{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T15:10:06Z","timestamp":1788189006140,"version":"build-2803163510"},"reference-count":31,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2017,10,21]],"date-time":"2017-10-21T00:00:00Z","timestamp":1508544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000199","name":"United States Department of Agriculture","doi-asserted-by":"publisher","award":["Afri Grant 30000045856"],"award-info":[{"award-number":["Afri Grant 30000045856"]}],"id":[{"id":"10.13039\/100000199","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Obesity rates are higher among rural versus urban adolescents. To examine possible mechanisms for the rural-urban adolescent obesity disparity, we examined the direct and indirect effects of food purchasing patterns, and the home, school, and consumer food environments on dietary intake among rural adolescents. Methods: A baseline survey was conducted among adolescents in eight rural high schools (four in Eastern Kentucky, and four in Eastern North Carolina). Participants answered questions about food purchasing patterns, dietary intake, home food availability, and demographics. The school and consumer food environments were assessed using validated measures from the School Meals Cost Study (United States Department of Agriculture-Mathematica) and the Nutrition Environment Measurement Survey for Stores, Restaurants, and Corner Stores. Results: Of 432 adolescents, 55% were normal weight, 24% were overweight, and 21% were obese. There was a direct association between unhealthy food purchasing patterns (shopping frequently at gas stations, fast food, and dollar stores) and consuming more added sugars, when compared to those with a healthy shopping pattern (shopping less frequently at gas stations, fast food, and dollar stores) [Odds Ratio = 2.41 (95% CI (confidence interval) 0.99, 3.82)]. Those who reported always having fruits and vegetables in the home consumed more servings of fruits and vegetables [OR = 0.31 cups (95% CI 0.22, 0.44)] compared to those who reported never having fruits and vegetables in the home. Adolescents attending a school with a low healthy food availability score consumed fewer servings of fruits and vegetables [\u22120.001 (95% CI \u22120.001, 0.0001)] compared to those attending a school with a high healthy food availability score. Conclusions: There are direct associations between food purchasing patterns, the home and school food environments, and dietary intake among rural adolescents. These cross-sectional results informed the development of the \u201cGo Big and Bring it Home\u201d program, a text messaging intervention to improve adolescents\u2019 fruit, vegetable, and healthy beverage intake.<\/jats:p>","DOI":"10.3390\/ijerph14101255","type":"journal-article","created":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T04:32:19Z","timestamp":1508733139000},"page":"1255","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Direct Effects of the Home, School, and Consumer Food Environments on the Association between Food Purchasing Patterns and Dietary Intake among Rural Adolescents in Kentucky and North Carolina, 2017"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1704-8695","authenticated-orcid":false,"given":"Alison","family":"Gustafson","sequence":"first","affiliation":[{"name":"Department of Dietetics and Human Nutrition, 206J Funkhouser Building, University of Kentucky, Lexington, KY 40546, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Jilcott Pitts","sequence":"additional","affiliation":[{"name":"Department of Public Health, Brody School of Medicine, ECU 600 Moye Blvd., Mailstop 660, Lakeside Annex Modular Unit 8 Room 126, Greenville, NC 27834, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Dietetics and Human Nutrition, 206J Funkhouser Building, University of Kentucky, Lexington, KY 40546, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Ford","sequence":"additional","affiliation":[{"name":"Department of Dietetics and Human Nutrition, 206J Funkhouser Building, University of Kentucky, Lexington, KY 40546, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige","family":"Connelly","sequence":"additional","affiliation":[{"name":"Department of Dietetics and Human Nutrition, 206J Funkhouser Building, University of Kentucky, Lexington, KY 40546, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Gillespie","sequence":"additional","affiliation":[{"name":"Department of Dietetics and Human Nutrition, 206J Funkhouser Building, University of Kentucky, Lexington, KY 40546, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Nutrition, University of Pennsylvania, College Station, PA 20067, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Bush","sequence":"additional","affiliation":[{"name":"College of Public Health, University of Kentucky, 725 Rose Street Room 301, Lexington, KY 40536, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candace","family":"Brancato","sequence":"additional","affiliation":[{"name":"College of Public Health, University of Kentucky, 725 Rose Street Room 301, Lexington, KY 40536, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyin","family":"Babatande","sequence":"additional","affiliation":[{"name":"Health Sciences Bldg, 3310J MailStop #668, College of Allied Health Sciences, East Carolina University, Greenville, NC 27834, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Mullins","sequence":"additional","affiliation":[{"name":"Department of Dietetics and Human Nutrition, 206J Funkhouser Building, University of Kentucky, Lexington, KY 40546, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2017,10,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1111\/j.1748-0361.2012.00411.x","article-title":"Prevalence of obesity among adults from rural and urban areas of the United States: Findings from NHANES (2005\u20132008)","volume":"28","author":"Befort","year":"2012","journal-title":"J. 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