Foraging, Farming or Shopping? A Decision Matrix Approach for Food Environment Assessments.

Food environments (the interfaces between consumers and the broader food system) shape dietary change and associated health outcomes. Characteristics of food environments (e.g., availability, accessibility, affordability, convenience, desirability) can influence consumer decision-making around food acquisition in different types of food environments (e.g., informal and formal markets, wild and cultivated natural environments). With the novel decision matrix approach presented in this paper, we aimed to develop a simple and rapid tool for collecting perceived evaluations and preferences of different types and characteristics of food environments. The decision matrix results were triangulated using a mixed methodology of geolocated participant observation, participatory mapping, market price comparisons and qualitative interviews. The decision matrix results were compared to the reported use of different food environment types in an Indigenous Pgaz K'Nyau community in Northern Thailand. Despite an ongoing food environment transition, participants preferred natural food environments and ranked market environments most poorly, largely reflecting actual food environment use. Interviewees stressed the importance of flavor and food safety, citing concerns over agrochemical contamination of market foods. The proposed decision matrix and mixed methods approach provides a rapid data collection method that can be used by food environment researchers and public health practitioners to assess food environment preferences and perceptions that influence decision-making in food environment transitions in low- and middle-income countries.