Rural Sociology Commons^™

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.

Application Of Rigour And Credibility In Qualitative Document Analysis: Lessons Learnt From A Case Study, Leanne M. Wood, Bernadette Sebar, Nerina Vecchio

The Qualitative Report

This paper probes functions and processes of qualitative document analysis (QDA), a method widely used in case study research. It firstly demonstrates the application of a QDA framework to inform a case study of women entrepreneurs in rural Australia; and provides insights into the lessons learnt, including strengths and limitations of QDA. Secondly, the paper provides guidelines for novice researchers seeking to use thematic analysis in a QDA process, arguing for rigour in naming assumptions and explicitness about the procedures employed. The paper contributes to discussion in the literature that positions QDA not only as a convenient tool, but as …

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.

The Nuclear Legacy In Appalachia, Michele Morrone, Harold Perkins

Journal of Appalachian Health

Nestled in the rolling hills of Appalachia Ohio is a reminder of the role that the region played in winning the Cold War. For more than 40 years in rural Pike County, the 3,700-acre Portsmouth Gaseous Diffusion Plant (PORTS), or the “A-Plant” as the locals refer to it, enriched uranium for use in nuclear weapons. While the facility produced nuclear fuel for national security, it simultaneously exposed plant workers to chemicals and radiation and discharged pollution into the surrounding community. The A-Plant is now being demolished and the site repurposed. However, the site continues to affect the community as, for …

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.

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 …

Support For Rural Practice: Female Physicians And The Life–Career Interface, Kimberly Stutzman, Ruth Ray Karpen, Pragna Naidoo, Sarah E. Toevs, Amanda Weidner, Ed Baker, David Schmitz

Public and Population Health Faculty Publications and Presentations

Introduction: The need for family physicians in rural areas across the USA and Canada is a longstanding issue that has been well documented. Since family physicians constitute the largest population of rural practitioners, the problem has been exacerbated by a sharp decline in medical students’ interest in the field of family medicine and the aging of the current rural workforce. Previous research has shown that female physicians in rural areas need strong support networks to maintain a healthy work–life balance. The purpose of this study was to better understand the types of support they need and how they find it, …

Knowledge Of Breast Cancer And Screening Methods Among Rural Women In Southwest Nigeria: A Mixed Method Analysis, Rowland Edet, Oluwayimika Ekundina, Obasanjo Afolabi Bolarinwa, Julianah Babajide, Juliet Amarachukwu Nwafor

Department of Sociology: Faculty Publications

The objective of this study was to assess the awareness of rural women on breast cancer and its screening methods in Southwest Nigeria. Descriptive cross-sectional survey design with the aid of a semi-structured questionnaire was used to generate data among 422 rural women in selected communities in Egbeda local government area of Ibadan. The qualitative data was generated through in-depth interviews among rural women and key informant interviews among health workers in the communities. The study revealed that only 63.7% were aware of breast cancer screening methods compared to 31.6% who were not aware of it. The commonly known screening …

A Virginia Mountain City Responds To The Challenge Of Improving Health Outcomes, Robert S. Cowell Jr.

Journal of Appalachian Health

In 2012, Roanoke Virginia was becoming a city of haves and have-nots, a place where many were benefitting from revitalization underway but too many were seeing their situation grow worse and becoming even more entrenched. Poverty with levels as high as 50% in some neighborhoods; life expectancy sometimes 14 years shorter than those living just one or two neighborhoods over; and lack of access to fresh food, medical care, and economic opportunities—all within view of the largest hospital in the region was unacceptable.

.

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, …

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.

Using Mini-Grants To Build Multi-Sector Partnerships In Rural Tennessee, Ginny Kidwell, Kristine Bowers, Taylor M. Dula, Randolph F. Wykoff

Journal of Appalachian Health

Rural counties in Tennessee, including those located in Appalachia, face some of the greatest health challenges in the nation. Unpublished data collated by the East Tennessee State University College of Public Health (ETSU) show that Tennessee’s 52 Appalachian counties vary dramatically from its 43 non-Appalachian counties in virtually all socioeconomic, behavioral, and health outcome metrics. Since 2011, the Tennessee Institute of Public Health (TNIPH) has actively encouraged local communities to address behavior change, enhance educational achievement, and improve economic conditions as essential components for improving health and well-being in rural Tennessee.

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.

Disparities In Quality Of Life By Appalachian-Designation Among Women With Breast Cancer, Robin C. Vanderpool, Ann L. Coker, Heather M. Bush, Sarah E. Cprek

Journal of Appalachian Health

Introduction: Few studies have examined the association of geography and quality of life (QOL) among breast cancer patients, particularly differences between Appalachian and non-Appalachian Kentucky women, which is important given the cancer and socioeconomic disparities present in Appalachia.

Purpose: The purpose of this study was to determine whether women with breast cancer residing in Appalachian Kentucky experience poorer health outcomes in regards to depression, stress, QOL, and spiritual wellbeing, relative to those living in non-Appalachian Kentucky after adjusting for demographic, socioeconomic, and health-related factors.

Methods: Women, aged 18–79, recruited from the Kentucky Cancer Registry between 2009 and 2013 with an …

West Virginia’S Sugary Drink Tax: Examining Print Media Frames In Local News Sources, Lauri Andress, Ogaga Urhie, Christine Compton

Journal of Appalachian Health

Introduction: Framing is an important aspect of the policy process that helps the public and decision makers sort through and resolve highly charged claims about an issue. Through slight changes in the presentation of issues, a framing effect may alter public support. The way a proposed sugary drink tax is discussed in public discourse and by the media significantly influences policy acceptance. Given the public health significance of obesity and diabetes in West Virginia (WV) the study of media frames employed to represent a sugary drink tax policy is useful.

Methods: Using quantitative content analysis, this study assessed news articles—published …

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. …

Dusty Shoes: Appalachia Wisdom Fertilizing The Future Of Religious Leadership, Jill Crainshaw

Journal of Appalachian Health

Dust from their journeys through the hills and hollows of Appalachia clings to their shoes and has forever shaped their vocational journeys. This is a refrain I have distilled from the reflections of students who have participated in Wake Forest University School of Divinity’s multicultural contexts course that includes a 10-day sojourn in the mountains of North Carolina.

Identifying Priority And “Bright-Spot” Counties For Diabetes Preventive Care In Appalachia: An Exploratory Analysis, Peter J. Mallow, Michael Topmiller, Jennifer Rankin, Jene Grandmont, David Grolling, Jessica L. Mccann, Mark Carrozza

Journal of Appalachian Health

Introduction: Type 2 diabetes mellitus (T2DM) prevalence and mortality in Appalachian counties is substantially higher when compared to non-Appalachian counties, although there is significant variation within Appalachia.

Purpose: The objectives of this research were to identify low-performing (priority) and high-performing (bright spot) counties with respect to improving T2DM preventive care.

Methods: Using data from the Centers for Medicare and Medicaid (CMS), the Dartmouth Atlas of Health Care, and the Appalachia Regional Commission, conditional maps were created using county-level estimates for T2DM prevalence, mortality, and annual hemoglobin A1c (HbA1c) testing rates. Priority counties were identified using the following criteria: top 33rd …

The Social Determinants Of Health And The Decline In U.S. Life Expectancy: Implications For Appalachia, Steven H. Woolf, Heidi Schoomaker, Latoya Hill, Christine M. Orndahl

Journal of Appalachian Health

For the past century, life expectancy in industrialized countries has increased, and the U.S. has shared in that progress. However, beginning in the 1980s, advances in U.S. life expectancy began to lose pace with peer countries. By 1998, U.S. life expectancy had fallen below the average for Organisation for Economic Cooperation and Development nations. U.S. life expectancy peaked in 2014 and has been decreasing for three consecutive years, a trend not been seen since the influenza pandemic a century ago. Put simply, U.S. health is in decline.

Delivering Health Knowledge And Wisdom From The Hills And Hollows Of Appalachia, F. Douglas Scutchfield Md, Erin N. Haynes, Robert M. Shapiro Ii, Charlotte S. Seidman

Journal of Appalachian Health

There is knowledge in the pages of Appalachia’s hills. This journal is positioned to find and publish those translations. It grows from a need to provide an outlet for scholarship about Appalachia’s health so that knowledge, and occasionally wisdom, is shared with those who care about and are committed to improving the region’s health.

Child Poverty, Physical & Mental Health In Maine, Katelyn Malloy

Thinking Matters Symposium Archive

Children who live below the national poverty line account for nearly one fifth of Maine’s overall population. Child poverty is a determinant of health that can lead to negative health outcomes that affect childhood development, educational achievement, as well as physical and mental health. The purpose of this study was to identify five Maine counties with the highest rates of child poverty according to the national average. Comparison of poverty rates between counties were analyzed along with two leading health indicators – mental and physical distress. This study used 2016 county-level childhood poverty estimates, assessed by the American Community Survey …

Characterizing Systems Of Reporting And Mitigating Anthrax Outbreaks Near Mto Wa Mbu, Monduli District, Tanzania, Megan Levy

Independent Study Project (ISP) Collection

Northern Tanzania has experienced several anthrax outbreaks in the recent past. In Monduli district, an outbreak in 2016 prompted an organization of district officials to create an updated outbreak response action plan. The pastoralist community is often affected by these outbreaks due to their frequent direct contact with cattle and herds’ proximity to wild species potentially affected by the disease. This characterization of the existing systems of reporting and mitigating anthrax outbreaks was accomplished through structured interviews with ward and village officers, local veterinarians, and members of the pastoralist community in Monduli district near Mto wa Mbu. The purpose of …

Social Networks, Identity, Health, And Quality Of Life Among Older Gay And Lesbian Individuals In Rural Environments, Marc Aaron Guest

Theses and Dissertations--Gerontology

The goal of this dissertation was to explore aging lesbian and gay individuals living in rural communities, in terms of their social networks and the relationships between these networks, identity, health, and quality of life. Guiding the study were three overarching questions. Using a multi-method design, the research was grounded within a socio-ecological context and focused on how structural systems create pathways for health and are affected by social position (intersectionality). Participants (n=25) were recruited from Kentucky (n=20), West Virginia (n=3), and Tennessee (n=2). Thirteen participants self-identified as gay and twelve as lesbian. Findings highlight the complexity of the aging …

Culture And The Development Of Traditional Medicine In Africa, Rowland Edet, Oyedolapo Isaac Bello, Julianah Babajide

Department of Sociology: Faculty Publications

Traditional medicine has been the dominant healthcare system in Africa before westernization, civilization and colonialism. For people living in the rural areas, traditional medicine is easily available, accessible and affordable. The purpose of this paper is to examine how the cultural way of the life of Africans has contributed to the emergence and development of traditional therapeutic systems in the continent. By explaining the way Africans perceive illness and disease, this paper argues that various forms of healing were predicated on the sociocultural environment of the people. The paper therefore opts for concerted efforts in the development of traditional medicine …

Sexual Behaviours Of Adolescents In Creek Town, Cross River State, Nigeria, Kabiru K. Salami, Rowland E. Edet

Department of Sociology: Faculty Publications

Risky sexual behaviors of adolescents in Creek Town have not been fully profiled. This study investigated the sexual behaviors of adolescents and their various dimensions in Creek Town, in Cross River State, Nigeria. This cross-sectional survey design adopted multi-stage sampling procedure to administer a 112-items questionnaire to 422 adolescents, to elicit information on their sexual behaviors and practices. Four focus group discussion sessions were also conducted with in-school and out-of-school adolescents. The mean age of adolescents was 17 years. Majority (65.4%) of the adolescents were sexually active. The mean age at sexual debut was 15 years for both male and …