Keywords
Food environment, nutrition, grocery stores, convenience stores, restaurants, Nutrition Environment Measures Survey, Lower Mississippi Delta, rural
This article is included in the Agriculture, Food and Nutrition gateway.
Food environment, nutrition, grocery stores, convenience stores, restaurants, Nutrition Environment Measures Survey, Lower Mississippi Delta, rural
Based on two thoughtful and thorough reviews of this data note, the following changes to the text were made. (1) Population characteristics of the five towns and the researchers’ reason for selecting the five towns were added. (2) Classification definitions for the food outlets – grocery stores, convenience stores, full-service restaurants, and fast food restaurants – were added. (3) Clarification that all outlets were physically visited to ensure that they were open, sold food, and classified correctly was provided. (4) Expanded descriptions of the survey tools used to measure the food outlets were provided. (5) Clarification about discussion and resolution of measurement discrepancies was provided. (6) Clarification about the types of scores available in the datasets (raw scores, component scores, and total scores) was provided and mention of ratio scores was removed because they are not included in the datasets. (7) The US Department of Agriculture Food Environment Atlas reference was updated to directly link to the documentation.
See the authors' detailed response to the review by Caitlin Caspi
See the authors' detailed response to the review by Donald Diego Rose
The Mississippi River Delta region is among the most socioeconomically disadvantaged areas of the United States (US) with less healthful food environments (e.g., low access to healthful foods, food insecurity) and poorer health outcomes than non-Delta counties in the same states and the nation1. Accessibility (location of healthful food outlets near neighborhoods, particularly in low-income and rural areas), availability (healthful options in local food outlets), and affordability (reasonable prices) of nutrient-dense foods are crucial to facilitate adoption of a healthful diet2–4. To inform future nutrition interventions designed for residents of the Lower Mississippi, the Delta Food Outlets Study was conducted to measure nutrition environments of towns located in this region.
Delta Food Outlets was an observational study designed to collect data on food outlets located in five rural Lower Mississippi Delta towns. These towns were selected because participants of a previously conducted nutrition intervention resided in the five towns and assessing environmental exposures potentially influencing their dietary habits was of interest to researchers5. The population of the five towns ranged from 1,750 to 32,612 residents. The percentage of the towns’population that was African American ranged from 49% to 91% and the percentage that lived below the federal poverty level ranged from 29% to 51%. Food outlet types included grocery stores, convenience stores, full-service restaurants, and fast food restaurants. The study was approved and classified as exempt by the Institutional Review Board of Delta State University. Data collection occurred from March 2016 through September 2018.
Grocery stores were identified by referencing two sources – the US Department of Agriculture (USDA) Food and Nutrition Service Supplemental Nutrition Assistance Program (SNAP) retailer locator6 and the Mississippi State Department of Health Restaurant and Food Facility Inspections website7. Convenience stores were identified by referencing three sources – the SNAP retailer locator6, the B2B Yellow Pages website8, and lists of current privilege licenses obtained from city clerks. Restaurants were identified by referencing the Mississippi State Department of Health Restaurant and Food Facility Inspections website7. Food outlets were classified using operational definitions contained in the Economic Research Service’s Food Environment Atlas documentation9. Grocery stores were defined as supermarkets and smaller grocery stores primarily engaged in retailing a general line of food, such as canned and frozen foods; fresh fruits and vegetables; and fresh and prepared meats, fish, and poultry. Convenience stores were defined as stores primarily engaged in retailing a limited line of goods that generally includes milk, bread, soda, and snacks. Full-service restaurants were defined as restaurants that provide food service to patrons who order and are served while seated and pay after eating. Fast food restaurants were defined as restaurants that provide food services (excluding snack and nonalcoholic beverage bars) where patrons generally order or select items and pay before eating. Before measurement, all outlets were physically visited to ensure that they were open, sold food, and were classified correctly. While the 266 food outlets included in the datasets represent the entire population of these types of food outlets in the five towns, they may not be representative of all such outlets located in rural Lower Mississippi Delta towns.
Nutrition environments of the food outlets were measured using the Nutrition Environment Measures Survey (NEMS) for grocery stores (NEMS-S), convenience stores (NEMS-CS), and restaurants (NEMS-R)10. NEMS tools are validated observational measures of retail store nutrition environments that focus on the availability of healthful food choices, quality of fresh produce (acceptable or unacceptable based on visual inspection), and comparative pricing between healthful and less healthful options (e.g., lower vs. higher fat, no added vs. added sugars, whole grain vs. refined grain) in 11 common categories11. The categories included milk, fruits, vegetables, ground beef, hot dogs, frozen dinners, baked goods, beverages, bread, chips, and cereal. For the restaurants, main dishes and main dish salads were measured rather than ground beef, hot dogs, and frozen dinners, and baked goods and cereal were not measured. Additionally, facilitators (e.g., nutrition information available) and barriers (e.g., supersizing available) for healthful eating were measured in restaurants. A comprehensive description of the Delta Food Outlets Study methodology and measures has been published elsewhere5.
The NEMS tools were recreated as electronic surveys using Snap Surveys software (version 11.20, Snap Surveys Ltd). All data were collected via tablets loaded with Snap Surveys software and stored on the Snap WebHost, an online mobile and secure survey management system. For quality assurance purposes, 25% of the food outlets were randomly selected for duplicate measurement. Discrepancies between measurements were discussed between senior researchers and data collectors and resolved (e.g., outlet re-visited to determine correct value).
Food outlets were scored using algorithms provided for the NEMS tools. Higher scores indicate a more healthful nutrition environment. The datasets include raw scores for each item, component scores (i.e., food groups, availability, pricing, quality, healthy options, facilitators, and barriers), and total scores. Scoring was performed using SAS® (version 9.4, SAS Institute Inc).
USDA National Agricultural Library’s Ag Data Commons: Delta Food Outlets Study, https://doi.org/10.15482/USDA.ADC/150370412.
This project contains all three datasets – NEMS-C (convenience stores), NEMS-G (grocery stores), and NEMS-R (restaurants) – along with their corresponding data dictionaries.
Data are available under the terms of the Creative Commons Zero "No rights reserved" data waiver (CC0 1.0 Public domain dedication).
The authors are grateful to Melissa Goodman, Debra Johnson, and Donna Ransome for their research support and Delta Health Alliance for their in-kind support.
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Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Public health nutrition, food security, food environment
Is the rationale for creating the dataset(s) clearly described?
Yes
Are the protocols appropriate and is the work technically sound?
Yes
Are sufficient details of methods and materials provided to allow replication by others?
Partly
Are the datasets clearly presented in a useable and accessible format?
Yes
Competing Interests: No competing interests were disclosed.
Reviewer Expertise: Food environment, food security, policies and interventions to address diet-related behaviors
Is the rationale for creating the dataset(s) clearly described?
Yes
Are the protocols appropriate and is the work technically sound?
Yes
Are sufficient details of methods and materials provided to allow replication by others?
Partly
Are the datasets clearly presented in a useable and accessible format?
Partly
References
1. Farley TA, Rice J, Bodor JN, Cohen DA, et al.: Measuring the food environment: shelf space of fruits, vegetables, and snack foods in stores.J Urban Health. 2009; 86 (5): 672-82 PubMed Abstract | Publisher Full TextCompeting Interests: No competing interests were disclosed.
Reviewer Expertise: Public health nutrition, food security, food environment
Alongside their report, reviewers assign a status to the article:
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