Appalachian Studies Commons^™

We Welcome Findings From Further Afield, Randy Wykoff Md, Mph & Tm, Rachel E. Dixon Mphil

Journal of Appalachian Health

For the past five years, the Journal of Appalachian Health has published timely, high-quality research from within Appalachia. We also welcome submissions from those working outside of Appalachia who produce quality research of direct relevance to our region.

An Analysis Of The Clear Horizons Program In Perry County, Kentucky On Smoking Cessation, Julia Kollitz

Lewis Honors College Thesis Collection

Perry County is an Appalachian county located in southeastern Kentucky. The population is 28,473 people (United States Census Bureau, 2020). It is a predominately white community, with 95.9% of people falling in this category, which is higher than the national percentage of 75.8% (United States Census Bureau, 2020). Being a rural county, this community uses few news sources, with the primary outlet being WYMT Eastern Kentucky News. This news outlet is a subset of CBS (WYMT, 2023). When comparing statewide and nationwide data, Perry County does consistently worse. They have a high school graduation rate that is lower than the …

Appalachian Adolsescence: A Creative Exploration Of Home, Nature, And Social Progress, Eleni Karelis

Lewis Honors College Thesis Collection

The Central Appalachian coalfields provide a rich culture to the American landscape, often shielded from outsiders to the region. While prevailing stereotypes of the region describe those living there as two-dimensional, the identity of Appalachia has always been complex— whether through the rich history with labor struggles, gender equality, or social progress. Finding one’s identity in a place that has been so strictly held to its stereotypical perceptions can be difficult. This creative project draws inspiration from my own experiences in Southeastern Kentucky as well as a myriad of stories collected through archival research in the Special Collections Research Center …

"Not Just Whites In Appalachia": The Black Appalachian Commission, Regional Black Power Politics, And The War On Poverty, 1965-1975, Jillean Mccommons

Theses and Dissertations--History

During the Black Power era of the late 1960s and 1970s, Black activists in Appalachia used the opening of the War on Poverty to wage a regional war against institutional and environmental racism. Through the Black Appalachian Commission, a grassroots organization created in 1969, Black activists worked to expose racism in local and federal policy as the root cause of poverty for Black Appalachians, who they argued were the poorest in the region. Their outward self-definition as Black and Appalachian was a political strategy to garner power over resources earmarked for Appalachians. The term “Black Appalachian'' was more than a …

Ambiguous Appalachianness: A Linguistic And Perceptual Investigation Into Arc-Labeled Pennsylvania Counties, Crissandra J. George

Theses and Dissertations--Linguistics

The Appalachian Regional Commission (2022) designates 52 of Pennsylvania’s 67 counties as Appalachia, excluding only the southeast portion of the state. Matthew Ferrence, in Appalachia North, states that his "home is sometimes called Appalachia, sometimes Rust Belt, other times Midwest, even though very few who live there would accept any of those labels as correct" (xi). This ambiguous and fluid identity is due to the shaping, forming, and changing of Pennsylvania’s role within society from a founding colony to a thriving state with industry, unselfishly spoiling others, to the grounds of converging identities (Ferrence xi). This ambiguous identity makes …

Covid-19 Experiences, Behaviors, Beliefs, And Well-Being Among Students And Employees At A University In Rural Appalachia: A Cross-Sectional Study, Lauren Wisnieski, Kimberly A. Carney, Jenny L. Thornley

Journal of Appalachian Health

Introduction: In response to the coronavirus disease (COVID-19) pandemic, most universities experienced drastic operational changes with shifts to online learning, work-from-home policies, and social distancing measures. These changes have caused concern for social isolation and mental health.

Purpose: This cross-sectional study explores differences in COVID-19 experiences, behaviors, beliefs, and well-being among students and employees (faculty and staff) at a rural Appalachian university.

Methods: Data were collected with an online anonymous survey in September-October 2020 using convenience sampling. The survey measured multiple domains including COVID-19-related 1) beliefs, 2) symptoms and diagnoses, 3) exposure and preventive behavior, and 4) social, mental, and …

Comparisons Of Cooking, Dietary, And Food Safety Characteristics Of Food Secure And Food Insecure Sophomores At A University In Appalachia, Hannah Boone, Melissa D. Gutschall, Alisha Farris, Kimberly Fasczewski, Don Holbert, Laura Mcarthur

Journal of Appalachian Health

Introduction: Food insecurity means lacking access to adequate, nutritious, and safe food. Collegiate food insecurity rates at ten Appalachian campuses range from 22.4% to 51.8%, and have been associated with unfavorable health and academic outcomes.

Purpose: This study compared cooking, dietary, and food safety characteristics of food secure (FS) and food insecure (FI) sophomores at a university in Appalachia in the context of the USDA definition of food security.

Methods: Data were collected using an online questionnaire. Descriptive and inferential procedures compared FS and FI sophomores (p < 0.05).

Results: Participants (n = 226) were 65.0% females, 76.1% …

Understanding Polarizing Community Perspectives On Harm Reduction Strategies: Challenges To Addressing The Opioid Crisis In Appalachian Pennsylvania, Stephanie L. Creasy Mph, Jessica R. Thompson Med, Christina F. Mair Phd, Jessica G. Burke Phd

Journal of Appalachian Health

Introduction: Rural communities face barriers to opioid treatment and overdose prevention including concerns about stigma and lack of harm reduction services.

Purpose: The aim of this study was to explore community perspectives and understanding of harm reduction approaches to opioid use and overdose in a high-risk Northern Appalachian case community in Pennsylvania.

Methods: A small town approximately 10 miles from Pittsburgh was identified as the community with the greatest predicted probabilities of epidemic outbreak using posteriors from spatial models of hospitalizations for opioid use disorders. We interviewed 20 key stakeholders in the case community in using a semi-structured interview guide …

Access To And Use Of Technology For Health: Comparisons Between Appalachian Kentuckians And The General U.S. Population, Robin C. Vanderpool, Lindsay R. Stradtman, Anna Gaysynsky, Quan Chen, Meghan Johnson, Bin Huang

Journal of Appalachian Health

Introduction: Technology may increase the availability of health information and enable health promoting behaviors. However, lack of access to and use of technology may also exacerbate disparities, particularly in rural communities with limited Internet access.

Purpose: The purpose of this study was to compare Internet access, device ownership, and use of technology for health between Appalachian Kentuckians and the general U.S. population.
Methods: Findings from the 2017 Assessing the Health Status of Kentucky (ASK) survey were compared to national estimates from the Health Information National Trends Survey (HINTS) 5, Cycle 1 (2017), with a particular focus on degree of rurality. …

Risk Factors Associated With Passenger Vehicle Fatal Rollover Crashes In West Virginia, 2001-2018, Yuni Tang, Toni Marie Rudisill, Ruchi Bhandari

Journal of Appalachian Health

Background: Rollover crashes cause more injuries and fatalities than other types of motor vehicle crashes. West Virginia (WV) has high rates of drug overdose deaths and motor vehicle crash fatality. However, no studies have investigated risk factors associated with fatal rollover crashes in WV.

Purpose: The objective of this study is to evaluate whether drug use and other risk factors are associated with fatal rollover crash fatalities in WV.

Methods: This cross-sectional study utilized the Fatality Analysis Reporting System dataset from passenger vehicle crashes involving WV drivers ≥ 16 years of age with known drug test results who died within …

Perceived Hearing Loss And Availability Of Audiologists In Appalachia, Charles B. Pudrith, Ellyn Grider, Blythe Kitner

Journal of Appalachian Health

Introduction: There is a high demand for audiologists throughout the United States. Previous research has supported an additional demand for these providers within Appalachia.

Purpose: The purpose of the study was to determine if Appalachia has a disproportionally high demand for audiologists compared to the rest of the United States.

Methods: A cross-sectional retrospective study was performed with population data from the Appalachian Regional Commission, the American Academy of Audiology, and the United States Census Bureau. County-level population-weighted averages of individuals with perceived hearing loss and number of audiologists per capita were compared between Appalachian and non-Appalachian counties. …

Review Of: Appalachians For Medicaid Website, Kendra Barker Dnp

Journal of Appalachian Health

The Journal of Appalachian Health is committed to reviewing published media that relates to contemporary concepts affecting the health of Appalachia. Access to care and the health disparities we face have a direct effect on our experience of illness. Dr. Kendra Barker reviews the website: Appalachians for Medicaid.

Geospatial Analysis Of Rurality And Food Banks In Appalachian Ohio, Cooper T. Johnson, Rebecca Fischbein, Kristin Baughman

Journal of Appalachian Health

Introduction: Food insecurity is a problem for individuals across Ohio, including those living in Appalachia. Adequate access to resources that help combat food insecurity is important for these populations.

Purpose: To examine how rurality relates to food insecurity and need for food resources, as well as availability of those resources including food pantries and soup kitchens, in 15 northern Ohio Appalachian counties.

Methods: A cross-sectional study with a geographical analysis was conducted using data from the American Community Survey census data, County Health Rankings data, and regional foodbank websites.

Results: Rural counties had a higher ratio of potential clients per …

Triple Negative Breast Cancer In An Appalachian Region: Exponential Tumor Grade Increase With Age Of Diagnosis, Gina Sizemore, Toni Marie Rudisill

Journal of Appalachian Health

Introduction: Triple negative breast cancer is an aggressive breast cancer with decreased five-year survival, increased risk for recurrence, and higher risk for metastases. Unlike other breast cancers, it has no targeted treatment and has heterogeneous genetics which make classification and treatment difficult.

Purpose: The purpose of our research was to compare triple negative breast cancer to non-triple negative breast cancer to identify key epidemiologic factors that might lead to improved basic science directives for biomarkers, treatments, and classification.

Methods: The state cancer registry was used to provide the first West Virginia state-wide population evaluation of triple negative breast cancer.

Results: …

Case Study Of A Comprehensive Team-Based Approach To Increase Colorectal Cancer Screening, Lauren E. Wright, Adam Baus, Andrea Calkins, Holly Hartman-Adams, Mary E. Conn, Susan Eason, Stephenie Kennedy-Rea

Journal of Appalachian Health

Introduction: Colorectal cancer is the second leading cause of cancer deaths among men and women in West Virginia. In addition, 51% of all colorectal cancers diagnosed in West Virginia from 2012 to 2016 were detected at either regional (31%) or distant (20%) stages indicating a need for improved early detection.

Methods: West Virginia University Cheat Lake Physicians participated in the West Virginia Program to Increase Colorectal Cancer Screening, a program of Cancer Prevention and Control at the WVU Cancer Institute. As a result, Cheat Lake Physicians assembled a team of health care professionals to implement evidence-based interventions and …

Addressing Diabetes Distress In Self-Management Programs: Results Of A Randomized Feasibility Study, Ranjita Misra, Samantha Shawley-Brzoska, Raihan Khan, Brenna O. Kirk, Sijin Wen, Usha Sambamoorthi

Journal of Appalachian Health

Background: West Virginia ranks 1st nationally in the prevalence of hypertension (HTN; 43.8%) and diabetes (16.2%). Patients with type 2 diabetes mellitus (T2DM) are distressed over physical and psychological burden of disease self-management.

Methods: This study investigated the effectiveness of an intervention to reduce diabetes distress and outcomes [glycemic control, blood pressure (BP)] among T2DM adults with comorbid HTN. Participants were randomized to a 12-week diabetes and hypertension self-management program versus a 3-month wait-listed control group. Trained health coaches and experts implemented the lifestyle program in a faith-based setting using an adapted evidence-based curriculum. Twenty adults with T2DM and HTN …

Emergence Of Covid-19 And Patterns Of Early Transmission In An Appalachian Sub-Region, Abbey K. Mann, Timothy A. Joyner, Ingrid E. Luffman, Megan Quinn, William Tollefson, Ashley Frazier

Journal of Appalachian Health

Background: In mid-March 2020, very few cases of COVID-19 had been confirmed in the Central Blue Ridge Region, an area in Appalachia that includes 47 jurisdictions across northeast Tennessee, western North Carolina, and southwest Virginia. Authors described the emergence of cases and outbreaks in the region between March 18 and June 11, 2020.

Methods: Data were collected from the health department websites of Tennessee, North Carolina, and Virginia beginning in mid-March for an ongoing set of COVID-19 monitoring projects, including a newsletter for local healthcare providers and a Geographic Information Systems (GIS) dashboard. In Fall 2020, using these databases, authors …

Review Of: The Cancer Crisis In Appalachia: Kentucky Students Take Action, Stephenie Kennedy-Rea

Journal of Appalachian Health

The Journal of Appalachian Health is committed to reviewing published media that relates to contemporary concepts affecting the health of Appalachia. With cancer mortality rates higher in rural and Appalachian communities, a focus on how cancer impacts our families and communities is more important than ever. Dr. Stephenie Kennedy-Rea reviews the book The Cancer Crisis in Appalachia: Kentucky Students Take Action.

Exploring Covid-19 Case Fatality In Relation To The Prevalence Of Chronic Conditions And Health Behaviors In Appalachian Kentucky, W. Jay Christian

Journal of Appalachian Health

Background: Research has demonstrated that common chronic conditions, especially those related to cardiovascular health, are important risk factors for severe COVID-19 symptoms or hospitalization. Population prevalence rates of such conditions have not previously been examined in relation to COVID-19 case fatality rates in the Central Appalachian region.

Purpose: This study examined prevalence rates of selected chronic conditions and COVID-19 case fatality rates to determine whether the relationship between them is consistent across Appalachian and non-Appalachian regions of Kentucky.

Methods: Data from Kentucky’s Behavioral Risk Factor Survey (KyBRFS) were used to calculate prevalence rates of asthma, diabetes, influenza vaccination, hypertension, obesity, …

Effects Of Sleep Duration On Falls In A West Virginia Population-Based Study, Brfss, 2018, R. Constance Wiener, Christopher Waters

Journal of Appalachian Health

Introduction: West Virginia is a state in which most counties are rural, as well as a state with multiple health disparities among its population. The purpose of this study was to determine the association of sleep duration and falls for non-institutionalized West Virginia adults, aged 40 years and above, using the National Sleep Foundation’s definition of “may be appropriate” and “not recommended” sleep durations for specific ages.

Methods: Behavior Risk Factor Surveillance System (BRFSS) 2018 data concerning West Virginia residents were extracted for sleep duration and number of falls within the previous year. Data were analyzed with Chi square and …

Diseases Of Despair: A Commentary, Andrew Howard

Journal of Appalachian Health

Across the nation, and within Appalachia, communities that struggle economically experience greater health challenges, with disparities observed across leading causes of death. Within our region, these disparities are particularly notable across diseases of despair.

Poll Finds Rural Residents More Hesitant To Get Vaccinated, Tim Marema

Journal of Appalachian Health

Rural residents are more hesitant than their metropolitan counterparts to get a Covid-19 vaccination, even though rural areas have higher rates of infections and deaths from the coronavirus.

Review Of: Ailing In Place: Environmental Inequities And Health Disparities In Appalachia, Jerome A. Paulson Md, Faap, Jennifer A. Mallow Phd

Journal of Appalachian Health

The Journal of Appalachian Health is committed to reviewing published media that relate to contemporary concepts affecting the health of Appalachia. The Appalachian environmental inequities and the health disparities we face have a direct effect on our experience of illness. Dr. Jerome Paulson reviews the book Ailing in Place: Environmental Inequities and Health Disparities in Appalachia.

Cancer Curriculum For Appalachian Kentucky Middle And High Schools, Lauren Hudson, Katherine Sharp, Chris Prichard, Melinda J. Ickes, Sahar Alameh, Nathan L. Vanderford

Journal of Appalachian Health

Background: Appalachian Kentucky faces the highest cancer incidence and mortality rates in the country due to poor health behaviors and lifestyle choices. These poor health behaviors are facilitated by a lack of cancer education. Youth represent a vulnerable population that could be greatly impacted by increased cancer education. Teachers have the power to facilitate this learning.

Purpose: This study examined the need for cancer education curriculum in Appalachian Kentucky middle and high schools from the perspective of educators.

Methods: An online survey was conducted with science and health teachers (n=21) in Appalachian Kentucky, consisting of questions that investigated existing cancer …

Impact Of The Covid-19 Shutdown On Mental Health In Appalachia By Working Status, Erin N. Haynes, Timothy J. Hilbert, Susan C. Westneat, Kate Leger, Katie Keynton, Heather M. Bush

Journal of Appalachian Health

Introduction: To slow the spread of COVID-19 in the United States, businesses shutdown in Spring 2020. Research has indicated the impact on frontline workers, yet little is known about the impact on those who were not working outside the home or switched to working remotely.

Purpose: The purpose of this report is to identify the financial and healthcare issues and mental health impact of the COVID-19 shutdown on Appalachians by worker categories.

Methods: An online survey was administered from May 8 – June 6, 2020 to a convenience sample of previous research participants and shared through social …

Students, Research, And The Health Of Appalachia, F. Douglas Scutchfield Md

Journal of Appalachian Health

The notion of publication in the peer-reviewed literature out of your doctoral or master’s thesis/dissertation or capstone is a characteristic of those who choose a career in the academy. This paper illustrates my pleasure by reflecting a student taking the additional step in research achievement by publishing results that contribute new knowledge to evidence-driven research and practice.

Producing Possibilities: Envisioning And Mediating Youth, Identities, And Futures In Central Appalachia, Tammy Lynn Clemons

Theses and Dissertations--Anthropology

This dissertation, based on anthropological research between 2015 and 2020, focuses on young people in different yet interconnected social contexts in Central Appalachia and how they envision, construct, and act upon possibilities for themselves and the region through multimodal cultural production processes like visual art, performance, and multisensory media. The research question focusing this project was: How do the social contexts of young Appalachians’ engagement in media consumption and production practices shape the possibilities they envision for themselves, others, and their region? I found that the specific contexts were less important than the interconnected mentoring conversations across sites and generations …

Almost Heaven: Religious Arguments In Appalachian Extractive Fiction, Darby Lane Campbell

Theses and Dissertations--English

Appalachia is a national sacrifice zone that hosts extractive industries directly responsible for many social problems in the region, however, many attribute these issues to the moral failings of Appalachians themselves. Activism in the area is heavily focused on opposing both extraction and the negative perceptions which contribute to its domination. One way this activism is conducted is through extractive fiction—novels which expose the destruction caused by extractive industries. Appalachian extractive fiction utilizes religion and spirituality to argue against extraction. This research examines how fiction can be an effective mode of activism and how the use of Christian arguments in …

Perceptions Of Rural Middle School Band Directors Regarding Student Recruitment Strategies: An Instrumental Multiple Case Study, Kaitlin Callihan

Theses and Dissertations--Music

The purpose of this instrumental multiple case study was to learn about middle school band directors’ perceptions of successful recruitment strategies. Specific areas of focus included insight on why middle school children choose band, successful recruitment activities/events, involvement of directors in the recruitment process, and advice for support in situations where an individual may be the only band director in the district. Six participants, two from Kentucky, two from West Virginia, and two from Virginia, were selected using purposive sampling criterion. Criterion for selecting participants at the time of the study were: (a) they were middle school band directors, (b) …

A Fat Imposter: The Embodied Intersection Between Race, Body Type And Fatness In Margaret Cho’S Comedy, Julia Cox

Theses and Dissertations--Linguistics

Margaret Cho is a comedic goddess who, in her mockery, serves flaming hot social commentary about race, body image, and fatness. Within this thesis, I used critical discourse analysis to understand how Margaret Cho embodies Asianness, whiteness, and the body types and images prescribed respectively. While working on data analysis, I came across a common media trope of fat women: the use of indexically Southern (United States), Appalachian, and Working class indexicals in speech and lexical items. I connected the ideologies surrounding Southern and Appalachian language to the inequalities that fat women face. This voicing had not previously been written …