This thesis analyzes differences in academic performance measures of males and females in a rural county in Northeast Tennessee. A transcript review was performed for the graduating classes of 1993, 1998, and 2003. Overall GPA and individual math, science, and English grades were recorded. Comparisons of females and males enrolled in AP English, Advanced Math, and Advanced Science courses were also recorded and analyzed. Findings revealed that females performed better than males in every subject. In 1993 the advantage is slight and is not statistically significant. However, in 1998 and 2003 the advantage is much more pronounced. In 1993 slightly more males took advanced Math and Science courses; however, by 2003 more females were enrolled in such courses than their male counterparts. The reasons for the differences noted in this study are largely because of sociological factors.

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Adherence to masking recommendations and requirements continues to have a wide variety of impacts in terms of viral spread during the ongoing pandemic. As governments, schools, and private sector businesses formulate decisions around mask requirements, it is important to observe real-life adherence to policies and discern subsequent implications. The CDC MASCUP! observational study tracked mask-wearing habits of students on higher-education campuses across the country to collect stratified data about mask typologies, correct mask usage, and differences in behaviors at locations on a college campus and in the surrounding community. Our findings from a single institution include a significant adherence difference between on-campus (86%) and off-campus sites (72%) across the course of this study as well as a notable change in adherence at the on-campus sites with the expiration of a county-wide governmental mandate, despite continuance of a university-wide mandate. This study, completed on and around the campus of East Tennessee State University in Washington County TN, was able to pivotally extract information regarding increased adherence on campus versus the surrounding community. Changes were also seen when mask mandates were implemented and when they expired.

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The purpose of this quantitative, non-experimental study was to explore the relationship between the implementation of the Tennessee Promise scholarship program and the two-year Tennessee community college retention rates and graduation rates of first-time, full-time Tennessee students from rural Appalachian counties. Results from this study may help higher education stake-holders better understand the features of Tennessee Promise that are influencing an increase in community college retention and graduation rates for Tennessee students from rural Appalachian counties. The theoretical framework that guided this research was the social capital framework. Data including use of Tennessee Promise, county of origin, retention, and graduation was collected via secure email from seven Tennessee community colleges. The null hypotheses of twelve research questions were tested through SPSS via two-way contingency table analyses using crosstabs. The results revealed that retention and graduation rates of first-time, full-time Tennessee students from rural Appalachian counties attending the participating Tennessee community colleges were significantly higher with the use of Tennessee Promise.

Human papillomavirus (HPV) is the most prevalent sexually transmitted infection in the U.S., where one HPV-related cancer is diagnosed every 20 minutes. The most common HPV-related cancer is cervical cancer, with an estimated incidence of 12,000 cases annually, a third of which lead to death. Cervical cancer disparately affects women of ethnic minority groups and geographically isolated regions, such as Appalachia. Tennessee ranks third highest in cervical cancer incidence in the country. Many cases of cervical cancer could be prevented through vaccination against HPV, however, vaccination rates for females in Tennessee are among the lowest in the country. This mixed-methods study included an in-depth exploration of the factors that influence HPV vaccine acceptance in Appalachian Tennessee. Healthcare providers, mothers of adolescent girls, and college-aged women were recruited to participate in the study. From October 2016 to January 2017, interviews were conducted with healthcare providers (n=12), focus groups were conducted with mothers (n=13), and a survey was administered to college women (n=479). Interview and focus group sessions were recorded, transcribed and analyzed using a thematic framework. Survey responses were analyzed using descriptive tests, comparison of means, and regression analyses. The predominant barriers to vaccine acceptance identified in the study were: cost and novelty of the vaccine, vaccine safety, lack of school-entry requirement, and the implication of vaccine acceptance on adolescents’ sexual activity. Most negative perceptions towards the vaccine appeared to be propagated by the sociocultural influence on sex and reproductive health communication within the community. Perceived benefits for cancer prevention and receipt of strong and personal provider recommendations facilitated vaccine acceptance. Additionally, college students who reported vaccine acceptance reported discussing sexual health topics with their mothers more often than those who had not been vaccinated. The findings from this study provide foundational insights about the facilitators and barriers of HPV vaccine acceptance in Appalachian Tennessee. Identifying and understanding these factors is crucial to improving HPV vaccination rates and essential to maximizing the primary benefit of the vaccine in addressing the existing cervical cancer disparity in the region.

Abstract available through the Journal of the American Pharmacists Association.