Qualitative Exploration of Cultural Influence on a Rural Health-Promotion Initiative.

To develop a conceptualization of cultural influence on perceptions of a rural food and physical activity policy, systems, and environmental (PSE) change project to inform public health research and practice. Basic qualitative research design, semistructured phone interviews with community health coalition members. Five rural Southern counties (obesity prevalence > 40%). Thirty-nine community coalition members. The Centers for Disease Control and Prevention High Obesity Program. PSE initiatives to increase access to healthy food and physical activity opportunities through a community coalition model. Social norms and cultural influences surrounding community members' food preferences, physical activity behavior, and future hopes for community development. Abductive content analysis. Major categories on food social norms (subcategories: physical health, eating habits, and food preference), race relations, generational factors, physical activity social norms, and hopes for the community (subcategories: increased engagement, health, awareness, cohesion, and inspiration) were discussed in relation to the progress of PSE initiatives. Because of community member perceptions, PSE initiatives became associated with factors beyond food and fitness, such as race relations, generational differences, and community cohesion. A focus on increased youth and church involvement, community values, relationship building, and input from diverse voices can be foundational to culturally-appropriate PSE efforts in rural settings. [ABSTRACT FROM AUTHOR]