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Transcript of 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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Journal of Nutrition Education and Behavior Volume 35 Number 6 November December 2003 285
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
286 Blake and Bisogni/FOOD CHOICE SCHEMAS OF RURAL WOMEN IN UPSTATE NEW YORK
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
Journal of Nutrition Education and Behavior Volume 35 Number 6 November December 2003 287
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
Journal of Nutrition Education and Behavior Volume 35 Number 6 November December 2003 289
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
Journal of Nutrition Education and Behavior Volume 35 Number 6 November December 2003 291
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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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