NEMS SHOWCASE
We would like to share with others all of the exciting applications of the NEMS tools and make this a useful webpage to other NEMS users. We need your help in order to do that by letting us know about your NEMS projects and developments! Please keep us in the loop and send us an email.
This showcase page contains project descriptions that have been shared with us over the years that reflect the range of how people are using the NEMS tools for different purposes. We hope that everyone continues to keep us in the loop on their NEMS activities, emailing us new items that we can add to the showcase!
NEMS-R Projects & Applications
NEMS-S Projects & Applications
Combinations of NEMS tools used
NEMS-R PROJECTS AND APPLICATIONS
The New Ulm Minnesota Project
The Minneapolis Heart Institute Foundation has been doing a variety of NEMS related work in New Ulm, Minnesota over the last few years. Click here to see their poster of their convenience store program. They also have been doing an ambitious restaurant program. Late 2013, they completed a follow-up NEMS-R assessment and wrote a paper. Click here to read their paper.
The LiveWell EatWell Restaurant Challenge in Lawrence, KS (April 2013)
LiveWell Lawrence began the LiveWell EatWell Restaurant Challenge in late 2010. To date, 17 restaurants have accepted the challenge to offer healthy options for restaurant patrons. The program is managed and sustained by a WIC nutritionist at the Lawrence-Douglas County Health Department. The initiative rewards participating restaurants by promoting them and featuring their menu offerings in short stories posted on WellCommons, an award-winning community-journalism website that empowers local consumers and community health advocates reporting on and communicating about health and well-being issues that impact residents of Douglas County, Kansas.
To understand the relationship of food environments to eating and weight patterns, researchers need to examine accessibility of restaurants, but also factors that are believed to contribute to food choices in restaurants, including availability of more healthful foods, factors that facilitate or hinder healthful eating, pricing, and signage or promotion of healthful and unhealthful foods. As the program was originally designed, restaurants qualify for recognition by LiveWell required meeting several criteria including but not limited to the following: offering fresh, frozen or canned fruit; entrées prepared with lower-fat method (baked, steamed, poached, broiled or barbecued); offering smaller servings of entrées; offering lower fat or sugar free dessert options on menu; and providing a substitute for fried side dishes (e.g., side salad, vegetables, pasta salad or fresh fruit). This original program design is being modified as a result of an evaluation activity supported by the 2012-2013 CDRR grant. That activity resulted in the assessment of 56 Douglas County restaurants, including 17 that are currently participating in the LiveWell EatWell Restaurant Challenge. The assessment was completed using the nationally recognized Nutrition Environment Measures Survey for Restaurants (NEMS-R), which was recommended by the Dr. Anthony Randles, KDHE Physical Activity and Nutrition Program Manager. The NEMS-R assessment activity targeted current and prospective participants in the LiveWell EatWell Restaurant Challenge. As part of the 2012-2013 CDRR NEMS-R activity, a NEMS-R assessment report will be produced and provided to the 56 Douglas County restaurants evaluated in 2012. The analysis will summarize restaurant practices that facilitate or create barriers to healthful dining. The report will also identify opportunities for improvement in healthy dining.
Among EatWell restaurants, scores on the NEMS-R assessment ranged from a high of 17 to a low of 3 (excluding points allowable for kids’ menus, which not all participating restaurants had). Higher NEMS-R scores are associated with health promoting restaurant environments. 24% (4 of 17) of EatWell restaurants scored 10 or higher: Jason’s Deli (17), Carlos O’Kelly’s (15), Applebee’s (13) and Bambino’s (10).
NEMS smart phone app related to NEMS-R scores developed for Cerro Gordo County in Iowa! (Nov. 2013)
The Cerro Gordo County Department of Public Health, located in north central Iowa, has been using the NEMS assessment tools for many years now. They have recently used the NEMS-R tool to assess every restaurant in the county in an effort to encourage restaurant managers to enhance their restaurant environment through healthy strategies. They have put together a book explaining the NEMS-R tool, the restaurant’s respective NEMS-R score, and highlighted a few strategies the restaurants could implement to improve their score and consequently provide a healthier eating environment for residents. Click here to see the NEMS-R Strategy Guide for Improvement that they would like to distribute to the restaurant managers.
To complement the NEMS-R Scores, they have released a Smart Phone App that utilizes NEMS-R scores in the county for public use when deciding where to dine throughout Cerro Gordo County. As restaurants improve, their scores will be updated. The public health department received funding through the Iowa Department of Public Health Community Transformation Grant. Click here to view Powerpoint presentation.
To see the Apple version, click here.
The Children’s Menu Assessment (CMA) Tool and how it is being used to track policy change in California (2012)
On January 31, 2012, Becca Krukowski, PhD, University of Arkansas for Medical Sciences and Jennifer Otten, PhD, RD, Stanford Prevention Research Center presented on the use and scoring of the Children’s Menu Assessment tool and how the tool is being used to track the impacts of toy giveaway legislation in California.
Background: The Children’s Menu Assessment tool was adapted from the NEMS-R, to focus attention on restaurant children’s menus. This tutorial will provide training on the use of the tool, how to score it and an example of how it is being used in the field to track the impacts of California’s toy giveaway legislation – legislation prohibiting restaurants from distributing toy giveaways with meals, foods, and beverages not meeting minimal nutrition criteria. The tool and the instructions are attached and can also be found here).
- If you’d like to view the webinar, click here.
- CMA tool and the scoring
Chenango Health Network NEMS Assessment (Nov. 2011)
The Chenango Health Network who is the lead organization of a local health planning group conducted NEMS assessments of restaurants in their area in Chenango County in rural New York in late 2010. If you’d like to read about their results, click here.
After reviewing the results, the group members developed The Restaurant project which is an ecological approach to healthy eating, uses evidence-based chronic disease prevention strategies, builds on community strengths and resources and, uses a logic model which enables partners to assess and evaluate progress. If you’d like to see their logic model, click here.
They launched The Restaurant Project which involves seven locally owned restaurants in different parts of this rural county. They have been working with the restaurants–adding and promoting healthy food choices and have started to promote these restaurants locally. These restaurants also have a strong community connection. The next step is to begin a broad community education campaign about eating out and ordering choices. They have been partnering with worksites/employers who have wellness activities underway. Other restaurants would like to participate but due to funding and staffing, they will have to wait.
If you’d like to view the webinar, click here.
If you’d like to learn more about this project, you can contact Tina Utley Edwards, Executive Director of the Chenango Health Network at tina@chenangohealth.org
Assessing Kid’s Menus in Restaurants in Thurston County, Washington (April 16, 2010)
Making a Better Choice for Kids: What Restaurants Have to Offer
Washington State University Extension partnered with Thurston County Public Health and Social Services to investigate the availability of healthier children’s menu options at restaurants. An adapted Nutrition Environment Measures Survey (NEMS) was used to assess availability of healthier entrees, sides, and beverages listed on children’s menus. All but nineteen potentially eligible restaurants in Thurston County, Washington were visited. After pre-testing and revising, surveys were completed by trained surveyors. A total of 129 quick service and 161 sit down restaurants were visited between April-May 2008. A children’s menu was present at 187 or 64% of all restaurants. Menu text, meal names, and food items were sometimes ambiguous or difficult to read. Zena Edwards, WSU Thurston County Extension Food Safety & Nutrition faculty will share lessons learned for conducting this type of assessment and plans for use of the data.
- To view the webinar, please click here.
- To read a brief summary of their findings, click here.
- To view their sit-down assessment tool, click here.
- To view their quick service assessment tool, click here.
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NEMS-S PROJECTS AND APPLICATIONS
The Detroit Food Map
Dr. Alex Hill, a professor at Wayne State, has an amazing website, https://detroitfoodmap.com, which incorporates his ongoing use of NEMS-S and NEMS-CS. He has been using NEMS tools for many years to track the food landscape of Detroit.His NEMS-S project, Grocery Stores as Anchors of Community Nutrition, has been testing the hypothesis that Detroit is a food desert as well as testing the reliability of food stores as access points for nutritional and healthy food options, using NEMS-S measures and GIS analysis to survey the nutritional food environment of Detroit, specifically focusing on access to healthy options in Detroit’s food system.
For his NEMS-CS project, Healthy Food in Corner Stores, it was motivated by the claim often cited that more Detroiters shop at liquor stores than at grocery stores. He knows this to be false and recent research proves it to be false. However, there is a lack of knowledge about what is available in convenience, corner, and dollar stores.
Using NEMS-S to Study Food Access in Baton Rouge, LA.
Dr. Stephanie Broyles at the Pennington Biomedical Research Center in Baton Rouge, LA, received a grant from the American Heart Association to study children’s neighborhood food environments. Four data collectors used the NEMS-S program for tablets and visited over 550 food stores and produce markets in the parishes surrounding Baton Rouge. The data are being linked to other study data to investigate the impact of local food environments on a variety of health outcomes and behavior changes. The data have also been used to inform local food access policy within the East Baton Rouge Food Access Policy Commission’s findings and recommendations.
Presentation of NEMS-S Adaptation for Mexican Americans
Dr. Donna M. Winham presented the adaptation of the NEMS-S tool for the Mexican American population at the Experimental Biology Conference in April 2013 that she and Dr. Seline Szkupinski Quiroga collaborated on while at Arizona State University. The tool itself has not been publicly released but you can click here to view the slides on the adaptation. Dr. Winham is the owner and principal consultant at Howell Research Associates, LLC, and can be contacted at dmwinham@howellresearch.org.
Using NEMS-S in a Latino Neighborhood in Milwaukee, WI (about 45 minutes) (2012)
Stephanie Calloway and Tatiana Maida of CORE/El Centro in Milwaukee, WI trained some promotoras to collect NEMS-S data. Learn about their project and results in this webinar. If you would like to contact them to learn more, email Stephanie at stephaniec@core-elcentro.org.
If you’d like to view the webinar, click here. If you would like to read more in-depth about their project, please go to the publication page.
Omaha’s use of NEMS-S for their WIC Project (March 12, 2010)
In the spring of 2009, Douglas County Health Department (DCHD)began a NEMS project to address childhood obesity and prepare for the new WIC food packages. They customized the NEMS-S tool to better understand the adequacy of the retail food network and its capacity system to meet the demands of the new WIC food packages. The tool captured data regarding the type of food available, number of healthy choices within a food category, cost of those choices and quality of the fresh produce. The project initially identified 507 food outlets in the metropolitan area; 89 were eliminated as single food outlets as bakeries and butcher shops. Fifty trained community volunteers collected data in 385 retail food establishments in the metropolitan area over a one month period. Stores with multiple healthy options in each of the five groups (fruits, vegetables, dairy, protein, and grains) were mapped with a one-mile radius. The results of the survey demonstrated geographic areas where the retail food system has limited ability to meet the needs of citizens and stores whose inventory had the potential to improve their nutrition profile. Since the initial assessment was conducted, follow-ups have been done to continue to assess the changes in the food landscape.
- To listen to Mary Balluff describe the initial project, please view the webinar.
- A more detailed report of Omaha’s work can be found here.
- To view the modified NEMS-S tool used in the project (Appendix B pg. 52) along with a detailed report on the follow-up NEMS assessment, click here.
Seattle, WA (2010)
Graduate student Sara Coulter wrote her thesis on her NEMS-S data collected in a low-income racially diverse neighborhood in Seattle, WA. To read the abstract of her results, please click here. To read the entire thesis, click here.
Leon County, Florida (2010)
Angela Leone, a graduate student at UGA analyzed the NEMS data collected in Leon County, Florida. To read the abstract of her results, please click here. You can also see her publication of the results on the publications webpage, under the NEMS-S section.
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COMBINATIONS OF NEMS TOOLS USED
CDC and NPS Tools and Protocol for Evaluating National Parks
CDC and the National Park Service modified NEMS tools to evaluate the nutrition environments in the national parks. To see each setting’s tool and protocol, click on each link below:
- Restaurant tool and protocol
- Store tool and protocol
- Snack shop tool and protocol
- Vending tool and protocol
- Public water tool and protocol
Hospital Food/Beverage and Physical Activity Environment Scans
Researchers at the Centers for Disease Control and Prevention have adapted a version of NEMS-R, NEMS-S and NEMS-V to assess the nutrition environment in hospitals.
They collaborated with hospitals across the country to conduct validity testing of these tools. The objectives of their project were to adapt a food & beverage retail environment assessment tool for hospitals and to disseminate these tools such that hospitals can increase knowledge about and monitor healthy hospital environments. To learn more about the project, click here.
Step-By-Step Guide to the Tool
Healthy Hospital Food and Beverage Environment Scan
If you are interested in learning more about the tool for your own use, please contact Dr. Brook Belay at hup1@cdc.gov.
NEMS Tool for Assessing the Nutrition Environment on College Campuses
Fifteen post-secondary institutions assessed their near and on-campus eating environment using NEMS-S and NEMS-R tools modified by Dr. Tanya Horacek from Syracuse University. In the study, Dr. Horacek concluded that a college campus provides an eating environment with an array of dining and shopping venues, most of which are not consistent with dietary recommendations for good health and obesity prevention. The findings of this study provide evidence in support of campus initiatives to evaluate and improve the quality of their own and surrounding eating environments.
The modifications made to NEMS-R to assess Campus Dining venues included the addition of a detailed evaluation of salad bars, vegetarian options, non-dairy milk alternatives, and cereals. NEMS-S was expanded to evaluate canned and frozen fruits and vegetables (F/V), other ground lean meats, vegetarian (meat alternative) products, and the cereal (by fiber criteria).
NEMS-R Campus Dining and protocol.
Please go to the publications page, to view Dr. Horacek’s published articles on the project.
NEMS Project in Rural Arizona Town
The Arizona Area Health Education Center (AHEC) is funding a project using both the NEMS-S and NEMS-R in a rural Arizona town as part of a comprehensive assessment of the community nutrition environment. The assessment combines data collected from surveys of members of a local coalition, community meetings, community surveys, secondary data, and the NEMS tools. The goal is to establish baseline measures and identify policy or environmental-level interventions that could potentially improve the local community nutrition environment. The assessment, including the NEMS project, is the preliminary research of a Mel and Enid Zuckerman College of Public Health, University of Arizona, doctoral student, Elizabeth Kizer, for a planned community based participatory research dissertation project. Six local residents are participating in the NEMS project by volunteering their time to be trained as NEMS raters and perform surveys in every licensed store and restaurant in town (a total of 35 surveys). A community action board will review the assessment, the NEMS data collected, and develop strategies to achieve policy or environmental-level change, which will guide this researcher and the local coalition, to improve the local food environment.
NEMS-Related Video from NEMS User
Sarah Moen, a student in Wisconsin who worked on a NEMS project over the summer of 2011, created a video of her NEMS experience. To see her video, click here.
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INTERNATIONAL PROJECTS
NEMS Project in Guatemala
Dr. Rebecca Kanter developed a mobile app with a modified NEMS-S to measure the Guatemalan food environment. To see her publication, please click here. [Make the link active to her publication on pubs page. If can take person straight to her name it would be better. With greater availability of ultra-processed foods and the transition away from subsistence agriculture, Guatemala is undergoing a nutrition transition. Whereby, with a greater availability of energy-dense, inexpensive foods high in fats and sugars, there is a greater consumption of these foods; this has often been associated with obesity. Amongst Guatemalan women aged 15-49 y, overweight and obesity have increased from rates of 34% to 59% between 1995-2008 (Kanter et al. 2013). To be able to conduct studies to assess associations between individual level diet, health, and socio-demographic data and food environment measures between urban and rural areas, respectively, in Guatemala, valid and reliable food environment measures are necessary.
To develop an appropriate NEMS-S tool for Guatemala, it was important to first pilot test the original NEMS-S in Guatemala in its verbatim, original form. This work is a collaboration between the Institute of Nutrition of Central America and Panama, specifically the INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), and CeSSIAM, Center for Studies on Sensory Impairment, Aging, and Metabolism, both located in Guatemala City, Guatemala. Two certified NEMS-S raters pilot tested the original NEMS-S on two separate occasions in four different supermarkets in Zone 3 of Quetzaltenango (Xela), Guatemala, the second largest city in Guatemala. We found that the original NEMS-S had both high inter-rater and test-test reliability. However, measurement validity varied by food item. Based on a subjective analysis regarding how easy raters could fill out the original NEMS-S, it performed very good for fruits and vegetables; good for juice, bread, chips, and cereal; but poor for lean meat, milk, frozen dinners, hot dogs, diet soda, and baked goods. Based on these results and Guatemalan dietary survey data, we have begun a process to design a modified NEMS-S tool for Guatemala; and are in the process of testing this tool. Ultimately, we plan to conduct studies that assess the relationship between individual level data and food environment measures between urban and rural areas of Guatemala with survey instruments of equal reliability, but adapted to the food-offering realities of the Western Highlands.
NEMS-P adaptation in Alicante (Spain)
We decided to adapt the NEMS-P survey to develop a tool that characterizes the perceived food environment in the Alicante área of Spain. First, we had two bilingual translators translate the original NEMS-P tool. Then with a committee of experts, a cultural adaptation was made and the most appropriate questions were selected. The initial adaptation of the questionnaire was created.
We are in the process of conducting the pilot study with the newly designed NEMS-P tool, following the same methodology as in the development of the original tool. We are going to pilot it in two neighborhoods that are classified as high and low socioeconomic status. We will analyze the data and assess the adaptation.
The emerging research project is titled: “Obesogenic Environment: Barriers to maintaining a healthy weight” funded by the Vice-Rectorate for Research, Development and Innovation at the University of Alicante (GRE14-20). Alba Martínez-García (PhD student), Dr. Eva Mª Trescastro, Dr. Eugenia Galiana, Dr. Pamela Pereyra, Manuela Ibarra, RN, Dr. Cristóbal Llorens, Dr. Carmen Ballesta, Dr. Josep Xavier Esplugues are collaborating on the research at the University of Alicante.
Master’s Student Assesses Food Environment at Maastricht University, The Netherlands
Eva Vobis, a master’s student at Maastricht University in The Netherlands, did a systematic assessment of the food environment on her campus for her thesis. She adapted the NEMS tools for her project and named them UNEMS for University Nutrition Environment Measures Survey which encompasses four different tools (the cafeteria, the snack shop, the food vending machine and the beverage vending machine). To learn more details of her project, please read her thesis.
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ADAPTATIONS AND MODIFICATIONS
NEMS-R & NEMS-C Accessibility Questions
Angela Drent (adrent@siouxlanddistricthealth.org) of the Sioux Land District Health Department of Iowa developed an 8 question modification to the NEMS-R tool to measure Accessibility for people with disabilities. Based on the results, one can offer recommendations to restaurants, some which can be implemented with little or no cost to the restaurant. The modification was adapted from the Community Health Inclusion Index On-site assessment tool.
NEMS-C NEMS-R Accessibility Questions
- Are menus available in any alternative formats?
- Is there at least one seating area that can accommodate a person using a mobility device and is not blocking paths?
- Are all, many, some or no counters 34” or less from the floor?
- Are all, many, some or none of the aisles/paths in the restaurant/cafeteria 3 feet wide or wider?
- Are there no obstacles, some obstacles or many obstacles in the aisles/paths that are difficult to traverse?
- Are checkout lanes designated with the international sign of accessibility?
- Is there an “assistance available upon request” sign posted at entrance, near salad bar or other hard to reach areas?
- Does the restaurant/cafeteria train staff to provide requested assistance and accommodations (reading menu, carry tray, lead around, assistance at self-serve areas)
Accessibility Form Sample
Cafeteria Accessibility Sample Recommendations
NEMS-P adaptation in Alicante (Spain)
We decided to adapt the NEMS-P survey to develop a tool that characterizes the perceived food environment in the Alicante área of Spain. First, we had two bilingual translators translate the original NEMS-P tool. Then with a committee of experts, a cultural adaptation was made and the most appropriate questions were selected. The initial adaptation of the questionnaire was created.
We are in the process of conducting the pilot study with the newly designed NEMS-P tool, following the same methodology as in the development of the original tool. We are going to pilot it in two neighborhoods that are classified as high and low socioeconomic status. We will analyze the data and assess the adaptation.
The emerging research project is titled: “Obesogenic Environment: Barriers to maintaining a healthy weight” funded by the Vice-Rectorate for Research, Development and Innovation at the University of Alicante (GRE14-20). Alba Martínez-García (PhD student), Dr. Eva Mª Trescastro, Dr. Eugenia Galiana, Dr. Pamela Pereyra, Manuela Ibarra, RN, Dr. Cristóbal Llorens, Dr. Carmen Ballesta, Dr. Josep Xavier Esplugues are collaborating on the research at the University of Alicante.
Master’s Student Assesses Food Environment at Maastricht University, The Netherlands
Eva Vobis, a master’s student at Maastricht University in The Netherlands, did a systematic assessment of the food environment on her campus for her thesis. She adapted the NEMS tools for her project and named them UNEMS for University Nutrition Environment Measures Survey which encompasses four different tools (the cafeteria, the snack shop, the food vending machine and the beverage vending machine). To learn more details of her project, please read her thesis.
Evaluation of ANCHOR Program using NEMS
In 2014, we, as evaluators at Texas A&M University, began work to evaluate a multifaceted program implemented by a large national non-profit at a variety of locations across the United States. Over the three-year span of the project, the main focus was to implement policy, systems, and/or environmental (PSE) changes focusing on nutrition, physical activity, and tobacco exposure. One of the main nutrition goals of this program was increasing access to healthy foods in a variety of settings. We chose NEMS as a key tool to be used in this evaluation because it was highly flexible and could be adapted to fit our needs, based on the chosen implementation settings, as this varied by community. We ultimately used the store tool in addition to variations of the tools to assess vending machines, cafeterias, and concessions. Local project staff collected baseline data for a variety of locations, and follow-up data if a PSE change was implemented. This allowed us to see whether or not the PSE change actually resulted in improvements to the food environment. In addition to the valuable information this provided us as evaluators, the local project managers appreciated quantifiable information and were able to use the information to start conversations with community organizations regarding potential improvements to the food environment.
ANCHOR stands for Accelerating National Community Health Outcomes through Reinforcing Partnerships. It is a community-based program being implemented in 15 sites across the United States by the American Heart Association/American Stroke Association (AHA/ASA). AHA was selected by the Centers for Disease Control (CDC) and Prevention to be a Community Capacity Building and Implementation grant awardee. The ANCHOR program will mobilize and enhance existing coalitions to accelerate prevention and population-based strategies that will reduce chronic disease and health disparities. These efforts will contribute to building a strong base for evidence-base prevention programming across the nation.
Farmers’ Market Audit Tool
Dr. Carmen Byker Shanks of Montana State and others have developed an audit tool for Farmer’s Markets modified from NEMS. Their recent publication of the tool (Shanks, C. B., Pitts, S. J., & Gustafson, A. (2015). Development and Validation of a Farmers’ Market Audit Tool in Rural and Urban Communities. Health Promotion Practice, 1524839915597899) is now available.
CDC and NPS Tools and Protocol for Evaluating National Parks
CDC and the National Park Service modified NEMS tools to evaluate the nutrition environments in the national parks. To see each setting’s tool and protocol, click on each link below:
- Restaurant tool and protocol
- Store tool and protocol
- Snack shop tool and protocol
- Vending tool and protocol
- Public water tool and protocol
NEMS Tool for Assessing the Nutrition Environment on College Campuses
Fifteen post-secondary institutions assessed their near and on-campus eating environment using NEMS-S and NEMS-R tools modified by Dr. Tanya Horacek from Syracuse University. In the study, Dr. Horacek concluded that a college campus provides an eating environment with an array of dining and shopping venues, most of which are not consistent with dietary recommendations for good health and obesity prevention. The findings of this study provide evidence in support of campus initiatives to evaluate and improve the quality of their own and surrounding eating environments.
The modifications made to NEMS-R to assess Campus Dining venues included the addition of a detailed evaluation of salad bars, vegetarian options, non-dairy milk alternatives, and cereals. NEMS-S was expanded to evaluate canned and frozen fruits and vegetables (F/V), other ground lean meats, vegetarian (meat alternative) products, and the cereal (by fiber criteria).
NEMS-R Campus Dining and protocol.
View Dr. Horacek’s published articles on the project, here.
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NEMS IN THE CLASSROOM
NEMS-S in a Political Science class at Johns Hopkins
John Hopkins Political Science Professor Adam Sheingate decided to use the NEMS-S tool with a summer class. Click here if you would like to read more about his class project.
NEMS-R in an Urban Health Issues Class at Long Island University
Professor Michelle Congo, of both St, Francis College and Long Island University, uses NEMS each year for an Urban Health class and a Nutrition class, combining some of the online training with fieldwork and a write-up of the experience.
Urban Health Issues NEMS-R Assignment & Submitted Student Sample
Nutrition Class NEMS-R Assignment & Submitted Student Sample
University of New Mexico Nursing Program uses NEMS
A group of nursing students in the Honor’s Class of University of New Mexico’s BSN nursing program chose to use NEMS to experience and participate in each step of the research process with their instructor, Dr. P.J. Wood. The group selected the concept of analyzing food environments surrounding high schools, wondering if having an open campus for lunch might expose students to a food environment which could either encourage or discourage healthy food choices. They used the NEMS tools to measure the food environments surrounding some Albuquerque open campus high schools.