People's and especially children's health behaviours are importantly influenced by the environment they are exposed to. For example, in a school environment that offers ample opportunities for physical activity and health eating, and little opportunities for sedentariness and unhealthy snacking, children will be more likely to engage in health energy balance related behaviours. The school environment can thus play an important role in the prevention of childhood overweight and obesity. To further study the impact of such environments, measurement of the 'obesopreventive' characteristics of the school environment is important. Photos of the school environment may contribute to more adequate, systematic, objective measurement of the school environment, as photos can be rated by different assessors. In a study we recently published in the Journal of Physical Activity and Health, -with Dr. Teatske Altenburg as first author- we aimed to examine the inter-rater reliability for rating photo-based characteristics of primary school environments related to physical activity and eating.Photos taken at 172 primary schools in seven European countries were rated according to a standardised protocol. Briefly, after categorising all photos in subsections of physical activity or eating opportunities, two researchers independently rated aspects of safety, functionality, aesthetics, type of food/drinks advertised, type/variety of foods provided. Inter-rater reliability was assessed using the intra-class correlation coefficient (ICC) and Cohen's kappa.
Six subsections of the photo-rating instrument showed excellent or good inter-rater reliability. Outdoor physical activity facilities showed moderate, and school canteens and vending machines showed poor inter-rater reliability.
Inter-rater reliability of the ENERGY photo-rating instrument was thus good-to-excellent for six out of nine characteristics of primary school environment components related to physical activity and eating.
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