본 연구는 도시지역의 식품상점 환경을 측정하기 위한 조사도구를 개발하고, 활용가능성 및 신뢰도를 검증하기 위해 실시하였다. 문헌고찰을 통해 기 개발된 식품상점 조사도구를 검토하여, 우리나라 실정에 맞는 식환경 조사도구를 개발하였고, 크게 식품상점의 특성, 접근성, 식품의 이 용가능성에 대한 문항으로 구성하였다. 개발된 조사도구의 현장적용성 검토를 위해 소요시간, 응답수월성, 참여의사, 현장조사의 어려움, 사용된 용어의 적절성 등을 평가한 결과, 조사시간이 상점의 특성에 따라 차이가 있다는 점을 제외하고는, 모든 측면에서 현장적용성이 높았다. 그리고 식품의 이용가능성 문항에 대해 신뢰도를 검증한 결과, 조사자간 및 조사자 내 일치율이 매우 높았다. 건강이 강조된 식품의 경우에는 일반식품에 비해 상대적으로 일치율이 낮았으나, 여전히 높은 일치율 수준을 보였다. 본 연구에서 개발한 식환경 조사도구는 현장적용성과 신뢰도가 높은 것이 확인되었으므로, 추후에 객관적인 식환경 측정이 필요한 연구에 다양하게 활용될 수 있을 것이다.
Purpose: The aim of this study was to develop a reliable measurement tool to assess the urban food environment, particularly focusing on food stores in Korea. Methods: The items for the measurement tool were selected through systematic literature reviews and adjusted to the Korean food environment. A total of 25 food stores in an urban area were recruited for the pilot test to evaluate the time required for completion of the survey, ease of response, willingness to participate, difficulties in conducting the survey, and appropriateness, and 34 food stores were recruited for assessment of the reliability of the tool using percent agreement and kappa value. Results: The measurement tool is composed of questions regarding food store characteristics, accessibility, and food availability. On average, 26 minutes was required to survey a single food store, and the subjects and interviewers answered that the process was not difficult for the survey. The percent agreement for the inter-rater and test-retest reliability ranged from 93.9~98.8% and 91.9~97.9, respectively. The kappa values ranged from 0.78 to 0.97, which was very high. Percent agreement and kappa value of food with healthy option were lower than those of the general food in the inter-rater reliability (p = 0.0027, p = 0.0095 respectively) as well as in the test-retest reliability (p = 0.0081, p = 0.0290, respectively), although they were still high enough (86.4~98.0% for percent agreement, 0.64~0.96 for kappa value). Conclusion: The newly developed measurement tool for assessment of food store environment appears to be feasible and reliable; therefore, it can be applied to research on the association between food environment and dietary behaviors as well as health outcomes.