Creating a food environment scoring index for online food delivery outlets: Delphi study with Australian nutrition and public health professionals.

Aims: This study aimed to develop a scoring index for the healthfulness of food outlet menu offerings available through Australian delivery platforms.

Methods: The Delphi method was employed to achieve consensus among a panel of Australian nutrition and public health experts regarding the food environment scores assigned to online food outlets, classified by type. From previous studies and scoping of delivery platforms, 36 food outlet types were identified. Australian nutrition and public health experts were recruited to complete an online Delphi survey to score the healthfulness of these outlets using a scale from -10 (least healthful) to +10 (most healthful), based on typical menu offerings. The first round of the survey was opened for approximately 5 weeks in July to August 2023, and the second round was opened for 2 weeks in September 2023. The mean food environment score, minimum and maximum awarded food environment score, and SD for each outlet type, and coefficient of variation was calculated after each survey round to provide a measure of the spread of the data around the mean and the degree of consistency in the distribution of responses. Following the second survey round, results were assessed for consensus among the participants.

Results: Fifty-four participants completed the round one survey, and n=14 completed round two. The majority of online food delivery outlet types received a food environment score of less than +5, and were considered 'less healthful.' Participants scored greengrocers as the most healthful outlet type (mean food environment score of 8.83 ± 0.37) and liquor selling stores as the least healthful (score of -8.10 ± 1.14). The group reached consensus after two survey rounds due to decreases in the standard deviations of mean food environment scores.

Conclusions: This study provides an expert-informed tool, the DIGIASSESS tool, that can be easily applied by researchers, policy makers, health workers and public health professionals to understand the rapidly evolving online food delivery environment, including changes over time and areas for potential intervention.