title: Assessing the Consumer Food Environment in Restaurants by Neighbourhood Distress Level across Saskatoon, Saskatchewan.
abstract: OBJECTIVE
  To assess the consumer food environment in restaurants in Saskatoon, using the Nutrition Environment Measures Survey for Restaurants (NEMS-R), to examine differences by neighbourhood distress level and to reflect on the need for further refinement of the assessment of restaurant consumer food environments.
  
  
  METHODS
  Neighbourhoods were classified as low, middle, or high distress level based on the socioeconomic indicators (income, employment, and education) in the Material Deprivation Index. Differences in restaurant consumer food environments, indicated by mean NEMS-R total and sub-scores, were examined by various restaurant categories and by varying neighbourhood distress levels.
  
  
  RESULTS
  Chain coffee shops and pita and sandwich restaurants had higher NEMS-R totals and "Healthy Entrées" sub-scores; however, burger and chicken restaurants and pizza restaurants had more barriers to healthful eating. Although restaurants in lower distress level neighbourhoods generally rated healthier (higher NEMS-R scores), only a few measures (such as "Facilitators" and "Barriers") significantly differed by neighbourhood distress level.
  
  
  CONCLUSIONS
  The findings highlight the importance of developing interventions to improve restaurant consumer food environments, especially in neighbourhoods with higher distress levels. The results suggest that reliable measures of the consumer food environment could be developed beginning with what can be measured by NEMS-R.
authors.affiliation: a Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK.
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.affiliation: a Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Engler-Stringer
authors.affiliation: a Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK.
authors.forename: Nazeem
authors.initials: N
authors.lastname: Muhajarine
mesh_terms: D002755:Choice Behavior; D000072001:Diet, Healthy; D004777:Environment; D057140:Fast Foods; D015438:Health Behavior; D006801:Humans; D009749:Nutrition Surveys; D012111:Residence Characteristics; D012147:Restaurants; D012525:Saskatchewan; D012959:Socioeconomic Factors