This study seeks to address the gap in existing prevention efforts among Appalachians through the development of a participatory and interactive, community-based intervention. Given the complex nature of rural communities, and Appalachia specifically, this intervention moves away from traditional methodologies and employs a holistic understanding of health as defined by the World Health Organization (“About WHO,” 2016), “a state of physical, mental, and social well-being and not merely the absence of disease or infirmity” (para. 1).
This paper focuses on findings from the formative research stage (focus groups, interviews, and participant observation), as well as concepts such as built environment barriers and normative influence, which are critical to intervention success and adherence. This stage is particularly important in reducing stigmatization and increase empathic feelings on behalf of community members, local organizations, and media.
Further, while much research has been done on Appalachians there is a significant gap in collaborative studies developed with and not for these individuals. This paper echoes the need for the integration of local expertise through the systematic involvement of Appalachians in studies where they are the target population. Specifically, this study will address potential cultural barriers that might influence prevention efforts among Appalachians. In addition, by gaining a deeper understanding of the risk factors within individual Appalachian communities, a participatory community-based research approach will be used to develop a multi-faceted culturally competent intervention for the people of Appalachia.
In the beginning of spring 2018, we will conduct 20 focus groups or until we reach substantiation. Participants will be recruited through Appalachian community organizations that have agreed to partner with us. These organizations include Pine Mountain, Appalshop, The Health Wagon, Appalachian Sustainable Development, Mountain Association for Community and Economic Development (MACED), and the Highlander Research and Education Center. Participant observations have accumulated over the past 4 years, and include 340 hours of observing Appalachian cultural norms, media representations, and Appalachian grassroots activism efforts. Naturalisic observation was conducted in the education settings of Appalachian Universities and public spaces. Observation and ethnographic efforts took place for the most part in Eastern Tennessee. As this project is founded upon a participatory approach and still in the formative research stage, the participant demographics will depend on the organization’s target population. However, our participants will be a representative population of Central Appalachians.