A Qualitative Exploration of School-Based Intervention Needs Among Rural Appalachian Youth

Disordered eating is prevalent in the United States, with over 20% of children and adolescents reporting some form of disordered eating. Eating disorders are associated with detrimental physical effects and co-occurring mental health difficulties. One population that appears to be at high risk for developing disordered eating symptoms is rural youth. Unfortunately, rural youth often do not receive treatment for their disordered eating symptoms due to myriad care barriers, including geographical restrictions and financial constraints. School-based interventions offer promise to address such barriers and increase access to treatment among this vulnerable group. This study represents a first step at identifying rural youth needs and formatting preferences for a school-based intervention. Participants were 11 rural adolescents (Mage = 15.09) from Appalachia. Participants reported their demographic characteristics in surveys and completed a semi-structured interview assessing their needs and formatting preferences for a school-based intervention for disordered eating. Data were analyzed using inductive thematic analysis; the following themes emerged. Rural youth reported that an intervention should promote healthy and balanced eating, teach social media literacy, and discuss external factors and overlapping mental health difficulties, and de-emphasize the value of weight and shape. Rural youth also suggested that the intervention design take into consideration logistical and cultural factors of rural communities. These data suggest that rural youth’s treatment preferences align with existing school-based interventions for disordered eating. However, modifications may be needed to address logistical and cultural factors that may impact acceptability and feasibility of school-based eating disorder interventions in rural communities