title: The SPOTLIGHT virtual audit tool: a valid and reliable tool to assess obesogenic characteristics of the built environment.
abstract: BACKGROUND
  A lack of physical activity and overconsumption of energy dense food is associated with overweight and obesity. The neighbourhood environment may stimulate or hinder the development and/or maintenance of a healthy lifestyle. To improve research on the obesogenicity of neighbourhood environments, reliable, valid and convenient assessment methods of potential obesogenic characteristics of neighbourhood environments are needed. This study examines the reliability and validity of the SPOTLIGHT-Virtual Audit Tool (S-VAT), which uses remote sensing techniques (Street View feature in Google Earth) for desk-based assessment of environmental obesogenicity.
  
  
  METHODS
  A total of 128 street segments in four Dutch urban neighbourhoods - heterogeneous in socio-economic status and residential density - were assessed using the S-VAT. Environmental characteristics were categorised as walking related items, cycling related items, public transport, aesthetics, land use-mix, grocery stores, food outlets and physical activity facilities. To assess concordance of inter- and intra-observer reliability of the Street View feature in Google Earth, and validity scores with real life audits, percentage agreement and Cohen's Kappa (k) were calculated.
  
  
  RESULTS
  Intra-observer reliability was high and ranged from 91.7% agreement (k = 0.654) to 100% agreement (k = 1.000) with an overall agreement of 96.4% (k = 0.848). Inter-observer reliability results ranged from substantial agreement 78.6% (k = 0.440) to high agreement, 99.2% (k = 0.579), with an overall agreement of 91.5% (k = 0.595). Criterion validity was substantial to high for most of the categories ranging from 87.3% agreement (k = 0.539) to 99.9% agreement (k = 0.887) with an overall score of 95.6% agreement (k = 0.747).
  
  
  CONCLUSIONS
  These study results suggest that the S-VAT is a highly reliable and valid remote sensing tool to assess potential obesogenic environmental characteristics.
authors.affiliation: Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands. j.bethlehem@outlook.com.
authors.forename: John R
authors.initials: JR
authors.lastname: Bethlehem
authors.forename: Joreintje D
authors.initials: JD
authors.lastname: Mackenbach
authors.forename: Maher
authors.initials: M
authors.lastname: Ben-Rebah
authors.forename: Sofie
authors.initials: S
authors.lastname: Compernolle
authors.forename: Ketevan
authors.initials: K
authors.lastname: Glonti
authors.forename: Helga
authors.initials: H
authors.lastname: Bárdos
authors.forename: Harry R
authors.initials: HR
authors.lastname: Rutter
authors.forename: Hélène
authors.initials: H
authors.lastname: Charreire
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Oppert
authors.forename: Johannes
authors.initials: J
authors.lastname: Brug
authors.forename: Jeroen
authors.initials: J
authors.lastname: Lakerveld
mesh_terms: D004779:Environment Design / Q000706:statistics & numerical data; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D058998:Remote Sensing Technology / Q000379:methods / Q000592:standards*; D015203:Reproducibility of Results; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data