Adaptation and Validation of a Nutrition Environment Measures Survey for University Grab-and-Go Establishments

Purpose: To adapt and validate a survey instrument to assess the nutrition environment of grab-and-go establishments at a university campus. Methods: A version of the Nutrition Environment Measures Survey for grab-and-go establishments (NEMS-GG) was adapted from existing NEMS instruments and tested for reliability and validity through a cross-sectional assessment of the grab-and-go establishments at the University of Toronto. Product availability, price, and presence of nutrition information were evaluated. Cohen's kappa coefficient and intra-class correlation coefficients (ICC) were assessed for inter-rater reliability, and construct validity was assessed using the known-groups comparison method (via store scores). Results: Fifteen grab-and-go establishments were assessed. Inter-rater reliability was high with an almost perfect agreement for availability (mean kappa = 0.995) and store scores (ICC = 0.999). The tool demonstrated good face and construct validity. About half of the venues carried fruit and vegetables (46.7% and 53.3%, respectively). Regular and healthier entree items were generally the same price. Healthier grains were cheaper than regular options. Six establishments displayed nutrition information. Establishments operated by the university's Food Services consistently scored the highest across all food premise types for nutrition signage, availability, and cost of healthier options. Conclusions: Health promotion strategies are needed to address availability and variety of healthier grab-and-go options in university settings.