Overweight and obesity affect 21.4% of children, 20.8% of adolescents and close to 60% of
adults in Costa Rica. The nutrition environment, which includes the social, political and
environmental factors that influence the access to food, might play an important role in the
development of obesity, as evidence suggests that local food stores are associated with
unhealthy eating patterns. An array of instruments and measures have been developed and
validated to assess food environment. The objective of this study is to adapt and validate the …

This study adapted and validated the NEMS-S in Costa Rica. Twenty-nine food stores were
assessed, three times, by two raters. Inter-rater precision and intra-rater stability were
quantified. Construct validity was determined with the known-groups method. Relative
precision ranged from 0.54 to 0.77 and was 0.87 for total score. Relative stability ranged
from 0.58 to 0.96 and was 0.94 for total score. For construct validity, the hypothesized
relationship that supermarkets would have the highest scores was supported. The …