Medicine and Health Sciences Commons^™

Preterm Birth Prevention In Appalachian Kentucky: Understanding Barriers And Facilitators Related To Transvaginal Ultrasound Cervical Length Surveillance Among Prenatal Care Providers, Anna Hansen, Mairead E. Moloney, Cynthia Cockerham-Morris, Jing Li, Niraj R. Chavan

Sociology Faculty Publications

Background: Appalachian Kentucky has higher-than-average rates of preterm birth (PTB)—a health disparity associated with increased maternal and fetal/neonatal morbidity and neonatal mortality. Transvaginal ultrasound (TVU) cervical length measurement is the best predictor of PTB risk, but is underutilized in Appalachia. This study explores prenatal care providers' TVU-related knowledge and practices, and identifies barriers and facilitators, which impact the adoption of this evidence-based technology.

Materials and Methods: This study recruited providers from three Appalachian Kentucky health care sites. Prenatal care providers took part in semistructured interviews and completed brief survey scales. Questions focused on PTB knowledge, TVU-related barriers, and suggestions for …

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 …

Clinician Identified Barriers To Treatment For Individuals In Appalachia With Opioid Use Disorder Following Release From Prison: A Social Ecological Approach, Amanda M. Bunting, Carrie B. Oser, Michele Staton, Katherine S. Eddens, Hannah K. Knudsen

Sociology Faculty Publications

Background: The non-medical use of opioids has reached epidemic levels nationwide, and rural areas have been particularly affected by increasing rates of overdose mortality as well as increases in the prison population. Individuals with opioid use disorder (OUD) are at increased risk for relapse and overdose upon reentry to the community due to decreased tolerance during incarceration. It is crucial to identify barriers to substance use disorder treatment post-release from prison because treatment can be particularly difficult to access in resource-limited rural Appalachia.

Methods: A social ecological framework was utilized to examine barriers to community-based substance use treatment among individuals …

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.

Mental Health Treatment Seeking Patterns And Preferences Of Appalachian Women With Depression, Claire Snell-Rood, Emily Hauenstein, Carl G. Leukefeld, Frances Feltner, Amber Marcum, Nancy E. Schoenberg

Behavioral Science Faculty Publications

This qualitative study explored social-cultural factors that shape treatment seeking behaviors among depressed rural, low-income women in Appalachia—a region with high rates of depression and a shortage of mental health services. Recent research shows that increasingly rural women are receiving some form of treatment and identifying their symptoms as depression. Using purposive sampling, investigators recruited 28 depressed low-income women living in Appalachian Kentucky and conducted semistructured interviews on participants’ perceptions of depression and treatment seeking. Even in this sample of women with diverse treatment behaviors (half reported current treatment), participants expressed ambivalence about treatment and its potential to promote recovery. …

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.

Opportunity, Community, And Teen Pregnancy In An Appalachian State, Robert Bickel, Susan Weaver, Tony Williams, Linda Lange

SHU Faculty Publications

Teen pregnancy has become an issue that educators and public policy makers are obliged to treat as a serious problem. Too often, explanations of teen pregnancy have included uncritical use of the notion of adolescents at risk. Recently, however, attention has been given to structurally-determined contextual factors in explaining teen pregnancy. Such contextual factors include economic and educational opportunities and costs, as well as chances for valued participation in socially and culturally stable communities. This interest in contextual factors parallels a development in the literature on high school dropouts. A data set previously employed to study variability in drop-out rates …