Journal of Community Health

, Volume 32, Issue 4, pp 245–267 | Cite as

Assessment Of The Nutrition And Physical Activity Education Needs Of Low-Income, Rural Mothers: Can Technology Play A Role?

  • Nancy L. AtkinsonEmail author
  • Amy S. Billing
  • Sharon M. Desmond
  • Robert S. Gold
  • Amy Tournas-Hardt


The purpose of this study was to examine the perceptions of low-income, rural mothers regarding their need for nutrition and physical activity education and the role of technology in addressing those needs. Quantitative and qualitative research was combined to examine the nature and scope of the issues faced by this target population. Women who were currently receiving food stamps and had children in nursery school to eighth grade were recruited through a state database to participate in a telephone survey (N  = 146) and focus groups (N = 56). Low-income, rural mothers were aware of and practiced many health behaviors related to nutrition and physical activity, but they faced additional barriers due to their income level, rural place of residence, and having children. They reported controlling the fat content in the food they cooked and integrating fruits and vegetables but showed less interest in increasing fiber consumption. They reported knowing little about physical activity recommendations, and their reported activity patterns were likely inflated because of seeing housework and child care as exercise. To stretch their food budget, the majority reported practicing typical shopping and budgeting skills, and many reported skills particularly useful in rural areas: hunting, fishing, and canning. Over two-thirds of the survey respondents reported computer access and previous Internet use, and most of those not yet online intended to use the Internet in the future. Those working in rural communities need to consider technology as a way to reach traditionally underserved populations like low-income mothers.


Technology Rural Health Nutrition Physical Activity 



Acknowledgment for funding of this study goes to the United States Department of Agriculture through a cooperative agreement between the Maryland Cooperative Extension Service and the University of Maryland, College Park.


  1. 1.
    Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM 2006 Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 295:1549–1555PubMedCrossRefGoogle Scholar
  2. 2.
    U.S. Department of Health and Human Services 2001 The Surgeon General’s call to action to prevent and decrease overweight and obesity. Overweight and Obesity as Public Health Problems in America. Rockville: Office of the Surgeon General pp. 8–14Google Scholar
  3. 3.
    U.S. Department of Health and Human Services 2000 Healthy People 2010, Volume II: Objectives for Improving Health. 2nd ed. Washington, DC: U.S. Government Printing OfficeGoogle Scholar
  4. 4.
    Gamm L., Hutchison LL, Dabney BJ, Dorsey AM (Eds.) 2003 Rural Healthy People 2010, Volume II: A Companion Document to Healthy People 2010. Washington, DC: Southwest Rural Health Research Center pp. 115–123Google Scholar
  5. 5.
    Palmeri D, Auld GW, Taylor T, Kendall P, Anderson J 1998 Multiple perspectives on nutrition education needs of low-income Hispanics. J Community Health 23:301–316PubMedCrossRefGoogle Scholar
  6. 6.
    Paluck EC, Allerdings M, Kealy K, Dorgan H 2006 Health promotion needs of women living in rural areas: An exploratory study. Can J Rural Med 11:111–116PubMedGoogle Scholar
  7. 7.
    Wilbur J, Chandler P, Dancy B, Choi J, Plonczynski D 2002 Environmental, policy, and cultural factors related to physical activity in urban, African American women. Women Health 36:17–28PubMedCrossRefGoogle Scholar
  8. 8.
    U.S. Department of Commerce 2002 A Nation Online: How Americans are Expanding Their Use of the Internet. Washington, DC: National Telecommunications and Information Administration pp. 11–30, 76–83Google Scholar
  9. 9.
    U.S. Department of Commerce. 2004 Entering the Broadband Age. Washington, DC: National Telecommunications and Information Administration pp. 14–16Google Scholar
  10. 10.
    Fox S 2005 Health information online. Washington, DC: Pew Internet & American Life Project pp. 1–17Google Scholar
  11. 11.
    Bell P, Reddy P, Rainie L 2004 Rural areas and the internet. Washington, DC: Pew Internet & American Life Project pp. 7–37Google Scholar
  12. 12.
    Lenhart A, Horrigan J, Rainie L, et al. 2003 The ever-shifting internet population: A new look at internet access and the digital divide. Washington, DC: Pew Internet & American Life Project pp. 1–46Google Scholar
  13. 13.
    National Cancer Institute. Clear & Simple: Developing Effective Print Materials for Low-literate Readers. Washington, DC: Department of Health and Human Services, 1995 Pub. No. NIH 95–3594Google Scholar
  14. 14.
    Poikolkainen, A. 2005 Characteristics of Food Stamp Households: Fiscal Year 2004. Alexandria, VA: US Department of Agriculture, Food and Nutrition Service, Office of Analysis, Nutrition and Evaluation Report No. FSP-05-CHARGoogle Scholar
  15. 15.
    Quatromoni PA, Carballeira NP, Brunt M, Milbauer M, Posner BM, Chipkin SR 1994 Use of focus groups to explore nutrition practices and health beliefs of urban Carribean Latinos with diabetes. Diabetes Care 17:869–73PubMedCrossRefGoogle Scholar
  16. 16.
    Albarran NB, Ortega MI, Ballesteros MN, Morales GG 2006 Dietary behavior and type 2 diabetes care. Patient Educ Couns 61:191–9PubMedCrossRefGoogle Scholar
  17. 17.
    Kieffer EC, Guzman JR, Loveluck J, et al. 2004 Reducing disparities in diabetes among African-American and Latino residents of Detroit: the essential role of community planning focus groups. Ethn Dis 14:S27–37PubMedGoogle Scholar
  18. 18.
    Coombs JB, Barrocas A, White JV 2004 Nutrition care of older adults with chronic disease: attitudes and practices of physicians and patients. South Med J 97:560–565PubMedCrossRefGoogle Scholar
  19. 19.
    Dye CJ, Haley-Zitlin V, Willoughby D 2003 Insights from older adults with type 2 diabetes: making dietary and exercise changes. Diabetes Educ 29:116–27PubMedGoogle Scholar
  20. 20.
    Bertera EM 1999 Assessing perceived health promotion needs and interests of low-income older women. J Womens Health Gend Based Med 8:1323–36PubMedGoogle Scholar
  21. 21.
    Duerr L 2003 Assessing nutrition education wants and needs of older adults through focus groups. J Nutr Elder 23:77–91PubMedCrossRefGoogle Scholar
  22. 22.
    Rainey CJ, Mayo RM, Haley-Zitlin V, Kemper KA, Cason KL 2000 Nutritional beliefs, attitudes and practices of elderly, rural, southern women. J Nutr Elder 20:3–27CrossRefGoogle Scholar
  23. 23.
    Dwyer J, Allison KR, Goldenberg ER, Fein AJ, Yoshida KK, Boutilier MA 2006 Adolescent girls’ perceived barriers to participation in physical activity. Adolescence 41:75–89PubMedGoogle Scholar
  24. 24.
    Evans AE, Wilson DK, Buck J, Torbett H, Williams J 2006 Outcome expectations, barriers, and strategies for healthful eating: a perspective from adolescents from low-income families. Fam Community Health 29:17–27PubMedGoogle Scholar
  25. 25.
    O’Brien K 1993 Improving Survey Questions Through Focus Groups. In: Morgan DL (Ed.). Successful Focus Groups. Newbury Park: Sage pp. 105–117Google Scholar
  26. 26.
    Nord M, Andrews M, Carlson, S 2003 Household Food Security in the United States FANRR-42, USDA/ERS, 2004, pp. 2–19Google Scholar
  27. 27.
    Institute of Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). Washington, DC: National Academies Press, 2005Google Scholar
  28. 28.
    National Center for Health Statistics Health, United States, 2005. With Chartbook on Trends in the Health of Americans. Hyattsville, Maryland: National Center for Health Statistics pp. 42, 275–278Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Nancy L. Atkinson
    • 1
    Email author
  • Amy S. Billing
    • 1
  • Sharon M. Desmond
    • 1
  • Robert S. Gold
    • 2
  • Amy Tournas-Hardt
    • 3
  1. 1.Department of Public and Community HealthUniversity of MarylandCollege ParkUSA
  2. 2.College of Health and Human PerformanceUniversity of MarylandCollege ParkUSA
  3. 3.Evaluation and Reporting CoordinatorCenter for Workplace DevelopmentHarvard UniversityCambridgeUSA

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