Social and Behavioral Sciences Commons^™

All Roads Lead To Darrington: Building A Bluegrass Community In Western Washington, James W. Edgar

Electronic Theses and Dissertations

Through the mid-twentieth century, a significant pattern of migration occurred between Appalachia and the Pacific Northwest, with Washington’s thriving timber industry offering compelling economic opportunities. Many workers and families from western North Carolina settled in the small mountain town of Darrington, Washington, frequently accompanied by their banjos and guitars. As a group of young bluegrass enthusiasts from Seattle established relationships with Darrington’s “Tar Heel” musicians, a collaborative music community formed, laying the foundation for the region’s contemporary bluegrass scene.

Drawn from a series of ethnographic interviews, this project illuminates the development of a bluegrass community in western Washington, while identifying …

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% …

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: …

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.

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.

Typology Of Projectile Points/Knives From Upper East Tennessee, Zoen Mclachlan

Undergraduate Honors Theses

Projectile points/ knives (PPKs) are categorized by morphology, also called typology, and associated with cultural periods. A total of 64 PPKs in collections in the Archaeology Lab at East Tennessee State University were curated as untyped and without provenience. They were allegedly collected from ground surveys in Upper East Tennessee, but without archaeological context research had not been prioritized. The importance of such research lies in the fact that few publications exist on the region of Upper East Tennessee and many reference books on lithic typology portray PPKs through illustrations of the ideal morphology of each type. The challenge herein …

Queer Spaces, Religious Places: Sharing Risk And Making Kin Within A Queer Church Amidst A Pandemic, Sadie V. Counts

Masters Theses

This thesis aims to explore the effects of the global COVID-19 pandemic on a queer, Christian congregation of the Metropolitan Community Church in Knoxville, TN and the impacts of the pandemic queer kinship and intimacy within the church setting. The thesis explores the ways in which queer kinship manifests within the church and how those relationships have been disrupted and altered by COVID. It also compares the long-term effects of the AIDS epidemic on the church congregation and they ways in which they may be experiencing COVID in a similar manner. Finally, the project explores the ways that intimacy has …

Darkness Falls Upon America’S Backyard: An Evaluation Of Central Appalachia’S Past Economic Woes And A Blueprint For The Region’S Future Economic Development, Jack Bergantino

Honors Scholar Theses

The United States prides itself as a nation that offers equity and opportunity to its citizens. However, in recent decades, regions of relative wealth and poverty have come to define the American landscape. Coastal communities have fared well with consistently declining rates of unemployment and increasing rates of college graduation. In contrast, Central Appalachia, which comprises parts of Kentucky, Tennessee, Virginia, and West Virginia, continues to falter with diverging employment and income levels relative to other areas of the country.

This report discusses the economic history of the Appalachian region and considers three case studies, concentrated in McDowell, Harrison, and …

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.

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 …

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 …

The Appalachian Medical Student Experience: A Case Study, Jason Scott Hedrick

Graduate Theses, Dissertations, and Problem Reports

The Appalachian region is a rural swath of mountainous terrain home to a historically distinct culture. The region’s population suffers from a multitude of health issues and disparities. Notably, the region also experiences a major healthcare provider shortage despite the fact that states, like West Virginia, produce per capita, a high volume of physicians. Appalachia, and particularly West Virginia, also suffers from a number of educational disparities, which culminates into low numbers of college graduates within the population. There is a plethora of research that has explored the first-generation college student, students from rural and Appalachian backgrounds, first-generation and rural …