Counseling Strategies To Improve Nutrition Care For Rural Appalachian Patients

Culturally sensitive nutrition counseling strategies may help the rural Appalachian population overcome barriers to good nutrition to prevent and manage chronic diseases. To investigate dietary obstacles and counseling strategies considerate of the specific framework of the rural population, semi-structured interviews were conducted with 36 practitioners (registered dietitians and dietetic interns) and 15 rural patients. Participants also completed follow-up questionnaires about the same topics (n=61). Interviews were transcribed, analyzed using concept coding and grouping, and categorized by themes (NVIVO Qualitative Analysis Software, QSR International, Version 10, 2013). Questionnaires were analyzed using descriptive statistics and t-tests to compare perspectives of practitioners and patients (SPSS Statistics, IBM, Version 20, 2012). Strategy subthemes were categorized into four broader themes from the previously established Rural Nutrition Care Model, including Access & Resources (Budgeting, Planning, Resources), Sociocultural Influences (Whole-Family Approach, Simple Messages, Building Rapport and Relationships, Avoiding Assumptions & Judgment), Traditional Foods (Gardening, How to Cook), and Health Behaviors (Small Changes, Prevention). Questionnaire results indicated differing views of the rural nutrition context. The compilation of data provided valuable insights about the success of various culturally sensitive nutrition counseling strategies for the rural population.