Skip to main content

Table 1 Description of studies and instruments included in the review

From: Measurement of availability and accessibility of food among youth: a systematic review of methodological studies

Author, year, country Sample description (sample size, age, gender distribution) Construct assessed Name of instrument Instrument type (self-report, interview etc) Number of items Methods for item development (grading 1–4)
Boles et al., 2014, US [30] 83 caregivers of preschool children ((51% female), 48.1 (19.2) months), 57% aged 30–49, 89% high school diploma or less, 22% hispanic, 47% with incomes < $27,000. Trained researchers conducted observations on 25 randomly selected homes (rater-parent inter-rater reliability study) Availability of different food items categorized as snacks, cereals, drinks, fruits and vegetables, meats, dairy, breads, ready to eat meals and others in the home Home-IDEA (Home Inventory Describing Eating and Activity Development) Home inventory 131 initially, 62 found to be unacceptable based on κ values (comparing observer-parent reports) and removed (categorized into 9 food categories) Based on a previously validated instrument, new items added (to capture foods potentially consumed by families with geographical and SES diversity) based on existing food frequency questionnaires and an exisiting allowable foods list, further items added based on expert opinion. Items removed after assessment of criterion validity- score = 4
Dewar et al., 2012, Australia [31] 173 secondary school students, age: 13.7 (1.2), 62% female, 80% Australian Availability of healthy snacks, healthy drinks, fruit and vegetables in the home and in general   Self-report questionnaire 6 initially reduced to 4 Qualitative methods used to develop and refine the scale; literature review was also used; experts were consulted to among other things assess content validity; focus groups were then conducted to further review and refine scales and after changes were made, expert panel was again asked to review the scales - score = 4
Bennaroch et al., 2011, Spain [32] 591 students aged 15–16 years, 50% girls, 61% from public schools, 37% had only the male parent working Accessibility of fish, fruit and vegetables at home and ability to eat everything and in reasonable amount Food consumption, intentions and preferences assessment test- FCIPAT questionnaire Self-report questionnaire 3 items Reviews of previous surveys on adolescent dietary habits and their correlates led to the first version of the questionnaire; the items were assessed by experts and changes made. Finally, a pilot study was conducted among students of same age and items were further refined - score = 4
Vyduna et al., 2016, US [33] Parents of young adolescents, n = 166, 87% female, 88% between 31 and 50 years, 61% Hispanic, 54% with college degree; 71 parents included in test-retest study Availability of calcium-rich foods in the home   Self-report questionnaire 10 items Open-ended person interviews were conducted with parents of young adolescents to identify factors to be included; the social cognitive theory was used to define the constructs and constructs’ subscales in the overall questionnaire; cognitive interviewing was then used to evaluate the first drafts of the questionnaire; finally, field testing was conduted, content validity was assessed by a group of experts, score = 4
Petty et al., 2013, Brazil [34] Parents of young children (mean age 8.3 (1.2), 52% girls), 582 parents, mostly mothers (86%), 71% of mothers and 60% of fathers had finished college; 55 participated in test-retest and 58 in convergent validity test Availability of fruits and vegetables at home Parent Mealtime Action Scale (PMAS), Portuguese version Self-report questionnaire 3 items The authors aimed to validate the PMAS which was previously validated using American parents, score = 2
Hearst et al., 2012, US [35] 30 low income, non-English speaking families (Somali and Hispanic) with children of pre-school age; only 3 had some college or graduate degree and only 4 had an annual household income of greater than 30,000 USD per year Availability of dairy, vegetables and fruits, meats and other non-diary protein, added fat, frozed desserts, prepared desserts, savoury snacks, micorwavable/quick-cook foods, bread, candy, cereals and beverages at home. Accessibility of selected foods at home Home Food Inventory (HFI) translated into Somali and Spanish Checklist 12 food categories with subcategories for availability, 1 item on obesogenic food environment, 4 items for accessibility Existing HFI was used and focus groups were used to modify the form as it relates to potential cultural food preferences; modifiations were then made - score = 3
Rimkus et al, 2013, US [36] 120 stores located in low, middle and high income tracts, and within and outside city limits were surveyed by 6 trained observers Availability of healthy and unhealthy food items and beverages in stores, number of fruit and vegetable options available Bridging the gap - Food store observation Form (BTG-FSOG Observation form 56 items Initially developed building on existing instruments and inputs from researchers, practitioners and advodates with expertise in nutrition, measurement of the food environment and food policy, then pre-tested and modified - score = 4
Nepper et al, 2014, US [37] 13 pairs of parents and their children aged 9-12 years (instruments filled in by parents); mean age of parents was 40.2 (4.9), the majority were mothers, 9 parents were college graduates and 9 were non-hispanic white, 11 had an income of 50,000 dollars or more Availability and accessibility of healthy and unhealthy food items, and of fruits and vegetables separately at home, HFA instrument adapted from Boles et al., 2013 Home Food Assessment Tool (HFA) and 30-day Home Food Environment Survey (HFES) Self-report inventory and survey instrument HFA: 23 items (healthy foods and beverages, unhealthy foods and beverages); 18 items (fresh fruits); 14 items (fresh vegetables); HFES: 18 items Both instruments were modified from previously validated instruments - score = 2
Boles et al., 2013, US [38] Trained research assistants conducted the survey in homes, 82 families of preschool children (mean age of 50.9 months); 35 obese and 47 healthy weight children, majority had income between 50,000–124,000 USD; for the inter-rater reliability, 18 observers included Availability and accessibility of 23 healthy and unhealthy food items and of fruits and vegetables at home Home Health Environment (HHE) instrument Observation tool 23 food items (healthy foods and beverages, unhealthy foods and beverages); 18 items (fresh fruits), 14 items (fresh vegetables) Previously validated self-report instruments (with good construct and test-retest reliability) provided the preliminary item pool, experts were consulted to further refine items and operationalize definitions - score = 4
Nathan et al., 2013, Australia [39] 42 primary school principals; 57% of schools were medium size, 67% were government schools, 98% were urban and 67% were in higher socioeconomic areas Availability of healthy and unhealthy food items at school via a) canteen, b) vending machines, c) via fundraisers School Environment Assessment Tool (SEAT) Computer assisted telephone survey 26 items (vending machine), 13 items (canteen), 13 items (fund raising) The instrument was developed by conducting a systematic review of the literature, followed by a draft survey which was assessed by experts, further refined and pilot tested among primary school principals to check for acceptability and comprehension - score = 4
Lee et al., 2014, US [40] Directors from 35 afterschool programs in 3 cities (step 1 conducted in 20 programs, and after revisions step 2 was conducted in 15 programs), low income, racially diverse settings Availability of fruit, vegetable, grains, whole grains, water, 100% juice in after-school settings Observations of physical activity participation and snack consumption (OSNAP-OPAT) Observation tool 5 items (fruit or vegetable, grains, whole grains, water, 100% juice) Items were focused on measuring specific intervention goals; the tool was piloted during after-school program time, reviewing the usefulness of instructions and clarity and feasiblity - score = 3
Dodds et al., 2014, Australia [41] Nominated supervisors and room leaders of 42 childcare services (preschools and long day care services), medium SEIFA for 69%, majority of services were long day care services (62%), 88% open 5 days Availability of cordial, flavoured milk, fruit juice, water, plain milk, soft drink, healthy foods, confectionary, chocolate, ice-cream, fruit or vegetable pieces, salads or platters, pretzels, plain popcorn or oven-baked chips, sweet biscuits with chocolate or cream filling in childcare services   Self-report survey instruments 14 items (8 beverages and 6 foods) Survey items were based on literature review and on existing tools, together with surveys previously developed and implemented by the research group, as well as regulations about service policies and practices related to healthy eating, obesity etc., surveys were piloted to assess comprehension and understanding, and items were then amended score = 4
Izumi et al., 2014, US [42] Trained observers conducted the study in 50 food stores located near elementary and middle schools Availability of healthier alternatives to energy-dense snacks and beverages consumed by children in food stores SNACZ food store checklist Checklist 48 snacks and beverages (6 beverages, 18 snacks, 24 fresh and frozen vegetables) The checklist was developed using a multi-step process, with snack and beverage items consumed by children identified by reviewing relevant literature and tools and surveying more than 750 children. The identified items were pretested in 10 food stores, score = 4
Krukowski et al., 2011, US [43] Trained raters completed the instrument at 81 schools, 58% elementary, 61% children eligible for free/reduced lunch, 73% white children, 42% medium sized Availability of fruits, vegetables, grains, side dishes, entrees, chips, desserts, a la carte, beverages in public school cafeterias SCNA-O (to observe foods offered in school cafeterias) and School Cafeteria Nutrition Assessment (SCNA)-M (to evaluate monthly school lunch menus) Observation tool and menu assessment form 9 broad categories of foods/beverages School menus from across the US were reviewed, school lunches were observed, and related food availability measures were evaluated; the items were then pre-tested and revisions were made; a pilot study was also conducted to assess the feasibility and reliability of the SCNA and modifications to the rater instruction manual were made, score = 4
Ding Ding et al., 2012, US [44] Adolescents (age: 14.6 (1.7), 51% females, 53% non-hispanic white), children (age: 8.3 (1.9), 52% females, 78% non-hispanic white), parents (age: 39.6 (7.7), 85% females) (n = 458), median household income $ 60,000–69,999 Availability of fruits and vegetables, more-healthful food, less-healthful food at home   Self-report questionnaire 19 items (3 for availability of fruits and vegetables, 7 for availability of more-healthful foods, 9 for availability of less-healthful foods) Instrument developed based on ecological model and on a list of food items recommended by other authors - score = 3
Singh et al., 2011, six European countries (Belgium, Greece, Hungary, the Netherlands, Norway, Spain) [45] 10-12 year old children (n = 730 for test-retest reliability and n = 96 for construct validity). For test-retest study, number ranged from 86 (Spain) to 155 (Greece), number ranged between 15 and 20 per country for construct validity study Availability of fizzy drinks or fruit squash, fruit juice and breakfast products at home ENERGY-child questionnaire Self-report questionnaire 3 items The questionnaire was developed based on existing validated questionnaire used in different European settings, the availability items were taken from the pro-children study; pre-tested among small samples in all participating countries to examine comprehensibility and duration of completion, score = 3
Ward et al., 2015, US [46] Teachers (average age was 37 years, 28% had bachelor’s degree or higher) in 50 early care and education centers provided information over 4 days. The centers had 52% of enrolled children who received subsidies towards their enrollment fees, and 57% were hispanic Availability of foods and beverages (total grains, meat or alternative, fruit, vegetables, milk, 100% fruit juice, water) in early care and education centers - called serving in the paper Staff Daily Questionnaire, which is one of the surveys of the Environment and Policy Assessment and Observation- Self report (EPAO-SR) instrument Self-report questionnaire 7 categories of food items Instrument developed in different phases: modification of items from existing observation-based instrument; review by community advisory group and experts; cognitive interviews with center directors and classroom teachers. Revisions were subsequently made, score = 4
Anzman-Frasca et al., 2015, US [47] Program leaders from 65 OST (Out-of -School-Time) programs; 1st sample (n = 31 programs), mean number of children = 29, <5% were < 5 years and 50% were 8–12 years, 45% girls, 50% white, 48% traditional afterschools; 2nd sample (n = 34 programs), mean number of children = 11, <1% were < 5 years and 77% were 8–12 years, 32% girls, 95% white, 91% enrichment programs Availability of foods and beverages (fresh FV, processed FV, salty snacks, sweet snacks, protein snacks, water, milk, juice, sweetened beverages) in outof-school-time programs Out-of -School-Time Snacks, Beverages and Physical Activity Questionnaire (OST-SBPA) Self-report questionnaire 9 categories of foods and beverages A team of nutrition researchers developed questionnaire; grouping made based on categories created by reviewing categories used in national surveillance datasets, snacks observed in field studies of OST and childcare programs, and evidence linking snacks and beverages with energy intake and weight status. Pilot testing was then done in a separate group of program leaders, score = 3
Fulkerson et al., 2012, US [48] 51 adults, mean age 39.4 (7.0), 94% female, 68% white, 62% had a college degree Availability of foods at home meals (served at meals): meat or other protein, beverages, vegetables, other starch, dessert, bread, salad, fruits   Self-administered screening instrument 8 categories of foods assessed (with sub-categories) Initial list of items drafted by investigators, opinions from experts requested for further instrument development and assessment of face validity. The instrument was then revised. Field testing was conducted to assess ease of completion and identify foods difficult to include on the form, score = 4
Hua et al., 2014, China [49] Two pairs of trained researchers assessed 141 restaurants and 84 retail food stores in three neighborhoods that vary in real estate prices, development histories and land use characteristics Availability of basic food items in stores; availability of food and drink categories in restaurants   Survey instruments (one for store, one for restaurant) 9 categories of basic food items (stores), 9 categories of foods (restaurants), 10 categories of drinks (restaurants) Conceptualization of survey instruments was informed by a previous instrument, was done in collaboration with local collaborators. Instruments were pretested for wording and content and then finalized for pilot testing in socioeconomically diverse neighborhoods, score = 3