title: A qualitative study of perceived barriers to fruit and vegetable consumption among low-income populations, North Carolina, 2011.
abstract: BACKGROUND
  Obesity is the leading preventable cause of illness and a major contributor to chronic disease. Eating fresh fruits and vegetables can help manage and prevent weight gain and reduce the risk of chronic diseases. Low-income communities often lack stores that sell fresh fruit and vegetables and have instead stores that sell foods low in nutritional value. The objective of this study was to understand perceived community-level barriers to fruit and vegetable consumption among low-income people.
  
  
  METHODS
  We conducted 8 focus groups involving 68 low-income participants in 2 North Carolina counties, from May 2011 through August 2011. The socioecological model of health guided data analysis, and 2 trained researchers coded transcripts and summarized findings. Four focus groups were conducted in each county; 1 was all male, 5 all female, and 2 mixed sexes. Most participants were black (68%), most were women (69.1%), and most had a high school education or less (61.8%). Almost half received support from either the Supplemental Nutrition Assistance Program or another government assistance program.
  
  
  RESULTS
  We identified 6 major community-level barriers to access to fruits and vegetables: cost, transportation, quality, variety, changing food environment, and changing societal norms on food.
  
  
  CONCLUSIONS
  Policymakers should consider supporting programs that decrease the cost and increase the supply of high-quality fruits and vegetables in low-income communities.
authors.affiliation: Department of Health Policy and Management, CB 7411, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7411, USA. lhaynes6@email.unc.edu
authors.forename: Lindsey
authors.initials: L
authors.lastname: Haynes-Maslow
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Parsons
authors.forename: Stephanie B
authors.initials: SB
authors.lastname: Wheeler
authors.forename: Lucia A
authors.initials: LA
authors.lastname: Leone
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000517:prevention & control; D004032:Diet; D005260:Female; D017144:Focus Groups; D005523:Food Supply / Q000191:economics / Q000592:standards; D005638:Fruit / Q000191:economics / Q000592:standards / Q000600:supply & distribution*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D009765:Obesity / Q000517:prevention & control; D011203:Poverty; D012111:Residence Characteristics; D012922:Social Change; D012923:Social Class; D014186:Transportation; D014675:Vegetables / Q000191:economics / Q000592:standards / Q000600:supply & distribution*; D055815:Young Adult