Medicine and Health Sciences Commons^™

Policy Implications Of The Covid-19 Pandemic On Food Security In Rural America: Evidence From Appalachia, Kathryn M. Cardarelli, Emily M. Dewitt, Rachel Gillespie, Rachel Hogg-Graham, Heather Norman-Burgdolf, Janet T. Mullins

Dietetics and Human Nutrition Faculty Publications

Rural communities are disproportionally affected by food insecurity, making them vulnerable to the consequences of supply disruptions caused by the COVID-19 pandemic. While access to food was initially diminished due to food supply disruptions, little is known about the mechanisms through which federal emergency assistance programs impacted food access in rural populations. Through a series of five focus groups in spring 2021, we examined the impact of the COVID-19 pandemic on food access in a rural Appalachian community in Kentucky. Data were analyzed using a Grounded Theory Approach. Findings revealed the following four primary themes: food scarcity in grocery stores; …

Perspectives Of Primary Care Physicians On Acceptance And Barriers To Covid-19 Vaccination, Philip Day, Chance Strenth, Neelima Kale, F. David Schneider, Elizabeth Mayfield Arnold

Family and Community Medicine Faculty Publications

OBJECTIVES: The purpose of this study was to examine the perspectives of primary care physicians in Texas around vaccine acceptance and potential patient barriers to vaccination. National surveys have shown fluctuating levels of acceptance for COVID-19 vaccination, and primary care physicians could play a crucial role in increasing vaccine uptake.

DESIGN: This study employed a cross-sectional anonymous survey design to collect data using an online questionnaire. Participants were asked about vaccination practices and policies at their practice site, perceptions of patient and community acceptance and confidence in responding to patient vaccine concerns.

SETTING: From November 2020 to January 2021, family …

Losses, Gains, And Changes To The Food Environment In A Rural Kentucky County During The Covid-19 Pandemic, Makenzie L. Barr, Courtney Martin, Courtney T. Luecking, Kathryn M. Cardarelli

Dietetics and Human Nutrition Faculty Publications

The COVID-19 pandemic has caused alterations to be made in the way many people access, prepare, and consume food. Rural communities are particularly impacted due to pre-existing structural vulnerabilities, i.e., poverty, lack of infrastructure, and limited fresh food options. This study aimed to characterize experiences of one rural Appalachian community’s changes to the food environment during the pandemic. In April 2021, six focus groups were conducted with residents of Laurel County, Kentucky. Using grounded theory, we identified losses, gains, and overall changes to the community food environment since the onset of COVID-19. Seventeen Laurel Countians (17 female; ages 30–74) participated …

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 …

The Compounding Effect Of Rurality On Health Disparities Among Black Patients With Covid-19, Jessica E. Johnson, Ruchi Bhandari, Allison Lastinger, Rebecca Reece

Journal of Appalachian Health

Background: West Virginia had garnered national attention for its vaccination rollout against coronavirus 2019 (COVID-19). Outcomes of this mostly rural population, however, have been underreported. As the pandemic continues, identifying high risk populations remains important to further epidemiologic information and target vaccines.

Purpose: The objective of this study is to examine the effects of COVID-19 and the influence of race and rurality on hospitalization and outcomes in Appalachians.

Methods: In this retrospective study, data from patients who tested positive and were admitted for COVID-19 and seen within the state’s largest health system (West Virginia University Health System) between March …

Association Between Post-Hospital Clinic And Telephone Follow-Up Provider Visits With 30-Day Readmission Risk In An Integrated Health System, Huong Q. Nguyen, Aileen Baecker, Timothy Ho, Dan N. Huynh, Heather L. Watson, Jing Li, Ernest Shen

Center for Health Services Research Faculty Publications

BACKGROUND: Follow-up visits with clinic providers after hospital discharge may not be feasible for some patients due to functional limitations, transportation challenges, need for physical distancing, or fear of exposure especially during the current COVID-19 pandemic.

METHODS: The aim of the study was to determine the effects of post-hospital clinic (POSH) and telephone (TPOSH) follow-up provider visits versus no visit on 30-day readmission. We used a retrospective cohort design based on data from 1/1/2017 to 12/31/2019 on adult patients (n = 213,513) discharged home from 15 Kaiser Permanente Southern California hospitals. Completion of POSH or TPOSH provider visits within …

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 …

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, …

Analysis Of Covid-19 Concerns Raised By The Construction Workforce And Development Of Mitigation Practices, Makram Bou Hatoum, Ali Faisal, Hala Nassereddine, Hadi Sarvari

Civil Engineering Faculty Publications

The coronavirus outbreak has created a global health crisis that has disrupted all industries, including the construction industry. Following the onset of the pandemic, construction workers faced and continue to face unprecedented safety and health challenges. Therefore, construction employers established new safety precautions to protect the health and safety of the workforce and minimize the spread of the virus. The new precautions followed the advice and guidelines offered by different health and safety agencies like the Occupational Safety and Health Administration (OSHA), Centers of Disease Control and Prevention (CDC), and the Associated General Contractors of America (AGC). With construction projects …

School Reopenings, Mobility, And Covid-19 Spread: Evidence From Texas, Charles J. Courtemanche, Anh Le, Aaron Yelowitz, Ron Zimmer

Institute for the Study of Free Enterprise Working Papers

This paper examines the effect of fall 2020 school reopenings in Texas on county-level COVID19 cases and fatalities. Previous evidence suggests that schools can be reopened safely if community spread is low and public health guidelines are followed. However, in Texas, reopenings often occurred alongside high community spread and at near capacity, likely making it difficult to meet social distancing recommendations. Using event-study models and hand-collected instruction modality and start dates for all school districts, we find robust evidence that reopening Texas schools gradually but substantially accelerated the community spread of COVID-19. Results from our preferred specification imply that school …

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.

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 …

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 …

Sex Differences And Psychological Stress: Responses To The Covid-19 Pandemic In China, Shiyan Yan, Rui Xu, Terry D. Stratton, Voyko Kavcic, Dan Luo, Fengsu Hou, Fengying Bi, Rong Jiao, Kangxing Song, Yang Jiang

Behavioral Science Faculty Publications

BACKGROUND: About 83,000 COVID-19 patients were confirmed in China up to May 2020. Amid the well-documented threats to physical health, the effects of this public health crisis - and the varied efforts to contain its spread - have altered individuals' "normal" daily functioning. These impacts on social, psychological, and emotional well-being remain relatively unexplored - in particular, the ways in which Chinese men and women experience and respond to potential behavioral stressors. Our study investigated sex differences in psychological stress, emotional reactions, and behavioral responses to COVID-19 and related threats among Chinese residents.

METHODS: In late February (2020), an anonymous …

Modes Of Transmission Of Severe Acute Respiratory Syndrome-Coronavirus-2 (Sars-Cov-2) And Factors Influencing On The Airborne Transmission: A Review, Mahdieh Delikhoon, Marcelo I. Guzman, Ramin Nabizadeh, Abbas Norouzian Baghani

Chemistry Faculty Publications

The multiple modes of SARS-CoV-2 transmission including airborne, droplet, contact, and fecal–oral transmissions that cause coronavirus disease 2019 (COVID-19) contribute to a public threat to the lives of people worldwide. Herein, different databases are reviewed to evaluate modes of transmission of SARS-CoV-2 and study the effects of negative pressure ventilation, air conditioning system, and related protection approaches of this virus. Droplet transmission was commonly reported to occur in particles with diameter >5 µm that can quickly settle gravitationally on surfaces (1–2 m). Instead, fine and ultrafine particles (airborne transmission) can stay suspended for an extended period of time (≥2 h) …

Factors Associated With Lifestyle Modification For Type 2 Diabetes Self-Management And Prevention, Leigh Anne Koonmen

Theses and Dissertations--Nursing

Diabetes is the seventh leading cause of death in the United States, affecting roughly 13% of U.S. adults aged 18 years or older. Type 2 diabetes accounts for 90-95% of all diabetes cases and is characterized by the progressive development of insulin resistance leading to sustained elevated blood glucose levels. Management of type 2 diabetes includes risk-reduction strategies and continuous medical care to prevent the development of complications.

Lifestyle is a major contributing factor to morbidity and mortality rates in the United States. Preventative health behaviors, such as engaging in physical activity, maintaining a healthy weight, and following a healthy …

Impact Of Mental Health And Financial Status Of Essential And Non-Essential Workers That Continued Working Outside The Home During The Spring 2020 Covid-19 Shutdown, Adrianne Deveira

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objective: A global pandemic caused businesses in the United States to shutdown based on essential vs. non-essential criteria. There has been a lot of research discussing the impact of the shutdown on healthcare frontline workers. Little is known about other essential and non-essential workers, that continued working outside the home during the shutdown. The purpose of this paper is to examine the financial and mental health issues encountered by essential and non-essential workers that continued working outside the home during the Spring 2020 shutdown.

Methods: Snowball sampling of an online survey that was available from May 8 – June 6, …