Social and Behavioral Sciences Commons^™

The Effect Of Health Care Entrepreneurship On Local Health: The Case Of Medexpress In Appalachia, Amir Borges Ferreira Neto, Joshua C. Hall

Regional Research Institute Working Papers

We test the hypothesis that the opening of an Urgent Care Center (UCC) has positive impacts on the local community. There are several mechanisms through which a UCC can have an impact: lower health care costs, emergency room decongestion, and improved access to medical information. We examine the entry of MedExpress into Appalachian counties between 2001 and 2013. Employing data from Health Resources Files, which provides information for all counties for specific years, we use Propensity Score Matching to create a year 2000 control group for the counties “treated” by MedExpress entry beginning in 2001. We then employ a standard …

Twenty-­‐First Century Deindustrialization And Uneven Development In Appalachia, Katherine Custis Gerlaugh

Doctoral Dissertations

The causes and consequences of deindustrialization in the United States are myriad and have created a dire situation for millions of working class people as blue-­collar jobs have mostly vanished. This reality has been particularly hard in places like Appalachia, where manufacturing and extraction were the largest, and often only, employers for most of the 20th Century. Especially for rural areas with little appeal for new markets, tourism often appears to be one way to attract people to the area to spend money, but it is unclear whether or not this strategy is helpful to local economies. In this study, …

Moving Mountains : A Study Examining Long-Term Impacts Of Mountaintop Removal Coal Mining On Mortality In The Appalachian Region Using Geographic Information Sciences Techniques., James Howard Kent Pugh

Electronic Theses and Dissertations

Over the last hundred years, the Appalachian region has been dominated by the coal industry. It has also been and currently is one of the unhealthiest regions in the United States. Recent scholarship has examined the relationship between coal mining and health and mortality rates in the Appalachian region. The first study incorporates air quality and pollution data to examine if coal mining counties have higher levels of pollution and if this pollution contributes to mortality disadvantage. In the second study, I construct a population-based coal-exposure measure to better evaluate the relationship between coal mining and health I find that …

Contingency Management For Smoking Cessation In Pregnancy, Jacob Miller, Brady Reynolds, Courtney Crain, Hisham Keblawi, Lynne J. Goebel

Marshall Journal of Medicine

This pilot study examined the feasibility of applying Contingency Management (CM), where the woman receives financial compensation for abstinence from smoking. Eleven subjects were recruited from Marshall’s OB clinic for the program. CO levels were measured daily using online video recording. Quit rates were determined at the end of pregnancy. Birth outcomes were measured at delivery. 21 pregnant smokers from Marshall’s OB clinic were used as the control group. The results demonstrated a trend toward improved rates of smoking abstinence in CM participants as compared with the control group. Our study also showed a trend towards improved birth outcomes in …

Invisible Outsiders: Developing A Working Alliance With Appalachian Clients, Jake Protivnak, Cassandra Pusateri, Matthew Paylo, Kyoung Choi

Faculty Publications

Appalachian clients are often ‘invisible’ within the majority culture and possess characteristics unique to the region that must be considered within the counseling relationship (Tang & Russ, 2007). Individuals in Appalachia have higher incidences of certain mental health disorders and substance use as compared to the national average (Appalachian Regional Commission [ARC], 2008). Although the need for mental health services is evident, limited research exists to inform mental health professionals how to deliver culturally competent interventions to build a working alliance with Appalachian clients. The authors will discuss a framework for mental health professionals to develop a strong working alliance …

Invisible Outsiders: Developing A Working Alliance With Appalachian Clients, Jake J. Protivnak, Cassandra G. Pusateri, Matthew J. Paylo, Kyoung Mi Choi

Kyoung Choi

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 Devil Is In The Details: Representations Of The Rural Appalachian Deviant, Stephen T. Young

Sociology & Criminal Justice Theses & Dissertations

Every year, it seems, a new film makes its way through theaters across America demonstrating a new variant of the rural Appalachian deviant. These films play a major role in continuing to shape societal perceptions of rural white populations in Appalachia. Drawing on theoretical insights of Cohen, Hunt, Simon, and Lupton this dissertation examines how film depictions of the rural white Appalachians supports the continued construction of the rural Appalachian deviant. This study finds that films support said construction by demonstrating this population through themes about tainted blood, intimate partner violence, and drug addiction. Moreover, these films camouflage the facts …

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 …

The Effects Of Motivational Interviewing On Heart Failure Self-Care During Transitional Care In An Appalachian Population, Jennifer Lynn Mabry

Doctoral Dissertations

Research has shown that patients who are successfully engaged in self-care for a chronic illness have a higher quality of life and reduced hospitalizations than those who are not. According to the National Center for Health Statistics, transitional care in the home setting has seen a 51% increase in mortality over the last 15 years (Reeder et al., 2015). This finding contrasts with the reported decline in hospital readmissions for chronic illnesses. With the lack of agreement on best practices for patient discharge education, transitional care has proven to be a weakness in chronic illness care that requires further research. …

Trout Fishing In The Smokies And The Blue Ridge, 1880-Present: How-To, History, And Habitat, Nathaniel Cole Skaggs

Electronic Theses and Dissertations

This study focuses on trout fishing in the Great Smoky Mountains and the Blue Ridge Mountains from 1880 to 2017. I begin with a collection of personal narratives of fly-fishing in Tennessee to portray the allure of southern Appalachia trout fishing. I then describe the transition from native Cherokee fishing practices to sport fishing in the Smokies and the Blue Ridge by 1880. I explore a brief history of the National Parks and the United States Forest Service during the early 1900s, and address European fly-fishing influences in the United States during the twentieth century. I examine the habitats of …

Financial Literacy In Local At-Risk Appalachia, Elijah R. Osborne

Undergraduate Honors Theses

Unfortunately, rural Appalachia is perennially one of the poorest areas of the United States. Many scholars have offered opinions as to why this trend of poverty continues in this region, but one potential cause has not been the subject of much research: do residents in Appalachia have a functional knowledge of the financial system, or even a simple understanding of basic savings, which is necessary for achieving certain levels of financial security?

We conduct a survey modeled after a national study which measures basic financial literacy in local Appalachia, expecting to find that at-risk Appalachians would have less financial literacy …

Social Support For Physical Activity For High Schoolers In Rural Appalachia, Pooja M. Shah

Undergraduate Honors Theses

The purpose of the present study is to conduct a secondary qualitative analysis to examine parent, teacher, and high school adolescents’ perceptions of social support for physical activity (PA) for high schoolers in Southern Appalachia. Social support for PA is linked to higher rates of PA participation in adolescents. Parents, siblings, and peers provide key sources of support. Social support for PA may be even more important in under-resourced communities such as Appalachia, where geographic, economic, and environmental barriers negatively impact PA engagement. During 2013-2014, focus groups and semi-structured interviews were conducted with parents of adolescents (n=39), high school teachers …

Progressive Education In Appalachia: East Tennessee State Normal School And Appalachian State Normal School, Holly Heacock

Undergraduate Honors Theses

In this thesis, I am examining how East Tennessee State Normal School in East Tennessee and Appalachian State Normal School in Western North Carolina interpreted progressive education differently in their states. This difference is that East Tennessee State began as a state funded school to educate future teachers therefore their school and their curriculum was more rounded and set to a structured schedule. Appalachian State Normal School was initially founded to educate the uneducated in the “lost provinces” therefore, curriculum was even more progressive than East Tennessee State’s – based strongly on the practices of farming, woodworking, and other practical …

Phenomenological Study Of The Lived Experiences Of Appalachian Spouses Of Combat Veterans With Post Traumatic Stress Disorder, Janice E. Greene

Electronic Theses and Dissertations

This study was conducted to identify gaps in existing knowledge regarding impacts of combat-related PTSD on the spouse and to gain an understanding of the lived experience of Appalachian Spouses of combat veterans with PTSD. A systematic literature review was conducted to identify research and findings on the impacts of combat-related PTSD on spouses of veterans and a qualitative study was conducted to gain an understanding of the lives of Appalachian spouses of combat veterans with PTSD.

The systematic review identified 16 qualitative studies conducted between 1988 and 2016 in five countries spanning five wars. Regardless of the country of …

Attention Deficit Hyperactivity Disorder In Appalachia: Proposed Methods To Analyze And Solve Social And Medical Issues Surrounding The Disorder, Alexis Rae Prillhart

Chancellor’s Honors Program Projects

No abstract provided.

Beyond The Coal Divide: The Cultural Politics Of Natural Resource Extraction In Central Appalachia, Julie A. Shepherd-Powell

Theses and Dissertations--Anthropology

During the last several years far southwest Virginia, like elsewhere in the central Appalachian region, has faced a decline in all coal mining activity and a subsequent loss of coal mining jobs, meaning that local economies are suffering and the unemployment line is long. In addition, this area continues to face environmental pollution from surface coal mines that are still in operation or have not been reclaimed. Drawing upon anthropological literature on natural resource extraction and economic and environmental inequality, this dissertation highlights the lives of members of a local grassroots environmental organization, as well as other local residents, in …

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. …

The Effect Of Health Care Entrepreneurship On Local Health: The Case Of Medexpress In Appalachia, Amir B. Neto, Joshua C. Hall

Economics Faculty Working Papers Series

We test the hypothesis that the opening of an Urgent Care Center (UCC) has positive impacts on the local community. There are several mechanisms through which a UCC can have an impact: lower health care costs, emergency room decongestion, and improved access to medical information. We examine the entry of MedExpress into Appalachian counties between 2001 and 2013. Employing data from Health Resources Files, which provides information for all counties for specific years, we use Propensity Score Matching to create a year 2000 control group for the counties “treated” by MedExpress entry beginning in 2001. We then employ a standard …

Politics Below The Surface: A Political Ecology Of Mineral Rights And Land Tenure Struggles In Appalachia And The Andes, Lindsay Shade

Theses and Dissertations--Geography

This dissertation examines how confusion and lack of access to information about subsurface property rights facilitates the rapid acquisition of mineral rights by mining interests, leaving those who live 'above the surface' to contend with complicated corporate and bureaucratic apparatuses. The research focuses on the first proposed state-run large scale mining project in Ecuador, believed to contain copper ores, and on the natural gas hydrofracking industry in three counties in north central West Virginia. Qualitative and visual methods, including mapping, are employed to determine (i.) how the geography of subsurface ownership patterns is changing, (ii.) links between changes in subsurface …

“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 …

Before Me, After Me, Through Me: Stories Of Food And Community In Eastern Kentucky, Abigail Myers Huggins

Electronic Theses and Dissertations

This text contextualizes and presents twenty-three oral history interviews conducted in eastern Kentucky during the summer of 2016 as a part of a Master of Arts thesis in southern studies. The interviews were conducted with people specifically connected to food, farming, and community activism in and near Letcher County, Kentucky. The interviews explore such topics as: past and present food traditions, seed saving, gardening, farming, food preservation, herbalism, local food systems, food access, youth, theater arts, lgbtq+ advocacy, and appalachian identity. This document complements an online collection of oral history excerpts created as an audio documentary portion of the overall …