No description available.

The objectives of the study were to identify which risk factors for heart disease were most prevalent in a poor, underserved, rural Appalachian county. A random sample of medical records was selected (n = 292) of adult men and women who participated in a countywide health care project. Data were obtained from a health risk appraisal questionnaire and other physical and demographic information and were analyzed using univariate and bivariate statistical procedures. The findings indicated that these rural Appalachian subjects had a significant number of heart disease risk factors: excessive smoking, lack of exercise, high fat diets, and abnormal serum lipid levels.

No description available.

The demand of blood products in the US is expected to rise over the years. Adolescents represent a potential population of eligible donors and it is fundamental to better understand what influences blood donation among this category of population. Such investigation has not been conducted in the Appalachian region. To elucidate the question, a voluntary and anonymous questionnaire was administered to high school students from five counties of South Central Appalachia. A sample of 568 adolescents were asked to provide demographic characteristics, blood donation status and to rate various motivating factors. The association between blood donation and motivating factors were analyzed using logistic regression. Caucasians were the most represented ethnicity in the study population with 94.52%. From the total respondents, 37.85% reported being blood donors with an average age of 17.29 years. Among the donors, 51.66% were females and 55.45% came from low socio-economic class families. Emergency involving someone they care about and personal story of someone whose life was saved by blood donation were the top rated motivating factors by the donors with respective frequencies of 76.74% and 72.09%. Adjusting for the gender, age and socio-economic status, donating blood with friends increased the likelihood of blood donation by 53.2% (95% confidence interval: 1.01 – 2.31). These finding suggest that strategies focused on promoting group donation such as during school events may increase the rate of blood donation.

In 1965, Duke Power announced the construction of a series of dams along the Keowee and Little rivers in Oconee County, South Carolina. The dams would create water reservoirs for one of the largest hydro-electric and nuclear power facilities in the nation. The dominant narrative focuses on the recreational activities, power generation, and economic development facilitated by the creation of lakes Jocassee and Keowee. However, residents of the Keowee and Jocassee valleys had to be removed, a process that started years earlier when Duke Power began serious land purchasing efforts. This study focused on discovering diverse narratives from people that were displaced or otherwise affected by the lakes. In doing so, made comparisons with other projects on displaced populations in Appalachia, examined the beneficiaries of the project, the treatment of locals, and how Duke Power and local government presented the project through local media.

Breastfeeding (BF) reduces maternal and infant risk for the development of a variety of short and long-term health outcomes. Appalachia faces several health disparities, with infants at increased risk for poor birth outcomes. The purpose of this study was to explore postpartum patients’ (PP) infant feeding experiences (IFE) and examine perceived barriers to BF among PPs and international board-certified lactation consultants (IBCLC) in Northeast Tennessee, located in Appalachia. PPs and IBCLCS were recruited using convenience and snowball sampling, respectively. Fourteen semi-structured interviews were conducted, 7 PPs and 7 IBCLCs. Interviews were conducted in-person or via Zoom and were recorded, transcribed, and de-identified. PPs were asked about their IFEs and barriers to BF, while IBCLCs were asked about perceived barriers to BF for their patient population. Rapid qualitative analysis was conducted with two coders, both summarizing the first interview for each participant type. Summaries were compared to ensure consistency and subsequent interviews were coded by a single coder. Summaries were used to identify high-level themes related to barriers to BF for each participant type. All analysis was conducted in Microsoft Excel, and the study was approved by the ETSU Institutional Review Board. High-level themes for PP IFEs included stressful experiences and the positive impacts of IBCLCs. Stressful experience sub-themes included latch and supply issues, pump and syringe feeding, PP and infant health complications, lack of hospital support, and expectations for supplementing. Barriers to BF for PPs incorporated physiological (latch and milk supply sub-themes) and environmental barriers (employment and family support sub-themes). High-level themes for IBCLCs perceived barriers to BF included PPs having access to too much information, perceptions and expectations of BF, cultural barriers, lack of support and prenatal education, physiological barriers, and maternal comorbidities. Overlap between PPs stressful IFEs and IBCLCs perceived barriers to BF included themes related to BF expectations, lack of support, physiological barriers, and comorbidities. Similarly, overlap between PPs and IBCLCs perceived barriers to BF included physiological and environmental factors. IBCLCs mentioned additional barriers such as access to too much information and lack of prenatal BF education, while these themes were not identified in PP interviews. A future focus for BF support includes discussions with clinicians after delivery about any physiologic barriers that PPs may face and informing providers on how to both avoid and treat these barriers as they arise to alleviate stress. Connection to BF support in the community before and after delivery could improve the chances that mothers receive help in addressing these issues as they arise. Furthermore, including family members in these discussions may help build family and overall social support.

Coal Mining has been the economic backbone of many communities in Southern Appalachia for over a century. As our nation and the world begin to feel the concrete effects of climate change, communities need to prepare for the necessary transition to renewable energy. We sought to gain a better understanding of how the transition away from industrial coal mining into renewable energy sources has changed the lives of not only the miners and their families but also the community at large, presently. Results were limited to peer reviewed academic journal materials and publications that are published by reputable and relevant sources with publication dates ranging from 2013 to 2023. The Key Search Terms were: “Coal” “Appalachia” “Renewable” “Energy” and “Just Transition.” Of the 109 articles that resulted roughly 82 were eliminated due to not aligning fully with our topic. Another 14 were removed because they did not deal with Appalachia. Out of the 13 remaining, eight were from scholarly journals, three were from scientific websites, and two were from both a book and a doctoral dissertation concerning the “Just Transition.” The review of our chosen sources supports the facts that there is a social movement away from coal and into renewable energy resources. The growing pains associated with this transformation have been taxing for the communities involved but, research indicates, the gains from new renewable energy sources such as solar, wind, and geothermal far outweigh any temporary financial booms gained from continuing to invest community resources in mining coal and cutting timber. These outdated modes of wealth accumulation have proven to be both harmful and ephemeral. The cost in the deteriorating health of both the miners and their families has been catastrophic for Appalachians. Black Lung and other pulmonary ailments as well as the Opioid Epidemic have lowered average life expectancies for the first time in generations. The transition into both natural gas and the use of renewables has made coal companies cut costs in both supervision and safety. The results have crippled and disabled many coal miners, driven them to the use of powerful opioids and the resulting black market even caused a small coal mine support town in Southwest Virginia, Norton, to become the “Oxycontin Capital of the World.” The technologies involved with renewable energy sources and subsequent cleaning up of the environment around reclaimed mines will create more jobs than the mines ever did and the extra capital will allow these towns, communities, and this region to grow robust and thriving public service and utility infrastructures that will heal both the great land and great people of Southern Appalachia.

Introduction: The rapid growth of social media provides new opportunities for non-profit organizations to network and influence the public. Rural non-profit organizations can expand organizational capacity and reach, engage more stakeholders, and acquire new donors at a relatively low cost by using social media effectively. Despite the obvious benefits of social media, many rural non-profits underutilize this technology due to social drivers in the community and lack of organizational capacity. This is particularly salient in rural Appalachia where inequities persist in access to broadband and wireless mobile services. Eliciting insights from the experts - rural nonprofit leaders – is critical in identifying strategies to help nonprofit organizations level up social media use. There is a paucity of research on social media use among nonprofit organizations in rural Appalachia. The present study fills this important knowledge gap in the literature. Methodology: This qualitative study used purposive sampling techniques to recruit representatives from nonprofit organizations located in an 8-county region of Appalachian Tennessee. Semi-structured phone interviews were conducted in 2018 with nonprofit representatives (n=21). Nonprofit representatives were asked questions pertaining to social media use, effective communication strategies, and best practices. Probing questions were used to explore topics further. The audio recordings of the interviews were transcribed verbatim. Braun and Clarke’s thematic analysis procedures were used to conduct an in-depth descriptive analysis of participants’ responses and develop themes. Result: Four best practice strategies were identified: 1) “Know your people”—relationships matter: It is important to develop strong ties within the community; 2) “We had to come up with something fast”—resourcefulness matters: Nonprofit organizations should practice resourcefulness and adaptability in program development and outreach, 3) “Catch their attention”—the message matters: Messaging should be brief and positive in nature, and 4) “A lot of nonprofits come and go…”—the nonprofit matters: Nonprofit organizations should implement sound business practices. These themes highlight practical steps nonprofit organizations can take to enhance their social media communication strategies. Conclusion: With the emergence of sophisticated, easily accessible social media platforms like Facebook, YouTube, and Twitter, there is an urgent need to identify simple strategies rural nonprofits can employ to use social media more effectively. Our research addresses this need by summarizing the best practices in social media practices for nonprofit organizations in rural Appalachia. Nonprofit organizations in rural Appalachia can use these best practices to enhance communication strategies, expand their reach, and strengthen relationships within the communities they serve.

Introduction: Over 420,000 women aged 13-44 in Tennessee depend on publicly funded contraceptive services, yet only 42.9% receive them. Lack of access to contraception leads to unintended pregnancies, which are associated with higher rates of maternal and neonatal morbidity and mortality. This study explores perceived barriers to contraception and patient awareness of preexisting resources to mitigate such barriers in a rural region. Methods: Women with a confirmed pregnancy establishing obstetric care at East Tennessee State University’s resident clinic were offered a 20-question survey assessing demographic variables and perspectives to contraceptive care. Results: 141 survey respondents met inclusion criteria. 95.7% denied using contraception prior to conception. Of these, 24.8% reported their pregnancy was unintended. Only 59.6% reported knowing where they could access free long-acting, reversible contraception (LARC) in the community. 50.4% agreed it would be helpful to have a free community clinic providing reproductive health care. Specifically, 73.7% of participants reported they would benefit from free LARCs; 61.0% expressed need for evening hours and 67.4% for weekend hours. Conclusions: One in four women experienced an unintended pregnancy. The known risks of unintended pregnancies to the mother and fetus will likely increase secondary to recent changes in abortion policies. Two in five women reported no awareness of resources for free LARCs in our community, suggesting that knowledge about and access to contraception is lacking at a time which women need autonomy over reproductive choices the most. Initiatives which aim to educate women regarding contraceptive care and to eliminate barriers which hinder access are warranted.

Recent research indicates that pregnant women in rural communities are at increased risk of experiencing IPV and comorbid illicit opioid use compared to urban-residing pregnant women. Few studies of the interactions among rurality, substance use, and victimization in pregnant women exist. The current study sought to examine the relationship between IPV and opioid use and the interaction effects of rurality in Appalachian pregnant women. A convenience sample of pregnant women who were enrolled in a smoking cessation research study was used for this analysis. Participants included 488 pregnant women from five prenatal clinics in South-Central Appalachia. Data were from self-reported assessments and semi-structured interviews on substance use and IPV conducted from first trimester of pregnancy through eight months postpartum. Four hundred and ten participants reported experiencing any form of IPV in the past year. Logistic regression results indicated that physical IPV was associated with opioid use, but sexual and psychological IPV were not. The moderation model indicated direct effects between IPV and opioid use, but were not moderated by rurality. This study suggests a need to further understand the relationship between substance use, IPV, and rurality in pregnant women. The specific subtopic of opioid use by pregnant women living in rural communities, and its relationship to IPV victimization and adverse fetal and maternal health outcomes, continues to be an understudied, but critically important area. Limitations and future directions pertaining to IPV screenings and interventions for pregnant women are discussed.