This study builds on the investigators' ongoing research of gender and ethnic differences in nutritional self-management of older adults in two rural North Carolina counties (RO1 AG 13469) to investigate the meanings and beliefs rural older adults have for food, diet and the relationship of food and diet to health. This study addresses the problem of using such information to adapt existing dietary instruments to more accurately collect nutrient and food intake data. This study will: (1) document older rural adults' meanings of foods and their cognitive models of nutrition; (2) compare and contrast food meanings and cognitive models of nutrition by ethnic group (African American, Native American, European American); and (3) identify cultural and socioeconomic predictors of differences in food meanings and cognitive models of nutrition that result in health disparities. Based on what is learned in the first three specific aims, this study will: (4) use the food and diet meanings to adapt two existing dietary intake instruments to be more culturally appropriate for this population; and (5) evaluate the new dietary intake instruments. The research is divided into 2 phases. Phase I data collection includes individual in-depth and group interviews. In-depth individual interviews will be completed with 48 African American, European American and Native American females and males aged 70 and older who reside in two rural North Carolina counties. Respondents will be asked to discuss their beliefs about different foods, their knowledge and beliefs about several nutritional categories (e.g., fat, fiber), and the connections between diet and foods and specific physical conditions (e.g., diabetes, cancer). Twelve group interviews will be conducted that include 96 older African American, European American and Native American females and males. Group participants will discuss the investigators' interpretations of food, diet measurement procedures and perform validation tests. Participants will include 120 older African American, European American and Native American males and females. These participants will complete six 24 hour diet recall interviews over a six month period, which will be used to validate the adapted Food Frequency Questionnaire and Meal Pattern Questionnaire.
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