Back in the Day: Nostalgia Frames Rural Residents' Perspectives on Diet and Physical Activity.

OBJECTIVE: To observe and interpret cultural influences on health behaviors in a rural area with a high prevalence of obesity. DESIGN: Descriptive, qualitative study. SETTING: Lenoir County, NC, US. PARTICIPANTS: Four focus groups (n = 33) were conducted. Participants were 76% African American and with an average of 25 years of county residence. PHENOMENON OF INTEREST: Diet, physical activity, environment ANALYSIS: Content analysis and thematic data analysis to identify key themes using qualitative analysis software. RESULTS: Participants frequently evoked nostalgia to frame recurrent themes including decreased opportunities for physical activity and changing food access and preparation in the community, contrasting with memories of enjoying local produce and safe outdoor recreation. They interpreted present health behaviors in the context of these past losses. CONCLUSIONS AND IMPLICATIONS: Nostalgia is an important element in our participants' cultural repertoires, revealing elements of place-based culture. Nostalgic narratives may foster a sense of reduced options for healthy eating and exercise by over-emphasizing loss. The incorporation of place-specific obesogenic cultural factors, including the way residents juxtapose past and present, may improve obesity interventions in rural settings.

Duke Scholars

Author Michelle Joette White Pediatrics, Hospital Medicine