title: Perceptions of the community food environment and related influences on food choice among midlife women residing in rural and urban areas: a qualitative analysis.
abstract: BACKGROUND
  Qualitative research on food choice has rarely focused on individuals' perceptions of the community food environment. Women remain gatekeepers of the family diet and food purchasing. Therefore we assessed midlife, Southern women's perceptions of the food environment. Related influences on food choices at work and at home were also examined.
  
  
  METHODS
  We recruited 28 low- and moderate-income, midlife (37-67 years) women from rural and urban areas of southeastern North Carolina, using typical case and snowball sampling. They responded to questions about multilevel influences on food choice in semi-structured, in-depth interviews.
  
  
  RESULTS
  Women perceived differences between urban and rural food environments, with rural areas having fewer supermarkets and fast food restaurants compared to urban areas, which had fewer produce stands. Workplace food choices were affected by the social environment (co-workers), personal health concerns, and the surrounding food environment. Food chosen at home was primarily influenced by family members, health concerns, and convenient food sources.
  
  
  CONCLUSIONS
  While future studies should explore findings in more representative populations, potential intervention strategies can be inferred, including emphasizing healthful aspects of the food environment. Intervention and advocacy efforts are needed to improve aspects of the food environment that make healthy choices difficult.
authors.affiliation: Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina 27834, USA. jilcotts@ecu.edu
authors.forename: Stephanie B
authors.initials: SB
authors.lastname: Jilcott
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Laraia
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Evenson
authors.forename: Alice S
authors.initials: AS
authors.lastname: Ammerman
mesh_terms: D000328:Adult; D000368:Aged; D002755:Choice Behavior; D003132:Commerce; D004032:Diet; D004034:Diet Surveys; D005260:Female; D005518:Food Preferences; D005523:Food Supply; D006801:Humans; D008875:Middle Aged; D009657:North Carolina; D036301:Qualitative Research; D012424:Rural Population; D012931:Social Environment; D012959:Socioeconomic Factors; D014505:Urban Population