New tools to assess nutrition environments: Usefulness for obesity prevention and institutional awareness

Rate of overweight and obesity have reached epidemic proportions. Since treatment is generally ineffective and short-lived for most individuals, and rising rates are related, in large part, to environmental factors, changing the food environment is the next frontier in the war against obesity. To this end, we developed unique tools that administrators can use to assess their nutrition environments, with the hope that information provided by these tools will be useful in promoting institutional changes that support healthful eating and obesity prevention. Our Nutrition Environment Assessment Tool (NEAT) was developed for use in hospitals (H-NEAT), as these institutions should be prime examples of healthful environments, and universities (U-NEAT), whose population of young adults is especially vulnerable to weight gain. Each tool contains specific questions about the food environment (e.g. locations where food is available for purchase, methods of food preparation, portion sizes, existence of nutrition policies and/or standards, and provision of nutrition information). Both tools were pilot tested and then sent to either hospitals or universities to be validated, and assessed for usefulness, efficacy in assessing the particular nutrition environment, ease of use, whether they thought such a tool would be important to their institution and likelihood it would be used to help improve their institution's nutrition environment. Results indicate overall satisfaction, efficacy and interest in these tools. Future studies will collect data across a wider range of hospitals and universities and a “rating” scale will be developed as a standard against which institutions can measure environmental change.