-02S1 from the National Cancer Institute. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.

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