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This study examines the effect of a Medicaid disenrollment on employment, sources of health insurance coverage, and health and health care utilization of childless adults using longitudinal data from the 2004 Panel of the Survey of Income and Program Participation. From July to September 2005, TennCare, the Tennessee Medicaid program, disenrolled approximately 170,000 adults following a change in eligibility rules. Following this eligibility change, the fraction of adults in Tennessee covered by Medicaid fell by over 5 percentage points while uninsured rates increased by almost 5 percentage points relative to adults in other Southern states. There is no evidence of an increase in employment rates in Tennessee following the disenrollment. Self-reported health and access to medical care worsened as hospitalization rates, doctor visits, and dentist visits all declined while the use of free or public clinics increased. The Tennessee experience suggests that undoing the expansion of Medicaid eligibility to adults that occurred under the Affordable Care Act likely would reduce health insurance coverage, reduce health care access, and worsen health but would not lead to increases in employment.

During the 1930s Franklin Roosevelt’s New Deal created a wide range of spending and loan programs. Brief descriptions are provided for the programs created by the New Deal and loan and spending programs that were in place before the New Deal. I worked with others to create a panel data set with estimates of the spending and lending by the programs each year from 1930 through 1940. The data aggregated to broad categories are reported here and the methods and sources used to construct the estimates of the spending and lending for the categories are discussed.

This chapter presents a gap analysis of the perspectives of small businesses and rural librarians in Tennessee in order to develop an implementation blueprint of a public library small business toolkit, a resource that the state’s rural public libraries can create for small businesses in the future.

The chapter reports on select comparison data sets collected via two exploratory online surveys with small businesses and rural public librarians, respectively, in an externally funded planning grant awarded by the Institute of Museum and Library Services’ National Leadership Grants for Libraries (Research category) to the School of Information Sciences at the University of Tennessee.

Findings from the gap analysis of the perspectives of small businesses and rural librarians provide similarities and differences between the two stakeholder groups in terms of

• existing assistance needs of small businesses,

• information-related challenges small businesses experience,

• desired public library use, and

• information-related components of a public library small business toolkit.

existing assistance needs of small businesses,

information-related challenges small businesses experience,

desired public library use, and

information-related components of a public library small business toolkit.

The study is a unique example of action research based on varied levels of participation in rural research and action, learning through collaboration, community inquiry into everyday experiences and potential impact, use of mixed methods, and the situated nature of applications and concrete outcomes. It serves as a pilot case experience and prototype assessment test bed to expand strategies for the entire Appalachian region and other rural environments in the future.

The University of Tennessee Medical Center in Knoxville (UTMC) Preston Medical Library (PML) and Health Information Center (HIC) has provided a novel contribution to increasing consumer health literacy and reducing health disparities in a unique variety of ways. UTMC librarians have used qualitative, quantitative, and practice-based methodology and research to demonstrate what a regional medical library working with internal and community partners can accomplish. At UTMC, there has been a focus on the value of health literacy for the patient, the clinician, and the health care system itself. In 1993, the UTMC PML began a consumer and patient health information service, which was the foundation for increasing consumer health literacy. In 2014, UTMC took a leading role in advancing consumer health literacy through the opening of the HIC, a patient- and family-focused library inside of UTMC. This chapter will focus on the PML’s history as a reliable resource in providing patients, family members, and the community with accurate and trustworthy health information, as well as the librarians’ role related to health literacy and health disparities through various initiatives and projects. Additionally, this chapter will highlight specific suggestions for libraries interested in starting similar initiatives, such as obtaining support from leadership, opportunities for funding, and how to address roadblocks.

Individual, interpersonal, and societal transformation will require continually working through the past. In this chapter, I process how inequalities contextualized my identity formation in the Southeastern United States. Racism, colonization, environmental degradation, misogyny, and homophobia shaped the institutions central to my Appalachian socialization – namely family, education, and law. Then, when the criminal punishment system interfered with one of my earliest intimate relationships, it sparked my interest and commitment to prison abolition. Ultimately, I find creativity and accountability, both personally and structurally, essential for potential transformation.

This chapter discusses the application of community informatics (CI) principles in the rural Southern and Central Appalachian (SCA) region to further the teaching of information and communication technologies (ICT) literacy concepts in courses that formed part of two externally funded grants, “Information Technology Rural Librarian Master’s Scholarship Program Part I” (ITRL) and “Part II” (ITRL2), awarded by the Institute of Museum and Library Services’ (IMLS) Laura Bush 21st Century Librarian Program to the School of Information Sciences (SIS) at the University of Tennessee (UT).

The chapter documents ICT use in ITRL and ITRL2 to extend librarian technology literacy training, allowing these public information providers to become change agents in the twenty-first century. It discusses aspects of CI that influenced these two projects and shaped the training of future rural library leaders embedded in traditionally underrepresented areas to further social justice and progressive changes in the region’s rural communities.

The chapter demonstrates the role that CI principles played in the context of ITRL and ITRL2 from project inception to the graduation of the rural librarians with examples of tangible IT services/products that the students developed in their courses that were directly applicable and tailored to their SCA contexts.

ITRL and ITRL2 provided a unique opportunity to apply a CI approach to train information librarians as agents of change in the SCA regions to further economic and cultural development via technology and management competencies. These change agents will continue to play a significant role in community building and community development efforts in the future.

A meta-evaluation is an assessment of evaluation practices. Meta-evaluations include assessments of validity and usefulness of two or more studies that focus on the same issues. Every performance audit is grounded explicitly or implicitly in one or more theories of program evaluation. A deep understanding of alternative theories of program evaluation is helpful to gain clarity about sound auditing practices. We present a review of several theories of program evaluation.

This study includes a meta-evaluation of seven government audits on the efficiency and effectiveness of tourism departments and programs. The seven tourism-marketing performance audits are program evaluations for: Missouri, North Carolina, Tennessee, Minnesota, Australia, and two for Hawaii. The majority of these audits are negative performance assessments. Similarly, although these audits are more useful than none at all, the central conclusion of the meta-evaluation is that most of these audit reports are inadequate assessments. These audits are too limited in the issues examined; not sufficiently grounded in relevant evaluation theory and practice; and fail to include recommendations, that if implemented, would result in substantial increases in performance.

This chapter examines how women deploy gendered motherhood norms to publicly challenge abortion stigma. Drawing on a sample of 41 abortion stories from women living in Tennessee, I find that women evoke notions of intensive, total, and idealized motherhood in order to manage and challenge the stigma of an abortion. A large proportion of these stories were written by married mothers who emphasized their identities as good mothers and wives. A close qualitative analysis of these trends reveals two dominant forms of recasting abortion. First, abortion is framed as an extension of total mothering to spare an unborn baby from risky health conditions. Part of this includes casting abortion as an often-necessary choice in order for a woman to develop into the perfect mother for the benefit of her children – altruistic self-development. Second, abortion is construed as a form of maternal protection of current children to continue intensively mothering them. Both themes speak to women’s strategies for reframing abortion as a health practice to promote the well-being of children. These findings have implications for the study of medical stigma, reproduction, and the impact of gender ideals on women’s health choices.

There are more than 40 million Americans with disabilities. If U.S. hospitality and leisure professionals are keen to attract customers with disabilities, then the particular services in line with the needs of those individuals have to be addressed, given the lack of clear actions toward the service delivery to individuals with disabilities. This study attempts to discover the issues pertaining to the perceptions of the services and facilities offered to visitors with disabilities. A total of three thousand questionnaires are distributed to visitors with disabilities. Cross-tabulations, chi-square, and ANOVA are deployed to determine the differences among visitors with different disabilities. Promotion strategies, suggestions regarding accessibility issues, and the benefits associated with a visit to various destinations are also presented.

In order to effectively serve diverse communities, an organization must first create an internal culture of empathy and acceptance. An organizational read can be an opportunity to create this culture as well as create times, spaces, and experiences to transfer knowledge and build community beyond an organization on a topic of importance that has an impact on the communities it serves. The University of Tennessee Libraries' 2019 organizational read program featured Robin DiAngelo's book White Fragility: Why It's So Hard for White People to Talk About Racism, which helped create diversity conversations to enable personal changes that facilitated more effective engagement. This chapter provides an overview of the Libraries' organizational read, including its structure and evaluation, and discusses the success of the program in building community engagement and outreach. Examples are shared regarding how the program has impacted the Libraries' outreach efforts to three new communities, as well as details for future iterations and plans for the program to continue to expand beyond the Libraries. Ideas are provided for adapting the program to other types of communities that want to build bridges for change.