Perspectives on healthy eating among Appalachian residents.
OBJECTIVE
Extensive attention has been focused on improving the dietary intake of Americans. Such focus is warranted due to increasing rates of overweight, obesity, and other dietary-related disease. To address suboptimal dietary intake requires an improved, contextualized understanding of the multiple and intersecting influences on healthy eating, particularly among those populations at greatest risk of and from poor diet, including rural residents.


METHODS
During 8 focus groups (N = 99) and 6 group key informant interviews (N = 20), diverse Appalachian rural residents were queried about their perceptions of healthy eating, determinants of healthy food intake, and recommendations for improving the dietary intake of people in their communities. Participants included church members and other laypeople, public health officials, social service providers, health care professionals, and others.


RESULTS
Participants offered insights on healthy eating consistent with the categories of individual, interpersonal, community, physical, environmental, and society-level influences described in the socioecological model. Although many participants identified gaps in dietary knowledge as a persistent problem, informants also identified extraindividual factors, including the influence of family, fellow church members, and schools, policy, advertising and media, and general societal trends, as challenges to healthy dietary intake. We highlight Appalachian residents' recommendations for promoting healthier diets, including support groups, educational workshops, cooking classes, and community gardening.


CONCLUSIONS
We discuss the implications of these findings for programmatic development in the Appalachian context.
Department of Behavioral Sciences, University of Kentucky, Lexington, KY 40536, USA. nesch@uky.edu
Nancy E
NE
Schoenberg
Britteny M
BM
Howell
Mark
M
Swanson
Christopher
C
Grosh
Shoshana
S
Bardach
D000293:Adolescent; D000328:Adult; D000368:Aged; D005247:Feeding Behavior; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D054624:Health Status Disparities; D006801:Humans; D007629:Kentucky; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D055815:Young Adult
dietary intake; health disparities; qualitative research; rural