Determining the level of belief one has in themselves, or their self-efficacy, can be a key factor to improve certain dietary patterns and choices in the rural youth population. Sugar sweetened food and beverage consumption continues to rise and fruit and vegetable intake remains a struggle in rural areas; addressing both the food environment and adolescents’ self-efficacy could have a lasting impact on changing the nature of a generation of rural student’s food and beverage choices. This study measured self-efficacy levels of (n=425) adolescents in rural Kentucky and North Carolina using the Youth Impact Questionnaire and dietary intake using the NHANES Dietary Screener. Multiple linear regression analysis found that higher levels of self-efficacy resulted in a statistically significant ability to consume more vegetables. Further associations found that higher levels of self-efficacy resulted in increased fruit consumption, and improved added sugar food and beverage selections. These findings suggest that it could be beneficial to target adolescents’ self-efficacy as a way to modify certain health behaviors in a sparse food environment such as these rural Appalachian areas.