Individuals in urban low-income areas often do not have easy access to large grocery stores and supermarkets, and regularly shop at nearby small/corner stores. These stores stock an abundance of processed, energy-dense, nutrient poor foods, combined with few nutrient-dense products. A high concentration of small/corner stores is associated with poor diets by nearby residents. Interventions that target small food stores for increasing the availability and sale of healthy foods have been launched in many communities, and validated survey instruments have been developed to evaluate the effectiveness of the interventions. However, in-store surveys can take up to thirty minutes to conduct and require individual visits from investigators. Many projects assess the food environment in a large number of stores spread across broad geographical areas, making in-person evaluations infeasible and resource-prohibitive. The purpose of this study was to develop a valid and feasible short survey that could be used in-store or over the phone to capture the healthfulness of corner stores. An adapted version of the Nutrition Environment Measures Survey for Corner Stores (NEMS-CS) was used to conduct store audits of 230 corner stores in four New Jersey cities. Audit results were used in exploratory factor analysis and item response theory to develop a seven-item survey. The short survey was highly correlated with the full survey (r=0.79), and the short survey's classification of stores as healthy (top 20% of scores) versus unhealthy (bottom 80% of stores) matched NEMS-CS categorizations in 88% of cases. A second round of audits was conducted in 100 corner stores to confirm the validity of the seven-item survey and to test its feasibility as a phone audit tool. Complete phone responses were obtained from 86% of stores. Response matches indicated that store owners did not distinguish between 2% and low-fat milk, and tended to round up the fruit and vegetable count to five if they had fewer varieties. The seven-item short survey discriminates between healthy and unhealthy stores and is feasible for use as a phone audit tool.

ABSTRACT Deciding what to eat can be difficult. There are multiple different diets which are popular today, and all of them say different things about which foods optimize health, and which foods are destructive. The situation become more complicated when the suggestions are all purportedly based on relevant science, and all have had demonstrated positive impacts on overall wellbeing. Even when we do have good information, financial factors, geography, and time constraints can prevent us from acting on it. In an attempt to portray the difficulties involved in eating well, I start by analyzing what each of six diets - The Paleo Diet, The Perfect Health Diet, the vegetarian diet, the vegan diet, the Mediterranean Diet, and the Traditional Asian Diet - says about what we should be eating. I then explore what the science says about what we should be eating, and whether this science lines up with the diets, by discussing an extensive review of books and literature on nutrition. Lastly, in order to gain an understanding of factors which discourage us from eating well, I tracked my consumption habits for a week using My Fitness Tracker, and noted any reasons that I chose to eat or not eat certain foods. I supplemented this with a discussion of the shortcomings of the Healthy, Hunger-Free Kids Act, and the types of factors that prevent people from acting on information. In conclusion, diets should be praised for attempting to align American eating habits with the best scientific information, but the vast amount of information and the difficulty involved in eating well may ultimately prevent people from doing so.