Development and Testing of the Church Environment Audit Tool

Objectives: In this paper, we describe development and reliability testing of a novel tool to evaluate the physical environment of faith-based settings pertaining to opportunities for physical activity (PA) and healthy eating (HE). Methods: Tool development was a multistage process including a review of similar tools, stakeholder review, expert feedback, and pilot testing. Final tool sections included indoor opportunities for PA, outdoor opportunities for PA, food preparation equipment, kitchen type, food for purchase, beverages for purchase, and media. Two independent audits were completed at 54 churches. Interrater reliability (IRR) was determined with Kappa and percent agreement. Results: Of 218 items, 102 were assessed for IRR and 116 could not be assessed because they were not present at enough churches. Percent agreement for all 102 items was over 80%. For 42 items, the sample was too homogeneous to assess Kappa. Forty-six of the remaining items had Kappas greater than 0.60 (25 items 0.80-1.00; 21 items 0.60-0.79), indicating substantial to almost perfect agreement. Conclusions: The tool proved reliable and efficient for assessing church environments and identifying potential intervention points. Future work can focus on applications within faith-based partnerships to understand how church environments influence diverse health outcomes.