title: Evaluating the use of in-store measures in retail food stores and restaurants in Brazil.
abstract: OBJECTIVE
  To assess inter-rater reliability, test-retest reliability, and construct validity of retail food store, open-air food market, and restaurant observation tools adapted to the Brazilian urban context.
  
  
  METHODS
  This study is part of a cross-sectional observation survey conducted in 13 districts across the city of Sao Paulo, Brazil in 2010-2011. Food store and restaurant observational tools were developed based on previously available tools, and then tested it. They included measures on the availability, variety, quality, pricing, and promotion of fruits and vegetables and ultra-processed foods. We used Kappa statistics and intra-class correlation coefficients to assess inter-rater and test-retest reliabilities in samples of 142 restaurants, 97 retail food stores (including open-air food markets), and of 62 restaurants and 45 retail food stores (including open-air food markets), respectively. Construct validity as the tool's abilities to discriminate based on store types and different income contexts were assessed in the entire sample: 305 retail food stores, 8 fruits and vegetable markets, and 472 restaurants.
  
  
  RESULTS
  Inter-rater and test-retest reliability were generally high, with most Kappa values greater than 0.70 (range 0.49-1.00). Both tools discriminated between store types and neighborhoods with different median income. Fruits and vegetables were more likely to be found in middle to higher-income neighborhoods, while soda, fruit-flavored drink mixes, cookies, and chips were cheaper and more likely to be found in lower-income neighborhoods.
  
  
  CONCLUSIONS
  The measures were reliable and able to reveal significant differences across store types and different contexts. Although some items may require revision, results suggest that the tools may be used to reliably measure the food stores and restaurant food environment in urban settings of middle-income countries. Such studies can help .inform health promotion interventions and policies in these contexts.
authors.affiliation: Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Ana Clara
authors.initials: AC
authors.lastname: Duran
authors.affiliation: Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, University of London, London, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Lock
authors.affiliation: Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Maria do Rosario D O
authors.initials: Mdo R
authors.lastname: Latorre
authors.affiliation: Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Patricia Constante
authors.initials: PC
authors.lastname: Jaime
mesh_terms: D001938:Brazil; D003132:Commerce / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D063427:Food Quality; D005523:Food Supply / Q000379:methods / Q000706:statistics & numerical data*; D005638:Fruit; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D009749:Nutrition Surveys; D015203:Reproducibility of Results; D012111:Residence Characteristics; D012147:Restaurants / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014675:Vegetables