“I come from a black-eyed pea background”: How women incorporate their personal history into dietary decision making

Introduction Improving individuals' dietary behaviors has become a central tenet to health promotion initiatives. However, some efforts focus exclusively on facilitating dietary change without consideration of the determinants of lifelong ingrained/embedded behaviors. Our research explores how women think about and articulate the concept of healthy eating. We seek to examine how individuals create meaning for food choices and how health issues factor into current and projected dietary behaviors. Methods We present data from eight focus groups with low-income women aged 40-64 with family incomes < 250% of the national poverty level. Such individuals are common targets for initiatives aimed at improving dietary behaviors. We recruited participants from a local health department breast and cervical cancer screening program. The focus group structure facilitated discussion of the complexities of food choice and salient concepts in decision-making. Thematic analysis focused on how women reference various aspects of their history and background to account for dietary choices and behaviors. Results Three themes emerged from the focus group discussions: What we ate when I grew up; What we eat where I come from; and What my people see as healthy. Analysis of these themes included descriptions of resources called upon to facilitate healthy-eating, comparisons of how current diet might be different, and explanations for current diet. Discussion These data suggest that understanding of healthy eating is shaped by personal identity, connections to family, cultural heritage and overall life experience. These factors may promote or inhibit how women are able to engage in making healthier choices.