RESUMO
Previous research has shown that environments with features that encourage walking are associated withincreased physical activity. Existing methods to assess the built environment using geographical information systems (GIS)data, direct audit or large surveys of the residents face constraints, such as data availability and comparability, when used tostudy communities in countries in diverse parts of the world. The aim of this study was to develop a method to evaluatefeatures of the built environment of communities using a standard set of photos. In this report we describe the method ofphoto collection, photo analysis instrument development and inter-rater reliability of the instrument.Methods/Principal Findings: A minimum of 5 photos were taken per community in 86 communities in 5 countriesaccording to a standard set of instructions from a designated central point of each community by researchers at each site. Astandard pro forma derived from reviewing existing instruments to assess the built environment was developed and used toscore the characteristics of each community. Photo sets from each community were assessed independently by threeobservers in the central research office according to the pro forma and the inter-rater reliability was compared by intra-classcorrelation (ICC). Overall 87% (53 of 60) items had an ICC of $0.70, 7% (4 of 60) had an ICC between 0.60 and 0.70 and 5% (3of 60) items had an ICC #0.50.Conclusions/Significance: Analysis of photos using a standardized protocol as described in this study offers a means toobtain reliable and reproducible information on the built environment in communities in very diverse locations around theworld. The collection of the photographic data required minimal training and the analysis demonstrated high reliability forthe majority of items of interest.