Obtaining healthy food is a challenge for rural Americans. Compared to urban and suburban areas, rural communities have fewer grocery stores, and stores that do exist are farther apart and tend to have fewer healthy options available.

While access and availability of healthy food is important to improving diet quality for rural residents, so is information about which types of food are healthy. Previous studies have shown that store-based, healthy-food interventions—such as prominent nutrition labeling and in-store signage — tend to successfully persuade consumers to make healthier food choices.

A new study from the University of Minnesota School of Public Health adds to this conversation by identifying which factors drive food choices in rural food deserts. To conduct the study, researchers tested the effectiveness of a two-part intervention intended to promote healthy eating. In one part of the intervention, large, highly visible, and simplified nutrition labels were placed prominently on food packaging; in the second part of the intervention, a one-day nutrition education workshop by a local university was promoted to store customers.

The intervention was conducted at two rural grocery stores in Kansas in communities with fewer than 2,500 people. Four other stores in Midwestern U.S. rural food deserts served as the control group to compare changes in the healthiness of food purchased.

The study, published in Appetite, found:

• Though the overall intervention had minimal impact on the food purchasing choices made by consumers, the nutrition-labeling component of the intervention was statistically slightly more effective than the nutrition workshop.
• The effects of the intervention diminished over time. One year after the intervention, the statistically slight improvements detected immediately after the intervention further diminished.
• While the intervention had limited practical significance at the population level, some rural residents benefited from the information it provided to them.

“The results of this study suggest that more engaging approaches may be needed to entice people living in rural areas to seek out healthier food options,” says Harshada Karnik, SPH researcher and lead author. “It is difficult to sustain changes in the long-term, as evidenced by the fact that some marginal improvements were seen soon after the interventions, but those diminished over time.”