Journal of Appalachian health最新文献

{"title":"Reviewer Acknowledgements.","authors":"Randy Wykoff, Emily Wilson","doi":"10.13023/jah.0603.08","DOIUrl":"10.13023/jah.0603.08","url":null,"abstract":"<p><p>We at the <i>Journal of Appalachian Health</i> would like to thank the multitude of reviewers who have volunteered their time, talents, and attention to the journal. Reviewers help us consider the rigor and quality of the submissions we receive, and their willingness to read material ahead of publication ensures we can bring timely research to our readers in Appalachia and further afield.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"6 3","pages":"93-96"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634041","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":"Using Public Funeral and Obituary Listings to Identify Spikes in Excess Mortality in One Appalachian County.","authors":"Allen Archer, Melissa White, Megan Quinn, Randy Wykoff","doi":"10.13023/jah.0603.03","DOIUrl":"10.13023/jah.0603.03","url":null,"abstract":"<p><strong>Introduction: </strong>Delays (10-22 months) in availability of official state and county-level mortality data could have significant public health consequences. The COVID-19 pandemic illuminated the need for health officials to access timely death data to identify unexpected increases in mortality in their communities.</p><p><strong>Purpose: </strong>The purpose of this study is to determine if funeral home listings and/or newspaper obituaries could help identify excess mortality on the local level, prior to the availability of official death records.</p><p><strong>Methods: </strong>To calculate excess mortality, four years (2017-2020) of data were collected from three sources: the state health department, online funeral home listings, and newspaper obituaries, all from Washington County, Tennessee. Simple linear regression was used to predict number of expected deaths by month for 2020 using 2017, 2018, and 2019 reported deaths, by data source. The percent difference of actual 2020 deaths from the expected deaths was then calculated by month and compared for each data source.</p><p><strong>Results: </strong>Official COVID-19 state-reported death data accounted for only 50% of excess mortality estimated in 2020. Nearly 100 excess deaths occurred before the first reported death due to COVID-19. Trends in the percent difference between actual and expected funeral home listings and newspaper obituaries followed similar patterns as percent differences in actual v. expected state-reported mortality data.</p><p><strong>Implications: </strong>Had funeral home listings and newspaper obituaries been used to identify excess mortality, health officials would have seen increases in mortality nearly five months prior to the first identified COVID-19 death. These publicly available tools could prove valuable to local health officials as an \"early warning\" sign of excess mortality.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"6 3","pages":"10-26"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634044","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":"Open Access in the Age of AI: The Journal of Appalachian Health and Hurricane Helene Recovery.","authors":"Noah Wren, Bradley Firchow","doi":"10.13023/jah.0603.02","DOIUrl":"10.13023/jah.0603.02","url":null,"abstract":"<p><p>The recent destruction brought upon the Appalachian region by Hurricane Helene has emphasized the importance of the <i>Journal of Appalachian Health</i>. As an open-access peer-reviewed source of information, the <i>Journal</i> plays a critical role in not only facilitating public health research about Hurricane Helene, but also combating misinformation regarding the event. In the days following Hurricane Helene, misinformation about the federal government's response, along AI generated images, have left many in the region confused and misled about what had happened. Going forward, the <i>Journal</i> will play an necessary part in making sure accurate information is shared to understand how we can prepare for future natural disasters, combat misinformation regarding response efforts, and facilitate long-term healing across Appalachia.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"6 3","pages":"4-9"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143559433","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":"Aftermath: A Word to Appalachia Following Hurricane Helene.","authors":"Emily Wilson","doi":"10.13023/jah.0603.01","DOIUrl":"https://doi.org/10.13023/jah.0603.01","url":null,"abstract":"<p><p>On September 27, 2024, Hurricane Helene caused massive and catastrophic flash flooding in the lower Appalachian Region, leveling towns and forever altering much of the landscape. This is an open letter to the people of Appalachia who were affected by the disaster that blindsided our region.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"6 3","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634024","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":"Impacts of the COVID-19 Pandemic on Intimate Partner Violence and Child Maltreatment Services in Rural Northwest North Carolina.","authors":"Elisabeth G Galphin, Adam Hege, Amy Dellinger Page","doi":"10.13023/jah.0603.08","DOIUrl":"10.13023/jah.0603.08","url":null,"abstract":"<p><p>The current study examined the impact of the COVID-19 pandemic on IPV and child maltreatment services in rural northwestern North Carolina. Qualitative interviews were conducted with eight professionals representing six service organizations across four counties. The findings highlighted challenges these agencies faced throughout the pandemic, new risks for the clients served, and positive outcomes. In addition, it has been a useful learning experience as public health and social service agencies learn to serve their communities more effectively moving forward. This is especially relevant for rural communities, as it has put public health preparedness at the forefront.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"6 3","pages":"93-98"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633938","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":"Assessing Chronic Pain Among Adults Diagnosed with Diabetes Residing in Rural Appalachia.","authors":"Brittany L Smalls, Adebola Adegboyega, Courtney Ortz, Ellen Combs, Tofial Azam, Philip M Westgate, Nancy Schoenberg","doi":"10.13023/jah.0603.07","DOIUrl":"10.13023/jah.0603.07","url":null,"abstract":"<p><strong>Introduction: </strong>Appalachian populations have some of the highest rates of overdose and comorbidity, all of which are considered risk factors for and contributors to chronic pain.</p><p><strong>Purpose: </strong>The purpose of this study was to examine the associations of comorbidity, disability (physical limitations), and depression with chronic pain among a community-based sample of Appalachian adults living with diabetes.</p><p><strong>Methods: </strong>This study used baseline data to conduct a secondary analysis of cross-sectional data (n=356). Data included sociodemographic, disability (physical limitations), chronic pain, and depression measures. These data were collected and analyzed from 2017-2019. Multiple logistic regression was used to investigate the association between comorbidity, disability, depression, and chronic pain.</p><p><strong>Results: </strong>Participants were predominantly non Hispanic white (98.0%), women (64.6%), and had a mean age of 64.2 years. Comorbidity (<i>p</i>=.044), physical limitations (<i>p</i>p.</p><p><strong>Implications: </strong>Chronic pain affects physical and psychosocial health among those diagnosed with diabetes who live in rural Appalachian communities. Alleviating chronic pain could have a synergistic benefit to healthy functioning.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"6 3","pages":"79-92"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633937","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":"The Impact of Primary Care Physician Capacity on Preventable Hospitalizations: Identifying Bright Spots in the Appalachian & Mississippi Delta Regions.","authors":"Michael Topmiller, Peter J Mallow, Hoon Byun, Mark Carrozza, Yalda Jabbarpour","doi":"10.13023/jah.0603.06","DOIUrl":"10.13023/jah.0603.06","url":null,"abstract":"<p><strong>Introduction: </strong>Several studies have documented that higher rates of primary care physicians are associated with lower rates of preventable hospitalizations. Counties with higher rates of preventable hospitalizations are found in the Appalachian and Mississippi (MS) Delta Regions.</p><p><strong>Purpose: </strong>(1) To determine if the association of primary care capacity with preventable hospitalizations is different in the Appalachian and MS Delta regions compared to the rest of the U.S., and (2) to explore primary care capacity in counties with lower-than-expected preventable hospitalization rates.</p><p><strong>Methods: </strong>This study modeled preventable hospitalizations with primary care physicians (PCP) per 100,000 (PCP capacity) while controlling for several factors. A spatial regime variable was also included, which modeled Appalachian and MS Delta regions separately. Next, PCP capacity was removed from the model and a geospatial residual analysis was performed to identify geographic clusters of counties with lower-than-expected rates of preventable hospitalizations (bright spots). PCP capacity in bright spots was then compared to that in counties with higher-than-expected rates (cold spots).</p><p><strong>Results: </strong>Higher PCP capacity was significantly associated with lower rates of preventable hospitalizations in the rest of U.S. model, though was not significant for the Appalachian or MS Delta models. The residual analysis showed that compared to counties with higher-than-expected rates (cold spots), counties with lower-than-expected rates (bright spots) had significantly higher PCP capacity, though not in the MS Delta region.</p><p><strong>Implications: </strong>Consistent with previous literature, it was found that the factors associated with preventable hospitalizations vary by region, though the results are mixed when looking at the Appalachian and MS Delta regions separately. Future research should explore characteristics of bright spots within the Appalachian and MS Delta regions.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"6 3","pages":"66-78"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634042","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":"Disasters and Impacts in Appalachian Kentucky: A Behavioral Health Analysis.","authors":"Walter David Mathews, Joseph M Clark, Amy S Potts","doi":"10.13023/jah.0601.09","DOIUrl":"10.13023/jah.0601.09","url":null,"abstract":"<p><strong>Introduction: </strong>Major disasters continue to occur in Appalachian Kentucky with devastating consequences. A major disaster, defined by the Federal Emergency Management Agency (FEMA) as an event too large for a community to manage without outside help, involves emergency responders from the local, state, and federal disaster agencies, plus national volunteers.</p><p><strong>Purpose: </strong>This paper reports on recent disasters in eight southeast Kentucky counties, the changing nature of these disasters, and the behavioral health impact on the people affected.</p><p><strong>Methods: </strong>In this large-scale disaster survey in the Appalachian counties in Southeast Kentucky, over 3,500 people were asked about their recent disaster experiences in 2021 and 2022. The Disaster, Impact, and Screening Survey (DISS) was used to explore the respondent's disaster history as a behavioral health client, general community member, or behavioral health professional, and how these views differed.</p><p><strong>Results: </strong>Respondents reported a higher rate of disaster experiences and requests for assistance than U.S. population surveys. Behavioral health clients and general community members disaster were not significantly coordinated but comparisons between behavioral health professionals clients were. Types of disasters and their impacts showed COVID pandemic caused the most widespread stressors such as school closings and missed work. Disasters such flooding caused the respondents property damage and homelessness Combining how widespread types of stressors and disaster severity ratings showed property damage, school closing, and home damage as the stressors with the greatest behavioral health impacts.</p><p><strong>Implications: </strong>Academic researchers and policymakers have expressed a desire to better integrate behavioral health services into the national emergency response system. To translate research into practice, health professionals need to better understand the disasters that have occurred in their service area, the types of impacts of those disasters, and how people have reacted. Local health providers should be involved in disaster preparedness, response, and long-term recovery as part of community resilience teams.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"6 1-2","pages":"133-148"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11617020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787964","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":"Conscientious Objection: Understanding When and Why Primary Care Physicians Object to Providing Health Care to Transgender and Gender-Diverse Patients in an Appalachian Medical Center.","authors":"Mili S Patel, Kelley A Jones, Laura Davisson, Elizabeth Miller, Nicole Kahn, Pamela J Murray, Kacie M Kidd","doi":"10.13023/jah.0601.05","DOIUrl":"10.13023/jah.0601.05","url":null,"abstract":"<p><strong>Introduction: </strong>Transgender and gender-diverse (TGD) individuals face barriers to accessing primary and gender-affirming care, especially in rural regions where a national shortage of medical providers with skills in caring for TGD people is further magnified. This care may also be impacted by individual providers' strongly held personal or faith beliefs and associated conscientious objection to care.</p><p><strong>Purpose: </strong>This study assesses the prevalence of conscientious objection to providing care and gender-affirming hormone (GAH) therapy to TGD individuals among physicians in an Appalachian academic medical center.</p><p><strong>Methods: </strong>An anonymous, online, cross-sectional survey of physicians was distributed to resident and faculty physicians in an Appalachian medical center. Survey domains included demographics, personal religious affiliations and practices, and assessments of willingness to provide specific types of care.</p><p><strong>Results: </strong>Surveyed physicians (n = 115) had no objection to caring for TGD patients but notable objection to prescribing GAH therapy to adults (23.5%) and minors (33.0%). Self-identified \"very religious\" physicians were more likely to object.</p><p><strong>Implications: </strong>Physician objection may present a barrier to care for TGD individuals in Appalachia. Provider and system-level interventions should be considered to ensure access to these necessary medical services.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"6 1-2","pages":"57-69"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11617021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787961","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":"Trilogies: Lessons from 50 Years Facilitating Community-based Health Assessments and Planning in Appalachia.","authors":"Bruce Behringer","doi":"10.13023/jah.0601.10","DOIUrl":"10.13023/jah.0601.10","url":null,"abstract":"<p><p>Involvement of community and organizational groups is fundamental to most public ventures. Most social, health, economic, and educational improvements in Appalachia have been characterized by successfully integrating community input and finding ways to encourage organizational change and collaboration. Managing group process and related facilitation skills are fundamental competencies for public health professionals and others guiding change efforts. Groups from communities and organizations can get stalled in their deliberations; a facilitator frequently must think quickly to diagnose the situation and propose alternative approaches. Creative and flexible approaches, learned through practice experiences, can blend with theories and frameworks learned in academic preparation from multiple disciplines in order to effectively encourage group progress. Over a 50-year career (1972-2022), sets of three related concepts were formed as trilogies and used during work with groups of diverse compositions, in multiple locations, and addressing varied topics. The trilogies proved helpful in encouraging group tasks related to assessment, planning, monitoring, and evaluation. Trilogies also were deployed as a facilitation technique to pose thoughtful options as groups considered difficult issues and maneuvered through stagnant or conflict-prone situations. This paper presents twelve trilogies organized around six common group-process questions. A reference for the source of each trilogy is provided, and several Appalachian-specific examples of how trilogies were deployed are described.</p>","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"6 1-2","pages":"149-163"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11617019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787977","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}