The objective of this study was to develop, implement, and refine a food environment survey to capture people’s perceptions of their food environments in low-and middle-income countries: the Food Environment Perceptions Survey (FEPS).

Identifying aspects of food environment to include: drawing from existing survey instruments; a Delphi survey with food environment experts working globally; workshops with local experts in India and Cambodia; cognitive testing of the survey items; and piloting the tools in diverse field settings in India and Cambodia.

Rural, peri-urban, and urban communities in India and Cambodia.

Global food environment experts for Delphi survey; food environment experts in India and Cambodia for workshops; convenience sample of participants in India (n=44) and Cambodia (n=60) for FEPS piloting.

The FEPS underwent many iterations prior to piloting. The initial versions of the survey were long, leading us to remove questions and reconfigure the survey to streamline it. The workshop participants rated the revised survey versions relatively favorably. The final survey consists of 109 questions covering six sections: accessibility and availability (48 questions); affordability (5 questions), convenience (17 questions); quality and safety (3 questions); information, promotion, and labeling (16 questions); and an optional sustainability section (20 questions). Based on pilot data, we found significant differences in how participants interacted with different food environment types across rural, peri-urban, and urban transects.

The finalized FEPS is a newly developed survey instrument that can be incorporated by other researchers to characterize diverse perceptions of food environments in LMICs.