Helpful Tips for Adaptingthe NEMS Measures

Below are a few tips that you may want to consider to simplify the NEMS measures as well as a few suggestions from past training participants on items to consider adding to the measures. If you decide to use any of the tips, be sureto update the restaurant or store measures instructions.

For Restaurants

  1. If there are no healthy options identified on the menu, you can save yourself some time by not counting the total number of entrees on a menu,because if the numerator is 0 for healthy options, it doesn’t matter what the denominator is, as the answer will always end up being 0. However, you may want to collect the data for other purposes.
  1. For counting tables, you may decide to simplify it by creating categories to denote whether the restaurant is small, medium or large, instead of having a rater count each table, if the seating capacity sign is not easy to locate. You will need to decide what cut-offpoints to use for each category (e.g., < 10 tables = small).
  1. The only item currently measuring access relates to on-site parking and having a drive-through window. You may want to incorporate other items measuring transportation access (bus stop, subway stop, sidewalks, etc.), depending on your project’s purpose.
  1. You may want to review the protocol and revise some of the guidelines based on your project’s purpose. For example, we included pickled vegetables as “non-fried vegetables”. However, if you are concerned about sodium intake in your study, you may not want pickled vegetables to count.

For Stores

  1. You may want to record the hours of operation for stores.
  1. You may want to incorporate items measuring transportation access (bus stop, subway stop, etc.), depending on your project’s purpose.
  1. If you are interested in fruit and vegetable consumption, and fresh fruits and vegetables are not sold at a store, you may want to have raters look in the freezer section and then in the canned section for certain fruit and vegetables. The list of options may change if you do this; for example, there is usually a small range of fruits that are sold frozen (e.g., berries and peaches) and canned (no bananas or apples). Also, you may need to consider whether to count these foods if they are prepared with, or packed in, sauce or syrup.
  1. Dependingon your area of interest(i.e., disease focus, risk factors), you may choose not to include certain measures (e.g., Frozen Dinners, Cereal, etc.).