Obesity rates in Appalachia are among the highest in the United States, and knowledge of upstream approaches to decrease prevalence among this vulnerable population is limited. The primary aim of this study was to examine the association between healthy, diet-based, social marketing interventions in grocery stores and frequency of fruit and vegetable intake.


A social marketing campaign was conducted among 17 grocery stores (N = 240 participant surveys) over 4 months in 5 rural Kentucky counties. Interventions included providing food samples, recipe cards, and promotional discounts on fruits and vegetables and moving high-calorie foods to side aisles.


Most survey participants reported that recipe cards influenced their desire to purchase ingredients as well as fruits and vegetables in general. Results indicated a significant association between the influence of recipe cards and frequency of fruit and vegetable consumption.


Small-scale interventions in grocery stores influenced purchasing choices among Appalachian residents. Working with various store managers and food venues in rural high-obesity communities is a promising way to encourage purchasing of fruits and vegetables.

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Notes/Citation Information

Published in Preventing Chronic Disease, v. 14, E94, p. 1-6.

This article was published by the Centers for Disease Control and Prevention, and is in the public domain.

Digital Object Identifier (DOI)

https:/ /doi.org/10.5888/pcd14.170109

Funding Information

The work was supported by a cooperative agreement with the Division of Nutrition, Physical Activity, Overweight, and Obesity of the Centers for Disease Control and Prevention (no. 5NU58DP005483).