Nutritional Environment Measures Survey

NEMS RESTAURANT MEASURES

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Assessments of nutrition environments at restaurants focus on eight types of food indicators: healthy main dish choices (low-fat, low-calorie, healthy main dish options), availability of fruits and vegetables without added sauce, whole grain bread and baked chips, beverages, children’s menus, signage and promotions, facilitators and barriers to healthy eating, pricing, and accessibility.

The NEMS-R tool has been updated since its original publication. The original published version of the instructions and the restaurant measures can be accessed by clicking on this link: NEMS-R survey and instructions. The updated version of the NEMS-R tool has an expanded kid’s menu.

NEMS STORE MEASURES

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There are 11 measures of store nutrition environments which assess the availability and pricing differences between healthier and less-healthy options: milk, fresh fruits and vegetables, ground beef, hot dogs, frozen dinners, baked goods, beverages (soda/juice), whole grain bread, baked chips, and cereal.

The NEMS-S tool has been updated since its original publication. The original published version of the instructions and the store measures can be accessed by clicking on this link: NEMS-S survey and instructions.

The updated version of the NEMS-S tool has an added measure of cereal as well as some changes to the layout.

NEMS CORNER STORE MEASURES

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The NEMS Corner Store survey assesses the nutrition environments, specifically in corner stores. While similar to NEMS-S, NEMS-CS also measures canned and frozen fruits and vegetables as well as additional snack and beverage items commonly found in corner stores.

See a table of the differences between the NEMS-CS and the NEMS-S tools.

 

NEMS VENDING TOOL

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The NEMS-Vending assessment tool assesses the availability of healthier food and beverage options in vending machines.

On January 26, 2012, Carol Voss of the Iowa Department of Public Health and Susan Klein of Iowans Fit for Life presented on Iowa’s experiences in using the NEMS vending machine assessment tool and its website development and how their project was leading to policy and environmental change in Iowa.

*As of February 2020, the NEMS-V website is down. We have added the resources and tools to nems-upenn.org, courtesy of the Iowa Department of Public Health.

 

 

The Perceived Nutrition Environment

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Dr. Glanz and staff have developed a survey on the perceived nutrition environment (NEMS-P). Unlike other NEMS tools, NEMS-P is not an observational measure – it is an instrument to evaluate the perceived nutrition environment.

Survey items cover the following constructs: community nutrition environment, consumer nutrition environment, home food environment, food shopping behaviors, eating behaviors, and background characteristics.

Note:

To clarify the scoring for store access and restaurant access:

The NEMS-P scoring guidance is in Table 1 in the linked paper. The direction/meaning of higher scores generally means greater access to nutritious options or a higher ranking for the motivating factor in the item. For items worded in reverse, the scores should be reversed. Some of these are noted as such in the footnotes, but some of the multi-item constructs don’t clearly ‘call that out.’

Also, please note that in Table 1 in the article, there are minor mistakes regarding the total scores for access to stores (should be 14, not 16) and restaurants (should be 11, not 12).

ACCESS TO STORES

There are 4 items; the first has a score of 1 or 2, and the other 3 have 1 to 4.  Thus, the (correct) total possible scores are 4 – 14.

How do you travel….

• 2 points for driving your own car
• 1 point for all other choices

How long would it take you to walk…

• 10 minutes or less (4 points)
• 11 to 20 minutes (3 points)
• 21 to 30 minutes (2 points)
• More than 30 minutes (1 point)

How important are each of the following factors in your decision to shop at the store where you buy most of your food?

• Near your home (1 to 4 points, with very important = 4 points)
• Near or on the way to other places where you spend time (1 to 4 points, with very important = 4 points)

EXAMPLES – access to stores

So, if a person drives to the store they usually go to (2 points), it’s 10 minutes or less away (4 points), and it is very important that it is near their home (4 points) and very important that it is near or on the way… (4 points), they will get a score of 14.

If they walk (1 pt), it takes > 30 minutes (1 pt), and it’s not at all important that it’s near their home (1 pt) or near/on the way to other places (1 pt), they will get a score of 4

ACCESS TO RESTAURANTS

There 3 items, the first two have scores 1 to 4 and the third has a score of 1 to 3.  Thus the (correct) total possible scores are 3 – 11.

How long would it take you to walk… [2 questions – fast-food restaurant & sit-down restaurant]

• 10 minutes or less (4 points)
• 11 to 20 minutes (3 points)
• 21 to 30 minutes (2 points)
• More than 30 minutes (1 point)

The question about convenience is later in the survey, where there are items rating the importance of various features of restaurants –

When you eat out at a restaurant or get take-out food, how important to you is…?

There is a 3-point response option to “convenience”

• not at all (1 point), somewhat (2 points), very (3 points)

The composite score of access to restaurants follows a similar pattern as access to stores. Also note that some researchers don’t use all of the items/constructs, and that is fine if you don’t need them for the purpose of your study.

 

Access the journal HERE

Access the journal .PDF HERE

 

 

NEMS – Grab and Go

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Brian Lo and other collaborators from Canada have published NEMS-GG, an audit tool assessing food outlets that sell grab and go foods around a University setting. The instructions are embedded in the tool so there is not a separate protocol.  If you have specific questions related to the tool, you will need to email Brian Lo, brianlc.lo@alum.utoronto.ca.