A Nutrition Environment Measure to Assess Tribal Convenience Stores: The THRIVE Study

Marianna S. Wetherill, Mary B. Williams, Tori Taniguchi, Alicia L. Salvatore, Tvli Jacob, Tamela Cannady, Mandy Grammar, Joy Standridge, Jill Fox, Jennifer Spiegel, Valarie Blue Bird Jernigan

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


In rural American Indian (AI) communities, where supermarkets are rare, tribally owned and operated convenience stores are an important food source. Food environment measures for these settings are needed to understand and address the significant diet-related disparities among AIs. Through a tribal-university partnership that included tribal health and commerce representatives from two Native Nations in rural southeastern Oklahoma, we developed the Nutrition Environment Measures Survey for Tribal Convenience Stores (NEMS-TCS) to inform the development and evaluation of a healthy food retail intervention. The NEMS-TCS assessed four scored domains of the rural convenience store food environment—food availability, pricing, quality, and placement—and included 11 food categories that emphasized ready-to-eat food items. Trained raters administered the NEMS-TCS using a sample of 18 rural convenience stores (primarily ranging between 2,400 and 3,600 square feet). We assessed interrater reliability with kappa statistics for dichotomized variables and intraclass correlation coefficients (ICC) for continuous variables. NEMS-TCS demonstrated high inter-rater reliability for all food categories (>85% agreement), subscores (ICC = 0.73-1.00), and the total score (ICC = 0.99). The NEMS-TCS responds to recent calls for reliable measures for rural food environments and may be valuable for studying food environments of large convenience stores in other Native Nations as well as other rural settings.

Original languageEnglish
Pages (from-to)410-420
Number of pages11
JournalHealth Promotion Practice
Issue number3
StatePublished - 21 Mar 2020


  • business partnerships
  • community assessment
  • community-based participatory research
  • environmental and systems change
  • health disparities
  • health research
  • minority health
  • Native American/American Indian
  • nutrition
  • partnerships/coalitions
  • program planning and evaluation
  • rural health
  • surveys


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