Nutritional Environment Measures Survey

Adaptations and Modifications

The NEMS Tools are observational measures to assess the community and consumer nutrition environments in food outlets, specifically stores, corner stores and restaurants. The measures focus on availability of healthful choices, prices and quality.

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.

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.

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.

Master Thesis, Eva Vobis

NEMS-V Poster Presentation at APHA 2013

Dr. Kimberly Narain used NEMS-V to analyze beverages sold in city parks and the impact of nutrition policy in Carson, CA.  She presented her findings at APHA 2013. 

NEMS Accessibility Modification

Angela Drent ( 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.

XYZ NEMS Accessibility Assessment
Cafeteria Accessibility Sample Recommendations
NEMS-C NEMS-R Accessibility Questions

Professor uses NEMS each year for Urban Health class

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 homework assignment sample
Nutrition Term Paper assignment

Honor’s Class of University of New Mexico’s BSN Nursing Program Choose 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.

We would like to share with others all of the exciting news and activities that relates to NEMS, whether it is a project update, a publication, grant funding, customizations, etc. Please send us an email at