Journal of Appalachian health最新文献

{"title":"Impact of West Virginia Abortion Ban on West Virginia Physician Trainee Practice Intentions.","authors":"Rebecca Wald, Kristy Ward, Sarah Dotson","doi":"10.13023/jah.0704.07","DOIUrl":"10.13023/jah.0704.07","url":null,"abstract":"<p><p>In June 2022, the Dobbs v Jackson Women's Health Organization overturned the constitutional right to abortion established by Roe vs. Wade. Shortly after, West Virginia (WV) began enforcing a near total ban on abortion. Statewide restrictions on access to reproductive health care have important implications for the recruitment and retention of physicians. This project aimed to determine overall awareness of the 2022 changes in abortion laws among physician trainees, and whether the law influenced the intention of resident/fellow physicians to practice medicine in the state following completion of their medical training. A total of 178 resident and fellow physicians at West Virginia University were recruited via an email invitation. Survey responses demonstrated that 91.6% of trainees were aware of the change in abortion legislation. Among all respondents, 52.2% reported being less likely to practice in WV because of the ban. Compared to residents, fellows were much more likely not to want to practice in WV (82.7% vs. 48.2%, pp =0.015). Open ended commentary revealed that this is an important issue for physician trainees. These findings have important implications for recruitment and retention of physicians to abortion-restricted states and may also suggest changes to where medical students are applying for residency.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"7 4","pages":"116-127"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Family Health History and Parental Education on Body Mass Index, Blood Pressure, and Lipid Levels in 5th Grade Children: A Secondary Data Analysis of the CARDIAC Project.","authors":"Madha Rani Das, Lee A Plyes, Eloise Elliott, Christa L Lilly","doi":"10.13023/jah.0704.02","DOIUrl":"10.13023/jah.0704.02","url":null,"abstract":"<p><strong>Introduction: </strong>Childhood obesity and related cardiovascular risks reflect the interplay of genetic predispositions and socioeconomic adversity. Appalachia's poverty, limited health care, and educational gaps worsen family health risks, driving early cardio-metabolic problems in children, highlighting the need for effective interventions.</p><p><strong>Purpose: </strong>The purpose of this study is to examine the association of family health history and parental education with BMI, BP, and lipid profiles among 5^th grade children in West Virginia (WV).</p><p><strong>Methods: </strong>The study used WV CARDIAC data from 2006-2009. Outcomes were BMI, SBP/DBP, and fasting lipids (HDL, LDL, TG). Predictors were parental education and family health history (heart disease, diabetes, high cholesterol, smoking). Multiple linear regression was used, adjusting for covariates.</p><p><strong>Results: </strong>Data from 30,756 fifth-grade children were analyzed. Among participating children, positive family history of smoking, diabetes, and high cholesterol was significantly associated with higher BMI (β = 3.07, 95% CI: 2.15-3.99, <i>p</i> < 0.0001). Paternal education showed a protective effect, with children of college-graduated fathers having lower BMI (β = -3.40, 95% CI: -4.20 to -2.60, <i>p</i> < 0.0001) and lower SBP (β = -0.94, 95% CI: -1.38 to -0.50, <i>p</i> < 0.0001) compared with those whose fathers had only a high school or GED education. Smoking (β = -0.69, 95% CI: -0.94 to -0.43, <i>p</i> < 0.0001) and diabetes (β = -0.48, 95% CI: -0.71 to -0.26, <i>p</i> < 0.0001) exhibited lower HDL levels.</p><p><strong>Implications: </strong>These findings highlight the effects of familial factors in shaping pediatric cardiovascular risk and emphasize the need for culturally tailored, family-centered interventions to reduce health disparities.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"7 4","pages":"19-54"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging Community Health Worker's Deep Community Knowledge to Address Food and Nutrition Security in Appalachia.","authors":"Alexis Kimbro Scott, Melissa D Olfert, Dawn Brewer, Makenzie Barr, Julie Plasencia","doi":"10.13023/jah.0704.05","DOIUrl":"10.13023/jah.0704.05","url":null,"abstract":"<p><strong>Introduction: </strong>Community health workers (CHWs) are trusted professionals in communities because of the deep understanding and cultural insights learned from their lived experiences. In Appalachia, CHWs are embedded in the community, giving them a unique understanding of how social determinants, like food and nutrition security, impact health outcomes.</p><p><strong>Purpose: </strong>This study aimed to examine the professional characteristics and knowledge of CHWs while identifying culturally sensitive practices around food insecurity.</p><p><strong>Methods: </strong>This cross-sectional, mixed-methods study used an online survey and in-depth phone interviews with CHWs in the Appalachian Region to examine their professional characteristics and knowledge on food security in their community. Quantitative surveys included a Cultural Competence Assessment (CCA) with two subscales: Cultural Awareness and Sensitivity (CAS) and Cultural Competence Behaviors (CCB). Surveys were analyzed descriptively to examine professional characteristics, while interviews underwent thematic analysis to identify community-based food and nutrition solutions.</p><p><strong>Results: </strong>Fourteen CHWs completed the online survey, and over 75% reported being able to provide guidance to families on food assistance programs. Findings from in-depth interviews highlight the challenges that families face in accessing these programs, including generational differences that affect access to home-cooked v packaged foods, as well as access to entitlement programs due to non-custodial caretaker status.</p><p><strong>Implications: </strong>The deep cultural competence among CHWs makes their partnerships a valuable community asset. Their unique position and knowledge of the community enable them to identify opportunities for community-based solutions to improve food and nutrition security in rural Appalachia.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"7 4","pages":"89-99"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stigmatization and Healthcare Inequity Perceived by Individuals Served by Homeless Shelters in an Appalachian City.","authors":"Molly Powney, James M Mears, Reagan Sharp, Lisa Calderwood","doi":"10.13023/jah.0704.04","DOIUrl":"10.13023/jah.0704.04","url":null,"abstract":"<p><strong>Introduction: </strong>People experiencing homelessness are medically vulnerable and suffer disproportionately from chronic physical and mental health conditions. Evidence-based standards to inform decisions surrounding care would be valuable for this population. Studies exploring how homeless individuals in Appalachia perceive their interactions with the healthcare system remain limited, however.</p><p><strong>Purpose: </strong>The purpose of this study is to assess perceptions of the healthcare system among homeless individuals served by temporary housing shelters in an Appalachian city.</p><p><strong>Methods: </strong>A voluntary anonymous survey was administered to residents at three shelters in Charleston, West Virginia (WV) from September 2023 - March 2024. Responses were collected utilizing REDCap by a medical student interest group that regularly provided services at the shelters.</p><p><strong>Results: </strong>Of 108 participants, 23.2% \"agreed\" or \"strongly agreed\" that they feel judged by healthcare workers, and 23.2% agreed/strongly agreed that they feel healthcare workers treat them differently from the non-homeless people in the hospital. Similarly, 19.4% agreed/strongly agreed that they do not like going to the hospital because of the way they are treated. Respondents with a history of a mental health diagnosis reported significantly higher levels of stigma or poor experience with providers (<i>p</i> =0.026). There was no significant difference in perceived stigma/judgement based on race, incarceration history, or employment status.</p><p><strong>Implications: </strong>Perceived inequity in health care was prevalent amongst the homeless individuals surveyed. Survey participants with a history of mental health diagnoses were more likely to report dissatisfaction with care. More studies are needed to determine the impact of perceived stigmatization on healthcare disparities in the homeless population in WV.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"7 4","pages":"70-88"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geospatial Analysis of Breast Cancer Incidence, Mortality, and Access to Screening in Rural and Appalachian Virginia.","authors":"Jennifer Osher, Caleb Brown, Phillip Nichols, Tariq Ayubi, Jeremy Powers","doi":"10.13023/jah.0704.03","DOIUrl":"10.13023/jah.0704.03","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer is the most common malignancy among women in the United States (U.S.), despite recent survival rates improving nationally. However, rural and Appalachian regions have experienced slower mortality declines. These communities face unique health care-related challenges that may contribute to observed disparities.</p><p><strong>Purpose: </strong>The purpose of this study is to assess differences in breast cancer incidence, mortality, and mortality-to-incidence ratio (MIR) between Appalachian and non-Appalachian counties, as well as rural and non-rural counties in Virginia (VA). Furthermore, we aim to evaluate whether availability of mammography is associated with these differences.</p><p><strong>Methods: </strong>County-level breast cancer incidence and mortality data (2015-2019) for women age 40 and above were obtained from the VA Department of Health. Mammography facility locations were obtained from the Food and Drug Administration (FDA) Mammography Database. Appalachian designation followed Appalachian Regional Commission criteria. Rurality designation followed the 2013 Rural-Urban Continuum Codes (4-9 = rural). Mammography density per eligible female population was calculated using 2016 Census data. Mean rates were compared with t-tests. Linear regression with interaction terms evaluated associations between mammography density and MIR.</p><p><strong>Results: </strong>Of the 133 counties in VA, 33 (24.8%) were considered Appalachian and 53 (39.8%) rural. Incidence and mortality rates in woman age 40 and above did not differ significantly by Appalachian status or rurality. MIRs were higher in Appalachian (0.24 vs. 0.18; <i>p</i> =0.04) and rural (0.23 vs. 0.18; <i>p</i> =0.01) counties. Mammography density was not significantly associated with MIR by Appalachian status (<i>p</i> =0.97) or rurality (<i>p</i> =0.06) with the exception of non-rural Appalachian counties.</p><p><strong>Implications: </strong>Despite similar incidence rates, Appalachian and rural counties in Virginia had higher MIRs, suggesting poorer survivability. Mammography availability alone did not explain disparities, necessitating further investigation.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"7 4","pages":"55-69"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Social Media Usage, Physical Activity and Flourishing in Rural University Students.","authors":"Anna Dysart, Minu Sara Thomas","doi":"10.13023/jah.0704.08","DOIUrl":"10.13023/jah.0704.08","url":null,"abstract":"<p><strong>Introduction: </strong>Most adolescents and young adults report significant use of social media.1-3 However, there is limited research on the effect of social media use, specifically on physical activity and flourishing.</p><p><strong>Purpose: </strong>This pilot research study examines the correlation between social media usage and the physical activity and flourishing levels of college students at a rural university in Appalachia.</p><p><strong>Methods: </strong>The authors conducted a survey including the validated Secure Flourishing Index and Stanford Leisure-Time Activity Categorical Item, containing questions on social media use and demographics. Spearman's rho was used for nonparametric correlations. Pearson's correlation was used to determine the correlation of flourishing with physical activity levels.</p><p><strong>Results: </strong>Time spent on Threads per login was positively associated with higher physical activity (pppp <0.001). Implications: Social media use, both frequency and time spent on the platforms, can impact how college students attending a rural university flourish and participate in physical activity. Continued research in this area should investigate the content on social media for its impact on different domains of flourishing including physical and mental health.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"7 4","pages":"128-136"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive Telemedicine Transitions of Care Clinic: A Prospective Feasibility Study of a Novel Ambulatory Model Serving Appalachian Patients.","authors":"Jessica Thayer, Brett Miller, Marcelino Mederos Liriano, Kathryn Hoffman, Gina Baugh, Jenna Sizemore","doi":"10.13023/jah.0703.07","DOIUrl":"10.13023/jah.0703.07","url":null,"abstract":"<p><strong>Introduction: </strong>Hospital discharge is a complex process plagued with medical errors and poor coordination. Disjointed discharges are detrimental to Appalachian patients with access barriers and multiple chronic diseases. Telehealth is a tool used to improve access within rural Appalachia. To address this high-risk transition period, an interprofessional team deployed telemedicine to improve post-hospital care for Appalachian patients.</p><p><strong>Purpose: </strong>Patients with uncontrolled chronic medical conditions were enrolled into the Intensive Telemedicine Transition of Care Clinic (I-TTC) with a primary outcome of 30-day Emergency Department (ED) presentations and hospital readmissions. Secondary outcomes included improved control of chronic conditions and patient cost savings.</p><p><strong>Methods: </strong>Patients with uncontrolled chronic conditions were given home-monitoring devices and enrolled in the I-TTC post-hospitalization. Telehealth visits were conducted with an interprofessional team comprised of graduate health science students under the supervision of I-TTC physicians. Hospital readmissions, emergency department (ED) presentations, and chronic disease specific measurements were analyzed through retrospective review.</p><p><strong>Results: </strong>Sixteen adult patients participated in the I-TTC pilot study from 2021-2022. At baseline all patients with hypertension were uncontrolled. The average HbA1C of patients with uncontrolled diabetes was 11%. Post-enrollment, 12.5% of patients had a 30-day ED presentation or hospital re-admission. The average HbA1c for those with uncontrolled diabetes was 8.1% after I-TTC intervention. Of the ten patients with uncontrolled blood pressure, six were controlled post-enrollment. The average cohort total cost savings was $3,144.35.</p><p><strong>Implications: </strong>The I-TTC suggests feasibility for an interprofessional team utilizing telemedicine in achieving control of chronic medical conditions through improved access to ambulatory healthcare.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"7 3","pages":"95-104"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Screening Patients for Alcohol Use in West Virginia: A Cross-Sectional Observational Study.","authors":"Bayan Abuhalimeh, Christopher Waters, R Constance Wiener","doi":"10.13023/jah.0703.04","DOIUrl":"10.13023/jah.0703.04","url":null,"abstract":"<p><strong>Introduction: </strong>Consequences of alcohol consumption are well-established and compounded by physiological changes of aging (increased sensitivity; medication interactions; etc.). Alcohol screening for all ages is recommended, especially as most Americans believe moderate drinking is acceptable. Screening is important in high alcohol use regions, such as rural areas where isolation is more likely, especially for older adults. The Appalachian Region has a significant rural population of older adults. West Virginia (WV) is representative of Appalachia. It is a rural state, has many older adults, and all counties are Appalachian.</p><p><strong>Purpose: </strong>The purpose of this cross-sectional study is to determine the likelihood of alcohol screening among older versus younger WV adults.</p><p><strong>Methods: </strong>Behavioral Risk Factor Surveillance System 2022 WV data were used. Study inclusion was complete data on sex (at birth), age, alcohol use, and alcohol screening responses. Data were analyzed using Rao-Scott Chi square and logistic regression analysis for the association of age on alcohol screening at routine healthcare visits.</p><p><strong>Results: </strong>Of the entire sample (n=3,297), 30% were ≥65 years; 53% were female; and 35.7% reported moderate drinking. Alcohol screening was 58.4% for individuals ≥65 years, and 89.8% for individuals ages 18 to <40 years>( <i>p</i><0.0001). Individuals ≥65 years were nearly 5 times more likely than individuals ages 18 to <40 years to not be screened (adjusted odds ratio=4.84 [95% CI: 3.24, 7.23]; <i>p</i><0.0001).</p><p><strong>Implications: </strong>There is a need for greater screening for alcohol use in older adults, as older adults are disproportionately less likely to receive an alcohol screening compared to individuals <40 >years.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"7 3","pages":"38-53"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radon Environmental Health Literacy among Health Council Participants in Northeast Tennessee.","authors":"Kawther Al Ksir, Stacy Stanifer, Hadii M Mamudu, Megan Quinn, Deborah L Slawson","doi":"10.13023/jah.0703.05","DOIUrl":"10.13023/jah.0703.05","url":null,"abstract":"<p><strong>Introduction: </strong>Radon, a radioactive gas, poses significant health risks, including lung cancer, and is prevalent in indoor environments. Understanding radon testing behavior and Environmental Health Literacy (EHL) is crucial for individuals to take appropriate preventive measures.</p><p><strong>Purpose: </strong>This study assessed radon-related EHL among Health Council participants in seven Northeast Tennessee (NETN) counties and examined associations between sociodemographic factors and EHL levels. Understanding radon knowledge and behaviors within this influential group is critical, as they often serve as trusted public health advocates.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted from September - November 2023 among Health Council participants across seven counties in NETN, assessing sociodemographic characteristics and radon EHL. Descriptive statistics and linear regression analyses were employed to examine associations between sociodemographic variables and radon EHL scores.</p><p><strong>Results: </strong>A total of 131 Health Council members participated in the study. Of these total participants, the majority of participants were homeowners (60.3%). While 80.2% of participants had heard of radon, only 12% had tested their homes for it. TV commercials were the primary source of radon information. Younger age (p<0.001), renters (p<0.001), and those of Hispanic ethnicity (p=0.033) were associated with decreased EHL scores.</p><p><strong>Implications: </strong>Study's findings reveal disparities in radon knowledge, testing behavior, and EHL among Health Council participants in NETN. Tailored risk communication strategies considering demographic factors are essential to bridge the radon EHL gap. Collaborative efforts between public health agencies, policymakers, and community members are crucial to enhancing radon knowledge and testing uptake.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"7 3","pages":"54-76"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Barriers and Place-Based Solutions to Physical Activity for Older Adults in East Tennessee.","authors":"Lydia Hoskins, Jodi Southerland","doi":"10.13023/jah.0703.08","DOIUrl":"10.13023/jah.0703.08","url":null,"abstract":"<p><strong>Introduction: </strong>Older adults in East Tennessee (TN), the fastest growing demographic, face significant health challenges, with 44% reporting four or more chronic conditions. The state ranks 45th in physical inactivity among older adults, exacerbating chronic disease risks, fall-related injuries, and mental health issues. Urban-rural disparities in East TN further complicate efforts to promote active living, particularly for rural residents.</p><p><strong>Purpose: </strong>This qualitative study explored socioecological barriers and solutions to increase physical activity (PA).</p><p><strong>Methods: </strong>In April 2024, two focus group were conducted in East TN, with a total of 11 participants composed of six community partners and five older adults. A semi-structured interview guide explored PA attitudes, beliefs, and behaviors and gathered recommendations for increasing physical activities among older adults. Data were analyzed thematically using a socioecological framework at individual, organizational, and community levels.</p><p><strong>Results: </strong>Barriers at the individual level included poor physical, psychological, and social health, and low digital literacy skills. Organizational-level barriers included limited capacity to support PA programming (e.g., staffing, facilities, and funding limitations) and overlapping community program efforts. Community level barriers included limited social support networks and inadequately built environmental features for active living. Solutions highlighted the role of relationships (e.g., peer-to-peer, trusted facilitators) at the individual level, tailored programming and marketing efforts at the organizational level, and leveraging local resources and multi-system collaborations at the community level.</p><p><strong>Implications: </strong>The findings highlight socioecological factors contributing to physical inactivity in East TN older adults and identifies strategies to address them. These findings can inform sustainable, multi-systems interventions to promote PA in the region.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"7 3","pages":"105-119"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}