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Objective: To investigate bow low-income rural residents living in food deserts access the normal food system and food safety net services within their communities and explore how social, personal, and environment drives food and food choice.

Design: Seven focus groups (90 minutes each) were conducted with 2 moderators present and were audio-taped.

Setting: Food deserts in rural Minnesota and Iowa.

Participants: Fifty-seven residents (Minnesota: 13 females and 8 males; Iowa: 24 females and 12 males). Most participants were white and had not completed high school or higher education.

Phenomenon of Interest: Food choice and food access among rural residents.

Analysis: Transcripts were evaluated For consistency and coded for themes and subthemes. Results: Three dominant themes influence Food access and choice and were identified as: (a) personal and household determinants of food; (b) social and cultural environment; and (c) structure of place or the external environment. external environment.

Conclusions and Implications: Personal, environmental, and dietary behavioral factors are all interconnected: each plays a major role in infleuncing dietary behavior and the resulting health outcomes in rural Minnesotans Iowans living in food deserts. However, although personal factors impact eating, behavior rural people, it is the physical and social environments that place constraints on food access, even in civically engaged communities. Food access may be improved in communities where civic engagement is strong, and where local organizations join in providing solutions to decrease barriers of food access by increasing access to the normal and food safety in systems and by creating informal alternatives, such as community gardens and informal transportation networks, or enhancing federal programs through greater volunteer involvement.