Development and Testing of the Sustainable Nutrition Environment Measures Survey for Retail Stores in Ontario

OBJECTIVE To develop and test a tool to assess the price and availability of low-carbon footprint and nutritionally balanced dietary patterns in retail food environments in Ontario, Canada. DESIGN Availability and price of selected food from discount and regular grocery stores (n 23) in urban/rural areas of northern/southern Ontario were assessed with the Sustainable Nutrition Environment Measures Survey in 2017. SETTING Ontario, Canada. RESULTS Inter-rater reliability was high for price (intra-class correlation coefficients = 0·819) and for availability (Cohen's κ = 0·993). The tool showed 78 % of the selected food items were available in all stores. Overall, price differences were small between urban and rural locations, and northern and southern Ontario. The greatest price difference was between discount and regular stores. CONCLUSIONS The tool showed excellent inter-rater agreement. Researchers and public health dietitians can use this tool for research, practice and policy to link consumer-level health outcomes to the retail environment.