Appalachian Studies Commons^™

The Barren Springs Songbook, Caroline Grace Sutphin

Masters Theses & Specialist Projects

The Barren Springs Songbook is a poetry collection exploring Appalachian themes through the lens of three representative characters and my own experience. The poems presented are in blank verse and lean heavily on musicality, as each poem features an epigraph from my own Great Uncle Henry’s song lyrics. The poetry explores themes of poverty, folklore, feminism, and Christianity within the context of Barren Springs, an insular Appalachian community. The characters of Henry, India, and Myrtle provide a glimpse into how things have been in my family history, and the more modern poems representing myself show the cultural shifts that are …

Place-Based And Non-Place-Based Performing Arts Experiences And First-Generation, Appalachian College Student Engagement, Rachel Schott

Ed.D. Dissertations

The purpose of this study was to examine the pre-college arts experiences of Appalachian college students who participated in place-based and non-place-based performance arts ensembles and, using a qualitative research approach informed by Kuh et al.’s (2005) study on positive student engagement, understand the influence that participation in these ensembles might have on Appalachian students who are the first in their generation to pursue higher education. In this study, the researcher examined student data from 28 first-generation, Appalachian college students who responded to an online survey, and 11 who volunteered to participate in-depth, personal interviews. All the student participants were …

The Powerful Presence Of Dams In Appalachian Poetry, Zoe Hester

Electronic Theses and Dissertations

Contemporary Appalachian poetry offers a lens through which we can see the immense impact that the Tennessee Valley Authority has had in Appalachia. In this thesis, I explore the powerful presence of dams in Appalachian poetry by analyzing three poems. Jesse Graves’s “The Road into the Lake” centers on personal and familial loss, Jackson Wheeler’s “The TVA Built a Dam” mourns the loss of communities, and Rose McLarney’s “Imminent Domain” focuses on the ecological destruction that has occurred in Appalachia and around the globe as the result of the construction of TVA dams. Ultimately, all three poems serve as eulogies …

Seeking Care At Free Episodic Health Care Clinics In Appalachia, Malerie Lazar, Sandra Thomas, Lisa Davenport

Journal of Appalachian Health

Background: People who live in rural Appalachia experience a wide variety of problems when seeking access to health care. Health care disparities continue to be one of the most complex and prevalent problems, and many barriers exist for impoverished men and women such as a lack of education, complications with health insurance, and personal distrust of healthcare providers.

Purpose: A critical gap in the literature is the unheard voice of persons in rural underserved areas. The purpose of this study was to explore the perspectives of persons in rural Appalachia who seek healthcare services at free episodic health care clinics, …

Skin Cancer And Uv Exposure-Related Behaviors Among Appalachian And Non-Appalachian Adults, Minal Patel, Katrina Serrano, Elise Rice, Chan Thai, Kelly Blake, Robin C. Vanderpool

Journal of Appalachian Health

Introduction: Appalachian communities experience elevated rates of cancer incidence and mortality relative to other regions in the U.S. Specifically, melanoma mortality rates are higher in Appalachia compared to the national average, despite comparable incidence rates.

Purpose: To examine differences in self-reported history of skin cancer and prevalence of two UV exposure behaviors between Appalachian and non-Appalachian adults in a nationally representative sample.

Methods: Data are from four cross-sectional cycles of the Health Information National Trends Survey (2011–2014) (N=14,451). We examined sunscreen use and tanning bed use, and self-reported history of melanoma and non-melanoma skin cancer. Descriptive and weighted …

Impact Of The Affordable Care Act On Referral To Care For People Living With Hiv In Appalachia, Cameron A. Wade, Timothy N. Crawford, Nicole Leedy, Alice C. Thornton

Journal of Appalachian Health

Introduction: The Affordable Care Act (ACA) enacted on March 23, 2010 significantly impacted access to healthcare for people living with HIV (PLWH). Expansion of care was accomplished in three areas: eliminating exclusions for pre-existing conditions, elimination of lifetime caps on healthcare expenditures, and expansion of Medicaid eligibility.

Purpose: This study evaluated the impact of state implementation of the ACA Medicaid expansion on referral to HIV care at a Ryan White federally funded clinic in Kentucky (University of Kentucky Bluegrass Care Clinic [UK BCC]).

Methods: Retrospective chart review of all newly enrolled patients at the UK BCC between March 2010 and …

A Nutritional And Environmental Analysis Of Local Food Pantries Accessible To College Students In Rural North Carolina, Emily E. Frymark, Jonathon Stickford, Alisha Farris

Journal of Appalachian Health

Introduction: Food insecurity is a growing concern among college students and is especially prevalent in rural areas. Food pantries often serve as a resource to food insecure individuals yet, their policies, standards, and nutritional quality vary due to the unpredictability of food donations.

Purpose: To examine the nutritional quality of food items and adherence of best practices at local food pantries accessible to college students near a university in rural Appalachia.

Methods: Three food pantries in North Carolina were selected due to their proximity to a local, rural university. Food items were analyzed for nutrient and food …

Use And Perceptions Of A Campus Food Pantry Among Food Insecure College Students: An Exploratory Study From Appalachia, Laura Mcarthur, Kimberly S. Fasczewski, Alisha Farris, Miranda R. Petrone

Journal of Appalachian Health

Introduction: Food insecurity has emerged as a public health problem among college students in Appalachia, jeopardizing their physical, mental, and emotional health and academic success. Campus food pantries have been established in this region, but no data are available concerning student use or perception of services.

Purpose: This study measured use and perceptions of a campus food pantry by students at a mid-sized university in rural North Carolina.

Methods: An online questionnaire collected behavioral and perceptual data, and follow-up interviews explored these variables. Descriptive statistics with significance at p<0.05 and thematic analytical procedures were used.

Results: Questionnaires were submitted by 896 of 6000 recruited students (14.9%), …

The Need For Evidence-Based Interventions To Reduce Food Insecurity Among College Students, Sarah Brothers, Stephanie Jilcott-Pitts Phd

Journal of Appalachian Health

Food insecurity is defined as insufficient resources to meet food needs. This is a global problem but is not confined to those countries identified as poor. One group of Americans who are particularly affected, and for whom the effects are particularly severe, is college students.

The Making And Unmaking Of An Appalachian “Home”: Tensions Between Tourism And Housing Development In Gatlinburg, Tennessee, J. Hope Amason

Anthropology and Museum Studies Faculty Scholarship

This article examines the economic and symbolic dimensions of redevelopment in Gatlinburg, Tennessee. I focus on one particular project, the East Parkway at Baskins Creek Bypass District, which concerned ten acres that contained a vital housing resource for low-income tourism-industry workers: residential motels. I connect Gatlinburg’s housing crisis with changing labor patterns in the wake of economic restructuring. I present two letters submitted by real estate developers and solicited by the City of Gatlinburg. In analyzing the letters, I identify two tensions: (1) between workers’ homes and the aesthetics of “Appalachian” tourism, and (2) between representations of workers and the …

Episcopal Sermons In The Library Of Appalachian Preaching, Robert Ellison, Larry Sheret

English Faculty Research

The Library of Appalachian Preaching provides online access to sermons preached in Appalachia, or elsewhere by preachers with ties to the Appalachian region. This article, in a newsletter published by the Historical Society of the Episcopal Church, discusses Episcopal sermons that are currently in the Library, and some that will be added in the very near future. 

Appalachian Sermons In Marshall's Special Collections: Holdings And Research Possibilities, Robert Ellison

English Faculty Research

This presentation focuses on a collection of Appalachian sermons housed in the Special Collections Department at Marshall University. As the subtitle suggests, it has two main parts. The “Holdings” section provides a brief survey of these materials (the ministers represented in the collection, their denominations, when they served and where, and so on) and shows the work that has been done thus far to place the copyright-free materials online.

The “Research Possibilities” section gives an overview of the theories, topics, and approaches used in the field of sermon studies. I argue--as my colleagues and I have done in other projects--that …

Reviewer Acknowledgments For 2019, F. Douglas Scutchfield Md, Erin N. Haynes, Erin Bouldin, Robert M. Shapiro Ii, Tim Marema, Charlotte S. Seidman

Journal of Appalachian Health

The Editorial Team extends a heart-felt “thank you” to those who have given their time and expertise in the past year to participate in this process with the Journal of Appalachian Health. We know that you have many competing pressures on your time, and that you are not financially compensated for the time you spend reviewing manuscripts. We hope that there are other forms of compensation that make the sacrifice worth the effort.

A Healthy Attitude: Rural Leaders In Tn County Organize To Address Well-Being In Appalachia, Tim Marema, Erin Bouldin

Journal of Appalachian Health

When it came to formal philanthropy, Grundy County was not on the map. That changed with the 2012 establishment of South Cumberland Community Fund, which serves the plateau portions of Grundy, Franklin, and Marion counties.

Appalachian Environmental Health Literacy: Building Knowledge And Skills To Protect Health, Anna G. Hoover, Annie Koempel, W. Jay Christian, Kimberly I. Tumlin, Kelly G. Pennell, Steven Evans, Malissa Mcalister, Lindell E. Ormsbee, Dawn Brewer

Journal of Appalachian Health

Environmental health literacy (EHL) is an emerging, multidisciplinary field that promotes understanding of how environmental exposures can affect human health. After discussing the regional relevance of environmental health knowledge and skills, this article describes three ongoing Appalachian projects that are focused on measuring and building EHL.

Development And Early Outcomes Of The Watauga Compassionate Community Initiative, North Carolina, Tim Marema, Erin Bouldin

Journal of Appalachian Health

Addressing adverse childhood experiences has become a public health imperative, and communities across the United States are working to develop and implement programs and policies to both prevent childhood trauma and support adults who experienced trauma as children. Here we describe the development of the Watauga Compassionate Community Initiative (WCCI) in Watauga, County, North Carolina.

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, …

Introduction To The New “Early Reports Of Innovation” Section, Erin Bouldin, Tim Marema

Journal of Appalachian Health

The Journal of Appalachian Health is introducing a new section this issue. While the journal is centralizing some of the best research and commentary on Appalachian health, the editorial team felt that practice-focused groups, organizations, and agencies may not be fully represented in the publication.

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.

Introducing The L.A.U.N.C.H. Collaborative, F. Douglas Scutchfield Md, Kevin Patrick

Journal of Appalachian Health

The L.A.U.N.C.H. Collaborative: Linking & Amplifying User-Centered Networks through Connected Health: A Demonstration of Broadband-Enabled Connected Health and Community-Based Co-Design brings together a group of organizations that are eager to use Appalachian Kentucky as a site for the development of a project aimed at creating an environment that addresses two of the nation’s major concerns about cancer. First, individuals who live in rural and remote areas are more likely to die of cancer than those who live in urban or suburban settings. And second, geographic obstacles hinder their ability to access evidence-based strategies that can prevent cancer or treat it …

The Mothman And Other Strange Tales: Shaping Queer Appalachia Through Folkloric Discourse In Online Social Media Communities, Brenton Watts

Theses and Dissertations--Linguistics

Little work has been conducted on the intersections of queer and Appalachian identities, in part because these two identities are viewed as incompatible (Mann 2016). This study uses a multimodal critical discourse analytic approach to examine the Instagram posts of the Queer Appalachia Project, which represent a substantial body of discourse created by and for queer Appalachians. Of specific interest to this analysis are those posts which employ folkloric figures, such as West Virginia’s Mothman, to do identity work that is queer, Appalachian, and queer-Appalachian. Often, this act is accomplished through juxtaposition with Appalachian imagery and the reclamation of homophobic …

Healing The Encounter Between People And Place In Southern Appalachia, Caroline Merritt

Expressive Therapies Capstone Theses

In southern Appalachia, we fail to make visible the roots. Existing not as a geographical location but as a socially constructed culture and a concentrated source of exploited energy, the region reflects a necessary element of the postcolonial American imagination. For nationally lucrative resources such as coal, oil, lumber, and natural gas to be extracted without consideration or consciousness for the people and the place of its origin, the otherized Appalachian stereotype must prevail. Further crystalizing this false construction, white Appalachian scholars traditionally address current health disparities via the victimization of poor white Appalachia. The capitalist initiative to concentrate power …

Why We Can’T Solve The Opioid Problem, Wayne F. Coombs, Ph.D.

Journal of Appalachian Health

Appalachia’s opioid epidemic is a complex, systemic problem being addressed by limited intervention processes conceptualized through narrow disciplinary models that are not working. We need a new comprehensive, collaborative approach if we ever hope to find solutions to this problem.

Adult Food Security And The Relationship With Adverse Childhood Experiences Among Residents Of Appalachian North Carolina, Manan Roy, Erin Bouldin, Maggie Bennett, Adam Hege

Journal of Appalachian Health

Introduction: The Appalachian region has worse health outcomes than the remainder of the United States. These disparities are often linked to the underlying social and environmental determinants of health. Adverse childhood experiences (ACEs) are associated with poor health outcomes across the lifespan and have a significant impact on future social determinants as an adult, including food security status.

Purpose: To explore the relationships between ACEs and food security among adults in the Appalachian counties of North Carolina and make comparisons with the rest of the state.

Methods: Researchers used North Carolina’s 2012 Behavioral Risk Factor Surveillance System data; namely, …

A Comparison Of Appalachian And Non-Appalachian Kentucky Dui Offenders, Megan F. Dickson, Megan Kissel, J. Matthew Webster

Journal of Appalachian Health

Background: Driving under the influence has been an overlooked consequence of the opioid epidemic. Although recent reports have highlighted the increased prevalence of DUI in rural communities and the extensive mental health problems and criminal and drug use histories among rural Appalachian DUI offenders, it is unclear how Appalachian DUI populations compare to DUI offenders in other regions.

Purpose: To help fill this void in the literature, the current study uses a statewide sample to examine how Appalachian DUI offenders differ from non-Appalachian DUI offenders in a predominantly rural state.

Methods: Assessment records were examined for 11,640 Kentucky DUI offenders …

Roanoke's Collective Public Health Activities, Michael Lytton

Journal of Appalachian Health

Roanoke is addressing problems that confront many small and medium sized cities in the U.S., especially disparities in health and life expectancy between neighborhoods. These disparities are often legacies of decades of racial and economic segregation, resulting in low-income or disinvested communities. Typically, such neighborhoods have fewer parks, higher vacancy rates and less stable affordable housing stock, inadequate public transit systems, too few clinics, too many fast food restaurants and insufficient access to high quality schools. In Roanoke these are the northwest and southeast quadrants, both federally designated Medically Underserved Areas, and characterized by a large proportion of the city’s …

A Legacy Of Disease, Arthur L. Frank

Journal of Appalachian Health

In Appalachia, like much of America, there are important health issues that have not always been appropriately predicted or dealt with when they occur. Lifestyle issues in Appalachia lead to obesity and heart disease, not surprisingly due to extensive use of sugary drinks. The current opioid crisis could have been better predicted given the trauma of mining and the past abuse of less-potent narcotics. A continuing major problem in the whole country is inadequate support for preventive health activities.

Improving Access To Addiction Recovery Care In Central Appalachia Through Organizational Collaboration, Katy Stigers

Journal of Appalachian Health

Fahe, a Network of 50+ members throughout Appalachia based in Berea KY, has brought together a coalition to finance, build, and manage several addiction recovery care centers across Kentucky and West Virginia, increase access to employment, and deploy vouchers for supportive services.

Investigating The Impact Of The Diseases Of Despair In Appalachia, Michael Meit, Megan Heffernan, Erin Tanenbaum

Journal of Appalachian Health

Introduction: Appalachia is one of the regions most significantly impacted by the opioid crisis. This study investigated mortality due to diseases of despair within the Appalachian Region, with an additional focus on deaths attributable to opioid overdose.

Methods: Diseases of despair include: alcohol, prescription drug and illegal drug overdose, suicide, and alcoholic liver disease/cirrhosis of the liver. Mortality data from the National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS) Multiple Cause of Death database were analyzed for this study, focusing on individuals aged 15–64.

Results: Over the past two decades, the mortality rate due to diseases of …

Root Causes Of Appalachia’S Deaths Of Despair, F. Douglas Scutchfield Md

Journal of Appalachian Health

The U.S. is experiencing a decline in life expectancy, particularly among rural white males in their most productive years. Appalachia is disproportionally represented in mortality rates, accounting for 30% of the U.S. population, but 50% of the excess mortality attributed to the “deaths of despair”: drug overdose, suicide, and alcoholic cirrhosis. A substantial proportion of that excess mortality is related to the current opioid crisis we are experiencing. We have data on evidence-based solutions to the treatment of addiction, but little information on prevention of addiction as well as the other deaths of despair, likely with the same etiologic agent. …