Fish and seafood consumption is recommended as part of a healthful diet. Higher intakes, particularly of fatty fish containing omega-3 fatty acids, are associated with improved brain and cardiovascular health. Most Americans do not consume the recommended amounts of fish and seafood. To explore fish and seafood food choice, a mixed methods project with two studies was designed and conducted in rural New York State with midlife adults (ages 50-75). The first project was an in-depth qualitative study using interviews with midlife adults (n=31). Two aspects of these interviews were examined: 1) social representations of the health effects of fish and seafood and 2) the scripts used for fish and seafood provisioning. Core and peripheral social representations were identified and described. Individual patterns of involvement with social representations were presented. Scripts used for acquiring and preparing fish and seafood as well as eating out were characterized. The importance of script integration between linked script types was suggested. Components of the qualitative findings and other factors were then examined in a survey of midlife adults (n=212), including a sub-sample that also provided dried blood spots (n=100) for analysis of fatty acid levels. Individuals who agreed more strongly with positive social representations and who reported greater fish preparation confidence reported higher levels of fish intake and had higher omega-3 index levels. Future research should explore these phenomena in other populations using longitudinal and experimental designs.