Social and Behavioral Sciences Commons^™

An Exploratory Study Of Flora Poaching In Central Appalachia, Mckinley Bowers

Electronic Theses and Dissertations

The purpose of this study was to explore perceptions of flora poaching among conservation officers, park rangers and botanists within Central Appalachia. Though some work has sought to understand poaching in other forms, such as animal poaching, little is known regarding the poaching of plants. This is especially true within the Appalachian Region. Several research questions were explored in this study, including the types of flora being poached, the characteristics of poachers, poaching tactics utilized, and deterrence measures that are currently in place. Data were collected through semi-structured interviews with 20 individuals working in the field. Findings contribute to the …

Treatment At An Academic Medical Center Eliminates Survival Disparities For Appalachian Kentuckians With Pancreatic Ductal Adenocarcinoma, Emily Cassim, Hannah Mcdonald, Megan Harper, Quan Chen, Miranda Lin, Reema Patel, Michael Cavnar, Prakash Pandalai, Bin Huang, Pamela C. Hull, Joseph Kim, Erin Burke

Journal of Appalachian Health

Introduction: Rates of cancer mortality in Appalachian Kentucky is among the highest in the nation. It is unknown whether geographic location of treatment for pancreatic ductal adenocarcinoma (PDAC), one of the deadliest cancers worldwide, influences survival in Appalachian Kentuckians.

Purpose: This study compares outcomes among Appalachian Kentuckians with PDAC who received treatment at an academic medical center (AMC) or community facility (CF).

Methods: Using the Kentucky Cancer Registry, patients diagnosed with PDAC between 2003 and 2018 were identified. Patients were categorized according to treatment location (AMC v. CF) and county of residence (Appalachian v. non-Appalachian). Kaplan-Meier curves were constructed to …

Maternal Age And Inadequate Prenatal Care In West Virginia: A Project Watch Study, Madelin Gardner, Amna Umer, Brian Hendricks, Toni Marie Rudisill, Candice Lefeber, Collin John, Christa Lilly

Journal of Appalachian Health

Introduction: Adequate prenatal care (PNC) is essential to the overall health of mother and infant. Teen age and advanced maternal age (AMA) are known risk factors for poor birth outcomes. However, less is known about whether these age groups are associated with inadequate PNC.

Purpose: This study sought to determine the potential association between maternal age (in groups, aged 20–24, 25–29, 30–34, 35–39, and >40) and inadequate PNC (visits).

Methods: West Virginia (WV) Project WATCH population-level data (May 2018–March 2022) were used for this study. Multiple logistic regressions were performed on inadequate PNC (less than 10 visits) with maternal age …

Trilogies: Lessons From 50 Years Facilitating Community-Based Health Assessments And Planning In Appalachia, Bruce Behringer

Journal of Appalachian Health

Involvement of community and organizational groups is fundamental to most public ventures. Most social, health, economic, and educational improvements in Appalachia have been characterized by successfully integrating community input and finding ways to encourage organizational change and collaboration.

Managing group process and related facilitation skills are fundamental competencies for public health professionals and others guiding change efforts. Groups from communities and organizations can get stalled in their deliberations; a facilitator frequently must think quickly to diagnose the situation and propose alternative approaches. Creative and flexible approaches, learned through practice experiences, can blend with theories and frameworks learned in academic preparation …

Appalachia In The Anthropocene: An Approach To Understanding Neo Appalachian Narratives As An Affective Ecology, Rachel Michel Bates

English Theses & Dissertations

Appalachia is all too often a commodified and mythologized place in the American consciousness. Yet the lived experience of Appalachia is one complicated by widescale ecological devastation, high poverty rates, and most recently, a devastating opioid crisis. Though much of Appalachian literature continues to dwell in an old vision of Appalachia, an endeavor Zackary Vernon terms post-Appalachian, I argue that a subset of texts published around the turn of the millennium, a time when many of the labor-dependent, exploitative industries such as logging, hydro damming, and coal mining were no longer at work in the region, reveal a shift in …

Book Review: Another Appalachia: Coming Up Queer And Indian In A Mountain Place, Sarah Trowbridge

Georgia Library Quarterly

No abstract provided.

Place Matters: The Role Of Public Libraries As Change Agents In Central Appalachia, Jasmyne R. Lewis

Theses, Dissertations and Capstones

The role of public libraries is changing in response to a multitude of influences and trends. The exponential growth of technology as the primary method of information access, funding challenges, changing demographics, and other mitigating factors have forced public libraries to become more than book repositories. Community library leaders and governing board members are faced with challenges such as decreased funding, community division regarding library services, and soaring costs for library materials and services, as they develop and adopt policies and practices to navigate this ever-changing environment.

The purpose of this qualitative study was to collect data from the public …

Growth In Appalachia: Downtown Revitalization Strategies For Covington, Virginia, Tucker L. Keener

Master of Urban and Regional Planning Capstone Projects

This plan was created for the City of Covington, Virginia which is located in the Western part of the state in the Blue Ridge Mountains. This plan aims to identify the goals and desires of local community members and business owners that prioritize economic growth in the downtown core. The City of Covington has many great assets, and the goal of this plan is to leverage these assets to assist with downtown revitalization. Recommendations in this plan relate to ideas of enhancing downtown, creating and strengthening anchor institutions, and create downtown as a tourist destination.

The Impact Of Opioids On Students And Schools In Appalachian And Non-Appalachian Ohio: Educational Leader Perspectives On The Crisis, Charles L. Lowery, Chetanath Gautam

Journal of Research Initiatives

Over the last several decades, the opioid crisis has had an increasing impact on the educational environment of schools. The role that principals and superintendents have in leading schools that have been affected by opioids has been mostly overlooked in the research. The present study was conducted in Ohio, a state with areas that have some of the highest death rates due to opioid-related incidents in the nation. Purpose: This study collected data on the perspectives and perceptions of school leaders in Ohio to better understand how principals and superintendents frame their decisions regarding the opioid crisis. Design: We analyze …

Disparities In Mortality Between Appalachian And Non-Appalachian Regions Of Kentucky, Sonali S. Salunkhe, Sahal Alzahrani, Beatrice Ugiliweneza

Journal of Appalachian Health

Introduction: In the opioid epidemic, the U.S. faces a significant public health crisis, with some areas of the country, such as rural and Appalachian regions, suffering more than others. The differential regional impact of the crisis in Kentucky—a state with both non-metropolitan/metropolitan and Appalachian/Non-Appalachian statuses—has not yet been documented despite such knowledge being essential to the success of overdose prevention efforts.

Purpose: This study compares all-cause, drug- and opioid-related mortality between counties in different regions of Kentucky: Appalachian non-metropolitan, Appalachian metropolitan, non-Appalachian non-metropolitan, and non-Appalachian metropolitan.

Methods: Age-adjusted mortality data from the Centers for Disease Control and Prevention’s Wide-ranging Online …

Review Of: Coal, Cages, Crisis: The Rise Of The Prison Economy In Central Appalachia, Ted Olson Phd

Journal of Appalachian Health

Ted Olson, PhD, is a professor of both Appalachian Studies and Bluegrass, Old-Time and Roots Music Studies at East Tennessee State University. In this piece, he reviews Professor Judah Schept's Coal, Cages, Crisis: The Rise of the Prison Economy in Central Appalachia and discusses the impacts of incarceration on the health of Appalachia and on its residents more broadly.

Carbapenem-Resistant Enterobacterales—Kentucky, 2013–2020: Challenges And Successes, Mary Issac, Andrea Flinchum, Kevin Spicer

Journal of Appalachian Health

Introduction: Carbapenem-resistant Enterobacterales (CRE) are considered urgent, antibiotic-resistant threats in the U.S. and are of global concern. Active collaboration between public health authorities and healthcare facilities and providers will be necessary to prevent and contain these organisms.

Purpose: To describe the epidemiology of CRE in Kentucky and to discuss challenges and successes with building and sustaining an effective prevention and containment program.

Methods: Retrospective descriptive summary of CRE isolates reported by healthcare providers, facilities, and laboratories in Kentucky from 2013 through 2020. Data available from case reporting forms and laboratory testing are summarized.

Results: From 2013 through 2020, 1805 CRE …

Changes In Perceptions Of First Responders After Witnessing A Drug Overdose: Individual And Contextual Variations Among People Who Use Opioids In West Virginia, Kathleen L. Egan, Kelly Gurka, Alexandria Macmadu, Herb Linn

Journal of Appalachian Health

Introduction: Success of opioid overdose interventions involving first responders is dependent on the comfort level that bystanders have with first responders and their willingness to call for assistance. Positive or negative experiences with first responders following witnessing an overdose may influence a person’s willingness to call a first responder for assistance in the future.

Purpose: The objective of this study was to examine changes in bystanders’ perceptions of first responders following witnessing an overdose attended by emergency medical services or a law enforcement official. It specifically explored perception changes among a sample of individuals residing in Appalachia who use prescription …

High-Risk Individuals And Naloxone Use: Implications For Thn Programs In Rural Appalachian Communities, Victor Garcia, Lisa Mccann, Erick Lauber, Christian Vaccaro, Melissa Swauger, Alex Daniel Heckert

Journal of Appalachian Health

Introduction: Take-home naloxone (THN) is being made available across rural Appalachia to curb opioid overdose fatalities. Despite this initiative, some opioid users do not possess naloxone, and if they do, do not administer it to others.

Purpose: Research findings on risk factors that contribute to opioid overdose are presented. These factors, identified in a sample of 16 overdose cases, are (1) early onset age of opioid use; (2) progressive opioid use; (3) a transition from pain medication to heroin and fentanyl; (4) fears of being arrested at a naloxone intervention if first responders are contacted, and (5) limited knowledge of …

Assessing And Addressing The Determinants Of Appalachian Population Health: A Scoping Review, David L. Driscoll, Hannah O'Donnell, Maitri Patel, David C. Cattell-Gordon

Journal of Appalachian Health

Introduction: Residents of Appalachia experience elevated rates of morbidity and mortality compared to national averages, and these disparities are associated with inequitable exposures to various determinants of population health. Social and environmental determinants of health are a useful lens through which to develop and evaluate programs to mitigate regional health disparities.

Methods: This 2023 scoping review was conducted of studies linking determinants of Appalachian health with leading causes of regional mortality and morbidity. The search strategy employed a keyword search that included geographic terms for the Appalachian Region and the primary adverse health outcomes in that region. Studies meeting the …

Reimagining A Caregiver-Friendly Society, Jodi L. Southerland

Journal of Appalachian Health

Demographic aging is accelerating in the Appalachian Region, resulting in a growing proportion of caregivers living in areas that lack services to support their needs. Strategies are urgently needed in Appalachia to address deficiencies in the region’s long-term supports and services for older adults and their caregivers. Strengthening equitable access to care and community supports for family caregivers is a policy priority for state and community leaders in Appalachia.

Experiences Of Appalachian People With Conflicting Christian And Lgbtq+ Identities, Zacharias Smith

Electronic Theses and Dissertations

This study explores the experiences of six LGBTQ+ individuals living in Appalachia who have felt conflict between their LGBTQ+ and Christian identities. Using data from six one-on-one intensive interviews, the study examines the various kinds of conflict participants experienced, the strategies they used to manage those conflicts, and the role that Christianity played in their lives. The author found that participant conflicts were grounded in struggles to find acceptance from others while living authentically, to reconcile ideological disputes with the church, and to accept themselves as LGBTQ+ and/or Christian. Included among their various management strategies were finding accepting people and …

When A Saunter Starts To Taunt Her: Exploring The Outdoors With Disabilities, Jessica Cory

The Goose

This first-person creative nonfiction piece examines engaging with the outdoors, primarily through walking and hiking, while struggling with diagnoses of Hypermobile Ehlers-Danlos (hEDS) and Mast Cell Activation Syndrome (MCAS). The author also considers how growing up with a parent whose disabilities made it more difficult to enjoy hikes impacted her own perception of the ableism inherent in the design, architecture, and infrastructure of many state and local parks. The author discusses the importance and struggle of teaching environmental literature through the lens of Disability Studies and advocates both for visibility as well as concrete changes to make hiking and sauntering …

Evaluation Of A Faculty Fellows Program In Science Communication, Stacy Stanifer, Beverly Delidow, Kathy Rademacher, Luz Huntington-Moskos, Kelly Kennoy, Amanda Thaxton-Wiggins, Craig Wilmhoff, Ellen J. Hahn

Journal of Appalachian Health

Introduction: Science communication plays a crucial role in tackling pressing regional, national, and global health issues. Effective communication with various audiences is integral to dissemination of science findings.

Purpose: This study evaluates changes in self-efficacy and attitudes toward science communication skills over time and also assesses program outcomes and satisfaction with a Faculty Fellows in Science Communication (FFSC) program among faculty (N = 30) with interest in environmental health science and/or education in Appalachia Kentucky.

Methods: A mixed methods program evaluation was employed using longitudinal data on behaviors, attitudes, and program outcomes from three cohorts of Faculty Fellows who participated …

Self-Reported Consumption Of Bottled Water V. Tap Water In Appalachian And Non-Appalachian Kentucky, Jason W. Marion

Journal of Appalachian Health

Introduction: Quantitative studies on drinking water perceptions in Appalachia are limited. High-profile water infrastructure failures in the U.S. and Eastern Kentucky, coupled with human-made and natural disasters in the Appalachian Region, have likely impacted opinions regarding tap water.

Purpose: To use existing unexplored data to describe baseline tap water v. bottled water consumption in Kentucky.

Methods: Telephone-based cross-sectional data were obtained from the 2013 Kentucky Health Issues Poll (KHIP) directed by the Foundation for a Healthy Kentucky. Among many items in KHIP, self-reported consumption of bottled water over tap water, reasons for bottled water use, and demographic data were obtained. …

The Ninth Myth Of Appalachia, Randolph Wykoff

Journal of Appalachian Health

Many stereotypes afflict our much-maligned region, and the Jonesborough­­–Washington County History Museum displays eight of these "myths of Appalachia." Here, our Editor-in-Chief suggests a ninth—that the people of Appalachia "do not care" about their health—and argues that regional health disparities result not from apathy but from a confluence of socioeconomic factors.

Bicultural Appalachian Females: The Mediating Effect Of Perceived Stigma On Health Outcomes, Victoria Lynn Evans-Fulton

Doctoral Dissertations and Projects

Appalachia has been the focus of ongoing curiosity and ascribed disdain in Euro-centric American history. An amalgamation of cultures found a home in the Appalachian Mountains, blending to create a unique collectivistic culture still visible today. However, this culture has often been misconstrued as unhealthy or undesirable at best and, by reductionistic intentions, relegated to a culture of poverty. Within this system, Appalachian females have faced the burden of the intersectionality of their identities, given the acculturation expectations and Appalachian identity stigma imposed by the dominant Euro-North American culture. As indicated in scholarly literature, despite chronic marginalization and systemic oppression, …

“It Takes A Village”: The Implications For Gender Roles On Appalachian Family Dynamics, Taryn Jayde Rollins

Undergraduate Theses

When we hear the word “Appalachian”, many will look towards the countless examples of negative stereotypes displayed in the media. From Hillbilly Elegy to hyperbolized stories of blue people in the mountains, Appalachians have been perpetuated as backward, dirty, incestual, and stupid. Through incessant dehumanization by the media, Appalachian communities have been ignored and even blamed for their disparities. However, there are historical and social implications factors that stemmed from the major shift in the economic makeup that has led to Appalachian poverty and in turn, shaped the culture and values of the region. In addition, due to geographic isolation, …

Exploring Sexual And Reproductive Health Care In Central Appalachia Through The Experiences Of Transgender And Gender Non-Binary People, Chase Harless

Electronic Theses and Dissertations

Background: Transgender or nonbinary (TNB) individuals in the United States experience higher rates of sexual and reproductive health disparities when compared to their cisgender counterparts, along with lower access to care. TNB people in the south experience higher rates of disparities. Societal, interpersonal, and individual barriers contribute to these disparities in the TNB population. However, there is a paucity of research examining the sexual and reproductive health experiences of TNB people living in Central Appalachia.

Methods: An interpretive phenomenological analysis (IPA) research design was used to collect and analyze semi-structured interviews with TNB individuals living in central Appalachia regarding their …

A Field Guide To Foodways And Foraging In Southern Appalachia, Aeryn Lorraine Longuevan

Chancellor’s Honors Program Projects

No abstract provided.

Ballad Health: Understanding Appalachia’S Regional Healthcare Monopoly, Meredith A. Bailey

Baker Scholar Projects

The Ballad Health merger of 2018, which combined the now 21 hospitals in the region under one organization, has impacted the healthcare landscape in Northeast Tennessee and Southwest Virginia. Historically, Appalachia has had to persevere through primary physician shortages, a lack of specialty care, geographic obstacles to accessing healthcare, challenges related to substance abuse, and much more. Since the merger of Mountain States Health Alliance and Wellmont Health System, little research has been done to assess the perceived impact the aggregation of providers has had on the population it serves. This study utilizes an online survey to better understand the …

When The Rural Hospital Closes: An Analysis Of Acute Health Impacts Following Closure Of Rural Hospitals In Appalachia, Bret M. Berry

Chancellor’s Honors Program Projects

No abstract provided.

Anthropology In A Rural Archive: A Study That Moves Along And Against The Archival Grain, Julian W. Mcdaniel

Masters Theses

Anthropologists have long engaged with archival materials in order to provide historically accurate information that might assist in the production of ethnographic projects. Archives are unique institutions where historical data can be found that contributes valuable information about particular groups of people; however, archives themselves are again and again being controlled by a higher power, particularly that of the State, and this act of ownership contributes to acts of omission that misconstrue historical narratives as well as descriptions of the people and places depicted within an archive. In this project, I engage with an archive located in a rural town …

Reviewer Acknowledgments, Randy Wykoff Md, Mph & Tm, Rachel E. Dixon Mphil

Journal of Appalachian Health

As we reach our fifth year, we are particularly thankful for the contributions of our peer reviewers. The knowledge, expertise, and guidance offered by the people listed below have ensured that we can continue to share timely research to effect health and well-being across Appalachia.

A Better Life: Factors That Help And Hinder Entry And Retention In Mat From The Perspective Of People In Recovery, Adam D. Baus, Martha Carter, Jennifer Boyd, Erin Mcmullen, Trey Bennett, Alexandra Persily, Danielle M. Davidov, Christa Lilly

Journal of Appalachian Health

Introduction: Opioid addiction and opioid-related overdoses and deaths are serious public health problems nationally and in West Virginia, in particular. Medication-assisted treatment (MAT) is an effective yet underutilized treatment for opioid use disorder (OUD).

Purpose: Research examining factors that help individuals succeed in MAT has been conducted from provider and program perspectives, but little research has been conducted from the perspective of those in recovery.

Methods: This study, co-developed with individuals in recovery, took place in West Virginia-based MAT programs using an exploratory sequential mixed methods approach. The survey was open February through August 2021. Data were analyzed late 2021 …