Social and Behavioral Sciences Commons^™

Exploration Of Factors Associated With Rural Appalachian Women's Use Of Buprenorphine Prior To Incarceration, Kelsey A. Redmayne

Theses and Dissertations--Educational, School, and Counseling Psychology

The Gelberg-Anderson Behavioral Model for Vulnerable Populations was used to identify factors related to buprenorphine use in general and through diversion (versus formal treatment) among rural Appalachian women using substances in the six months prior to their incarceration. This study is a secondary analysis of data from interviews completed with rural Appalachian women (N=400) residing in rural Kentucky jails. Independent variables were analyzed using chi square and independent t-tests for buprenorphine use generally and diverted buprenorphine use. The significant predictors were then evaluated through hierarchical logistic regression to explore which factors account for the most variance in general …

The Women Of Owen Clinic And Their Impact On Rural Mental Health, Mallory Stanley

Manuscripts

The mid-1900s was a pivotal moment in reforming mental health treatment in American Psychiatry. This movement becomes particularly clear when examining the championing work of two women, Dr. Thelma V. Owen and Dr. M. G. Stemmermann, at a rural mental health facility located in Huntington, WV: Owen Clinic Institute. While mental health stigma was at an extreme high among the general population, many factors aligned to allow for a new era of mental health care, including deinstitutionalization, World War II, and the advocation of professionals in the field. In West Virginia, no two people were more outspoken and active in …

Differences In Distress Between Rural And Non-Rural Appalachian Breast Cancer Patient / Caregiver Dyads During The First Year Of Treatment, Jordan Tasman, Callie D. Mcadams, Jillian Lloyd, Ashton J. Brooks, Patricia Nola Eugene Roberson

Journal of Appalachian Health

Introduction: Breast cancer patients and their caregivers living in rural Appalachia face substantial health disparities compared to their non-rural Appalachian counterparts. However, there is limited research on how these specific health disparities in rural Appalachian communities may impact patient psychological distress and caregiver strain during the first year of breast cancer treatment.

Purpose: The purpose of the current study was to assess differences in patient psychological distress (depression and anxiety) and caregiver strain between rural non-rural Appalachian breast-cancer-affected dyads (patients and their caregivers) during the first year of treatment.

Methods: A total of 48 Appalachian breast cancer patients (with a …

Anxiety, Depression, Immunity, Quality Of Life, And Cannabis In Appalachia, Matthew Ian Frazier Ostrander

Walden Dissertations and Doctoral Studies

As decriminalization of cannabis in the United States increases, understanding how cannabis use may alter physical and mental health is important. The Appalachian Mountain region is an area with poor support systems, stigma against mental health, and historic drug use problems, resulting in residents being more vulnerable to societal change. The theoretical framework for this research is psychoneuroimmunology (PNI), which is the study of the interconnections between psychology, neurology, and immunology as a holistic approach to health. Via SurveyMonkey, 160 participants completed the study, and data were based on self-reporting of cannabis use patterns in relation to anxiety, depression, immunity, …

Appalachians’ Intentions To Use Online And In-Person Counseling, Jade Hollan

Theses and Dissertations--Educational, School, and Counseling Psychology

Appalachians face higher rates of mental health concerns, yet they are less likely to have access to quality treatment. Online counseling, counseling using videoconferencing technology, may provide a viable solution to narrow this gap. However, little is known about Appalachians’ intention to use in-person or online counseling. This study examined Appalachians’ (N = 490) intentions to use online and in-person counseling using the theoretical framework of Theory of Planned Behavior (TPB; Ajzen, 1991). Results from structural equation modeling supported the indirect model for online and in-person counseling, where the associations between distal help-seeking factors (i.e., self-stigma, perceived stigma of …

A Description Of Covid-19 Lifestyle Restrictions Among A Sample Of Rural Appalachian Women, Michele Staton, Martha Tillson, J. Matthew Webster

Journal of Appalachian Health

Background: COVID-19 has led to swift federal and state response to control virus transmission, which has resulted in unprecedented lifestyle changes for U.S. citizens including social distancing and isolation. Understanding the impact of COVID-19 lifestyle restrictions and related behavioral risks is important, particularly among individuals who may be more vulnerable (such as rural women with a history of substance use living in Appalachia).

Purpose: The overall purpose of this study was to better understand the perceptions of lifestyle changes due to COVID-19 restrictions among this vulnerable group.

Methods: The study included a mixed methods survey with a convenience sample of …

Validation Of The College Planning Behaviors Scale, Katherine Danielle Cook

Masters Theses

College preparation is an important topic in the educational attainment for high school students. Much of the research on college planning focuses on the importance and timing of preparing for postsecondary education; however, little research exists that has determined which steps students actually take while preparing for college. The current study utilizes the Social Cognitive Career Theory (SCCT; Lent et al., 1994) framework to create a validated measure to assess choice behavior. In this study, college planning behaviors (CPB), which are the concrete behaviors an individual engages in to prepare for college, were considered as choice actions within the SCCT …

Access To Autism Spectrum Disorder Services For Rural Appalachian Citizens, Angela Scarpa, Laura S. Jensen, Denis Gracanin, Sharon L. Ramey, Angela V. Dahiya, L. Maria Ingram, Jordan Albright, Alyssa J. Gatto, Jen P. Scott, Lisa Ruble

Journal of Appalachian Health

Background: Low-resource rural communities face significant challenges regarding availability and adequacy of evidence-based services.

Purposes: With respect to accessing evidence-based services for Autism Spectrum Disorder (ASD), this brief report summarizes needs of rural citizens in the South-Central Appalachian region, an area notable for persistent health disparities.

Methods: A mixed-methods approach was used to collect quantitative and qualitative data during focus groups with 33 service providers and 15 caregivers of children with ASD in rural southwest Virginia.

Results: Results supported the barriers of availability and affordability of ASD services in this region, especially relating to the need for more ASD-trained providers, …

Barn-Raising On The Digital Frontier: The L.A.U.N.C.H. Collaborative, Bradford W. Hesse, David Ahern, Michele Ellison, Eliah Aronoff-Spencer, Robin C. Vanderpool, Karen Onyeije, Michael C. Gibbons, Timothy W. Mullett, Ming-Yuan Chih, Victoria Attencio, Grant Patterson, Jessica Boten, Christopher Hartshorn, Ben Bartolome, Katie Gorscak, Melanie Mccomsey, Alexandra Hubenko, Bin Huang, Corey Baker, Don Norman

Journal of Appalachian Health

A meta-analysis of oncology papers from around the world revealed that cancer patients who lived more than 50 miles away from hospital centers routinely presented with more advanced stages of disease at diagnosis, exhibited lower adherence to prescribed treatments, presented with poorer diagnoses, and reported a lower quality of life than patients who lived nearer to care facilities. Connected health approaches—or the use of broadband and telecommunications technologies to evaluate, diagnose, and monitor patients beyond the clinic—are becoming an indispensable tool in medicine to overcome the obstacle of distance.

Effects Of Appalachian Culture And Pregnancy Status On Pain-Related Fear, Cecelia Irene Nelson

Graduate Theses, Dissertations, and Problem Reports

Fear of pain during pregnancy is an understudied phenomenon with important implications for prenatal and postpartum functioning. The aim of the current study was to understand the role of pregnancy and culture on pain-related fear in Appalachia. Archival datasets, and a new sample of women recruited via Amazon’s Mechanical Turk, were sources of data. Participants completed the Fear of Pain Questionnaire-9 and responded to demographic questions in order to ascertain whether they were pregnant at the time of the study as well as the number and nature of prior pregnancies. In support of hypotheses, results indicated that pregnant women reported …

Resilience Among Survivors Of Adverse Childhood Experiences In Appalachia, Bridget Jeter

Electronic Theses and Dissertations

The empirical investigation of adverse childhood events (ACEs) and their relationship with health and well-being outcomes in later life is increasing. Less is known about factors that may promote resilience for those who have survived such challenges, such as how resilience may be facilitated for those with ACEs residing in a marginalized region such as South Central Appalachia. Multidimensional spirituality, social support, stigma related to ACEs, and Appalachian acculturation may serve as both valid cultural factors and potential indicators of resilience. Cross-sectional, simultaneous multiple regression analysis was performed on data collected from 272 adult patients of a South Central Appalachian …

Psychosocial Well-Being And Efforts To Quit Smoking In Pregnant Women Of South-Central Appalachia, Brittney Stubbs, Valerie Hoots, Andrea D. Clements, Beth Bailey

ETSU Faculty Works

Introduction: Psychosocial well-being variables from the Tennessee Intervention for Pregnant Smokers (TIPS) study, a longitudinal smoking cessation study in South-Central Appalachia, were investigated as potential predictors of smoking status.

Methods: A sample of 1031 pregnant women participated in an expanded 5A's (Ask, Advise, Assess, Assist, Arrange) program, from 2008 to 2011. Measures of stress, self-esteem, depressive symptoms, and disordered eating collected by interview during the first trimester, or during the third trimester in a combined interview if participants began prenatal care late, were hypothesized to differ among three groups of participants: pregnant women who never smoked, pregnant women who smoked …

Collectivism In Central Appalachia: Educational And Career Implications, Heidi Leigh Creamer

Theses, Dissertations and Capstones

Individualistic cultures tend to focus on freedom, individuality, and personal autonomy. Mainstream America is found to be a vertical individualistic society, but research has shown there are pockets of collectivistic cultures within the US. Collectivistic cultures, in contrast, tend to focus on family, conformity, and thinking of the group before one’s self. Collectivism arises due to a population’s need to rely on one another for resources. As such, low resource environments are subject to having collectivistic values. Research suggests that collectivism rates are higher in impoverished areas, such as Appalachia. This investigation focused on central Appalachia and the attributes that …

Proximal Minority Stress, Drinking Motives, And Alcohol Use In Appalachian Sexual Minority Women, Sarah Job

Electronic Theses and Dissertations

Sexual minorities face identity-specific stressors (minority stress). Minority stress often predicts worse health outcomes and behaviors, like increased substance use. The current study examined the relationship between proximal minority stress and hazardous alcohol use. Possible mediators were considered. The current study involved a secondary data analysis of data from 48 sexual minority women who completed an online survey. Measures included the Lesbian Internalized Homophobia Scale, the Connectedness to the LGBT Community Scale, the AUDIT-5, the Drinking Motives scale, and an item that measured frequency of drinking. Data, analyzed via R, included t-tests, correlations, regression, and mediational analyses. Results showed that …

The Relationship Between Breastfeeding Practices And Postpartum Depressive Symptoms In Appalachian Women, Rose Stephens, Andrea D. Clements, Valerie M. Hoots, Beth A. Bailey

ETSU Faculty Works

Abstract available through the Annals of Behavioral Medicine.

A Case Study Of A Mature Appalachian Hiv Negative Homosexual Man On Hiv Positive Homosexual Men, Jacob Lee Nelson

Masters Theses

Because of the lack of study, little is known about how members of the gay community immersed in rural areas relate to one another especially relative to the AIDS Crisis and those gay men living with HIV (Eldridge, Mack, & Swank, 2008). The purpose of this study was to investigate features of attitude (fears, threats, preconceived notions, and convictions) of a mature HIV negative homosexual man from rural Appalachia on HIV positive homosexual men (Thurstone, 1928). The central research question asked was, “How do you relate to HIV positive gay men as a HIV negative gay man having been raised …

The Relationship Between Adverse Childhood Experiences (Aces) And Intrinsic Religiosity In Southern Appalachia, Celina V. Unzueta Ms., Andrea Clements Dr.

Undergraduate Honors Theses

The present exploratory study examined adverse childhood experiences and religiosity in a sample of individuals from Southern Appalachia. Self-reports of childhood adversity and intrinsic religion were obtained from 167 individuals. Results showed that fifty-five percent had not experienced a childhood adversity while forty-three percent had experienced one to five episodes. Although a little under half the sample had one or more adverse experiences, there was no significant relationship between ACEs and intrinsic religion (r= -.037, p= .631). Sex and intrinsic religion were significantly related in that men endorsed the use of intrinsic religiosity more than women …

“I Wonder What You Think Of Me”: A Qualitative Approach To Examining Stereotype Awareness In Appalachian Students, Chelsea G. Adams

Theses and Dissertations--Educational, School, and Counseling Psychology

Historically, Appalachia has been stereotyped as being a culture bred in poverty and ignorance. Much research has shown that stereotyping reveals a pattern of behavioral change and an impact on psychological well-being for the stereotyped (e.g., Pinel, 1999; Woodcock, Jernandez, Estrada, & Schultz, 2012), and has largely been centered on race and gender (e.g., Byrnes, 2008; Tuckman & Monetti, 2011). Less is known about the development of culture-specific stereotypes such as those related to Appalachians – a highly stigmatized group (Daniels, 2014; Otto, 2002). The purpose of this study was to gain an understanding of how adolescents in rural Appalachia …

Appalachian Parent Perceptions Of Adhd Symptomology, Shaina Lee Meadows

Theses, Dissertations and Capstones

Attention-deficit/hyperactivity disorder (ADHD) is the most widely documented referral concern among children and adolescents referred to mental health practitioners. The current study examined Appalachian parents’ (N=68) knowledge of ADHD, accuracy in identifying ADHD symptoms, and treatment preferences. Findings of the survey indicate the majority of parents received no training on ADHD; however, most were able to recognize the majority of the signs of ADHD. Equally important, parents of children with ADHD and those who reported receiving some form of ADHD training demonstrated a negligible advantage in correctly identifying ADHD symptoms. Results, moreover, showed a significant preference for discipline as a …

Teacher Perception Of Principal Leadership Practices: Impacting Teachers' Sense Of Self-Efficacy In Rural Appalachia Kentucky, Brandon Lee Hibbard

Online Theses and Dissertations

The purpose of this study was to determine if a significant relationship existed between principal leadership practices, as perceived by teachers, and teacher’s sense of self-efficacy. The target population was rural Appalachian teachers that worked for a principal that had been in administration for at least three consecutive years. This study utilized teacher responses from a survey consisting of the Teachers’ Sense of Efficacy Scale (TSES, Tschannen-Moran & Woolfolk-Hoy, 2001) and the Leadership Practice Inventory – observer (LPI, Kouzes & Posner, 2003).

Results from the survey categorized levels of self-efficacy for teachers based on the works of Tschannen-Moran and Woolfolk-Hoy …

Prevalence, Types, Risk Factors, And Course Of Intimate Partner Violence In Appalachian Pregnant Women, Tifani Fletcher

Electronic Theses and Dissertations

Intimate partner violence (IPV) during pregnancy can lead to a myriad of poor physical and psychological outcomes for both mother and child. There is a paucity of research examining IPV risk factors for rural pregnant women and on information regarding the course of the specific types of IPV throughout pregnancy. The current project was an investigation of the prevalence of IPV and IPV risk factors for different types of IPV in an Appalachian pregnant sample that contained women from both rural and nonrural locations (Study 1), and was an examination of the occurrence of any IPV and the different types …

The Fragility Of Persistently Economically Distressed Counties In Central Appalachia And The Promise Of Public Leadership, Christine E. Emrich, Stephen Lange, Blake Bedingfield, Bonita Fraley, Justin May, Kyle Yarawsky

Commonwealth Review of Political Science

Appalachia has long experienced economic distress, but significant progress has been made since the establishment of the Appalachian Regional Commission (ARC) in the 1960s. However, many counties in central Appalachia continue to experience persistent economic distress despite several advantages that are normally conducive to progress. This study examines Rowan County, Kentucky in comparison to four other rural Kentucky counties with varying degrees of economic progress. Quantitative comparisons were made on the basis of out-migration, educational attainment, and industrial diversity. Qualitative data was then gathered till·ough interviews to understand decisive events that affected progress as well as long-term causes of change …

The Effect Of Appalachian Regional Dialect On Performance Appraisal And Leadership Perceptions, Amie Sparks Ball

Online Theses and Dissertations

Speakers of Appalachian English face unique difficulties in the workplace. Long-held stereotypes of Appalachian English speakers can lead to unfair presumptions about a person's competence and professionalism. Previous research has shown stereotyping on the basis of non-standard dialect can affect recruitment and hiring decisions made by employers. The present study addresses the possibility that these biases extend beyond the hiring process by investigating the impact of Appalachian regional dialect on performance appraisal, perceptions of leadership potential, promotion potential, status perceptions, and solidarity perceptions.

Technology Use In Rural Appalachia: A Pilot Study Of The Implications For Pediatric Behavioral Health, Courtney E. Lilly

Electronic Theses and Dissertations

Technology is a promising means for increasing rural individuals’ access to behavioral healthcare. However, the range of technology use in rural areas is currently unknown. The aims of this study were to examine the use of technology in rural areas, the relationship between technology use and willingness to access pediatric mental health services via videoconferencing, and this relationship within the context of other critical variables linked to service uptake. Data were collected at 2 pediatric primary care clinics. While no significant relationship was found between technology use and willingness to use videoconferencing, a significant relationship emerged between previous service seeking …

Marital Status And Religious Commitment Predict Prenatal Tobacco, Alcohol, And Illicit Substance Use In Southern Appalachia, Andrea D. Clements, Tifani R. Fletcher, Lana Mcgrady, Beth A. Bailey

ETSU Faculty Works

Abstract available through the Annals of Behavioral Medicine.

Melungeon Portraits: Lived Experience And Identity, Tamara L. Stachowicz

Antioch University Dissertations & Theses

The desire to claim an ethnicity may be in response to an institutional and systemic political movement towards multiculturalism where ethnic difference is something to be recognized and celebrated (Jimenez, 2010; Tatum, 1997). Those who were a member of a dominant or advantaged group took that element of their identity for granted (Tatum, 1997). Identity work has included reflections and congruence between how individuals see themselves and how they perceive others to see them, including Optimal Distinctiveness Theory where one determines the optimal amount of individual distinctiveness needed to feel a healthy group and personal identity (Brewer, 2012). When most …

The Relationship Between Self-Directed Learning And Information Literacy Among Adult Learners In Higher Education, Tiffani Reneau Conner

Doctoral Dissertations

The purpose of this study was to investigate the relationship between self-directed learning and information literacy. Participants completed the Personal Orientation in Self-Directed Learning Scale ([PRO-SDLS], Stockdale, 2003) and the Information Literacy Test ([ILT], James Madison University, 2003). The PRO-SDLS is a self-report scale consisting of 25 statements about self-directed learning preferences in college classrooms. The ILT is a 60-item multiple-choice test that assesses the information literacy skills of college students. Correlation, ANOVA, and multiple regressions were used to test relationships and differences between self-directed learning and information literacy. Despite claims that teaching information literacy creates self-directed learners, composite scores …

Dual Consciousness: Identity Construction Among Appalachian Professional Women In Southern Ohio, Rebecca Nicole Roades

Antioch University Dissertations & Theses

This study examined identity construction among a purposeful sample of professional women of Appalachian origin with particular regard to the blending of their cultural heritage in a society in which they are often marginalized. The questions guiding the research were grounded in a conceptual framework encompassing elements of culture, gender, leadership, and identity theories specifically using internal colonization, social cognitive, and social identity theories. They included the following: How do these women identify with their Appalachian heritage? How has their Appalachian heritage influenced real or perceived feelings of marginalization and how has that shaped their identity? Do they perceive themselves …

Mental Health Services In Appalachia, Miranda Renee Waters

Online Theses and Dissertations

People from rural areas of the country, such as the Appalachian region of Kentucky, continue to struggle with inadequate mental health services. Past research has identified several barriers for mental health services in rural communities such as lack of mental health providers, lack of transportation, and lack of education. The purpose of this study was to examine the severity of a psychological problem and how it could influence Appalachian and non-Appalachians' preference for type of help. It was hypothesized that people from the Appalachian region would recommend seeing a mental health professional when a problem had reached its highest severity. …

Appalachian Origin Moderates The Association Between School Connectedness And Gpa, Steffen Wilson, Jonathan Gore

Steffen Wilson

The relationship between connectedness to the university, Appalachian regional origin, and self-reported GPA was investigated in two studies. Both studies found that the association between school connectedness and GPA was positive among Appalachian students. However, counter to previous research, there was no association among the non-Appalachian students.