Surviving Cancer in Appalachia: A Qualitative Study of Family Cancer Communication and Changing Personal Identities Through the Cancer Journey.

The Appalachian region is known for its beautiful mountains, close-knit communities, and health care disparities including higher rates of cancer and premature mortality. Being diagnosed with cancer in the region may present a unique experience for survivors in regards to family cancer communication and changing personal identities. In a multiphasic study, the stories of 29 female Appalachian cancer survivors were collected through either a day-long modified story circle event (n=26) or an in-depth interview (n=3). Qualitative content analysis was used to identify emergent themes in the data. The analysis revealed 5 types of family cancer communication and five barriers to family cancer communication. The analysis additionally revealed the identity struggle women experience between maintaining traditional Appalachian gender roles and surviving cancer. These findings suggest that female Appalachian cancer survivors appear to have additional challenges that may make the cancer experience in Appalachia unique

Barriers to Family Cancer Communication in Southern Appalachia

This study examines cultural issues surrounding family cancer communication in Appalachia, providing insight into participants’ communication choices regarding their illness within their families. Stories of 29 female Appalachian cancer survivors from Northeast Tennessee and Southwest Virginia were collected via a mixed methods approach in either a day-long story circle (N=26) or an in-depth interview (N=3). Qualitative content analysis was used to identify unique barriers to family cancer communication in Appalachia. Two barriers emerged: 1) the health of other family members and 2) cancer in a “taboo” area. These findings suggest that Appalachian female cancer survivors struggle with similar issues as survivors outside of the region regarding family cancer communication. However, there appear to be additional barriers to family cancer communication for Appalachian women that may be a result of cultural norms of the region

Personal Identity Changes of Female Cancer Survivors in Southern Appalachia

Navigating personal identity changes through the cancer journey can be challenging, especially for women in a culture that places emphasis on traditional gender roles and values close-knit families. Drawing on a story circule approach, this study examined the intersecting identities of female cancer survivors in southern Appalachia. Stories of 29 female Appalachian cancer survivors from Northeast Tennessee and Southwest Virginia were collected via a mixed methods approach in either a day-long story circule (N-26) or an in-depth interview (N=3). Transcripts from both phases were audio-recorded and transcribed verbatim; NVivo 8.0 facilitated qualitative content analysis of the data. Inductive analysis revealed that women in this study appeared in struggle with (1) maintaining place in the family, (2) mothering, and (3) navigating physical changes. Ideas of family versus self appeared to overlap and intertwine with how women in Appalachia navigate personal identify changes through the cancer journey

Navigating Family Cancer Communication: Communication Strategies of Female Cancer Survivors in Central Appalachia

In a multiphasic study, the stories of 29 female Appalachian cancer survivors were collected through either a day-long modified story circle event (n=26) or an in-depth interview (n=3). Qualitative content analysis was used to identify emergent themes in the data. The analysis revealed 5 types of family cancer communication including both pre-diagnosis and postdiagnosis cancer communication strategie

Omnibus Survivorship Narratives: Multiple Morbidities Among Female Cancer Survivors in South Central Appalachia

This study examines the illness narratives of female cancer survivors living in Southern Central Appalachia. Stories of 29 female Appalachian cancer survivors from northeastern Tennessee and southwcstmn Virginia were collected via a mixed methods approach in either a day-long story circle (n=26) or an in-depth interview (n=3), Qualitative content analysis was used to guide an inductive analysis of the tTanscript\u3c;, What emerged was that as participants survived cancer, they also survived other health conditions, their intorsccting stories yielding an omnibus survivorship narrative

Mothered, Mothering & Motherizing in Illness Narratives: What Women Cancer Survivors in Southern Central Appalachia Reveal About Mothering-Disruption

Informed by a mothering-disruption framework, our study examines the illness narratives of women cancer survivors living in Southern Central Appalachia. We collected the stories of twenty-nine women cancer survivors from northeast Tennessee and southwest Virginia using a multi-phasic qualitative design. Phase I consisted of women cancer survivors participating in a day-long story circle (n=26). Phase II consisted of women cancer survivors who were unable to attend the story circle ; this sample sub-set participated in in-depth interviews (n=3) designed to capture their illness narratives. Participants\u27 illness narratives revealed the presence of: (1) mothering-disruption whereby cancer adversely impacted the mothering role ; and (2) mothering-connection , whereby the cancer experience motivatedmother-survivors. Participants\u27 illness narratives reflected thatthe role of mother was the preeminent role for mother-survivor and whenever there was oppositional tension between the roles of mother and survivor , the women-survivors seemed to linguistically relocate away from the survivor role and toward the mothering role. As a result , women-survivors seemingly rejected medicalization of their identities by emphasizing their mothering responsibilities , something we term motherizing

Who are Adolescents Talking to?: Understanding who Adolescents in Appalachia Talk with about Health

Co-Authors: Johnson, Kiana R., PhD, MSEd, MPH & Wood, David L., MD, MPH Health disparities within Appalachian are not a new concept or challenge for the region, and the medical community, public health officials, and Appalachian scholars continue to look for ways to both understand the complex reasons behind the disparities and improve the health of people within the region. One challenge in Appalachia is how people obtain health information. Previous research shows adults in Appalachia tend to rely on friends and family instead of health care professionals for health information and advice, which contributes to the lack of health knowledge in the region; however, research is lacking on who adolescents in Appalachia discuss matters of health. One avenue to improving health in Appalachia may come from understanding with whom adolescents in Appalachia discuss matters of health and developing interventions around that information. From October 2016 through March 2017 the authors surveyed 829 11th and 12th students in three counties in Northeast Tennessee and Southwest Virginia regarding health and health care access. The authors specifically asked adolescents with whom they discuss health and health risks behaviors like weight, exercise, and alcohol use. Chi-squared tests were performed to examine differences among reports of where adolescents seek information. Results of the analyses revealed that adolescents do not tend report discussing health matters with health care professionals. Additionally sex differences were observed among adolescents seeking health information

Who are Adolescents Talking To? Understanding who Adolescents in Appalachia Talk with about Health

Health disparities within Appalachian are not a new concept or challenge for the region, and the medical community, public health officials, and Appalachian scholars continue to look for ways to both understand the complex reasons behind the disparities and improve the health of people within the region. One challenge in Appalachia is how people obtain health information. Previous research shows adults in Appalachia tend to rely on friends and family instead of health care professionals for health information and advice, which contributes to the lack of health knowledge in the region; however, research is lacking on who adolescents in Appalachia discuss matters of health. One avenue to improving health in Appalachia may come from understanding with whom adolescents in Appalachia discuss matters of health and developing interventions around that information. From October 2016 through March 2017 the authors surveyed 829 11th and 12th students in three counties in Northeast Tennessee and Southwest Virginia regarding health and health care access. The authors specifically asked adolescents with whom they discuss health and health risks behaviors like weight, exercise, and alcohol use. Chi-squared tests were performed to examine differences among reports of where adolescents seek information. Results of the analyses revealed that adolescents do not tend report discussing health matters with health care professionals. Additionally sex differences were observed among adolescents seeking health information