title: Rural adults' perspectives on school food in a North Carolina county.
abstract: BACKGROUND
  To address alarming rates of youth obesity, multiple stakeholder perspectives must be understood and considered when developing nutrition interventions. The purpose of this qualitative study was to examine adults' perceptions of school food in rural North Carolina and their opinions about potential changes to encourage students to eat more fruits and vegetables in school meals.
  
  
  METHODS
  We conducted semistructured key informant interviews by telephone from February through March 2013 to determine adult opinions regarding elementary school food and child health. Participants included parents, teachers, school administrators, and a cafeteria staff member. Interview transcripts were thematically analyzed using Dedoose qualitative analysis software.
  
  
  RESULTS
  Four themes emerged from key informant interviews regarding school meals and increasing fruit and vegetable consumption: 1) schools are an appropriate place for nutritious food, 2) current school food is bland and unappealing, 3) school cafeterias can use simple strategies to increase fruit and vegetable intake, and 4) federal school meal guidelines are perceived as barriers to increased fruit and vegetable intake during school meals.
  
  
  CONCLUSIONS
  Study findings suggest that training and support for cafeteria staff on healthy food preparation and presentation are critical and that there should be a "meeting in the middle" between child appeal and health. Nutritious and appealing school food options may have the potential to greatly increase fruit and vegetable consumption in rural elementary schools in North Carolina.
authors.affiliation: The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Dr, Chapel Hill, NC 27599. Email: jayne.k.jeffries@gmail.com.
authors.forename: Jayne K
authors.initials: JK
authors.lastname: Jeffries
authors.affiliation: The Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Linden M
authors.initials: LM
authors.lastname: Thayer
authors.affiliation: School of Journalism and Mass Communications, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Heidi
authors.initials: H
authors.lastname: Hennink-Kaminski
authors.affiliation: School of Journalism and Mass Communications, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Seth M
authors.initials: SM
authors.lastname: Noar
mesh_terms: D000288:Administrative Personnel / Q000523:psychology; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D002648:Child; D000067576:Child Health; D002755:Choice Behavior; D005260:Female; D005522:Food Services / Q000331:legislation & jurisprudence / Q000592:standards; D005638:Fruit; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D018673:Nutrition Policy; D063766:Pediatric Obesity / Q000517:prevention & control; D010865:Pilot Projects; D011361:Professional Competence / Q000706:statistics & numerical data; D036301:Qualitative Research; D012424:Rural Population; D012574:Schools / Q000331:legislation & jurisprudence; D012923:Social Class; D011795:Surveys and Questionnaires; D055697:Taste Perception; D014675:Vegetables; D000078329:Workforce