The Impact of Individual-Level Motivators of and Barriers to Healthy Food Choices on Perceived Healthy Food Access in a Rural Community

Background: Although only 19.3% of the U.S. population live in rural areas, rural adults experience disproportionately higher rates of obesity and related chronic health conditions (e.g., type 2 diabetes and hypertension) than urban adults. These health inequities may be attributed to significant barriers such as cost of healthier foods, lack of variety, and increased access to fast-food restaurants and convenience stores, which likely contributes to lack of perceived access to affordable, quality, healthy food choices. Adults in rural communities may also feel less motivated to engage in healthier food practices due to limited perceived access. These significant challenges may be further influenced by one’s current body mass index (BMI), as those with increased BMI may view current food stores as adequate. Thus, the purpose of the present study was to examine the associations between barriers, motivators, and perceived access. Another purpose of the present study was to examine BMI as a moderator of these associations.

Method: A sample of 121 adults (M_age = 54.30±16.03, M_BMI = 27.67±5.70) from a rural region of Oregon completed an online survey. Participants were primarily Caucasian/White (93%) and female (64%). The survey assessed BMI, motivators of and barriers to healthy foods and snacks (Motivators of and Barriers to Health-Smart Behaviors Inventory), and perceived food access (Food Choice and Access Survey). A hierarchical regression was conducted to examine the associations between barriers, motivators, and perceived access with BMI as a moderator.

Results: Preliminary analyses revealed that increased barriers were associated with less perceived access (β = -.27, p < .01). BMI was also found to moderate the association between motivators and perceived access (β = .24, p = .04). Probing of the interaction revealed that in rural adults with lower BMI, higher levels of motivators were associated with less perceived access (β = -.34, p = .01).

Conclusion: For adults in a rural, Oregon community, increased barriers to eating healthy foods and snacks were associated with less perceived access to healthy food choices. Interestingly, the presence of motivators was not enough to increase one’s perceived access to healthy foods for those with lower BMIs. This could be attributed to heightened awareness of what is required to eat healthier yet having limited access to healthy food options in one’s current food environment. These findings support the continued need to identify ways to mitigate food access issues in rural communities.

Note: In remembrance of Dr. Tasia Smith, University of Oregon