Author ORCID Identifier

Date Available


Year of Publication


Degree Name

Master of Science in Nutrition and Food Systems (MSNFS)

Document Type

Master's Thesis


Agriculture, Food and Environment


Dietetics and Human Nutrition

First Advisor

Dr. Heather Norman-Burgdolf


Diet and physical activity are influenced by a person’s culture and may contribute to the presence of health disparities within a geographic region. Health disparities are evident in Appalachia where a unique cultural identity exists. Culture-based initiatives focused on improving diet quality and increasing physical activity have improved health outcomes in diverse groups, yet interventions considering geographically tied cultures, like Appalachia, are limited. This study aims to identify specific aspects of Appalachian culture that influence health outcomes to inform and increase success of health focused interventions. Five focus groups were conducted in one rural Appalachian community in summer 2021. Grounded Theory Approach was used to identify primary themes related to culture and health-promoting behaviors. Participants (n=59) indicated economic hardship and community decline as barriers to health-promoting behaviors. Poor infrastructure was recognized as the main obstacle to physical activity, including broken or non-existent sidewalks. Limited access to traditional food procurement methods was also consistently noted. Participants revealed the loss of multigenerational food traditions, such as canning, affected dietary choices. However, many reported adaptive responses to limited food access, including homegrown produce. These adaptations were made despite geographic isolation and poverty, revealing the pride this community takes in providing for themselves and the importance of familial and social bonds. The value of community and family units, focusing on youth, was further identified as a major facilitator for making healthy choices. These findings indicate several cultural factors influence health-promoting behaviors along with unique regional barriers that should be addressed. These results have implications for future interventions in Appalachia. For example, programming could be multigenerational with a youth focus and incorporate cultural practices like gardening and canning to address nutritious food procurement. Other geographically based subcultures may consider culturally tailored approaches to promote and support improved health outcomes.

Digital Object Identifier (DOI)

Funding Information

This research was funded in 2018 by Centers for Disease Control and Prevention (CDC) Division of Nutrition, Physical Activity, and Obesity (DNPAO), Cooperative Agreement number 1NU58DP0065690100.

Included in

Nutrition Commons