Research Article| Volume 54, ISSUE 7, P621-635, July 2022

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The 5 A's Approach for Contextual Assessment of Food Environment

  • Archana Konapur
    Nutrition Information, Communication, and Health Education Division, Indian Council of Medical Research-National Institute of Nutrition, Hyderabad, Telangana, India
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  • SubbaRao M. Gavaravarapu
    Address for correspondence: SubbaRao M. Gavaravarapu, Nutrition Information, Communication, and Health Education Division, Indian Council of Medical Research-National Institute of Nutrition, Jamia-Osmania PO, Tarnaka, Hyderabad 500007, Telangana, India
    Nutrition Information, Communication, and Health Education Division, Indian Council of Medical Research-National Institute of Nutrition, Hyderabad, Telangana, India
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  • Krishnapillai Madhavan Nair
    Micronutrient Research Group, Indian Council of Medical Research-National Institute of Nutrition, Hyderabad, Telangana, India
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      To develop a context-specific methodology to assess the 5 A's of food environment: availability, accessibility, affordability, acceptability, and accommodation.


      Cross-sectional mixed-methods study. Availability of foods was assessed by on-site observation and interviewing vendors. To assess accessibility, buffer zones around food stores were created using geographic information systems. Affordability was controlled by selecting participants from the middle-income group. Accommodation and acceptability were assessed by interviewing vendors and caregivers.


      Villages of Ghatkesar subdistrict (n = 4), Telangana, South India.


      Caregivers of children aged 6–10 years (n = 160) and food vendors (n = 68).


      The quality of the 5 A's was graded on the basis of concurrence between actual and perceived measures.


      The actual and perceived 5 A's for semiperishable foods matched, and hence the food environment was graded as good across the villages. However, for perishable foods, the food environment was graded as poor with respect to accommodation and acceptability in all villages; and with respect to availability and affordability in at least 2 villages as the actual and perceived measures did not match.

      Conclusions and Implications

      This study demonstrated the use of context-specific methods to assess the 5 key dimensions of the food environment, which can be attempted in other contexts with suitable modifications.

      Key Words

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