title: Interrater Reliability of the ENERGY Photo-Rating Instrument for School Environments Related to Physical Activity and Eating.
abstract: The school environment can play an important role in the prevention of childhood overweight and obesity. Photos of the school environment may contribute to more adequate measurement of the school environment, as photos can be rated by different assessors. We aimed to examine the interrater reliability for rating characteristics of primary school environments related to physical activity and eating.
  
  
  
  Photos taken at 172 primary schools in 7 European countries were rated according to a standardized protocol. Briefly, after categorizing all photos in subsections of physical activity or eating opportunities, 2 researchers independently rated aspects of safety, functionality, aesthetics, type of food/drinks advertised, type/variety of foods provided. Interrater reliability was assessed using the intraclass correlation coefficient (ICC) and Cohen's kappa.
  
  
  
  Six subsections of the photo-rating instrument showed excellent (ICC or Cohen's kappa ≥0.81) or good (ICC or Cohen's kappa 0.61 to 0.80) interrater reliability. Outdoor physical activity facilities (ICC = 0.54) showed moderate, and school canteens (Cohen's kappa = 0.05) and vending machines showed poor (Cohen's kappa = 0.16) interrater reliability.
  
  
  
  Interrater reliability of the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) photo-rating instrument was good-to-excellent for 6 out of 9 characteristics of primary school environment components related to physical activity and eating.
authors.affiliation: Dept of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
authors.forename: Teatske
authors.initials: T
authors.lastname: Altenburg
authors.forename: Saskia
authors.initials: S
authors.lastname: Te Velde
authors.forename: Kai-Jan
authors.initials: KJ
authors.lastname: Chiu
authors.forename: George
authors.initials: G
authors.lastname: Moschonis
authors.forename: Yannis
authors.initials: Y
authors.lastname: Manios
authors.forename: Ilse
authors.initials: I
authors.lastname: De Bourdeaudhuij
authors.forename: Frøydis N
authors.initials: FN
authors.lastname: Vik
authors.forename: Nanna
authors.initials: N
authors.lastname: Lien
authors.forename: Johannes
authors.initials: J
authors.lastname: Brug
authors.forename: Mai
authors.initials: M
authors.lastname: Chinapaw
mesh_terms: D000293:Adolescent; D002648:Child; D004435:Eating; D004777:Environment; D004779:Environment Design; D005060:Europe; D015444:Exercise; D006801:Humans; D010781:Photography; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012449:Safety; D012574:Schools