Indiana University-Purdue University, Indianpolis / In 1936, Clarence J. Gamble, heir to the Proctor & Gamble fortune, established the Mountain Maternal Health League (MMHL) in Berea, Kentucky. Gamble had a strong interest in testing the effectiveness of simple birth control methods as a means to reduce the birth rate of impoverished and rural people and he would fund the organization for nearly six years as an experiment to test a jelly-and-syringe method of birth control in rural Kentucky. After his financial support ended, however, the organization continued. The women activists who worked with Gamble shifted the organizational focus, models of operation, and available methods to accommodate changing perspectives and expanding communities.

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Tobacco has been recognized as the number one cause of preventable death in America and results in almost 5.2 million years of potential life lost each year. The use of tobacco products is highly correlated with pulmonary disease, cardiovascular disease, and other forms of chronic illness in America. New tobacco products are trending in the tobacco market such as the water pipe/hookah and e-cigarettes. With e-cigarettes and other newer forms of tobacco on the rise, it is important to look at the underlying factors for using all kinds of tobacco products as a means of prevention. Certain adult attachment styles (secure, preoccupied, dismissing-avoidant, and fearful-avoidant) in emotionally meaningful relationships could be indicators for physical illness, mental illness, and even addiction. This study investigated whether or not there is a relationship between tobacco use and attachment style. Based on a university-wide survey that was sent out at a university in Appalachia with 522 participants, demographic data revealed 68.5% (n = 358) did not currently use tobacco products. Of those who did currently use tobacco products 54.5% (n = 90) were male, 84.8% (n = 140) were undergraduate students, and 66.7% (n = 110) were between the ages of 18-25. For individuals who used tobacco 23.5% (n = 38) were in the secure attachment group, 27.8% (n = 45) were in the dismissing-avoidant attachment group, 30.2% (n = 49) were in the fearful-avoidant attachment group, and 18.5% (n = 30) were in the preoccupied attachment group. Chi Square analysis demonstrated that attachment style was significantly (p < 0.001) different between tobacco users and non-users revealing that there is a possibility for prevention of smoking initiation through the development of a secure attachment style.

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To assist disadvantaged Appalachian nursing students, a grant-supported peer mentor-tutor project was initiated in a regional university. Located in the NURSE Center (Nursing Undergraduate Resource for Successful Education), the goals of the project were to improve participants'academic achievement, increase retention, encourage timely academic progression, and improve NCLEX-RN passing rates. The authors describe the project, the first year of operation, and future directions.

In the 1960s and 1970s, Canadian music educator R. Murray Schafer developed the field of soundscape studies, later introducing the “soundwalk”: an empirical method for identifying a soundscape and its components through the activities of walking and close listening. Human activity in a soundscape, or a soundwalk, is known as anthropophony: a category of sounds produced by humans, including language, vocalizations, and musics. In this individual oral presentation, the primary researcher will share her experiences in creating a framework for her Master’s in Appalachian Studies Applied Project at East Tennessee State University. The soundwalk method will be adapted into a series of recorded “soundhikes.” During these hikes, the primary researcher and her participants will engage in a series of interviews in areas designated as state parks and national forests in the Upstate of South Carolina. These oral histories (with English-language translations, when applicable) will be submitted to the Archives of Appalachia, and will be used in the primary researcher’s ongoing research on Appalachian representation in the region’s protected spaces. As these protected spaces have reached nearly one hundred years of existence as “state parks” or “national forests”, the demographics of the people visiting them have changed drastically. The lenses of Critical Race Theory and Feminist Disability Theory will be used to explore these new demographic realties, and to advocate for resources benefitting those who have self-reported any of the following while attempting to enjoy Appalachian nature spaces: barriers to access, feelings of fear, or experiences of rejection. The ultimate goal of the oral history soundhike project, influenced by the principles of Public Sphere Theory, is to feature present-day voices which have not been historically included in Appalachian “nature narratives,” leading to increased representation in the field of Appalachian Studies. Though data collection has not yet begun, it is the hope of the primary researcher that this information will have a pragmatic application. Applicable portions of this project will be submitted to agencies, located in South Carolina’s Upstate region, which have indicated an interest in attracting more diverse stakeholders. The finished project will advocate for more diverse language and cultural resources and programming in protected nature spaces.

The purpose of this study is to closely analyze opioid overdose response efforts on county, state, and federal levels in designated Appalachian regions in order to better understand program methodology standards that ensure success in combating the opioid epidemic. The study exists to answer the question: What approaches have worked best in combating the opioid epidemic and should be implemented in any future potential solutions? The research data scope involved comparison of existing data from county reports, government agencies, and response efforts to best identify program decline rates of opioid usage by the following indicators; declines in opioid overdose deaths, drug distribution per capita, deaths attributing to synthetic opioid overdose, and decline in neonatal abstinence syndrome births. All sources used are publicly available and depict de-identifiable population health information. When compiling research, important background information including how to define the opioid epidemic, root cause identification, and existing response effort methodologies were addressed. While hard to define, the opioid epidemic refers to a public health crisis by which Appalachian individuals unproportionally die at the hands of opioid overdose in comparison to the rest of the country; which is evident and alarming. This opioid crisis has many social and economic causes relating to the demographic majority of Appalachian regions, as well as occurrences that jumpstart a quick decline. The existing response effort methodologies of county, state, and federal programs are expensive and challenging to implement with only some success. There are also many facets to addressing the opioid epidemic including government initiatives, federal or state agencies, non-profit agencies, educational facilities, public health initiatives, and faith-based organizations. While the complexity of response efforts can be beneficial to have many options for addressing the issue, it can also quickly muddle the most effective methods to success. However, the most notable programs that saw a quick decline in overdose death rates included those that coordinated multiple types of entities such as schools, health departments, and correctional departments. Other successful programs reinstituted training and education both with regional providers on appropriate opioid prescriptions; and to the community on proper use, handling, and disposal of opioids. The most effective methods to reduce the health disparities relating to the opioid epidemic in Appalachian regions are extensive collaboration and re-education across the communities most deeply affected by the crisis. Any future response efforts should address these key success indicators.

Indicates numerous railroad lines from Florida to New York and west to the Mississippi, including line from Spartanburg to Elkhorn City in red. M.B. Brown Printing and Binding Company, N.Y. No scale provided. / https://dc.etsu.edu/rare-maps/1157/thumbnail.jpg

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This research applies qualitative literary analysis and ethnographic methods to examine the portrayal of Appalachia in the operas Susannah and Cold Mountain. The operas were premiered 60 years apart, yet they share many themes that epitomize roles, patterns, and stereotypes within the Appalachian region. One theme observed is the expectations of Appalachian women and how they have developed over time, as the plots are placed roughly a century apart. The depictions of Appalachian religious traditions and representations of violence are explored as these themes also play considerable roles in Susannah and Cold Mountain. By analyzing the representation of Appalachia in these operas, this study places the significance of opera among other forms of media that are evaluated in the field of Appalachian Studies.