Nutritional Environment Measures Survey

NEMS RESTAURANT MEASURES

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

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

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

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

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:

The NEMS-P scoring guidance is in Table 1. 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).

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.

NEMS – Grab and Go

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.