142nd APHA Annual Meeting and Exposition

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Development and evaluation of a food environment survey to assess the risk of adolescent overweight in three urban environments of Kunming, China

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Jenna Hua, MPH, RD , School of Public Health, Environmental Health Sciences, University of California, Berkeley, Berkeley, CA
Sue Eom , Seoul National University, Seoul, South Korea
Yan Li , Kunming Medical University, Kunming, China, China
May Wang, DrPH , Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA
Edmund Y. W. Seto, PhD , School of Public Health, University of Washington, Seattle, WA
INTRODUCTION: Culturally-specific food environment survey instruments are important tools for studying changing food availability and pricing. Here, we present findings from an effort to develop and evaluate food environment survey instruments for use in a rapidly developing city in southwest China.

  METHODS: We developed two survey instruments (for stores and restaurants), each designed to be completed within 10 minutes. Two pairs of researchers surveyed a pre-selected 1-km stretch of street in each of three socio-demographically different neighborhoods to assess inter-rater reliability. Construct validity was assessed by comparing the food environments of the neighborhoods to cross-sectional height and weight data obtained on 575 adolescents in the corresponding regions of the city.

  RESULTS: 273 food establishments (163 restaurants and 110 retail stores) were surveyed. Sit-down, take-out, and fast food restaurants accounted for 40%, 21% and 19% of all restaurants surveyed. Tobacco and alcohol shops, convenience stores and supermarkets accounted for 25%, 12% and 11%, respectively, of all stores surveyed. We found a high percentage of agreement between teams (>75%) for all categorical variables with moderate kappa scores (0.4-0.6), and no statistically significant differences between teams for any of the continuous variables. More developed inner city neighborhoods had a higher number of fast food resturants and convenience stores than surrounding neighborhoods. Adolescents who lived in the more developed inner neighborhoods also had a higher percentage of overweight, indicating well-founded construct validity.

  DISCUSSION: These instruments may be useful in future systematic longitudinal assessments of the changing food environment and its health impact in China. 

Learning Areas:

Biostatistics, economics
Chronic disease management and prevention
Environmental health sciences
Epidemiology
Public health or related public policy
Public health or related research

Learning Objectives:
Design culturally-specific food environment surveys Evaluate and validate food environment surveys Assess neighborhood food environments using food environment surveys

Keyword(s): Obesity, Built Environment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I jointly oversee the survey development, data collection, and lead data analysis and writing.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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