Café Scout: development and pilot evaluation of a real-time tool for assessing and planning improvements to the healthiness of foodservice environments.

Abstract

Community-based foodservice outlets (e.g., cafés in sporting centres or healthcare settings) have the potential to support population health, but currently these outlets predominantly encourage less healthy food purchases. No tools exist to rapidly assess the healthiness of the in-store food environments in foodservice outlets from the '4Ps of marketing' perspective (product, placement, price, and promotion) while providing real-time feedback to support the planning and implementation of healthy changes. This study aimed to adapt the 'Store Scout App', originally developed for grocery stores, to assess the healthiness of in-store food environments in Australian foodservice outlets, and to evaluate the validity and reliability of the new tool. A two-stage approach was used to develop 'Café Scout': (1) tool development (convening a working group, identifying tool requirements, and developing an initial prototype; February 2022 -February 2023); and (2) tool refinement and validity evaluation (pilot testing - "Round 1", tool updates, training development, and extended testing - "Round 2"; February 2023 - December 2023). /setting: Tool testers included health promotion or local government officers (n=12), food outlet managers (n=3), researchers (n=3), and university nutrition placement students (n=5), all based in Victoria, Australia. The tool was tested across 27 foodservice outlets in community-based sporting centres in regional and metropolitan areas of Victoria. Interrater reliability, validity (construct, concurrent criterion and face validity), and usability were assessed. Gwet's Agreement Coefficient were used to assess interrater reliability, Pearson correlation to assess construct and concurrent validity, and descriptive analysis to assess face validity and usability based on user feedback. 'Café Scout' with up to 278 Yes/No questions was developed to assess food outlet marketing practices across eight food and drink product categories. Evaluation showed good interrater reliability (mean Gwet's Agreement Coefficient 0.70 [95% CI: 0.64-0.76]), strong alignment between tool scores and product healthiness (e.g., total score versus healthiest product availability, r=0.70, p<0.001), and moderate alignment between tool scores and the healthiness of customer drink purchases (e.g., mean drink score versus healthiest drink purchases, r=0.60, p=0.01). User feedback (n=13 surveys) highlighted the tool's value in supporting healthy changes. Café Scout can rapidly assess the in-store food environments and provide real-time feedback, facilitating the continuous monitoring and planning of healthy changes in foodservice outlets to support healthier food choices and population health.