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Perspectives on Healthy Eating Among Appalachian Residents


  • Funding: Support for this research was provided by the National Institutes of Health/National Center on Minority Health and Health Disparities/National Institute on Diabetes and Digestive and Kidney Disease (R01 DK081324: Schoenberg).

  • Acknowledgments: We appreciate the contributions of Kaye Dollarhide, Sherry Wright, and the dozens of participants.

For further information, contact: Nancy E. Schoenberg, PhD, University of Kentucky, Department of Behavioral Science, 125 Medical Behavioral Science Office Bldg., Lexington, KY 40536–0086; e-mail:



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.


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.


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.


We discuss the implications of these findings for programmatic development in the Appalachian context.