Enhancing dietary choices and activity through simplified navigation: the digital Nourish program

BACKGROUND: Individuals who reside in rural areas often consume diets with less nutrient-dense foods and engage in less physical activity than those in metro areas. Nourish is a free, interactive, and easy-to-use digital program created to engage and empower adults aged 40 and older living in rural areas to make healthy lifestyle changes. It provides practical knowledge about healthy lifestyles to encourage positive behavior changes and improve overall health. Interviews were conducted to gauge impact of the Nourish program on participants. PURPOSE: We sought to assess healthful behaviors implemented by individuals who completed the Nourish program while identifying barriers and challenges to behavior change. METHODS: Nourish educational modules included information about nourishing the body through changes in nutrition, physical activity, and other lifestyle changes. Participants were required to complete 6 out of 7 modules within a Nourish series to be eligible for a follow-up interview and to be awarded a $20.00 gift card. Structured interviews via telephone were conducted roughly 90 days after program completion from fall, 2023 to spring, 2026 by graduate students enrolled in Nutrition and Exercise Science academic programs. Qualitative responses were thematically analyzed using open and closed coding by two researchers. RESULTS: One hundred sixteen participants completed follow-up interviews between fall 2023 and spring 2026 of 1,877 who registered for the program. When asked, "What is one major change you have implemented since taking the Nourish program", 54.3% and 36.2% increased their vegetable and fruit intake, respectively. The most frequently reported behavior change related to physical activity was increased walking (44.8%). Many also reported increased yardwork/outdoor activities/gardening (11.2%). Challenges to implementing healthful dietary changes included avoiding sweets (16.4%) and lacking access or availability for purchase of nutritious foods (9.5%). Challenges and frustrations related to the implementation of physical activity included "lack of motivation" (24.1%), the environment (e.g., winter weather, lack of equipment) (19.0), too busy/not enough time (14.7%) and injuries/illness (14.7%). CONCLUSION: The Nourish program supported rural adults in adopting and sustaining healthful behaviors, particularly increased physical activity and improved dietary choices. These findings highlight the value of accessible, evidence-based digital health interventions in promoting wellness among rural populations.