Reduced-Item Food Audits Based on the Nutrition Environment Measures Surveys.

INTRODUCTION: The community food environment may contribute to obesity by influencing food choice. Store and restaurant audits are increasingly common methods for assessing food environments, but are time consuming and costly. A valid, reliable brief measurement tool is needed. The purpose of this study was to develop and validate reduced-item food environment audit tools for stores and restaurants. METHODS: Nutrition Environment Measures Surveys for stores (NEMS-S) and restaurants (NEMS-R) were completed in 820 stores and 1,795 restaurants in West Virginia, San Diego, and Seattle. Data mining techniques (correlation-based feature selection and linear regression) were used to identify survey items highly correlated to total survey scores and produce reduced-item audit tools that were subsequently validated against full NEMS surveys. Regression coefficients were used as weights that were applied to reduced-item tool items to generate comparable scores to full NEMS surveys. Data were collected and analyzed in 2008-2013. RESULTS: The reduced-item tools included eight items for grocery, ten for convenience, seven for variety, and five for other stores; and 16 items for sit-down, 14 for fast casual, 19 for fast food, and 13 for specialty restaurants-10% of the full NEMS-S and 25% of the full NEMS-R. There were no significant differences in median scores for varying types of retail food outlets when compared to the full survey scores. Median in-store audit time was reduced 25%-50%. CONCLUSIONS: Reduced-item audit tools can reduce the burden and complexity of large-scale or repeated assessments of the retail food environment without compromising measurement quality.

Nutrition-labeling regulation impacts on restaurant environments.

BACKGROUND: Recent attempts to improve the healthfulness of away-from-home eating include regulations requiring restaurants to post nutrition information. The impact of such regulations on restaurant environments is unknown. PURPOSE: To examine changes in restaurant environments from before to after nutrition-labeling regulation in a newly regulated county versus a nonregulated county. METHODS: Using the Nutrition Environment Measures Survey-Restaurant version audit, environments within the same quick-service chain restaurants were evaluated in King County (regulated) before and 6 and 18 months after regulation enforcement and in Multnomah County (nonregulated) restaurants over a 6-month period. Data were collected in 2008-2010 and analyses conducted in 2011. RESULTS: Overall availability of healthy options and facilitation of healthy eating did not increase differentially in King County versus Multnomah County restaurants aside from the substantial increase in onsite nutrition information posting in King County restaurants required by the new regulation. Barriers to healthful eating decreased in King County relative to Multnomah County restaurants, particularly in food-oriented establishments. King County restaurants demonstrated modest increases in signage that promotes healthy eating, although the frequency of such promotion remained low, and the availability of reduced portions decreased in these restaurants. The healthfulness of children's menus improved modestly over time, but not differentially by county. CONCLUSIONS: A restaurant nutrition-labeling regulation was accompanied by some, but not uniform, improvements in other aspects of restaurant environments in the regulated compared to the nonregulated county. Additional opportunities exist for improving the healthfulness of away-from-home eating beyond menu labeling.

Shame, guilt, symptoms of depression, and reported history of psychological maltreatment.

OBJECTIVE: The purpose of the present study was to provide preliminary data extending earlier research on shame and guilt, examining their relationships both to symptoms of depression and to psychological maltreatment. Symptoms of depression were expected to correlate positively with shame, but not with guilt. Psychological maltreatment was also expected to correlate positively with shame. The relationship between psychological maltreatment and guilt was examined on an exploratory basis. METHOD: Two hundred and eighty participants from a public community college and a private university completed scales assessing shame, guilt, depression, and history of childhood psychological maltreatment. Pearson correlations were conducted with all data. RESULTS: Results indicated that symptoms of depression were positively correlated with both shame and guilt. Partial correlations were then conducted in which the linear effects of shame were removed from guilt. In this latter analysis, guilt was no longer positively correlated with symptoms of depression. Psychological maltreatment was also positively correlated with depression and with shame, but not with guilt. CONCLUSIONS: These results highlight the significance of psychological maltreatment in the relationship to the self-conscious emotions of guilt and shame. As in earlier studies, shame has been consistently correlated to poor psychological functioning, while guilt appears to be relatively unrelated to pathological functioning.