interview- personal and family food choice schemas of rural women in

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ABSTRACT

Objective: The purpose of this study was to gain conceptualunderstanding of the cognitive processes involved in food

choice among low- to moderate-income rural women.

Design: This interpretivist study used grounded theorymethods and a theory-guided approach.

Participants/Setting: Sixteen women aged 18 to 50 yearsfrom varied household compositions were purposivelyrecruited in an upstate New York rural county.

Methods: Semi-structured interviews were conducted. Ver-batim transcripts were analyzed using the constant compar-ative method.

Results: Study participants held both personal and family

food choice schemas characterized by food meanings andbehavioral scripts. Food meanings encompassed self-reportedbeliefs and feelings associated with food.Food choice scriptsdescribed behavioral plans for regularized food and eatingsituations. Five personal food choice schemas (dieter, healthfanatic, picky eater, nonrestrictive eater, inconsistent eater)and 4 family food choice schemas (peacekeeper, healthyprovider, struggler, partnership) emerged.

Conclusions and Implications: The findings advance con-ceptual understanding of the cognitive processes involved infood choice by demonstrating the existence of different foodchoice schemas for personal and family food choice situa-

tions.Further study is needed on food choice schemas in dif-ferent populations in various food and eating situations.

KEY WORDS: food choice, schema,rural women,qualitative

(J Nutr Educ Behav. 2003;35:282-293.)

INTRODUCTION

The involvement of many factors in food choice is well rec-

ognized, but the different ways in which individuals make

food choices in various roles and contexts are poorly under-stood.1,2 An exploration of cognitions related to food choice

in different social and physical settings could provide useful

information for programs designed to promote changes in

food choice behaviors.3,4

In interpretivist studies, investigators focus on partici-

pants perspectives. Researchers venture outside precon-

ceived beliefs for participants to tell their own stories.5

Recent interpretivist studies have resulted in multiple per-

spective and life course models of food choice that consider

the ecological, sociological, psychological, cultural, and life

experience factors that influence food practices.6-8 These

models are based on qualitative, in-depth interviews with

adults and attempt to explain the factors and processes

involved in food choice from the perspectives of the inter-

view participants. These models depict a persons food

choices as resulting from his or her life course events and

experiences,current physical and social environments, ideals,

personal factors, and resources.These factors serve to shape

the personal food system in which individuals mentally con-

struct the options, trade-offs,rules, and routines for eating in

daily life.7,8 These mental processes include negotiations

among food choice values such as sensory perceptions, mon-

etary considerations,convenience,managing social contexts,

and physical well-being; personal definitions for healthful

eating; classification of foods and eating situations; and bal-

ancing priorities across personally meaningful timeframes.4,9-11

These studies demonstrate the complexity of the mental

processes that guide food choice behaviors and stress that

further research is needed to explain the intricacies of the

processes.9

Although these models recognize the importance of

social context and managing social relationships in food

choice,7,8 they have not attended to the cognitive processes

that a person may use in food choice depending on the per-

sons role as an eater or a provider of foods for others.8,12

Other interpretivist studies of food choice have indicated

that identities and roles must be considered when trying to

282

RESEARCH ARTICLE

Personal and Family Food Choice Schemas of Rural Women in

Upstate New York

CHRISTINE BLAKE , MS, RD; CAROLE A. B ISOGNI , PHD

Division of Nutritional Sciences, Cornell University, Ithaca, New York

This project was supported by funds (Special Needs Grant #94-34324-0987) from

the Cooperative State Research,Education and Extension Service, US Department

of Agriculture, to the Division of Nutritional Sciences at Cornell University.

Address for correspondence:Chr istine Blake, MS, RD, Division of Nutritional Sci-

ences, 335 Martha Van Rensselaer Hall, Cornell University, Ithaca, NY 14853;

Tel: (607) 255-3435; Fax: (607) 255-0178; e-mail: [email protected].

2003 SOCIETY FOR NUTRITION EDUCATION


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understand food choice,11,12 and schema theory13-17 was rec-

ommended as a way to understand how people manage their

identities and roles in eating.11 According to Olson, research

on food schemas is important because much of the inter-

subject variation in food choice is due to the effects of dif-

ferent knowledge structures on perceptual processing.13 In

addition, greater understanding of knowledge structurescan help food and nutrition researchers develop more effec-

tive nutrition education messages.17

Schema theory has roots in cognitive anthropology,18

cognitive psychology,19-23 artificial intelligence, and linguis-

tics.24 People have many highly context-specific schemas

related to various domains, including food choice, that serve

to organize and provide coherence to perceptions.13 Food

choice schemas consist of long-term, enduring personal

knowledge structures that contain hierarchically arranged

classification systems of food meanings.These include beliefs

about food and affects related to food (such as attitudes and

feelings) triggered in response to certain foods or eating sit-uations and situational food choice scripts that guide behav-

ior.13,14,17 Food choice scr ipts are the organized knowledge

people hold regarding a particular situation and the way

events in that situation unfold.20,21 At the level of food and

eating, these are the plans that people have for familiar food

and eating situations.

An individual makes personal sense of life course events

and experiences through the process of interpretation

guided by existing schema structure and content.21,22,25 These

schemas are continually modified in response to new food-

related experiences or information.17,26 To make sense of

new experiences or information, people draw on existingknowledge stored in memory and combine it with coded

incoming information leading to maintenance or modifica-

tion of personal knowledge structures. Modifications in

structure and content of the schema may influence behavior

change through changes in behavioral scripts.13,17

Prior applications of schema theory to food and nutrition

issues have primarily concentrated on the area of eating dis-

orders.14-16,27-31 The identification and understanding of

weight-related schemas16,30 and food-related schemas14,29

have been cited as significant to the treatment of eating dis-

orders such as bulimia and anorexia nervosa. Other areas of

application related to nutrition and health include novelfood schema,32 food classification,33 beliefs in health anxi-

ety,34 food acceptance,13 and exercise schemas.35

The existing food choice literature includes limited infor-

mation from the perspectives of rural women, particularly

those with low incomes, who are difficult for researchers to

access.Studies of other populations of women have reported

that life stage influences womens motives for preventive

dietary behavior because of womens changing perceptions

of health status, body weight, and social roles.36 Social roles

shape womens attitudes and beliefs about personal nutrition

care and can be both a positive and a negative influence on

preventive dietary behaviors, varying according to changing

interpretations of family roles at different life stages.37

A disproportionate number of female-headed households

experience chronic poverty and its deleterious effects, pre-

disposing them to risk of poor nutritional status.38 Studies

comparing rural and urban women show that rural women

live in poverty in greater numbers,39 generally have less for-

mal education,40 and are at higher risk for food insecurity.41

Women of lower socioeconomic status have been shown tobe at risk for lower intakes of fruits and vegetables,42,43 and for

rural women, availability of all food categories declines as

food insecurity worsens.44 Food insecurity has been related to

disordered eating behaviors,44 and low-income women often

skip a meal to provide more food for their children.45 Under-

standing the cognitive processes involved in food choice in

this population is particularly important, considering their

overall vulnerable position in society and their potential

impact on the health status of other family members.

This study was designed to gain conceptual understand-

ing of the cognitive processes involved in food choice in var-

ious situations among low- to moderate-income women liv-ing in a rural area.The study was part of a larger investigation

designed to understand the perspectives on food and eating

of rural women with low to moderate incomes.46

METHODS

This interpretive investigation used a combination of

grounded theory methods47,48 and a theory-guided

approach,49 a research approach used in previous studies of

food choice.5,7,9,50 Grounded theory methods were used to

ensure that the resulting theory was inductively derived andwas grounded in the participants real-life experiences. A

theory-guided approach allowed the researchers to use exist-

ing theoretical frameworks to inform data collection and

analysis and to compare the emerging conceptual model

with existing theories.49

Three convenience sampling strategies, including purpo-

sive, opportunistic, and snowball sampling, were used to

ensure adequate recruitment because this population is typ-

ically difficult to access.Women were deemed eligible for the

study if they were 18 years of age or older, of low to mod-

erate income and education,living in the defined geographic

region, reported current or prior eligibility for social welfareprograms such as food stamps, and identified themselves as

the household food manager.Ten participants were recruited

through referrals made by a local family social service orga-

nization, 2 through opportunistic sampling, and 4 through

snowball sampling. Recruitment stopped when analysis of

the data from 16 women indicated that theoretical saturation

had been achieved and that new informants would not add

new analytical insights.51

Prospective participants were asked questions about their

choices, preferences, feelings, and childhood experiences

related to food and that of their families. They were also

asked to provide demographic information, including age,

income, education, household composition, marital status,

Journal of Nutrition Education and Behavior Volume 35 Number 6 November December 2003 283


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and social welfare program eligibility. Participants were all

white and ranged in age from 18 to 50 years, with a mean

age of 32 years. Household incomes ranged from less than

$5000 to more than $50 000 per year, with 11 participants

reporting incomes of less than $26 000 per year. Participants

education levels ranged from 8 to 17 years. Eleven partici-

pants reported 12 years or less of education, with 5 partici-pants completing 10 years or less.Thirteen participants had

children ranging in age from 6 months to 14 years old, and

one participant had an adult son who lived with her and her

husband.Two participants had no children.Thirteen partic-

ipants were married or had partners; 2 were separated or

divorced, and 1 was single. In addition, 2 of the participants

had elderly or disabled individuals living with them. Four

of the participants had grown up in alternative living situa-

tions, including foster care, group homes, or relatives other

than parents. Eleven of the participants had lived locally all

of their lives and had never lived in a metropolitan area.All

of the others had grown up in rural areas and had movedto the area as teenagers or adults (Table 1).The university

committee on human subjects reviewed and approved the

research protocol.

Open-ended, in-depth interviews lasting 30 to 120 min-

utes were conducted in locations chosen by the participants.

Follow-up interviews were conducted with 9 of the 16 par-

ticipants to gain clarification and elaboration on some infor-

mation provided during the first interview. A semistructured

interview guide was used in all interviews (Table 2). The

Food Choice Process Model8 and the Life Course Model of

Food Choice6,12 provided constructs to guide the interview

protocol.The questions were adapted to each persons situ-ation, and the interviewer probed for more detail as relevant

themes emerged in the conversation.Topics included food

preferences, food roles, upbringing, fruits and vegetables,

conflict management, eating influences, educating children,

health definitions, eating locations, others food habits, cul-

tural values, environmental influences, and food identity.

All interviews were audiotape recorded and transcribed

verbatim. Immediately after each interview, field notes were

completed to record a summary of the interview,visual obser-vations, a description of the setting,and any relevant observa-

tions that may not have been captured on tape.The informa-

tion was used during analysis to aid the researchers memory

and to provide a context for the transcribed interview.

Participant observation was carried out at food shopping

centers, restaurants, and community events. Conversations

about food were elicited when opportunities arose.These par-

ticipant observations allowed for contact with local residents

and retailers in natural settings. Flyers and advertisements for

upcoming events related to food, takeout menus from local

food establishments, the local newspaper, and restaurant menus

were reviewed for food availability. Field notes were recordedafter each experience with attention to themes of food avail-

ability and food meanings. These observations strengthened

understanding of the community and were used in the devel-

opment of interview questions during the early stages of the

investigation. Participant observations conducted throughout

the course of the study provided additional data, which were

used to refine interview question probes.48

The data analysis reported in this article about the cogni-

tive processes involved in personal and family eating was part

of a larger analysis focused on developing a theoretical

understanding of the factors and processes involved in the

participants food choices.Data analysis began with a reviewof transcripts for emerging categories, themes, and relation-

ships between these categories and themes. Coding of the

284 Blake and Bisogni/FOOD CHOICE SCHEMAS OF RURAL WOMEN IN UPSTATE NEW YORK

Table 1. Participants Descriptions, Personal Food Choice Schema Typologies, and Family Food Choice Schema Typologies

Marital Years of Household Household Personal Food Family Food

Participant Age Status Education Size Income, $ Choice Schema Choice Schema

1 18 Partner 12 4 $15 000 Nonrestrictive Peacekeeper

2 21 Single 17 4 > 50 000 Nonrestrictive Partnership

3 25 Married 12 3 15 000 Picky eater Partnership

4 25 Separated 10 4 15 000 Dieter Struggler5 26 Married 10 5 7500 Nonrestrictive Partnership

6 26 Partner 10 4 35 000 Inconsistent Peacekeeper

7 26 Married 8 5 10 000 Picky eater Peacekeeper

8 30 Partner 9 5 Declined Health fanatic Healthy Provider

9 32 Married 13.5 5 25 000 Picky eater Peacekeeper

10 32 Divorced 13.5 2 < 5000 Picky eater Struggler

11 34 Partner 12 5 25 000 Nonrestrictive Peacekeeper

12 37 Partner 12 5 15 000 Inconsistent Healthy Provider

13 38 Married 13.5 5 25 000 Picky eater Peacekeeper

14 43 Married 10 5 45 000 Picky eater Partnership

15 45 Married 16 5 > 50 000 Health fanatic Healthy Provider

16 50 Married 12 3 15 000 Dieter Peacekeeper


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data was ongoing and included open, axial, and selective

coding.47,48 Using a constant comparative approach, the list

of categories was considered saturated when analysis of new

data did not yield additional categories.48

When analysis revealed that personal eating situations,

family eating situations, and the cognitive processes related

to food and eating were important themes in the data, these

themes became the focus of the analysis. Because cognitions

related to food and eating seemed to influence food choices,

the researcher investigated several related constructs, includ-

ing locus of control,

52

self-efficacy,

53

and schema.

19

Analysis resulted in descriptions of how the participants

conceptualized their food situations, with an emphasis on

how women characterized personal versus family food situ-

ations. As distinct sets of meanings and scripts for food

choice emerged from this analysis, the researchers clustered

the women into groups with common sets of meanings and

scripts for personal and family food situations.The groups

were labeled with the words that the women used to iden-

tify their approaches to personal and family food choice.

Then, to assist in the interpretation of the cognitive processes

being examined in this analysis, the researchers consulted

the schema literature.18,19,21-24,26 The researchers determined

that personal and family food choice schemas, food mean-

ings, and food choice scripts were suitable labels for the

common sets of cognitions that emerged in the data.

Several steps were taken to ensure the credibility of the

findings, including peer debriefing, member checks, advisor

consultations, audit trails, prolonged engagement, data trian-

gulation, and the researchers experience.48 Throughout the

analysis, the groupings of participants were checked against allcases in an iterative process, and the researchers modified the

groupings until they represented all cases.47,48

RESULTS

Personal Food Choice Schemas

Five personal food choice schemas emerged from the analy-

sis, including dieter,health fanatic,picky eater,nonre-

strictive eater, and inconsistent eater.Table 3 presents the

food meanings and scripts associated with each personal

food choice schema.

Dieters. The two dieters reported dieting for most of their

lives and explained that weight loss diets and binging and

purging behaviors had become part of their everyday way of

eating. One woman explained her experiences with dieting

over the years:

I thought I was a horse at 95 pounds, I thought I was huge, but

I look back on the pictures now, and Im like, oh gosh! If I

could only be like half of that now. Ive been dieting, for 7

years I gained 100 pounds when I was pregnant.I mean

I was 95 pounds, I was a little tiny thing, and now Im really

pissed I couldnt get it off, so hopefully this Zone thing [diet]will work; otherwise, you know, Ill just die.

The dieters stated that their focus on weight interfered

with their daily lives:So the more you make yourself throw

up or whatever, the more nauseous you are all the time, and

its really hard to take care of kids when youre nauseous all

the time. These women conceptualized foods in terms of

their potential to promote or inhibit weight gain, with

little emphasis given to other qualities of a food, such as

healthfulness.

Health fanatics. The two health fanatics expressed devo-

tion to making sure that they were eating healthfully.Theydescribed themselves with statements such as I think Im a

healthy eater or Ive always been more health food,

health fanatic. Personal eating for these women involved

health maintenance and disease prevention.They were con-

scious of the link between diet and disease and expressed

confidence in their personal ability to maintain health

through food choices:

I like every vegetable and just about every fruit. Theyre

healthy, I thrive on the healthy part of it, I guess.Cancer runs

in the family and stuff too, so its scary. So Im trying to stay

as healthy as I can. Especially getting older I try to maintain

a healthier diet, just for that purpose.

Table 2. Selected Questions from the Semi-structured Interview

Guide

1. Can you describe the foods that you usually eat? Give me anexample of a typical day. Are all the days the same? Probes:days off work, weekends, holidays, seasons.

2. What foods do you never eat? Why? What foods do you tend to

eat most often? Why?

3. Have you always eaten this way? How much has yourupbringing influenced what you eat? In what ways has theway that you eat changed over the years? Specific foods?

4. Do you see yourself influencing how others eat? How do youinfluence what others eat? How do other people influencewhat you eat?

5. Tell me about a typical dinner? Who prepares it? Who decideswhat will be served? What are these decisions based on?Probes: preferences of others in the household, self-preference, health considerations (whose?). Tell me about atypical meal with friends or relatives.

6. Where do you usually eat? If at home, where else do you eatbesides home?

7. When you eat at ___________, do you choose foods differentlythan you might at home? Probes: When you eat at homeversus when you eat at someone elses house or arestaurant? What kinds of foods? How do you decide on whatfoods to choose in these different types of situations?

8. How does the way that you eat compare with others that youknow? In your family? Coworkers? Someone from anotherplace?

9. Can you please complete the following statements? Im nota____________ eater. I am a _______________eater.What type of eater would other people say that you are?Probes: husband, daughter, mother, etc.

*Adapted from previous studies.6,8,11


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Part of their health maintenance strategies included

avoiding or limiting foods they considered junk food or

unhealthy and feeling guilty if they gave in to cravings:

Once in a blue moon I will buy hot dogs because I will crave

them. But thats very seldom.And then I buy the white hot dogs

that dont have the sodium nitrate in [them]. I try my hardest tostay away from that stuff. Its really hard to just alway stay away

from it.

The health fanatics had life experiences similar to those of

dieters, such as divorce,financial difficulties,and struggles with

weight; however, they had adopted healthful eating and

lifestyle practices in which weight control was not the primary

motivator.They attributed their adoption of healthful eating

habits to education they had received through formal classes,

community programs, or nutrition education materials.

Picky eaters. The 6 picky eaters described themselvesusing statements such as I am a picky eater or Im very

choosy in what I eat. These women reported that they

believed their diets to be unhealthy overall. They explained

that they did not select foods based on health quality and

that they had very specific food likes and dislikes on which

they would not compromise. One woman described her

basis for choosing foods, stating,I wont buy the things that

I didnt like. Even though I know that theyre good for

me, I wont buy them.

The picky eaters felt that they were unique in their eat-

ing habits and made statements such as nobody eats like

me. They reported that other people found their eating

habits to be weird, strange, or abnormal. All picky

eaters explained that others criticized their eating habits,

telling them that they were eating incorrectly or should be

willing to try different foods.These women reported that

because of prior criticism, they avoided eating in front of

other people: So, if Im at somewhere else, I dont eat. I

just dont like eatin at other peoples houses. Havin themlook at me while Im eatin.

The picky eaters expressed dissatisfaction with their eat-

ing habits, explaining, Im not a very good eater and I

wish I wasnt so picky. They explained that part of their dis-

satisfaction was related to concern for their influence on

their childrens eating habits and that they verbally instructed

their children not to eat like them.They also reported that

they often avoided eating in front of their children.

Most picky eaters attributed their choosiness to specific

events in childhood that had turned them off certain foods.

In many cases, these women were unwilling to try the

offending food again regardless of the circumstances. Onewoman explained her dislike for fish:I found a bone in my

fish patty [as a child].So,that right there. Forget it! No fish!

Nonrestrictive eaters. The 4 nonrestrictive eaters were

very different from the picky eaters in the way in which they

conceptualized food and made food choices.They described

themselves using statements such as I am not a picky eater

and I am a big eater. These women explained that they

would eat what was available to them, often overeating.One

woman said,I eat a lot. I do eat a lot!

The nonrestrictive eaters did not make food choices for

health or dieting reasons, and they were relaxed about when,

what, and where they ate. They described themselves as


Table 3. Summary of Food Meanings and Food Choice Scripts in Participants Personal Food Choice Schemas

Personal Food

Choice Schema Food Meanings Food Choice Scripts

Dieter Food as enemy Starvation Weight loss/control is primary concern Binge/purge behaviors Guilt about eating Food quantity restriction

Weight loss diet plans

Health fanatic Eating healthy is primary concern Avoid junk food Guilt about eating bad foods Focus on learning about food and health Food as disease prevention Regularly practice other health behaviors

such as exercise

Picky eater Believe personal eating habits are unhealthy, Only eat familiar foodsstrange, or abnormal Only eat preferred foods

Guilt about personal eating habits Avoid eating in front of child Self-conscious eating in front of others Will not try new foods Angry if others push foods Will not eat at others houses

Nonrestrictive eater No guilt about food Eat almost anything Limited concern for weight control or health when Willing to try new foods

choosing foods No set mealtimes or places

Inconsistent eater Feel that they are abnormal in their way of eating Quantity of food consumed is not

Food is not a pr imary concern at this po in t in life owing consistent day to dayto other stressful life events Sometimes particular about what they eatand other times will eat anything


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average in their eating habits and were able to identify

individuals whom they saw as either more or less health con-

scious than themselves.

These participants expressed some dissatisfaction with

their tendency to overeat and a desire to be more restrained.

One woman explained that she tried to go on a diet but was

unable to because she did not like to restrict what she ate:Iwent on Slim Fast for a while.Tried to lose weight. Over

a couple of weeks, I just decided I like to eat better.

Inconsistent eaters. The two inconsistent eaters reported

no patterns related to food and eating.They reported some

periods of low appetite and food aversion, with little food

intake alternating with other periods of high appetite, food

cravings, and overeating. One woman explained how her

hunger directed her eating practices:

I am not a consistent eater. Oh, I could go days. I am one of

these people that eat when Im hungry. Ill always eat dinner.

But like theres some days where I will eat during the day

constantly. Im like starving! And then theres other days where,

even at dinner, Im not very hungry. My system will tell me

when Im hungry.

These women believed that they did not eat normally

and that the other people around them were more normal

in their eating habits.However, inconsistent eaters described

acute stressful life events that were occupying a great deal of

their physical, emotional, and mental energy. One partici-

pant with a seriously ill mother reported that food might be

more important to her under different circumstances. A

mother of a chronically ill young child said that she was ableto ensure that her family ate well but that her own food

practices had become inconsistent since her child became

ill. Both women explained that when life situations were

not so stressful, they were much more conscious of what,

how, and when they ate.

These women expressed concerns about the example that

they were setting for their children that were similar to the

concerns of the picky eaters.One woman said,I have no set

eating patterns, and, God knows, I hope this kid never

eats like I do.

Family Food Choice Schemas

The analysis of responses related to family food situations

resulted in the identification of 4 different food choice

schemas: peacekeeper, healthy provider, struggler, and part-

nership.A summary of the food meanings and food choice

scripts associated with each family food choice schema is

presented in Table 4.

Peacekeepers. The 7 peacekeepers explained that they

accommodated the preferences and demands of as many

family members as possible, often regardless of their own

preferences or needs.Their ultimate goal at mealtimes was tokeep people happy and not cause any conflicts.

These women said that they often prepared more than one

type of main dish at meals to satisfy all other family members.

However, in these cases, the women usually did not change

their own eating habits and preferences but found ways to

meet their own needs without compromising the needs and

preferences of the other family members involved.

So if were not all together, I might cook two meals, one for my

son and one for my husband, and then cook whatever I cook for

my husband for my older son when he gets home from basket-

ball. Depending on my mood, I might eat some of that, or I

might just forget it. Ill serve them what I think they want

and what they need, and if I dont like it, Ill choose some-

thing else.

These women also reported that they did not force chil-

dren to eat foods.At the most, they would ask the child to


Table 4. Summary of Food Meanings and Food Choice Scripts in Participants Family Food Choice Schemas

Family FoodChoice Schema Food Meanings Food Choice Scripts

Peacekeeper Primary concern is to avoid conflict Accommodate needs and preferences of others

Own needs and preferences are secondary Satisfy own needs and preferences only afterthose of others satisfied

Provide alternatives

Healthy provider Primary concern is health quality of foods Careful organization of all food activities Health quality of family food cho ices reflect quality Keep track of what family members eat

of care (parental/spousal/other) Encourage and enforce healthy eating habits offamily members

Struggler Primary concern is to obtain adequate quantities of food Use social welfare system to obtain food for Feel ings of inadequacy and inabi li ty with food preparation extended periods of t ime

and budgeting financial resources Use alternative free food sources Purchase processed and takeout foods to make

up for lack of food preparation skill/ability

Partnership Primary focus is fair distribution of family food choice activities Share responsibi li ty for shopping and cooking with Ultimately feel responsible for food-related activities other family members Limited enjoyment of cooking/prefer to have others cook Pool household f inancial resources to obtain food

Satisfaction with shared food provider role


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try a food, but they would provide an alternative if the child

continued to refuse the food:[I make] what [my son] wants,

cause he wont eat it, and if it gets to be the point where

I really want that, I would make that for myself and fix him

something so we dont fight about it.

Healthy providers. The 3 healthy providers focused onthe health benefits and consequences of foods when they

explained how they fed their families. They believed that

the foods they provided influenced the current health of

their family members and would establish healthful eating

habits for later life. One woman described how she fed her

family:

The apples, the oranges, you know, the vitamin C, its just I

kind of believe that kind of stuff cut down on the colds, cut

down on the illnesses. I guess food is one of the things that

you really believe is gonna help [kids] be healthy. And I

really believe that.

These women described being very aware of what other

family members ate, including extended family members.

One healthy eater explained, Oh, I totally keep track of

what everybody eats.Although they did not force foods on

their spouses and partners, these women were more con-

cerned about promoting healthful eating than minimizing

conflict and encouraged their spouses and partners to adopt

healthful eating habits.One healthy eater explained how she

influenced her spouse, stating,I think Ive changed my hus-

bands eating habits. Like,he turned vegetarian a number of

years after I was.Another healthy eater said,

Well, its not good for [my husband] either.You know, all this

old adage about organ meat is not so good, thats Organ

meat is not good for you. It is very high in cholesterol.You

know, it is horrible for him.So, if he gets it once a year, thats [it].

The healthy providers often compared their childrens

eating habits with those of others.These women were often

shocked to learn how others ate and what other mothers fed

to their children, and they believed that they were doing the

right thing. One mother described her reaction to the foods

that other children ate:

They bring Twinkies! And bring Ho Hos and all this stuff!

and all this stuff, that they see on TV, and they hear. Somepeople must just disregard [it]! I dont know. I thought every-

body ate the way that we ate.You know, everybody paid atten-

tion in making sure their vegetable was on the table, and their

starch was on the table, and their protein was on the table. I

thought everybody cooked like that. Its in the Betty Crocker

cookbook in the front pages! It tells you right in there, way back

50 years ago! You know, the 4 basic food groups, and what

should be on the table for every meal. I thought it was com-

mon knowledge!

The healthy providers reported that they avoided things

that they considered to be junk food and discouraged other

family members from eating these types of foods by limiting

the household supply of such items.Because of their unwill-

ingness to provide such foods to family members, others

often criticized them and called them fanatical. One woman

stated,[My mother] thinks Im a fanatic about what my kids

eat because I dont buy chocolate, I dont buy candy.

Strugglers. The two strugglers reported dealing withchronic, difficult financial and social situations. They were

unemployed,with limited incomes, and trying to raise young

children on their own.The strugglers often discussed food in

terms of what they could afford and the strategies that they

employed to ensure that their children would be fed.They

relied on social welfare services such as food stamps,the Spe-

cial Supplemental Nutrition Program for Women, Infants

and Children (WIC), and food pantries to obtain enough

food for themselves and their children,but this was often dif-

ficult. For these women, food was primarily thought of in

terms of affordability:

I have to be very picky about the food that I choose to buy.

Because I have to remember its onlyfor Joseph and I,and I only

get 85 dollars a month in food stamps, and I try not to go over

that amount because during the month I have to go out and

buy milk. And my food stamps have to help me with that

because its too expensive. I dont have enough cash to keep buy-

ing milk every 2 days, every 3 days, depending on how much

milk Joseph and I drink.

Both of the strugglers described difficult childhood expe-

riences; they had been raised in alternative living situations

in which they had limited exposure to food-related activi-

ties. As adults, they found it difficult to provide food forthemselves and their children, and they attributed this prob-

lem to never learning how to budget money for food or how

to cook. One woman explained, I was in foster care in a

group home after 10. Thats why I couldnt [cook] or

nothing because [the food] was brought from the main

[kitchen]. I mean I didnt know how to boil water 7

years ago.

The participants who presented the struggler food choice

schema described challenging food situations,with a lack of

personal resources being a major influence on their food sit-

uations. For the strugglers, providing food was a difficult,

confusing, and painful experience.

Partnership. The 4 women who presented a partnership

family food choice schema had family members or partners

who made a significant contribution to all food-related

activities, including shopping and cooking. Some of these

women described the family partnership as a fend for your-

self system in which anyone who was able to cook would

provide for himself or herself unless all members of the fam-

ily were going to eat at the same time. These women

explained that they often felt responsible for these activities

but were secure in the knowledge that their partners or

other family members would contribute a great deal of effort

voluntarily on a regular basis.



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The women who were married described strong rela-

tionships with their spouses that involved partnerships in

more than just the food activities.Those who were unmar-

ried and living with family explained that within the house-

hold,financial resources were pooled,and everyone made an

equal effort in all household tasks.

Relationships between Personal and Family Food

Choice Schemas

Participants personal food choice schemas and family food

choice schemas are shown in Table 1 with corresponding

demographic information. Few patterns emerged between

personal food choice and family food choice schemas. How-

ever, one trend that appeared was that both health fanatics

were also healthy providers. In addition, the participant who

presented a healthy provider family food choice schema and

an inconsistent personal food choice schema explained that

she used to be a healthy eater and that she was currently

inconsistent in her personal eating habits owing to stress.

Under different circumstances, she may have presented a

health fanatic food choice schema.

Conceptual Model

The Figure presents the conceptual model that emerged

from this analysis for the role of food choice schemas in food

choice.At the center of the model are womens personal and

family food choice schemas, the cognitive processes that link

the many forces shaping food choice to food behavior. Awomans personal food choice and family food choice

schemas may be very similar or different.The schemas con-

sist of meanings related to food and eating as well as scripts

for food choice in different settings.

In this study, the womens personal and family food choice

schemas were shaped by many forces, including their current

resources, social contexts, and personal factors, as well as their

life course experiences. Current resources included income

and assistance programs, physical and emotional energy to

attend to food choice, and knowledge and skills related to

food buying and cooking. Social contexts influencing food

choice schemas included parenting and caregiving roles and

support from spouses and other household members. Impor-

tant personal factors were body image and weight concerns,

interest and concern for health,and taste preferences. Among


Figure. Conceptual model for role of food schema in linking current situation and shaping factors to food behaviors among low- to moder-

ate-income women living in rural New York.


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the life course experiences that were important in shaping

food choice were exposure to food preparation in upbring-

ing, specific food episodes resulting in dislikes, and educa-

tional experiences related to nutrition.

DISCUSSION

This investigation set out to gain a conceptual understand-

ing of the cognitive processes involved in the food choices

of low- to moderate-income rural women, a hard to reach

population for which information about food choices is

lacking.40,54The use of the grounded theory methods47,48 and

a theory-guided approach49 provided the opportunity to

build on prior work while merging perspectives from several

fields with the perspectives of the participants so that the

participants cognitions related to food choice could be

understood. The approach and methods allowed for new

ideas and relationships to emerge that address the need forcreative approaches to understanding food choice.3

Recognizing the role of food choice schemas in personal

and family food choice advances understanding of food

choice by emphasizing the meanings that people hold about

food and how these meanings are linked to situational

actions through the scripts that people construct. Meanings

have long been recognized as important in food choice,55

but the ways in which meanings are linked with food prac-

tices are not well developed. Grounded theory models of

food choice recognize some of the cognitive processes

involved in food choice, such as the influences of life course

events and experiences, classification of foods and eating sit-uations, negotiation of values, and balancing of priorities.6,8

However, meanings have not been given explicit attention

in these models. The study results emphasize that models

of food choice have to emphasize the meanings and scripts

that clients construct for food choice.This recommendation

also emerged in other interpretivist studies of food

choice.10,50 A study of food choice among college athletes

found that athletes meanings, feelings, and approaches to

eating varied in a cyclical pattern throughout the year

according to the season of competition.50 A study of how

adults living in an urban area of upstate New York concep-

tualize and manage healthful eating found that individualsdefinitions of healthful eating and related classifications of

foods and eating situations were associated with different

eating strategies.10

The model that emerged in this study advances concep-

tual understanding of food choice by recognizing that

women have both personal and family food choice schemas

and that these schemas may differ in meanings and scr ipts for

food behavior. Existing food choice models do not portray

distinctions of this type, although the importance of social

relationships and context in shaping situational food choice

is recognized.7,8 Other studies of domestic activities related

to diet have noted the complexity and variability in rela-

tionships, responsibilities, and situations that underlie daily

household food activities,56 but few studies have explored

both womens personal approaches to eating and their

approaches to providing food for their families as well.An

exception is work by Devine and Olson that examined how

womens family roles may conflict with personal nutrition

care.36,37

As indicated by the conceptual model, a host of factorsinteract in shaping the food choices of the study participants,

including resources, social environments, personal factors,

and life course experiences.The findings are similar to prior

studies of food choice in different populations.7,8

The finding that women with relatively similar socio-

demographic characteristics held different personal and fam-

ily food choice schemas and different combinations of these

schemas demonstrates the importance of psychosocial factors

in explaining food behavior. All of the interviewees were

white women of low to moderate income from the same

rural area. Represented in the data were 5 personal food

choice schemas,4 family food choice schemas, and 10 com-binations of personal and family food choice schemas.Very

few associations between food choice schemas and socio-

demographic characteristics emerged, indicating the varia-

tion in the ways in which these women constructed their

food choices.

In designing this study, the researchers expected the par-

ticipants rural experiences to emerge as important factors

shaping the cognitive processes involved in food choice.

However, this could not be inferred from the data. Inter-

views with individuals from the same sociodemographic

group who lived in an urban area may have enabled the

rural/urban distinction to emerge. It is also possible that therural/urban distinction is not as important in shaping cog-

nitions related to food as some other factors, such as educa-

tion, age, or psychosocial factors.

Diversity in the ways in which women approach family

food choice was also found in a study of middle-income

mothers.57 Some of the family food choice schemas held by

the women in this study are similar to those that emerged in

Kirk and Gillespies study.57 The healthy provider schema in

this study is related to the nutritionist perspective in that

study, and the peacekeeper schema in this study is related to

their family diplomat perspective. Kirk and Gillespie

reported that women in their study used 3 to 5 of the 5 per-spectives when making food choices, including other per-

spectives (meaning creator, economist, and manager/orga-

nizer) that did not emerge in our study. 57 These perspectives

may not have emerged in this study of low- to moderate-

income women because of the different historical context

and socioedemographic characteristics of the study sample.

Several food schemas that the women in this study

expressed are consistent with other findings related to the

meanings and approaches that people hold for food and eat-

ing in the United States. The dieter personal food choice

schema is consistent with the reports of chronic dieting and

the wide concern about body image as related to eating in

this culture.58 The health fanatic food choice schema is con-



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sistent with other studies reporting the predominance of

health concerns as an influence on food behavior in the

United States.59 The picky eater, inconsistent eater, health

fanatic, and nonrestrictive eater food choice schemas that

emerged in this study are similar to the findings from a study

of identities and eating among middle-income white adults

that reported picky, nonrestrictive, health conscious,and inconsistent as words adults used to describe them-

selves as eaters.11 In the present study, the picky eater and

inconsistent eater labels express negative connotations that

are consistent with the participants overall description of

themselves and their eating habits. The study of identities

also reported that being a pickyeater had negative conno-

tations, similar to the feelings expressed by the picky eaters

in the present study.11

Although this study explored cognitions related to food

choice at one point in time, the results demonstrate the

dynamic nature of food choice schemas. The inconsistent

eaters reported being in a transitional state in terms of foodand eating, providing evidence that these food choice

schemas are not static phenomena but that they change over

time.Previous work on the life course has demonstrated that

individuals follow food choice trajectories that often change

direction at significant life stages, such as marriage, personal

illness, or retirement.6

One limitation of this study was its small sample of white

women from one rural county in New York. The specific

types of personal and family food choice schemas that

emerged in the study cannot be generalized to the larger

population,particularly those of other ethnocultural groups.

Although the specific food choice schema labels used in thisinvestigation may not be relevant to other populations, the

concept of personal and family food choice schemas that

emerged from this research may be useful in understanding

food choice in other populations.

Another limitation of the study is that the interview

guide did not probe comprehensively on participants food

schemas because the concepts of personal and family food

schema emerged during analysis. Had the interviewer set

out to conduct a comprehensive exploration of schema,

some other data collection approaches, such as pile sorting

and rating scales,60 would have been useful. Finally, this study

focused on understanding participants cognitions related tofood and eating, and the researcher did not collect food con-

sumption data in a systematic way, such as in food records or

dietary recalls for the woman or her family.

IMPLICATIONS FOR RESEARCH

AND PRACTICE

This interpretivist study of the food choices of a sample of

low- to moderate-income women living in a rural area con-

tributes new conceptual understanding to the cognitive

processes involved in food choice. These results build on

existing knowledge about food choice and provide a new

level of investigation in the form of food choice schema

from which to view the phenomenon.

The study results should be helpful to other investigators

interested in food choice or the eating practices of rural

women. More interpretivist work is needed to examine the

nature and operation of food choice schemas in different pop-

ulations.This work could focus on how food choice schemasdevelop and change over time by looking at meanings and

scripts related to food. Future research could draw on the lit-

erature on life course experiences related to food choice,5,11

the acquisition of meanings related to food and eating,55 and

the classification of foods and creation of food choice scr ipts.33

More work is needed on the relationship between food choice

schemas and food choice behaviors, and future investigations

should incorporate measures of dietary intake.

Nutritionists are often expected to develop interventions

that promote healthful food choices among low- to moder-

ate-income populations. However, these interventions are

frequently ineffective in attracting the attention of thosemost in need and limited in their ability to promote health-

ful eating habits.61 Refinement of program design and tai-

loring of messages could improve the quality of such inter-

ventions.The results of this study suggest that it is important

to distinguish between personal and family food choice

schemas. In practice settings, this could be accomplished by

adapting nutrition screening and assessment questions to dis-

tinguish between family food and personal food.Assessment

of an individuals food choice schema in a one-on-one

counseling setting could allow the nutritionist to individu-

ally tailor nutrition education messages. In group settings, an

assessment of food choice schema could be used to set upeducation classes containing individuals with similar food

choice schemas, allowing for more effective tailoring of

nutrition education to that particular group.At the popula-

tion level, an understanding of common cultural schemas or

the diversity of schemas within a cultural group could pro-

vide valuable information for program planning and message

development. For each of these examples, a distinction can

be made between family food choice situations and personal

food choice situations. Interventions designed to promote

change in the individual participant could focus on personal

food choice schemas, whereas interventions focused on

other family members using the women as gatekeeperscould attend primarily to the family food choice schemas.

By taking steps to understand food choice schemas, nutri-

tionists might be able to create interventions that are both

meaningful to participants and more likely to succeed in fos-

tering adoption of healthful food choices.

ACKNOWLEDGMENTS

This project was supported by funds (Special Needs Grant

#94-34324-0987) from the Cooperative State Research,

Education and Extension Service, US Department of Agri-

culture, to the Division of Nutritional Sciences at Cornell



11/12

University. Any opinions, findings, conclusions, or recom-

mendations expressed in this publication are those of the

authors and do not necessarily reflect the view of the US

Department of Agriculture.The authors thank the study par-

ticipants for making this possible.

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