Journal of Appalachian health最新文献_第9页

Understanding Polarizing Community Perspectives on Harm Reduction Strategies: Challenges to Addressing the Opioid Crisis in Appalachian Pennsylvania. 了解社区对减低伤害策略的两极化观点：宾夕法尼亚州阿巴拉契亚地区应对阿片类药物危机的挑战。

Journal of Appalachian health Pub Date : 2021-10-25 eCollection Date: 2021-01-01 DOI: 10.13023/jah.0304.07

Stephanie L Creasy, Jessica R Thompson, Christina F Mair, Jessica G Burke

{"title":"Understanding Polarizing Community Perspectives on Harm Reduction Strategies: Challenges to Addressing the Opioid Crisis in Appalachian Pennsylvania.","authors":"Stephanie L Creasy, Jessica R Thompson, Christina F Mair, Jessica G Burke","doi":"10.13023/jah.0304.07","DOIUrl":"10.13023/jah.0304.07","url":null,"abstract":"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 posteriors from spatial models of hospitalizations for opioid use disorders. We interviewed 20 key stakeholders in the case community in using a semi-structured interview guide and analyzed the qualitative data using an inductive grounded theory approach.Results: Our findings illustrate how conflicting perspectives about opioid dependence lay the foundation for the polarizing community perspectives on addressing opioid use and overdose and general disagreement regarding the legitimacy of harm reduction approaches versus abstinence-based recovery plans. Community members shared varying perspectives on multiple aspects of the opioid epidemic, including appropriate strategies, treatment, and overdose prevention methods and how community leaders and organizations should respond.Implications: Opinions, coupled with a general lack of education regarding opioid use and harm reduction options, make it challenging for small communities with limited resources to create comprehensive plans to address the opioid crisis.","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"3 4","pages":"74-88"},"PeriodicalIF":0.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9183794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40409990","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}

引用次数: 0

The Compounding Effect of Rurality on Health Disparities Among Black Patients with COVID-19. 农村因素对黑人COVID-19患者健康差异的复合效应

Journal of Appalachian health Pub Date : 2021-10-25 eCollection Date: 2021-01-01 DOI: 10.13023/jah.0304.03

Jessica E Johnson, Ruchi Bhandari, Allison Lastinger, Rebecca Reece

{"title":"The Compounding Effect of Rurality on Health Disparities Among Black Patients with COVID-19.","authors":"Jessica E Johnson, Ruchi Bhandari, Allison Lastinger, Rebecca Reece","doi":"10.13023/jah.0304.03","DOIUrl":"https://doi.org/10.13023/jah.0304.03","url":null,"abstract":"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 patients who tested positive and were admitted for COVID-19 and seen within the state's largest health system (West Virginia University Health System) between March 18 and September 16, 2020 were analyzed. Cases were stratified into rural or urban based on rural urban continuum codes (RUCCs) and by race into 'white,' 'black,' or 'other.' Associations between rurality, rurality and race, and outcomes were assessed.Results: A total of 2011 adult West Virginians tested positive, of which 8.2% were hospitalized. Of the hospitalized patients, 33.5% were rural and 11.6% were black. Rural black patients were three times more likely (OR: 3.33; 95%CI:1.46-7.60) to be admitted. Rural blacks were also more likely to have a history of obstructive pulmonary disease (OR: 2.73; 1.24-6.01), hypertension (OR: 2.78; 1.38-5.57), and multiple chronic conditions (3.04; 1.48-6.22).Implications: Rural blacks were more likely to have risk factors for severe COVID-19 influencing their increased risk of hospitalization. These findings support that race as a risk factor for severe COVID-19 is compounded by rurality and identifies an important target group for vaccination.","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"3 4","pages":"11-28"},"PeriodicalIF":0.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9183793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40409993","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}

引用次数: 1

COVID-19 Experiences, Behaviors, Beliefs, and Well-Being Among Students and Employees at a University In Rural Appalachia: A Cross-Sectional Study. 阿巴拉契亚农村一所大学学生和员工的COVID-19经历、行为、信仰和幸福感:一项横断面研究

Journal of Appalachian health Pub Date : 2021-10-25 eCollection Date: 2021-01-01 DOI: 10.13023/jah.0304.09

Lauren Wisnieski, Kimberly A Carney, Jenny L Thornley

{"title":"COVID-19 Experiences, Behaviors, Beliefs, and Well-Being Among Students and Employees at a University In Rural Appalachia: A Cross-Sectional Study.","authors":"Lauren Wisnieski, Kimberly A Carney, Jenny L Thornley","doi":"10.13023/jah.0304.09","DOIUrl":"https://doi.org/10.13023/jah.0304.09","url":null,"abstract":"ABSTRACT: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 convenience sampling. The survey measured multiple domains including COVID-19-related (1) beliefs, (2) symptoms and diagnoses, (3) exposure and preventive behavior, and (4) social, mental, and financial health. Chi-square tests and linear regression models were used to determine differences in survey responses between students and employees.Results: The final sample used for analysis included 416 respondents. The majority of respondents believed COVID-19 was a serious disease and followed mask and social distancing guidelines, although employees were more likely to adhere to mask and social distancing guidelines compared to students. Most of the respondents (>50%) reported feeling more stressed, anxious, and sad since the pandemic began. Students were more impacted by the pandemic compared to employees as measured by the mental, social, and financial impact scale. A limitation of this study was that convenience sampling was used instead of a probability sampling technique, which limits the inference that can be made from the results.Implications: There may be a need for greater mental health support among university employees and students. However, future studies should confirm these findings.","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":"3 4","pages":"109-122"},"PeriodicalIF":0.0,"publicationDate":"2021-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9183797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40409992","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}

引用次数: 0

Review of: Understanding and Dismantling Racism: Crowdsourcing a Pathway Model in Appalachia 《理解和拆除种族主义:阿巴拉契亚地区的众包路径模式》综述

Journal of Appalachian health Pub Date : 2021-08-07 DOI: 10.13023/JAH.0303.11

M. Hudson

引用次数: 0

Diabetes Knowledge, Behaviors, and Perceptions of Risk in Rural West Virginia Counties. 西弗吉尼亚州农村地区的糖尿病知识、行为和风险认知。

Journal of Appalachian health Pub Date : 2021-07-25 eCollection Date: 2021-01-01 DOI: 10.13023/jah.0303.05

Ranjita Misra, Sara Farjo, Renee McGinnis, Megan Adelman Elavsky, Summer Kuhn, Catherine Morton-McSwain

{"title":"Diabetes Knowledge, Behaviors, and Perceptions of Risk in Rural West Virginia Counties.","authors":"Ranjita Misra, Sara Farjo, Renee McGinnis, Megan Adelman Elavsky, Summer Kuhn, Catherine Morton-McSwain","doi":"10.13023/jah.0303.05","DOIUrl":"10.13023/jah.0303.05","url":null,"abstract":"Introduction: A little less than half of American adults have diabetes or pre-diabetes. In 2016, West Virginia (WV) had the highest percentage (15.2%) of adults with diagnosed diabetes in the U.S.Purpose: In partnership with the Health Sciences and Technology Academy (HSTA), a cross-sectional study was preformed to assess knowledge, behaviors, and perceptions of diabetes risk.Methods: Data was collected by trained HSTA students and teachers who lived in rural counties in WV. Information was assessed using validated surveys, and HbA1c was obtained by utilizing professional point-of-care (Bayer) kits.Results: Mean age and Body Mass Index (BMI) was 36.11±17.86 years and 27.80±6.09 kg/m2, respectively. More than half of the participants had a family history of diabetes (58.8%) and hypertension (60.2%), and a majority had elevated BMI (65.9%). However, only 29.2% rated their future risk for diabetes as moderate to high. Eighty percent (80%) had an inadequate amount of weekly exercise, and 36% had lower quality of diet. Overall, dietary quality and diabetes knowledge was associated with a low to moderate diabetes risk score; risk score positively correlated with higher HbA1c (r=0.439, P<.001). Participants' HbA1c, perceived future risk of diabetes and family history of diabetes emerged as significant predictors of diabetes risk in the regression model, controlling for health behavior and diabetes knowledge.Implications: HbA1c, perceived future risk of diabetes and family history of diabetes may be the best predictors of developing diabetes in the future and, therefore, are important to assess during community screening. Perception of diabetes risk is lower than actual diabetes risk in WV.","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":" ","pages":"51-67"},"PeriodicalIF":0.0,"publicationDate":"2021-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9192115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40411045","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}

引用次数: 0

Rural Re-entry and Opioid Use: Identifying Health-Related Predictors of Relapse Among Formerly Incarcerated Women in Appalachia. 农村重归社会与阿片类药物的使用：确定阿巴拉契亚地区曾被监禁妇女中与健康相关的复发预测因素》（Rural Re-entry and Opioid Use: Identifying Health-Related Predictors of Relapse Among Formerly Incarcerated Women in Appalachia.

Journal of Appalachian health Pub Date : 2021-07-25 eCollection Date: 2021-01-01 DOI: 10.13023/jah.0303.03

Joseph M Calvert, Megan F Dickson, Martha Tillson, Erika Pike, Michele Staton

{"title":"Rural Re-entry and Opioid Use: Identifying Health-Related Predictors of Relapse Among Formerly Incarcerated Women in Appalachia.","authors":"Joseph M Calvert, Megan F Dickson, Martha Tillson, Erika Pike, Michele Staton","doi":"10.13023/jah.0303.03","DOIUrl":"10.13023/jah.0303.03","url":null,"abstract":"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 history of substance use were recruited from three Appalachian jails in Kentucky. Analyses focused on participants reporting a history of illicit opioid use prior to incarceration, who had also completed follow-up interviews at 6- and 12-months post-release from jail.Results: Fifty-five percent of participants reported relapse to opioids during the 12-month follow-up period. Compared to those who did not use opioids during this time, women who relapsed reported poorer mental and physical health, as well as encountered more barriers to needed health services. They were also more likely to report a usual source of care. Multivariate regression analyses reveal that, even when controlling for other known correlates of opioid use and relapse to any non-opioid drug during the follow-up period, the number of barriers to health service utilization was a significant predictor of opioid relapse.Implications: Stakeholders should address the complex reentry needs of women who use opioids in rural Appalachia. This includes examining innovative approaches to reduce extensive barriers to quality health care utilization, such as implementing telehealth for opioid use treatment.","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":" ","pages":"22-35"},"PeriodicalIF":0.0,"publicationDate":"2021-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9192118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40411046","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}

引用次数: 0

Review of: Appalachians for Medicaid Website. 回顾:阿巴拉契亚医疗补助网站。

Journal of Appalachian health Pub Date : 2021-07-25 eCollection Date: 2021-01-01 DOI: 10.13023/jah.0303.10

Kendra Barker

引用次数: 0

Addressing Diabetes Distress in Self-Management Programs: Results of a Randomized Feasibility Study. 在自我管理计划中解决糖尿病困扰:一项随机可行性研究的结果。

Journal of Appalachian health Pub Date : 2021-07-25 eCollection Date: 2021-01-01 DOI: 10.13023/jah.0303.06

Ranjita Misra, Samantha Shawley-Brzoska, Raihan Khan, Brenna O Kirk, Sijin Wen, Usha Sambamoorthi

{"title":"Addressing Diabetes Distress in Self-Management Programs: Results of a Randomized Feasibility Study.","authors":"Ranjita Misra, Samantha Shawley-Brzoska, Raihan Khan, Brenna O Kirk, Sijin Wen, Usha Sambamoorthi","doi":"10.13023/jah.0303.06","DOIUrl":"https://doi.org/10.13023/jah.0303.06","url":null,"abstract":"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 group. Trained health coaches and experts implemented the lifestyle program in a faith-based setting using an adapted evidence-based curriculum. Twenty adults with T2DM and HTN (n=10 per group) completed baseline and 12-week assessments. Diabetes distress was measured by using a validated Diabetes Distress Survey (17-item Likert scale; four sub-scales of emotional burden, physician related burden, regimen related burden, and interpersonal distress). Baseline and post-intervention changes in diabetes distress were compared for both groups; reduction in distress in the intervention groups are depicted using waterfall plots. The mean age, HbA1c and BMI were 55 ± 9.6 years, 7.8 ± 2.24 and 36.4 ± 8.8, respectively. Diabetes distress (total; mean) was 1.84±0.71.Results: Participants reported higher diabetes distress related to emotional burden (2.1±0.94) and regimen-related distress (2.0 ± 0.74); physician-related distress was the lowest (1.18±0.64). In general, diabetes distress reduced among intervention participants and was especially significant among those with HbA1c ≤ 8% (r=0.28, p=0.4), and systolic/diastolic BP ≤140/80 mm Hg (r=0.045, P=0.18).Implications: Findings suggest that lifestyle self-management programs have the potential to reduce diabetes distress.","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":" ","pages":"68-85"},"PeriodicalIF":0.0,"publicationDate":"2021-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9192112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40411041","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}

引用次数: 1

Geospatial Analysis of Rurality and Food Banks in Appalachian Ohio. 俄亥俄州阿巴拉契亚农村和食品银行的地理空间分析。

Journal of Appalachian health Pub Date : 2021-07-25 eCollection Date: 2021-01-01 DOI: 10.13023/jah.0303.09

Cooper T Johnson, Rebecca Fischbein, Kristin R Baughman

{"title":"Geospatial Analysis of Rurality and Food Banks in Appalachian Ohio.","authors":"Cooper T Johnson, Rebecca Fischbein, Kristin R Baughman","doi":"10.13023/jah.0303.09","DOIUrl":"https://doi.org/10.13023/jah.0303.09","url":null,"abstract":"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 the American Community Survey census data, County Health Rankings data, and regional foodbank websites.Results: Rural counties had a higher ratio of potential clients per service for food insecurity than did non-rural counties. They also had slightly more children eligible for free or reduced-price lunches than non-rural counties. However, the non-rural counties had slightly higher percentages of residents classified as food insecure and with limited access to healthy food.Implications: There are more potential clients per service for food insecurity in rural counties compared to non-rural counties. To promote greater access, additional food pantries should be opened in rural counties.","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":" ","pages":"110-119"},"PeriodicalIF":0.0,"publicationDate":"2021-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9192117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40411040","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}

引用次数: 0

Emergence of COVID-19 and Patterns of Early Transmission in an Appalachian Sub-Region. 阿巴拉契亚次区域COVID-19的出现和早期传播模式

Journal of Appalachian health Pub Date : 2021-07-25 eCollection Date: 2021-01-01 DOI: 10.13023/jah.0303.02

Abbey K Mann, T Andrew Joyner, Ingrid Luffman, Megan Quinn, William Tollefson, Ashley D Frazier

{"title":"Emergence of COVID-19 and Patterns of Early Transmission in an Appalachian Sub-Region.","authors":"Abbey K Mann, T Andrew Joyner, Ingrid Luffman, Megan Quinn, William Tollefson, Ashley D Frazier","doi":"10.13023/jah.0303.02","DOIUrl":"https://doi.org/10.13023/jah.0303.02","url":null,"abstract":"Background: In mid-March 2020, very few cases of COVID-19 had been confirmed in the Central Blue Ridge Region, an area in Appalachia that includes 47 jurisdictions across northeast Tennessee, western North Carolina, and southwest Virginia. Authors described the emergence of cases and outbreaks in the region between March 18 and June 11, 2020.Methods: Data were collected from the health department websites of Tennessee, North Carolina, and Virginia beginning in mid-March for an ongoing set of COVID-19 monitoring projects, including a newsletter for local healthcare providers and a Geographic Information Systems (GIS) dashboard. In Fall 2020, using these databases, authors conducted descriptive and geospatial cluster analyses to examine case incidence and fatalities over space and time.Results: In the Central Blue Ridge Region, there were 4432 cases on June 11, or 163.22 cases per 100,000 residents in the region. Multiple days during which a particularly high number of cases were identified in the region were connected to outbreaks reported by local news outlets and health departments. Most of these outbreaks were linked to congregate settings such as schools, long-term care facilities, and food processing facilities.Implications: By examining data available in a largely rural region that includes jurisdictions across three states, authors were able to describe and disseminate information about COVID-19 case incidence and fatalities and identify acute and prolonged local outbreaks. Continuing to follow, interpret, and report accurate and timely COVID-19 case data in regions like this one is vital to residents, businesses, healthcare providers, and policymakers.","PeriodicalId":73599,"journal":{"name":"Journal of Appalachian health","volume":" ","pages":"7-21"},"PeriodicalIF":0.0,"publicationDate":"2021-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9192114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40411042","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}

引用次数: 0