Browsing by Subject "Appalachia"

Now showing 1 - 3 of 3
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    The Mountain Maternal Health League and the changing politics of birth control in Kentucky, 1936-1949
    (2017-04) Holly, Jenny M.; Robertson, Nancy; Schneider, William; Schultz, Jane
    In 1936, Clarence J. Gamble, heir to the Proctor & Gamble fortune, established the Mountain Maternal Health League (MMHL) in Berea, Kentucky. Gamble had a strong interest in testing the effectiveness of simple birth control methods as a means to reduce the birth rate of impoverished and rural people and he would fund the organization for nearly six years as an experiment to test a jelly-and-syringe method of birth control in rural Kentucky. After his financial support ended, however, the organization continued. The women activists who worked with Gamble shifted the organizational focus, models of operation, and available methods to accommodate changing perspectives and expanding communities.
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    Program ACTIVE: Cognitive Behavioral Therapy to Treat Depression in Adults With Type 2 Diabetes in Rural Appalachia
    (Springer, 2017-08) de Groot, Mary; Doyle, Todd; Averyt, Jennifer; Medicine, School of Medicine
    High rates of type 2 diabetes (T2DM) and depression exist in rural Appalachia with limited access to psychotherapeutic treatment. No manualized cognitive behavioral therapy (CBT) treatment materials exist that are culturally tailored for individuals in this region with T2DM. We describe the development of the Program ACTIVE CBT intervention for use with adults with T2DM and depression by mental health providers in rural Appalachia. Qualitative and quantitative methods were used to test the feasibility and acceptability of Program ACTIVE. Intervention materials were rated at the 6th-7th grade reading level. Key informant interviews evaluated materials as culturally sensitive and accessible. Participants indicated high levels of satisfaction with therapy (94%), support from their therapist (86%), and usefulness of therapy and depression improvement (80.3%). Program ACTIVE was found to be a feasible and acceptable culturally tailored manualized CBT treatment for adults with T2DM and depression living in rural Appalachia. Implementation of these materials on a regional scale needs to be assessed.
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    The Intersection of Stress, Health, and Health Care Opportunities for Appalachian Transgender and Nonbinary People: An Interpretative Phenomenological Analysis
    (Sage, 2023) Harless, Chase; Murphy-Nugen, Amy B.; Surles, Kristen; School of Social Work
    Transgender or nonbinary (TNB) individuals in the United States South experience higher rates of physical and mental health disparities when compared to their cisgender counterparts. Societal, interpersonal, and individual stigmas contribute to these disparities by increasing the levels of stress in the TNB population, which is a primary factor in higher morbidity and mortality. However, there is a paucity of research examining the impact of these stigmas on health through the lived experiences of TNB people living in Appalachia. An interpretive phenomenological analysis (IPA) research design was used to collect and analyze semi-structured interviews with TNB individuals living in Appalachia. Transcribed interviews were analyzed repeatedly by two analysts to identify emergent themes which focused on understanding an individual's lived experiences through interpretation. Ten participants from four Appalachian states within three Appalachian sub-regions participated in this study. Three shared healthcare themes were identified: experiences of stigma related to gender, the impact of stigma on personal wellbeing and perception of health, and the need for affirming TNB healthcare services. Respondents noted that chronic stress factors such as continual and compounding experiences of stigma and discrimination, stemming from religion or lack of affirming providers, negatively impacted their health. TNB individuals living in Appalachia experience chronic societal, interpersonal, and individual stressors that negatively impact their health. By addressing the stigmas, public health leaders, policymakers, and providers can improve access to health care and the health and quality of life of Appalachian TNB people.