title: Perceptions of individual and community environmental influences on fruit and vegetable intake, North Carolina, 2004.
abstract: BACKGROUND
  Increases in obesity and other chronic conditions continue to fuel efforts for lifestyle behavior changes. However, many strategies do not address the impact of environment on lifestyle behaviors, particularly healthy dietary intake. This study explored the perceptions of environment on intake of fruits and vegetables in a cohort of 2,479 people recruited from 22 family practices in North Carolina.
  
  
  METHODS
  Participants were administered a health and social demographic survey. Formative assessment was conducted on a subsample of 32 people by using focus groups, semistructured individual interviews, community mapping, and photographs. Interviews and discussions were transcribed and content was analyzed using ATLAS.ti version 5. Survey data were evaluated for means, frequencies, and group differences.
  
  
  RESULTS
  The 2,479 participants had a mean age of 52.8 years, mean body mass index (BMI) of 29.4, and were predominantly female, white, married, and high school graduates. The 32 subsample participants were older, heavier, and less educated. Some prevalent perceptions about contextual factors related to dietary intake included taste-bud fatigue (boredom with commonly eaten foods), life stresses, lack of forethought in meal planning, current health status, economic status, the ability to garden, lifetime dietary exposure, concerns about food safety, contradictory nutrition messages from the media, and variable work schedules.
  
  
  CONCLUSIONS
  Perceptions about intake of fruits and vegetables intake are influenced by individual (intrinsic) and community (extrinsic) environmental factors. We suggest approaches for influencing behavior and changing perceptions using available resources.
authors.affiliation: NIH/NINR, One Democracy Plaza, 6701 Democracy Blvd, Suite 710, Bethesda, MD 20892, USA. boyingtonje@mail.nih.gov
authors.forename: Josephine E A
authors.initials: JE
authors.lastname: Boyington
authors.forename: Britta
authors.initials: B
authors.lastname: Schoster
authors.forename: Kathryn
authors.initials: K
authors.lastname: Remmes Martin
authors.forename: Jack
authors.initials: J
authors.lastname: Shreffler
authors.forename: Leigh F
authors.initials: LF
authors.lastname: Callahan
mesh_terms: D000328:Adult; D000368:Aged; D003469:Culture; D003625:Data Collection; D004032:Diet; D004777:Environment; D005260:Female; D017144:Focus Groups; D005638:Fruit; D006801:Humans; D008297:Male; D008377:Maps as Topic; D008875:Middle Aged; D009657:North Carolina; D010781:Photography; D011795:Surveys and Questionnaires; D014675:Vegetables