Eating healthfully is a daily struggle for many of us. Often, just the thought about how to get more healthy food is, well, just too much to think about. The food environment can be really challenging to navigate for anyone, and particularly trying for people with mobility impairments.
The Food Environment Assessment Survey Tool, or FEAST, study focused on developing an instrument to measure the food environment from the perspective of people with mobility impairments. In FEAST, we used a scientific strategy that sounds really fancy, a mixed sequential equal status design. This exhausting sounding design really just means that we actually spent time talking with people from our priority group—in this case, people with mobility impairments—rather than just administering a survey. Full disclosure: There was a survey (2! in fact), eventually, but that will come later (not today, but soon). Two of the most important stages of FEAST were the part where we talked with people. We used two research methods in this first part of survey development. For those of you who are more research inclined, these are more on the qualitative end of the qualitative research to quantitative research continuum. First, we talked with people using a special kind of focus group called a nominal group technique group. Sometimes we short-cut this to be “NGT”. This should not be confused with “Next Generation Tackle” which is a company that supplies fishing-related supplies. Although fishing could be related to the food environment, it just didn’t come up in this study. During the NGT group phase of FEAST, researchers asked people with mobility impairments about their experiences obtaining nutritious foods. We worked in small groups using Zoom. The groups were either all men or all women. And, we further broke up the groups to be all men in rural areas or all men in urban areas as well as all women in rural areas or all women in urban areas. There were four kinds of groups that people could have been in, depending on their gender and area of residence. We ended up completing 7 groups. We brainstormed together in the groups, and came up with a list of barriers. Then, we rank ordered them confidentially using a survey after the group was over. That way, we could be honest, because others in the group would not know which barriers we each thought were the most challenging. We gathered a wide variety of opinions from people with mobility impairments all over the country, representing diverse experiences and challenges. These special focus group conversations were used to create survey questions. The scientific team took actual quotes brought forward by our focus group participants to create the FEAST survey. This was super cool, because every question represented the authentic experience of one of our research participants. After the investigative team created the FEAST survey, we also asked new people to help us further test the survey questions. We used one-on-one, cognitive interviews to do this. Researchers asked participants about each question. How did the questions read? Were they easy or hard to understand? Was any language or wording not relevant, or worse, offensive? What, if anything, should we change? Based on their responses, the investigative team refined the FEAST survey. To make a long story short, the whole process took several months and several research technicians in addition to the investigative team of scientists. It was an enriching experience for everyone involved. The FEAST team loved the opportunity to interact with real people, the consumers of our research, to make the survey happen. Thanks to all our research participants who provided knowledge and insight unique into their experiences. Public health science relies on its users to make it happen. Please consider saying yes to helping move science and innovation forward when you can. Your contribution is much appreciated!
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