46 Works

Perceived Ability to Treat Opioid Use Disorder in West Virginia

Ashley Brianna Sheppard, Jonathan C. Young, Stephen Davis & Garrett E. Moran
Introduction: Medication-assisted treatment (MAT) is an evidence-based therapy for opioid use disorder (OUD) that has not been fully implemented in rural areas due to patient, provider, and logistical barriers. Limited information is available on provider perceptions of barriers to MAT in rural Central Appalachia which has very high rates of OUD compared to the rest the United States. Purpose: Determine perceived barriers for potential prescribers to using MAT, including buprenorphine, as part of treatment for...

Geospatial Analysis of Rurality and Food Banks in Appalachian Ohio

Cooper T. Johnson, Rebecca Fischbein & Kristin Baughman
Introduction: Food insecurity is a problem for individuals across Ohio, including those living in Appalachia. Adequate access to resources that help combat food insecurity is important for these populations. Purpose: To examine how rurality relates to food insecurity and need for food resources, as well as availability of those resources including food pantries and soup kitchens, in 15 northern Ohio Appalachian counties. Methods: A cross-sectional study with a geographical analysis was conducted using data from...

Understanding Polarizing Community Perspectives on Harm Reduction Strategies

Stephanie L. Creasy, Jessica R. Thompson, Christina F. Mair & Jessica G. Burke
Introduction: Rural communities face barriers to opioid treatment and overdose prevention including concerns about stigma and lack of harm reduction services. Purpose: The aim of this study was to explore community perspectives and understanding of harm reduction approaches to opioid use and overdose in a high-risk Northern Appalachian case community in Pennsylvania. Methods: A small town approximately 10 miles from Pittsburgh was identified as the community with the greatest predicted probabilities of epidemic outbreak using...

COVID-19 Experiences, Behaviors, Beliefs, and Well-Being Among Students and Employees at a University In Rural Appalachia

Lauren Wisnieski, Kimberly Carney & Jenny L. Thornley
Introduction: In response to the coronavirus disease (COVID-19) pandemic, most universities experienced drastic operational changes with shifts to online learning, work-from-home policies, and social distancing measures. These changes have caused concern for social isolation and mental health. Purpose: This cross-sectional study explores differences in COVID-19 experiences, behaviors, beliefs, and well-being among students and employees (faculty and staff) at a rural Appalachian university. Methods: Data were collected with an online anonymous survey in September-October 2020 using...

Perceived Hearing Loss and Availability of Audiologists in Appalachia

Charles B. Pudrith, Ellyn Grider & Blythe Kitner, Northern Illinois University
Introduction: There is a high demand for audiologists throughout the United States. Previous research has supported an additional demand for these providers within Appalachia. Purpose: The purpose of the study was to determine if Appalachia has a disproportionally high demand for audiologists compared to the rest of the United States. Methods: A cross-sectional retrospective study was performed with population data from the Appalachian Regional Commission, the American Academy of Audiology, and the United States Census...

Community Strengths and Challenges Related to Opioid Use Disorder in Rural Counties of East Tennessee

Ashlyn Schwartz, Zeruiah V. Buchanan & Laurie Meschke
Introduction: Appalachia, particularly Rural East Tennessee, has been and continues to be disproportionately impacted by opioid use disorder and its many tragic ramifications. Purpose: Community-engaged strategies can inform and support the development of relevant prevention efforts. Hence, people connected to a ten-county rural Appalachian region in East Tennessee were asked to identify and prioritize strengths and challenges related to opioid use disorder (OUD). Methods: Adult community members (n=577) completed a brief survey administered across 11...

Prevalence and Types of Drugs Used Among Hepatitis A Patients During Outbreaks Associated with Person-to-Person Transmission, Kentucky, Michigan, and West Virginia, 2016–2019

Megan G. Hofmeister, Alice Asher, Christopher M. Jones, Ryan J. Augustine, Cole Burkholder, Jim Collins, Monique A. Foster, Shannon McBee, Erica D. Thomasson, Doug Thoroughman, Mark K. Weng & Philip R. Spradling
Background: People who use drugs are at increased risk for hepatitis A virus infection. Since 1996, the Advisory Committee on Immunization Practices has recommended hepatitis A vaccination for people who use drugs. Since 2016, the U.S. has experienced widespread hepatitis A outbreaks associated with person-to-person transmission. Purpose: To describe the prevalence of drug use, route of use, and drugs used among hepatitis A outbreak-associated patients. Methods: State outbreak and medical records were reviewed to describe...

SARS-CoV-2 (COVID-19) Vaccine Intentions in Kentucky

Kevin A. Pearce, Emily Messerli, Mary E. Lacy, Brittany L. Smalls, Diane B. Francis, Sukruthi Yerramreddy & Marc Kiviniemi
Background: At the time of our writing, the COVID-19 pandemic continues to cause significant disruption to daily lives. In Kentucky, the burdens from this disease are higher, and vaccination rates for COVID-19 are lower, in comparison to the U.S. as a whole. Understanding vaccine intentions across key subpopulations is critical to increasing vaccination rates. Purpose: This study explores COVID-19 vaccine intentions in Kentucky across demographic subpopulations and also investigates the influences on vaccine intention of...

Evaluating Social Support and T2D Risk Factors Among Members of Rural-Dwelling Grandparent-Headed Households

Brittany L. Smalls, Abebola Adegboyega, Kelly N.B. Palmer & Jennifer Hatcher
Purpose: This study examines the associations of social support and type 2 diabetes (T2D) risk factors among members of rural-dwelling, grandparent-headed households (GHH). Methods: Prospective data were collected from rural-dwelling members of GHH with no known diagnosis of T2D. Data collected on family characteristics, T2D clinical risk factors, and social support were assessed. Results: Sixty-six grandparents and 72 grandchildren participated in the study. The average age and HbA1Cs were 59.4 years and 6.2% ± 1.4...

Review of: Wide Neighborhoods

Tauna Gulley
The Journal of Appalachian Health is committed to reviewing published media that relates to contemporary concepts affecting the health of Appalachia. Access to care remains one of the biggest challenges to Appalachian Health. The book, Wide Neighborhoods: A Story of the Frontier Nursing Service by Mary Breckinridge, is a well-known title that seems as relevant today as it was in 1952.

Risk Factors Associated with Passenger Vehicle Fatal Rollover Crashes in West Virginia, 2001-2018

Yuni Tang, Toni Rudisill & Ruchi Bhandari
Background: Rollover crashes cause more injuries and fatalities than other types of motor vehicle crashes. West Virginia (WV) has high rates of drug overdose deaths and motor vehicle crash fatality. However, no studies have investigated risk factors associated with fatal rollover crashes in WV. Purpose: The objective of this study is to evaluate whether drug use and other risk factors are associated with fatal rollover crash fatalities in WV. Methods: This cross-sectional study utilized the...

Hearing Health Healthcare Disparities in Appalachia

Matthew L. Bush
Hearing loss is a global public health issue with disproportionate negative impacts on those who live in rural regions, such as Appalachia. This commentary provides an overview of hearing health and healthcare disparities in rural regions along with discussion of the significance of recent research findings which highlight the incidence of hearing loss and the shortage of hearing specialists in Appalachia.

Access to and Use of Technology for Health

Robin C. Vanderpool, Lindsay R. Stradtman, Anna Gaysynsky, Quan Chen, Meghan Johnson & Bin Huang
Introduction: Technology may increase the availability of health information and enable health promoting behaviors. However, lack of access to and use of technology may also exacerbate disparities, particularly in rural communities with limited Internet access. Purpose: The purpose of this study was to compare Internet access, device ownership, and use of technology for health between Appalachian Kentuckians and the general U.S. population. Methods: Findings from the 2017 Assessing the Health Status of Kentucky (ASK) survey...

Scale Model Equations and Optimization for Annular Flow of Non-Newtonian Fluids Between Eccentric and Rotating Cylinders

Wei Zhang, Pooya Khodaparast, Amin Mehrabian & Amir Shojaei
A broad range of engineering applications involves helical flow of non-Newtonian fluids between two eccentric cylinders. These applications often require estimation of the frictional pressure losses along the axes of the cylinders. Laboratory flow loops are commonly used to study the flow characteristics at smaller scales of investigation. This study uses the laws of similarity and dimensional analysis to obtain a set of scaling equations between the laboratory and prototype scales of the described annular...

Review of: The Cancer Crisis in Appalachia: Kentucky Students Take Action

Stephenie Kennedy-Rea
The Journal of Appalachian Health is committed to reviewing published media that relates to contemporary concepts affecting the health of Appalachia. With cancer mortality rates higher in rural and Appalachian communities, a focus on how cancer impacts our families and communities is more important than ever. Dr. Stephenie Kennedy-Rea reviews the book The Cancer Crisis in Appalachia: Kentucky Students Take Action.

Exploring COVID-19 Case Fatality in Relation to the Prevalence of Chronic Conditions and Health Behaviors in Appalachian Kentucky

Warren Christian
Background: Research has demonstrated that common chronic conditions, especially those related to cardiovascular health, are important risk factors for severe COVID-19 symptoms or hospitalization. Population prevalence rates of such conditions have not previously been examined in relation to COVID-19 case fatality rates in the Central Appalachian region. Purpose: This study examined prevalence rates of selected chronic conditions and COVID-19 case fatality rates to determine whether the relationship between them is consistent across Appalachian and non-Appalachian...

Loss of Obstetric Services in Rural Appalachia

Caroline Efird, David Dry & Rachel F. Seidman
Background: As rural hospitals across the United States increasingly downsize or close, the availability of inpatient obstetric services continues to decline in rural areas. In rural Appalachia, the termination of obstetric services threatens to exacerbate the existing risk of adverse birth outcomes for women and infants, yet less is known about how the cessation of these services affects the broader community. Purpose: The purpose of this paper is to explain how the loss of local...

Addressing Diabetes Distress in Self-Management Programs

Ranjita Misra, Samantha Shawley-Brzoska, Raihan Khan, Brenna Kirk, Sijin Wen & Usha Sambamoorthi
Background: West Virginia ranks 1st nationally in the prevalence of hypertension (HTN; 43.8%) and diabetes (16.2%). Patients with type 2 diabetes mellitus (T2DM) are distressed over physical and psychological burden of disease self-management. Methods: This study investigated the effectiveness of an intervention to reduce diabetes distress and outcomes [glycemic control, blood pressure (BP)] among T2DM adults with comorbid HTN. Participants were randomized to a 12-week diabetes and hypertension self-management program versus a 3-month wait-listed control...

Review of: Understanding and Dismantling Racism

Matthew F. Hudson
The Journal of Appalachian Health is committed to reviewing published media that relates to contemporary concepts affecting the health of Appalachia. Examining Institutional Racism’s impact on health, career advancement and outcomes in Appalachian communities, impacts our ability to address and identify solutions to inform the fundamental framing of health equity. Dr. Matthew F. Hudson critiques the website: Understanding and Dismantling Racism: Crowdsourcing a Pathway Model in Appalachia.

Fully-developed Fire Temperature in a Compartment with Varying Wood Fuel Loads

Keisuke Himoto, Masaki Noaki & Ken Matsuyama
Appropriate evaluation of fire behavior during the fully-developed phase is important for assessing the risk of building collapse and fire spread to adjacent buildings. In this study, a series of model experiments was conducted to investigate the fire behavior in compartments with varying wood fuel loads. Under small opening conditions, the increase in the wood fuel load had no notable effect on the heat release rate (HRR), but increased the fire duration and gas temperature....

The Compounding Effect of Rurality on Health Disparities Among Black Patients with COVID-19

Jessica Johnson, Ruchi Bhandari, Allison Lastinger & Rebecca Reece
Background: West Virginia had garnered national attention for its vaccination rollout against coronavirus 2019 (COVID-19). Outcomes of this mostly rural population, however, have been underreported. As the pandemic continues, identifying high risk populations remains important to further epidemiologic information and target vaccines. Purpose: The objective of this study is to examine the effects of COVID-19 and the influence of race and rurality on hospitalization and outcomes in Appalachians. Methods: In this retrospective study, data from...

Changes in Adolescent Birth Rates within Appalachian Subregions and Non-Appalachian Counties in the United States, 2012–2018

Nathan Hale, Kathleen Tatro, Sylvester Olubolu Orimaye, Michael Smith, Michael Meit, Kate E. Beatty & Amal Khoury
Background: Adolescent births are associated with numerous challenges. While adolescent birth rates have declined across the U.S., disparities persist and little is known about the extent to which broader declines are seen within Appalachia. Purpose: The purpose of this study was to examine the extent to which adolescent birth rates have declined across the subregions of Appalachia relative to non-Appalachia. Methods: We conducted a retrospective study of adolescent birth rates between 2012 and 2018 using...

Effects of Sleep Duration on Falls in a West Virginia Population-Based study, BRFSS, 2018

R. Constance Wiener & Christopher Waters
Introduction: West Virginia is a state in which most counties are rural, as well as a state with multiple health disparities among its population. The purpose of this study was to determine the association of sleep duration and falls for non-institutionalized West Virginia adults, aged 40 years and above, using the National Sleep Foundation’s definition of “may be appropriate” and “not recommended” sleep durations for specific ages. Methods: Behavior Risk Factor Surveillance System (BRFSS) 2018...

Rural Re-entry and Opioid Use

Joseph Calvert, Megan F. Dickson, Martha Tillson, Erika Pike & Michele Staton
Introduction: Despite improved knowledge of the health care needs of formerly incarcerated women, there exists a gap regarding the relationship between health, health care access, and relapse among rural women returning to the community during the opioid epidemic. Purpose: With an emphasis on health care access, this study examined health-related factors associated with opioid relapse among women reentering the community in rural Appalachia. Methods: As part of a larger study, 400 rural women reporting a...


Lauri Andress & Keri Valentine
As the website Understanding and Dismantling Racism: Crowdsourcing a Pathway Model in Appalachia explains, we are seeking assistance in refining a pathway model that elucidates institutional racism from the unique standpoint of Appalachia. We think that Appalachia has a distinctive cultural toolkit that shapes its orientation on issues. Our goal is to use crowdsourcing to harness this unique Appalachian ethos to refine the Pathway model on Institutional Racism based on comments, edits, questions, and ideas...

Registration Year

  • 2022
  • 2021

Resource Types

  • Journal Article


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