ETSU - Illuminated - Fall 2021 by East Tennessee State University

ILLUMINATED

Graduate Student Research Magazine ETSU Graduate School Fall 2021 Volume 11 Issue 1

FROM THE GRADUATE SCHOOL The East Tennessee State University Graduate School is proud to present Illuminated, a magazine that showcases the excellent work of our graduate students and their faculty advisors. There are over 2,400 students enrolled in graduate programs at ETSU. Illuminated presents some of our students’ research and creative works that make meaningful contributions to various disciplines, and contribute to our strong graduate programs. Illuminated features research and creative projects that are currently happening on campus, and provides updates on alumni of ETSU graduate programs.

Sharon James McGee, PhD, Dean

Karin Bartoszuk, PhD Associate Dean

Scott Kirkby, PhD Associate Dean

EDITORIAL STAFF

EDITOR

Dr. Karin Bartoszuk Associate Dean, School of Graduate Studies

WRITER

Marten Baur MS Sport Science & Coach Education

DESIGN

Emily Redd, MFA Thesis/Dissertation Coordinator, School of Graduate Studies

PHOTOGRAPHY

Emily Redd Student/Faculty submitted

East Tennessee State University is accredited by the Commission on Colleges, Southern Association of Colleges and Schools to award baccalaureate, masters, specialist, and doctoral degrees. Contact the Commission on Colleges at 1866 Southern Lane, Decatur, Georgia 30033-4097, telephone 404-679-4500, or Website: www.sacscoc.org with any question regarding the accreditation of East Tennessee State University. ETSU is an Equal Opportunity/Affirmative Action University: etsu.edu/universitycounsel/compliance. ETSU-220480-A-100 Produced by BMC Creative.

C O N CONTENTS

Where are they now? Featuring: Chelsea Robertson

FROM THE GRADUATE SCHOOL

A New Approach: Empowering Primary Care Providers to Serve the Appalachian Transgender Community, Rebecca Altschuler, Psychology, PhD

Authenticity in LGBTQ+ Marketing: Are Corporations Practicing What They Preach?, Becky Parsons, Brand and Media Strategy, MA

Where are they going? Featuring: Cally Chisholm

Where are they now? Featuring: Steven Hunt

Where are they now? Featuring: Maya Mathis

Where are they now? Featuring: Matthew Harrington

Development of Pharmacodynamic Biomarkers Propels Neuropsychiatric Drug Development, Ummear Raza, Biomedical Sciences, PhD

Peer Recovery Support Specialists Promote Addiction Recovery Throughout Central Appalachia, Angela Hagaman, Public Health, DrPH

Where are they going? Featuring: Caroline Burkette

Care Without Compromise: Adapting Autism Diagnostic Assessments During COVID-19, Rebecca OtwellDove, Psychology, PhD

A Focus On: ETSU’s Student Media Center, Don Armstrong, Director of Student Media

Where are they now? Featuring: Kris Truelsen

GRADUATE STUDENTS & ADVISORS Are you excited about your research and would like to share your hypothesis or findings?

YOU MIGHT BE A PERFECT FIT FOR ILLUMINATED. There is more than one way to get into the next issue of the magazine!

For current graduate students and their advisors: Are you or one of your graduate students working on a culminating experience (e.g., thesis, dissertation, capstone)? Your research could receive additional exposure through Illuminated magazine and help educate the rest of the campus about your department and program. This is a unique opportunity to get your work recognized!

For current graduate students and their advisors: Did you or one of your students get into an excellent doctoral program or get an excellent position? We want to hear about it! Share your story in the “Where Are They Going?” section.

For former graduate students and their advisors: Do you know an outstanding student who graduated from ETSU more than a year ago? We want to hear from them! The “Where Are They Now?” section features former ETSU graduate students who are now professionals in positions across the country.

Click here for Nomination Form: etsu.jotform.com/212844078429058 For more information on nominating students or getting featured in Illuminated, please contact: Dr. Karin Bartoszuk, bartoszu@etsu.edu

A New Approach: Empowering Primary Care Providers to Serve the Appalachian Transgender Community

Rebecca Altschuler Psychology, PhD, concentration in Clinical Psychology

Dr. Jill Stinson Faculty Advisor

Written by Marten Baur

ebecca Altschuler, after nearly passing out while dissecting a frog in her freshman biology class, questioned her ability to perform in her future nursing profession. “I don’t like fluids,” she said candidly. “This was not going to work for me.” Rebecca’s career track turned a sharp corner when she took her first sociology class. It was in this class that Rebecca fell in love with the social sciences, and became fascinated by people and their unique, yet similar nature. This newfound passion inspired her to earn her bachelor’s degree in forensic psychology from the University of New Haven in Connecticut. Her continued interest in the social sciences then drew her to Columbia University where she earned her master’s degree in clinical psychology.

During an experiential rotation at a hospital that treats schizophrenia patients in New York City, Rebecca worked with several people who have experienced trauma. She realized that trauma is a common experience, and that everyone, at some point, experiences something that impacts their lives. Rebecca went on, saying, “This is what matters to me: Talking with people about things that have happened to them, that maybe they have never gotten a chance to share with anyone else.” These meaningful conversations with patients led Rebecca to ETSU to study the intersection of health, psychology, and trauma as she pursued her PhD in clinical psychology. Rebecca chose to attend ETSU because of

Rebecca Altschuler

its emphasis on integrated primary care, which is unique for a clinical psychology program. Integrated primary care is a new approach that combines medical and behavioral health services into the primary care setting in order to address a wider array of medical problems. ETSU is one of few colleges that focuses on integrated primary care, and it also gives students the opportunity to work firsthand in primary care health clinics. Students are placed at local clinics such as ETSU Family Medicine, ETSU Pediatrics, and State of Franklin Pediatrics. Rebecca herself is working at State of Franklin Pediatrics in Kingsport, Tennessee. Rebecca was drawn to ETSU, not only for its integrated care model or experiential learning experiences, but for the geography. She enjoys hiking, kayaking, and mushroom foraging—all of which are readily accessible in Appalachia. As Rebecca prepared for her dissertation project, a particular form of trauma was brought to her attention by former College of Medicine faculty member Dr. Abbey Mann: the trauma that results from cumulative discrimination. People from marginalized identities experience this form of trauma over the course of their lifetimes. Both nationally and here in Appalachia, transgender people have conflictual relationships with health care providers, and this often prevents

them from seeking care at all. Rebecca’s dissertation focuses on the transgender population’s interactions with health care. She focuses on medical trauma, the cumulative effects of microaggressions, access to care, and how these factors implicate health outcomes. Transgender people overwhelmingly report interpersonal discrimination when visiting a primary care facility. Interpersonal discrimination can include misgendering people, calling people by their birth name instead of their chosen name, and sometimes forcing people to submit to physical exams they are not comfortable with. Oftentimes, transgender patients are required to educate their doctors about their specific medical needs in order to receive the care they require. Other times still, transgender people are blatantly refused care. Rebecca summarized the lack of access to care by saying, “Imagine you go to the doctor and you have a terrible experience. They do all these things to you that you don’t want them to do, and they call you by the wrong name. That makes you not want to go to the doctor!” It is clear to Rebecca that transgender people are not receiving affirming care due to the lack of accessibility of trainings among primary care providers. To combat this, Rebecca has built an entire training curriculum to empower primary care providers to

“This is what matters to me: Talking with people about things that have happened to them, that maybe they have never gotten a chance to share with anyone else.”

treat their transgender patients with a higher degree of competency. Rebecca’s curriculum consists of a two-part training, and it includes access to a living resource containing information such as medical encyclopedias detailing hormone replacement therapy options, affirming cancer screening protocols, and local community resources. This curriculum is being implemented at Bristol Family Medicine, Johnson City Family Medicine, and Kingsport Family Medicine to prepare residents, social workers, and psychologists to provide more competent care for the transgender population. In preparation for her dissertation, Rebecca analyzed the literature surrounding transgender access to care. Within the literature, she found that primary care providers around the nation say things like, “We can’t treat these people,” “We don’t know how [to treat these people],” “We can’t get the pronouns right,” and “Send them elsewhere for

the needs of the transgender population. The needs of the transgender population include primary care providers who understand the importance of pronouns and chosen names, can determine the appropriate type of preventative medicine, can provide hormone replacement therapy, and make their patients feel welcome by having general knowledge about the transgender population. Utilizing resident liaisons in each of the three ETSU Family Medicine clinics, Rebecca identified that primary care providers wanted more specialized knowledge regarding affirming care for their transgender patients. Next, Rebecca built the curriculum by incorporating best practices from pedagogical research and using methods taught to her by Dr. Mann and Dr. Williams. Finally, in order to measure the effectiveness of the training, Rebecca created a quantitative survey using preexisting measures that are used in medical education. She administered the survey once before the first training session Rebecca Altschuler

Dr. Jill Stinson

treatment.” It was from statements like these that Rebecca formed her hypotheses: Can the training improve the residents’ confidence in treating transgender patients in Appalachia? And; do the residents know, pre-training and post-training, what impacts care for transgender people?

In order to build the training curriculum, Rebecca entered the realm of pedagogy. Dr. Abbey Mann (Rebecca’s project mentor) and Dr. Alicia Williams (Director of Faculty Development in the Department of Family Medicine) were pivotal resources to Rebecca as she built her curriculum. First, Rebecca immersed herself in Dr. Mann’s TransAccess data to determine

and once after the final training session to measure the training’s usefulness, helpfulness, and sustainability. Residents overwhelmingly reported that the training was useful and helpful, and they did not feel burdened by the training—a necessary element of providing medical training to busy residents. The residents appreciated the training to such an extent that they requested Rebecca leave the training curriculum with the three medical clinics for future resident cohorts. Rebecca’s dissertation adds to the current body of literature because the majority of research regarding the training of medical providers in transgender health

needs is either limited to urban areas or does not consider the needs of the community. Several of the trainings found in the literature do not apply to the context of south-central Appalachia. Because Rebecca’s trainings consider the different elements of Appalachian culture, her dissertation lays the groundwork for providing competent integrated care for people who identify with the overlapping Appalachian and transgender identities. Rebecca is grateful to have worked with several talented and established women in health education and sciences. Dr. Mann, Dr. Williams, and Dr. Jill Stinson were all integral to her success. Rebecca expressed gratitude for Dr. Stinson, remarking that, “She is the person who everyone goes to when the world is burning . . . and she always puts those fires out for us.” Together, Rebecca and Dr. Stinson (along with Dr. Stacey Williams and other members of the Psychology Department) are part of a new diversity and inclusion committee at ETSU’s Department of Psychology. With psychology faculty member and Clinic Director, Dr. Natasha Gouge, Rebecca and Dr. Stinson have also helped facilitate several changes to ETSU’s Behavioral Health and Wellness Clinic to make the clinic more inclusive to the patients they serve in the larger Tri-Cities region. Rebecca also adapted the training she developed for the medical residents to fit the needs of the mental health clinicians at ETSU’s Behavioral Health and Wellness Clinic. Currently, Rebecca is awaiting a reply from the United States Professional Association for Transgender Health conference where she plans on presenting her project. In the meantime, she is preparing to submit internship applications to several sites out west. In the future, Rebecca hopes to work in a hospital setting where she can continue to develop educational and clinical programs, conduct research, see patients, and train students and providers. Rebecca’s dissertation made tangible impacts on the south-central Appalachian transgender community by increasing their access to competent healthcare. Although access to care for transgender people is still not where it needs to be, Rebecca has taken the first of many steps toward improving the lives of a marginalized population.

Where are they now? Matthew Harrington MS in Geosciences, concentration in Paleontology Department of Geosciences Graduate: 2021

Why did you choose ETSU for your education? When I was applying to graduate programs, I wanted to choose a university where I could learn as much as possible within my field while also working on a project that fit my interests. My advisor at ETSU, Dr. Widga, specialized in the type of paleontological research I wanted to pursue and solidified my decision to choose ETSU. The university provided me the opportunities to engage in meaningful research and take unique courses that directly benefited my academic path.

What is your current position and/or research? I am working for the National Park Service’s Alaska Regional Office engaging in paleontological projects across Alaskan national park sites. My position is part of the Scientists in Parks Program.

What does this position/research entail? The summer season with this position is dedicated to various paleontological fieldwork in different regions of Alaska. Multiple field excursions have been completed in Katmai National Park and

Preserve, including searching for dinosaur tracks within the park boundaries and monitoring fossil localities along the coast. Fieldwork in Katmai is particularly unique, as the park contains the world’s densest population of brown bears. This led to many close encounters and fieldwork precautions that aren’t required in most other places. Additional work has included helicoptering around Bering Land Bridge National Preserve looking for Ice Age and early human artifacts, Structure from Motion (SfM) flights in Denali National Park and Preserve, and pack-rafting down the Kobuk River in Kobuk Valley National Park and Preserve in search of mammoth and other late Pleistocene bones. Offseason work includes writing reports, creating maps, and assisting the National Park Service with collections and educational graphics.

How did your time at ETSU prepare you for this career? The classes and experiences I gained at ETSU helped me not only get chosen for this position but have helped me succeed

professionally. The diversity of classes and skills I acquired from my program allowed me to be a more competitive candidate. More specifically, my thesis, projects, and independent studies during my time at ETSU gave me extensive knowledge of the last ice age, particularly in the Great Plains, Midwest, and Beringia (the region including Alaska, Siberia, and the now submerged land bridge connecting the two). That knowledge has been applied to enhancing the National Park Service’s collections and understanding of their fossils.

What advice would you offer current or future graduate students? I think it is critical that you have a genuine interest in your thesis. Writing a thesis requires months and months of hard work, late nights, and effort. If you don’t actually enjoy or care about your study results, motivation to work will be much lower than if you love your work. Picking a project that I felt passionate about allowed me to persevere through all the highs and lows (especially during a pandemic!) of my time at ETSU. With hard work and passion to learn, anyone from any background can successfully complete a master’s program.

Development of Pharmacodynamic Biomarkers Propels Neuropsychiatric Drug Development

Ummear Raza

Biomedical Sciences, PhD, concentration in Pharmacology

Written by Marten Baur

Dr. Siva Digavalli Faculty Advisor

ccording to Dr. Digavalli (Associate Professor, Biomedical Sciences and Gatton College of Pharmacy), neuropsychiatric drug development has stalled to such an extent that no breakthrough medications for several psychiatric conditions (schizophrenia, depression, etc.) have materialized in over 60 years. Antipsychotic drugs such as haloperidol and clozapine, introduced over half a century ago, are still some of the more prevalent drugs prescribed to treat psychiatric conditions. Unfortunately these drugs, and other drugs like them, show serious side effects and are not effective in treating all patients. Patients with psychiatric conditions need new drugs with better efficacy and improved safety. Although some incremental progress has been made, the field is still limited to drugs that are only slightly differentiated from each other. Here at ETSU, neuropsychiatric drug development is gaining traction

as Ummear Raza and Dr. Siva Digavalli develop important biomarkers to propel the field forward. Ummear Raza, from Sahiwal, Pakistan, received a BA in Animal Sciences and an MS in Human Genetics from Quaid-I-Azam University in Islamabad, Pakistan. He arrived at ETSU during the fall of 2015 as a visiting scholar in the biomedical sciences program. After spending two years as a visiting scholar, Ummear decided to pursue his PhD in Biomedical Sciences with a concentration in Pharmacology. Ummear wanted to see how the brain encodes different behaviors and senses of perception. One way to observe this is through electroencephalography (EEG), which is an important tool used in Dr. Digavalli’s lab. Dr. Digavalli specializes in translational research—a type of research that traverses pre-clinical and clinical domains. There are few ways to objectively measure the improvements of symptoms in patients with neuropsychiatric illness. Dr.

Digavalli, who has 18 years of experience in industrial drug development, explained, “Short of asking the patient, ‘did your symptoms improve?’ we do not have a good way to measure whether the drug actually worked. This is because we have no indicator to show if the drug is improving any brain related process.” Biological markers, or biomarkers, are measurable responses in an organism that offer an objective way to determine the presence and progress of a disease. Experts lack biomarkers to classify neuropsychiatric illnesses, which can lead to inaccurate diagnoses. Dr. Digavalli explains, “Unfortunately for psychiatric illness, which affects 1 in 5 people across the globe, we do not have biomarkers to classify these illnesses. If you are a

clinician you might say, ‘The patient has schizophrenia and another clinician might feel that it is a schizoaffective disorder—a different diagnosis—so there is a bit of ambiguity.” Lack of objective biomarkers is a major hurdle not only in disease classification, but also for new drug development. Biomarkers are needed to assess the efficacy of new drugs. To help address this challenge, Ummear and Dr. Digavalli are working on a biomarker through the use of EEG and click trains that elicit a synchronized neural response in the auditory cortex and other regions of the brain. Neurons in the brain communicate through electrochemical impulses, and EEG records this electrical activity in

Left, Ummear Raza, Right, Dr. Siva Digavalli

“Work like this can improve patient treatment by bringing objectivity to the diagnosis”

wave-like patterns commonly referred to as brainwaves. When sound strikes the ear drum, the vibrations are converted into nerve impulses and transmitted to the brain for interpretation. The brain has a natural capability to synchronize to stimuli, meaning that the neurons will fire at a specific frequency corresponding to the sound being played. Therefore, a click train at 40 cycles/second (Hz) will cause a rhythmic brain activity that can be observed on EEG as the auditory steady-state response (ASSR). The 40 Hz frequency (also known as a gamma frequency) is significant for sensory and cognitive processes in the brain. Patients 15

synchrony. Haloperidol, a prototypical antipsychotic, failed to improve the rat’s ability to entrain to the 40 Hz click train. Clozapine, an antipsychotic that differentiates itself from all other existing antipsychotics in terms of its superior efficacy, substantially improved the entrainment response. It suggested that clozapine is somehow able to overcome the disruption in the NMDA neurotransmission. Unfortunately, clozapine has several serious side effects, unrelated to its efficacy, that preclude its extensive use. The significance of Ummear and Dr. Digavalli’s work lies in its potential for clinical application. Clinicians can use 40 Hz click trains to assess a patient’s auditory gamma synchrony. This might provide them an objective basis to establish a sensory processing deficit at the beginning of a treatment. Clinicians can follow up to see how a given treatment has improved this deficit. “It can happen tomorrow with an iphone,” explained Dr. Digavalli. “Play the clicks and observe the response. Give the patient a drug and see if the response to the 40 Hz clicks improves.” This biomarker also sets the foundation for future drug development. Pharmaceutical companies are more likely to invest in drugs that show improvements in an objective biomarker like the 40 Hz gamma synchrony.

Left, Dr. Siva Digavalli, Right, Ummear Raza

with schizophrenia show reduced 40 Hz synchrony. Dr. Digavalli relates this to an early information processing deficit seen in the patients: “Oftentimes patients with schizophrenia miss the emotional context of the speech. They may understand the literal meaning of the spoken words, but may not grasp the emotional content. This suggests that some very fundamental sensory processing is compromised in schizophrenia, which might lead to distortion of perception and thought at a higher level.”

Ummear and Dr. Digavalli have shown that blocking the N-methyl D-aspartate (NMDA) receptor, a key player in healthy neurotransmission, can result in a disruption in 40 Hz gamma reminiscent of the deficit seen in schizophrenia. Similar disruption of the NMDA receptor occurs in the brain when under the influence of the street drugs “angel dust” (PCP) or “special K” (ketamine). Many

times, habitual users of these drugs show symptoms, which are indistinguishable from schizophrenia patients. Therefore, Ummear and Dr. Digavalli think a medication that can improve the NMDA receptor function may serve as a treatment option for patients with schizophrenia. Ummear and Dr. Digavalli wanted to know if the presently available antipsychotic drugs improve NMDA transmission, and they wanted to know if they could use 40 Hz ASSR as a biomarker to measure the efficacy of these drugs. In order to research this, Ummear implanted electrodes onto the brains of rats to record their EEG. Then, he gave the rats doses of an NMDA receptor blocker. In the presence of the blocker, gamma synchrony to 40 Hz click trains was markedly impaired. Ummear then administered a variety of neuropsychiatric drugs to the rats at clinically relevant doses and compared their ability to restore the

Ummear’s work was recently published in the journal Psychopharmacology, and he also presented his work online last year at the Society for Neuroscience. This year, he plans on presenting updates to his work at the Society for Neuroscience in Chicago. Ummear will graduate in May of 2022 and is currently applying to post-doc positions that use advanced techniques like optogenetics and fiber photometry. He wants to see how neurons communicate and how neuronal interactions correlate with behavior. Dr. Digavalli has been a true mentor to Ummear. Ummear praised Dr. Digavalli for helping him understand how to approach a research question, design a test, and bring research to a conclusion. Because new biomarkers provide an objective basis to measure drug efficacy, Ummear’s research may be a springboard that will allow the field of neuropsychiatric drug development to overcome a sixtyyear barrier to developing better drugs.

Where are they now? Chelsea Robertson MA and PhD in Psychology, concentration in Experimental Psychology Department of Psychology Graduate: 2019 and 2021

Why did you choose ETSU for your education? I chose ETSU for my education primarily because I wanted to work under my advisor, Dr. Wallace Dixon, and study early childhood development. Being able to receive my MA and PhD at the same school while remaining close to family were also great benefits!

What is your current position and/or research? I am currently an assistant professor of psychology at West Liberty University in West Liberty, West Virginia.

What does this position/research entail? In this position, I teach four undergraduate-level psychology courses per semester and work with students in organizations like Psi Chi (The International Honor Society in Psychology) and the Psychology Club. I am also in the beginning stages of conducting research on Adverse Childhood Experiences (ACEs) at my university!

How did your time at ETSU prepare you for this career? While at ETSU I had the opportunity to be the instructor of record for many classes as a graduate student. That experience was invaluable, not only in helping me in the job market, but it also confirmed my interest in teaching.

What advice would you offer current or future graduate students? Take care of yourself! It’s easy to get stuck in the mindset of thinking you need to stay up late, wake up early every day, and

work without allowing yourself to have breaks. There will always be something to be done but prioritizing your mental and physical health is paramount. Seek support when you need it; there will always be someone you can reach out to.

Anything else you would like to add? Godspeed and Go Bucs!

Authenticity in LGBTQ+ Marketing: Are Corporations Practicing What They Preach?

... Social Media Post: Today at 10:53am •

“Are these brands being authentic, or are they just doing this to pander to us?”

Becky Parsons

Brand and Media Strategy, MA

Dr. Mildred Perreault Faculty Advisor

Written by Marten Baur

he LGBTQ+ community in the United States spends nearly one trillion dollars every year. LGBTQ+ inclusive companies receive the vast majority of this market share, which creates a growing incentive to appeal to the LGBTQ+ community. As companies increasingly release LGBTQ+ corporate social responsibility (CSR) posts and advertisements, consumers face a dilemma: Are these companies being authentic, or are they trying to take advantage of a growing market share? Becky Parsons, a media and

communications graduate student, and her faculty advisor Dr. Mildred Perreault search for the answers to these questions at ETSU’s Department of Marketing and Communication.

Left, Becky Parsons, Right, Dr. Mildred Perreault

Becky Parsons is from Greensboro, North Carolina, and she graduated from Appalachian State University in 2018 with a BS in Public Relations. Dr. Perreault, who had previously taught at Appalachian State, mentored Becky throughout her undergraduate studies. After Dr. Perreault began teaching at ETSU in 2019, she encouraged Becky to come to ETSU and pursue her master’s degree. Becky described Dr. Perreault’s influence on her when saying, “She was one of the driving forces that got me to ETSU when I was considering different programs. Her

mentorship and friendship really were something that was a big factor in why I came, because I knew I could always rely on her to open me up to opportunities.” Over the summer of 2020, Becky noticed companies making several CSR posts on social media in response to current events. Becky followed the dialogue in the comments of such CSR posts, and she noticed people were questioning the authenticity of the companies. She was intrigued by the question: “Are these brands being authentic, or are they just doing this to pander to us?” Dr. Perreault, an expert in crisis communications, spoke to the difficulty of gauging the authenticity of a company—especially in the digital space. “People are skeptical, and it is harder to tell when a company is authentic

“Are these brands being authentic, or are they just doing this to pander to us?” because we live in this social media veil where everything is curated, catered, and tailored,” said Dr. Perreault. When determining if a company is LGBTQ+ friendly, there are scales such as the Corporate Equality Index (CEI), created by the Human Rights Campaign, that evaluate corporate policies pertaining to equal rights for the LGBTQ+ community.

Examples of these policies include equivalent medical benefits for both LGBTQ+ and heterosexual domestic partners and spouses. Although metrics such as the CEI are helpful, it occurred to Becky that there is no real measurement for corporate authenticity. This was especially true in regards to LGBTQ+ communications in the digital space.

Becky, as part of her graduate capstone project, researched what made a brand or corporation’s external communication, specifically on social media, appear authentic. Becky sought out the answers to two research questions: (1) How does authenticity impact consumer perceptions online; and (2) how does authenticity align with LGBTQ+ consumer reactions? To answer these questions, Becky selected four large food companies that were ranked on the Corporate Equality Index (CEI) and had made an LGBTQ+ CSR post in 2020. These companies were Ben and Jerry’s, Starbucks, Panera Bread, and Domino’s Pizza. Next, Becky counted the total number of social media posts

Becky and Dr. Perreault found that a company’s authenticity can be assessed through its CEI score, consistency and history of CSR posts, frequency of CSR posts outside of awareness months (e.g., posting about the LGBTQ+ community outside of pride month), corporate policies, history of social justice misconduct, and efforts to create spaces that facilitate further discussion of social issues. In other words, “authenticity,” explained Becky, “was more-so the concept, do companies actually practice what they preach?” Ben and Jerry’s, for example, had a perfect CEI score and made several posts in support of the LGBTQ+ community throughout 2020. Panera Bread, on the other hand, posted about the

Left, Becky Parsons, Right, Dr. Mildred Perreault

and the total number of CSR posts for each company. She then looked at the comments on each post and coded them into four different categories: positive about the company or post, negative about the company or post, critiquing the authenticity of the company based on the post, or unrelated. After gathering this information, Becky conducted a thematic evaluation of the posts and comments. She compared the amount of positive comments to the amount of negative comments, noted recurring narratives, and tried to discern if the commenters identified within the LGBTQ+ community. Lastly, Becky looked at each company’s website and overall marketing to see how social media content compared to information on the website. 20

LGTBQ+ community only once in 2020 during pride month. In addition, Becky found several negative and critiquing comments on this post that questioned Panera Bread’s authenticity. Based on Becky’s assessment, Ben and Jerry’s was a more authentic company than Panera Bread in 2020. Becky and Dr. Perreault’s work adds a novel perspective to the CSR literature, for “there is not really a body of work in this area of the field. It contributes to our understanding of corporate action versus corporate statements—specifically in the online space,” explained Becky. Marketing research that dates back more than ten years focuses on how to increase LGBTQ+ market share without offending straight consumers. In other

words, companies were often more concerned with exploiting the LGBTQ+ population than supporting them. Now, as consumers grow more concerned with a company’s CSR efforts, marketing and communications researchers are shifting focus towards the factors that influence authenticity. Becky’s research on perceived authenticity is valuable to several fields, as it provides insights that can inform consumers about the nature of a company, lays the groundwork for future research on authenticity, and improves corporate communications strategies. Dr. Perreault was paramount to Becky’s success. In addition to encouraging Becky to pursue graduate school at ETSU, Dr. Perreault assisted her throughout the research process and provided important professional connections, such as publication opportunities for Becky’s work. Becky’s research will be published in an LGBTQ+ communications textbook “LGBTQ Digital Cultures: A Global Perspective” early next year, and she is thrilled to contribute to the growing body of literature. As the field continues to evolve, Becky hopes to see the development of an authenticity score for corporations, which can help consumers determine where to spend their money and place their loyalty without concerns of a company’s ulterior motives. After she graduates in May of 2022, Becky plans to become involved in entertainment public relations and communications, specifically in the music industry, and “would love to work for a record company or a label.” Once she acquires more field experience, Becky plans on returning for her PhD and pursuing a career in teaching. As companies attempt to capture more of the LGBTQ+ market share, it becomes increasingly important for consumers to consider the motives behind a brand’s actions and whether these motives are authentic. Becky and Dr. Perreault are forerunners in the blossoming field of LGBTQ+ CSR authenticity research, and they are changing the narrative from “how do we take advantage of the LGBTQ+ community,” to “how do we represent and support the LGBTQ+ community in the long-term.” Although more work is needed, Becky and Dr. Perreault bring the field closer to understanding how authenticity impacts consumer perceptions in the digital space.

Where are they going? Why did you choose to pursue this position?

What are your plans after graduation? My post-graduation plans are still up in the air. I am in the process of deciding whether or not to pursue a PhD in Communications. Taking time off from academia is a tempting choice, but I truly do love being a student and would like to continue when the time is right. My new job is remote, which means that after I graduate from ETSU, I can be adventurous and move somewhere I’ve never been before.

What is the title of your new position? Creative Coordinator of Publishing and Marketing at Good Faith Media.

What are the primary responsibilities of your new position? In this role, I am responsible for the design of Nurturing Faith books, the Nurturing Faith Journal, and graphics for social media and other events. Management of the organization’s social media is another aspect of the job.

I was one of the Ernest C. Hynds Jr. interns for Good Faith Media over the summer, and I loved it. Good Faith Media is an excellent organization with an amazing staff. They produce media content concerning the intersection of faith and culture through an inclusive Christian lens. I couldn’t pass up the opportunity to contribute to such an important part of their organization. Working with Good Faith Media has allowed me to revisit the type of design work that I created during my undergraduate studies. This experience also has taught me about book publishing and editing. I’m very grateful to the Good Faith Media executive team for believing in me and trusting me with such an important staff role.

How has your master’s degree prepared you for this position? The Master of Arts in Liberal Studies (MALS) program helped me become a well-rounded person through its interdisciplinary approach to various topics. It has helped me learn more about the effects of homophobia, racism, and sexism. I’ve always been an outspoken feminist and LGBTQ+ ally within the Christian community. Good Faith Media writes several social justice pieces that are published through various channels: book publishing, news and opinion, podcasting, and experiences. This position allows me to use my communications background to write about gender and diversity issues. The MALS program has given me tremendous opportunities to widen my breadth of knowledge and integrate all of

Cally Chisholm MA in Liberal Studies, concentration in Gender and Diversity Studies College of Graduate and Continuing Studies Graduate: 2022

my passions into one program of study. My degree is already helping me become a more confident writer and speaker.

Did any professors/ advisors help you obtain this position? I would like to thank my advisor, Dr. LeRoy-Frazier, for supporting me. Balancing school, work, and a graduate assistantship is challenging, and I am very grateful for her advice and encouragement along the way.

What advice would you give to current graduate students who would like to enter the workforce after graduation? Apply for internships! Internships are a great way to get a feel for the culture of an organization or company before starting a full-time job. These short-term positions offer a glimpse into a particular career path. You will get out of it what you put into it. Who knows? It might turn into a job offer!

Anything else you would like to share? I am very grateful for the opportunities I’ve had over the years and the great mentors that have helped me succeed. I’m looking forward to entering into this new chapter of my life.

Peer Recovery Support Specialists Promote Addiction Recovery Throughout Central Appalachia Angela Hagaman

Public Health, DrPH, concentration in Community Health Director of Operations, ETSU Addiction Science Center

Elizabeth Childress

Social Work, MSW Screening Brief Intervention and Referral to Treatment (SBIRT) Grant Coordinator Written by Marten Baur

ddiction is a complex brain disorder and mental illness, yet society continues to stigmatize people who struggle with addiction. The stigma is based on the false idea that poor motivation, lack of will power, and flawed character result in addictive behaviors. Instead, addiction is caused by the neurochemical changes that occur within the brain in response to an addictive stimulus. For many years, Tennessee was ranked second in the nation for opioid prescriptions per person, and in 2020, Tennessee was still ranked third in the nation. New interventions for addiction are necessary to better handle the ongoing epidemic. This article features ETSU’s Angela Hagaman and Elizabeth Childress, and their approach to reducing the prevalence of addiction in Central Appalachia. Angela Hagaman graduated from Appalachian State University with a bachelor’s in secondary education and a master’s in professional school counseling. In pursuit of her interests in population health and substance use prevention, Angela applied for and received a full-time position as program director for the Diversity Promoting Drug Abuse Research Project (DIDARP) at ETSU. This project, funded by the National Institute on Drug Abuse (NIDA), along with the community partnerships created through ETSU’s Prescriptions Drug Abuse and Misuse Working Group, led to the development of ETSU’s Center for Prescription Drug Abuse Prevention and Treatment in 2016. This name changed to the Addiction Science Center (ASC) in 2019 to better capture the changing epidemic.

Angela Hagaman

Angela and others recognized the severity of the opioid epidemic, and knew a community-based approach was needed to improve the situation. Angela, now the operations director of the Addiction Science Center, supports multiple research projects designed to promote substancefree communities. Of these projects, she is the principal investigator for the grant titled Screening Brief Intervention and Referral to Treatment (SBIRT). The purpose of SBIRT is to implement screening, brief intervention, and referral to treatment services in primary care and community health settings with a focus on screening for substance use. Elizabeth Childress is the SBIRT coordinator and the first Peer Recovery Support Specialist (PRSS) hired by the ASC. PRSS are trained professionals with lived addiction experience who help people overcome addiction. The initial idea for including PRSS in this evidence-based intervention was developed in partnership with colleagues at Meharry University. Angela recognizes peers as crucial components of a community-based approach to improve the addiction epidemic. Elizabeth began working full-time at ETSU Family Medicine in September 2021 under the SBIRT grant, where she conducts substance use screens and brief interventions with patients. It is common to receive a substance use screen when visiting a health clinic, but oftentimes clinicians fail to follow up on positive screens due to time and other constraints. If a patient screens positive, Elizabeth

conducts a brief intervention utilizing the evidence-based practice of motivational interviewing. The goal of a motivational interview is to help patients understand how their substance misuse is impacting their lives. Engaging peers in the SBIRT process is a new paradigm, but Elizabeth and others believe that it may increase the overall success of the intervention. Part of the reason the SBIRT process is thought to be successful is because it is conducted by peers. Elizabeth’s voice, because she has lived experience with addiction, strongly influences her patients. “If I went in front of someone and explained to them that I have lived experience, they would open up,” explained Elizabeth. “If a doctor tells a patient something, and they have never smoked a cigarette or anything else in their life, it is a little harder for patients to relate.” Because of her lived experience, Elizabeth is able to connect and provide more effective care to her patients. Elizabeth is currently on medical leave caring for her young son who is battling high risk neuroblastoma at St. Jude’s in Memphis. While away, she continues to work on her master’s degree in social work and her counseling addiction graduate certificate. She is expected to return to the SBIRT project once her son recovers. Elizabeth’s motivation to become a PRSS stems from her lived experience. “I did not want everything that I have lived through, that I went through in addiction, to be for nothing,” she explained. “It feeds my recovery. I love it; I mean, I would not do anything else.” A person recovering from

“[Peers are] the bridge between professionals and the people that need help.”

addiction can find hope and meaning through their work as a PRSS. It gives them a job they care about—one that does not discriminate based off their past drug use or criminal records. In a cyclical manner, people with addiction are transformed into community leaders, and this propagates recovery throughout the region. People who have struggled with addiction can now leverage their life experience in a fulfilling occupation that improves the health of their community.

Despite the recent growth in PRSS, evidence measuring the effectiveness of peers is still lacking. Angela recognized this gap in the research, and she was inspired to start her doctorate in public health in 2015. Her dissertation focuses on the roles of PRSS in the addiction recovery ecosystems of central Appalachia. Elizabeth assisted Angela with the development of the dissertation aims and surveys. Part of the reason researchers have yet to investigate this topic is because of the varied settings in which peers work. Angela explained, “the literature overwhelmingly says that in order to study the effectiveness of peers, we need to understand their roles and activities better.” Angela’s dissertation, a sequential exploratory mixed-methods study entitled, “Peer Recovery Support Specialists: Role Clarification and Fit Within the Recovery Ecosystems of Central Appalachia,” seeks to understand the roles of PRSS in order to improve the research methods that measure the impact of PRSS on recovery. As part of her project, Angela organized focus groups to help design a quantitative survey that would assess the roles of PRSS in central Appalachia. The study surveyed PRSS in five states of Central Appalachia in order to better understand the nature of their work, their personal recovery characteristics, and their interactions within existing recovery ecosystems. The total sample included 565 employed or previously employed PRSS. Results indicate that PRSS provide emotional support (52%) more frequently than other types of support such as informational (23%), instrumental (23%), or affiliational (28%) support to persons they work with. They are overwhelmingly satisfied with their work, scoring an average of 32 (M= 31.52, SD= 6.51) on a 40 point satisfaction scale designed in this study. However, they report they have few professional advancement

Angela Hagaman

opportunities and generally feel that others misunderstand their role. Additional ad hoc analyses were performed on three outcomes of interest: financial fragility, professional advancement and job satisfaction. These results indicate the need for future research focused on PRSS level of education, hourly wage, duration of recovery, and reason for recovery. PRSS have a strong voice and wish to be heard as evidenced by their responses to the multiple open text questions embedded in this survey. They also expressed interest in future research, as 423 respondents indicated interest in participating in a PRSS research registry and 309 submitted ideas for future research. This work can serve as the beginning of a framework for

Elizabeth Childress

improved research methods for PRSS work if it is driven by PRSS themselves. Elizabeth describes peers as “the bridge between professionals and the people that need help.” Peers are creating nonjudgmental spaces in a society that continues to stigmatize addiction. Angela’s dissertation and work at ETSU’s Addiction Science Center builds upon the understanding of addiction recovery. As peers like Elizabeth join the recovery ecosystem, more people are given a fighting chance for life after addiction.

Where are they going? Caroline Burkette MBA in Business Administration Department of Management and Marketing Graduate: 2022 What are your plans after graduation? After graduation, I will be moving to Rhode Island and starting my career with Textron Corporate

What is the title of your new position? 2022 University Relations Associate

What are the primary responsibilities of your new position? In my new role, I will be traveling to Textron’s target universities to recruit new talent. Leading up to these events, I will collaborate with each university to ensure an efficient and successful recruiting process.

Why did you choose to pursue this position? Over the summer, I completed a Human Resources Internship with Bell—one of Textron’s business units. During the internship, I fell in love with the company and its values; each employee is respected and truly a part of the Textron family. I was also able to explore many functions of Human Resources, including Talent Acquisition and University Relations, leading me to find my passion for these areas. The scope of the

University Relations Associate position is closely aligned with my career goals and passions, which is why I applied for, and ultimately accepted the position.

How has your master’s degree prepared you for this position? My master’s degree has helped prepare me for this position in several ways: Not only have I received the technical knowledge I need, but I have also learned soft skills needed to be successful in the workplace.

Did any professors/ advisors help you obtain this position? I first learned about the Human Resources Internship with Bell through Melinda LaPrade, the Director of Career Services here in the College of Business and Technology. This internship was a major

factor in being offered the University Relations position with Textron.

What advice would you give to current graduate students who would like to enter the workforce after graduation? My first piece of advice would be to set a goal for yourself and then pursue it fiercely. Secondly, I advise all students, graduate or undergraduate, to find an internship with a positive career outlook. Finally, do not be afraid to try new things and step out of your comfort zone

Anything else you would like to share? Be intentional, determined, and hardworking to get the results that you want. 25

A Focus On: ETSU’s STUDENT MEDIA CENTER Written by Marten Baur

hether creating a presentation, seeking assistance with Photoshop, or editing videos, the Student Media Center (SMC) has all the resources needed to create professional-quality media. This article features ETSU’s SMC and the free resources it offers to students. The SMC is located in room 240 on the second floor of the D.P. Culp Student Center. It houses several different

units such as the East Tennessean, the student-run newspaper; The Edge, the student-run radio station; the One Button Studio, a professional-grade presentation recording studio; and the soon-to-be-completed Audio/Video Editing Suite, a dedicated space for post-production purposes. Don Armstrong, the director of Student Media in the Department of Student Life and Enrollment, oversees the SMC.

Don Armstrong, Director of Student Media

The SMC was created during the renovations of the D.P. Culp Student Center. One goal of the SMC was to make student units such as the East Tennessean and The Edge more visible and accessible to students. Since the mid-1990s, The Edge was located in the basement of Warf-Pickel Hall. Now, students can see these studentrun organizations in action as they pass through the Culp Center on their way to class or lunch. To read the East Tennessean, visit easttennessean.com/. To listen to The Edge, visit tunein.com/ radio/theEdge-895-s255872/. One of the most useful resources offered at the SMC is the One Button Studio, which offers professionalgrade audio and video presentation recording equipment. The studio is a sound-insulated room consisting of two monitors, a video camera, a green screen, and a recording button. The first monitor is a presentation screen, which can be projected to the green screen or used like a teleprompter. The second monitor shows exactly what is being recorded as to provide instant feedback to the user. To use the One Button Studio, simply plug in a USB 3 jump drive, choose a background to appear on the green screen (or project a presentation), and hit the recording button. Pressing the button again stops the recording and automatically saves it as an MP4 file on the jump drive. Don speaks highly of the One Button Studio, emphasizing that “a student can come in with a jump drive and leave with their entire presentation.” Students have already started taking advantage of this great resource. One group of students needed to create a professional-quality lecture presentation. Using the green screen, they projected their slides and displayed their department’s logo as a water mark. Other students used the One Button Studio to record professional-quality speeches. As the One Button Studio is sound insulated, student musicians can even bring in their instruments to record songs. The 27

possibilities “are seemingly endless,” said Don. The One Button Studio offers students the ability to create professional presentations and videos with relative ease, and is “one of the absolute biggest draws of the Student Media Center for graduate students,” explained Don. The Audio-Video Editing Suite (coming soon) will be another great component of the SMC. It offers students the ability to edit and enhance their media files using software such as Adobe Premiere Pro. The AudioVideo Editing Suite has state of the art equipment, including a large screen to view edits in real time. This allows the editor to get instant feedback as they fine-tune their projects. In order to use the SMC’s resources,

students and staff are free to drop in or schedule an appointment. The SMC is open Monday-Friday from 8:00 am to 8:00 pm, and it is always staffed by someone trained to help students and staff with media projects. Appointments can be made through the 25Live scheduling system using the following link: 25live.collegenet. com/pro/etsu#!/home/location/894/ availability/daily. After visiting this link, sign in with an ETSU username and password, and then select a time and day to reserve the One Button Studio. Don urges students to take advantage of this great resource, saying, “We want students to come here if they need help. This can be anything from PowerPoint to Photoshop, or guidance

on how to make a better One Button video. This was part of the vision of the Student Media Center.” For more information about the SMC, or to request assistance with a media project, visit www.etsu.edu/students/ studentpub/. The SMC is a state-of-the-art facility intended to make student life easier. It is the premier destination for ETSU students, faculty, and staff to create professional-grade presentations and recordings. For those looking for free resources to improve their multimedia presentations and projects, look no further than the SMC.

To make an appointment: //25live.collegenet.com/pro/etsu#!/home/location/894/availability/daily For more information about the SMC, or to request assistance with a media project, visit: www.etsu.edu/students/studentpub/ East Tennessean: easttennessean.com/ The Edge: tunein.com/radio/theEdge-895-s255872/ 28 28

Where are they now? Steven Hunt BS and MS in Nursing, concentration in Family Nurse Practitioner Department of Nursing Graduate: 2008 and 2021

Why did you choose ETSU for your education? ETSU has always served the Appalachian region and its diverse group of people. I chose ETSU Nursing due to the program’s exceptional reputation in educating future leaders and its positive trajectory.

What is your current position and/or research? I am currently a flight nurse at Air Evac Lifeteam. In my military career, I am an emergency/trauma nurse in the Army Reserve.

What does this position/research entail? My civilian career provides me with the opportunity to practice autonomy in nursing while providing critical care throughout Tennessee, Virginia, and Kentucky. I am able to work with other nurses, paramedics, pilots, dispatchers, and mechanics on a daily basis in a team dynamic. Flight nursing requires close teamwork with multiple people working

in stressful conditions to complete the single task of caring for patients in critical need. Nursing in the military is substantially different than in my civilian occupation. Military nurses are leaders and care givers. On one mission, I may be processing soldiers for deployment. On the next, I will be providing direct emergency care. In each career, every day is a new challenge, and remaining adaptable is key. My military career has given me the ability to focus on leadership skills and understand a different perspective on heath care.

How did your time at ETSU prepare you for this career? My diverse group of instructors at ETSU taught my classmates and I how to prepare for specific nursing tracks. One of my clinical instructors was a flight nurse, and she assisted me with making a plan and provided me with mentors in my

process of becoming a flight nurse. My time at ETSU also allowed me to connect with other students that remain active in nursing—many of whom are in leadership positions. In my master’s program, ETSU instructors helped me understand how I could best utilize my nursing degree in Family Practice. Guidance from my professors allowed me to understand how my background in nursing could be utilized as a practitioner.

What advice would you offer current or future graduate students? My best advice would be to obtain all the information you can in your clinical rotations and learn from those willing to teach. Set goals early, and find mentors to help you meet these goals. In this journey you are not alone, and others around you are in the same process. Reach out to others frequently, and enjoy the process. 29

Musical Performance, Scholarship, and Writing in a Technical Description of Mash Thomas Cassell

MA, Appalachian Studies

Dr. Lee Bidgood Faculty Advisor

Dr. Nate Olson, Faculty Advisor

Written by Marten Baur

30 30

“Mash is more grounded and laid back, and it hits each beat really hard, sitting very deep in what is called a ‘pocket’ of rhythm.”

Rachelle Kromash

Dr. Kelly Moore

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Where are they now? Maya Mathis BS in Physical Education, concentration in Exercise Science; MS in Sport Management Department of Sport, Exercise, Recreation, and Kinesiology Graduate: 2018 and 2020 Why did you choose ETSU for your education? Completing my masters at ETSU was second nature. I was familiar with the university because I attended as an undergraduate student. At the time, I was unsure of what I wanted to do regarding a career. I was playing softball, and I had been around sports my whole life. I knew I had a passion for sports, but I did not know how to implement that in my future career path. When I saw that ETSU had a Sport Management master’s program, it all clicked. Immediately after I applied to the program, Dr. Smith reached out to me about a possible research graduate assistantship with Dr. Greene, the undergraduate Sport Management coordinator. I accepted the position, and that was the beginning of a great program experience and so much more.

What is your current position and/or research?

How did your time at ETSU prepare you for this career? When I first started graduate school, I was unsure of what I wanted to do after completing the program. However, through various projects and hands-on experience, I gained further knowledge of the sport-related areas I wanted to work in. Also, through my graduate assistantship, I learned different skills that helped me grow as a student and person.

I am currently the General Manager of the Elizabethton River Riders, a collegiate summer baseball team in the Appalachian League.

During graduate school, my research focused on corporate social responsibility. The knowledge and skills I acquired from my research assist me in my current position as our organization becomes more involved in the community.

What does this position/research entail?

What advice would you offer current or future graduate students?

In my current position, I am responsible for managing all aspects of the franchise from corporate sales to marketing to community relations, etc.

If you are considering the sport management master’s program, I say go for it. From my personal experience, graduate-level courses are more handson when compared to undergraduate

courses. Instead of just attending inperson lectures, I was able to network with professionals in this field, which aided in securing my position with the Elizabethton River Riders. Another piece of advice I would give you is to have an open communication channel with your professors. I had the privilege of working with Dr. Greene, Dr. Smith, and Dr. Jones who are all truly amazing. They genuinely care about their students, and they want to see them succeed both inside and outside of the classroom.

Anything else you would like to add? Learn to accept the fact that you may not know everything. Do not hesitate to ask for help. Lastly, I know everyone says this, but get comfortable being uncomfortable. Do not be afraid to try something new that makes you step outside of your comfort zone, because that may lead you to success.

Care Without Compromise: Adapting Autism Diagnostic Assessments During COVID-19

Rebecca Otwell-Dove Psychology, PhD, concentration in Clinical Psychology

Dr. Natasha Gouge

Clinic Director, Behavioral Health and Wellness Clinic Written by Marten Baur

utism assessments for children and adolescents during the COVID-19 pandemic have become significantly less accessible due to mask mandates and social distancing requirements. Waitlists for clinics are overflowing, and some families are turned away as clinics struggle to cope with the new challenges presented by the pandemic. ETSU’s Rebecca Otwell-Dove, a PhD candidate in Psychology, and Dr. Natasha Gouge, the Clinic Director of ETSU’s Behavioral Health & Wellness Clinic (BHWC), have answered the pandemic’s challenges with the development of autism assessment protocols that can be conducted through telehealth. Using these new protocols, the BHWC has begun to work through their long waitlist of families seeking autism assessments. This article seeks to present Rebecca’s work and how she assisted in adapting pre-pandemic clinic services to fill the gap in care created by COVID-19.

Rebecca is from Fayetteville, Georgia, a small city on the outskirts of Atlanta. She enjoys the Tri-Cities region with its small town feel and perimeter city life, but recognizes the limited access to care experienced by rural populations. Rebecca was drawn to ETSU’s clinical psychology program because of her interest in meeting the unique needs of children and families in rural areas through integrated primary care. Throughout ETSU’s doctoral psychology program, students experience a wide array of clinical experiences that prepare them for their future careers as clinical psychologists. The experience of working with rural children and families in the primary medical care setting made ETSU the perfect match for Rebecca, and she is set to graduate with her PhD in psychology in spring or fall of 2022. During Rebecca’s third and fourth years at ETSU, her interests and personality matched with a rigorous pediatric practice

“I always imagined I would enjoy opportunities to work closely with medical providers and meet families in these settings that I otherwise might not encounter.” Rebecca Otwell-Dove, photography (left and right) by Jeremy Gouge

in Kingsport, Tennessee for her externship site. Dr. Gouge served as her supervisor, and together they worked with hundreds of children and families. Dr. Gouge noticed Rebecca’s talent and skill when working with families, and she requested her assistance with developing a virtual autism assessment clinic to address the growing waitlist at the BHWC. Dr. Gouge stated, “Rebecca was so fantastic working with children and families, and she had such a good innate clinical diagnostic ability. I really wanted her to take the lead on this project.” Rebecca, having cultivated the skill of identifying atypical behavior, was one of few students who possessed the level of experience and skill needed to take the lead on this project. Before COVID-19, autism assessments were conducted completely in person. Psychologists primarily used the Autism Diagnostic Observational Schedule (ADOS) to guide a diagnosis. The ADOS assesses a child’s behaviors through a variety of interactions and activities referred to as “social bids.” Social bids are any activity or prompt that offers

an opportunity to respond. The ADOS uses highly standardized and controlled social bids, which makes the ADOS a gold standard for autism evaluations. It provides step-by-step instructions to the practitioner and requires the use of 100 manipulative materials (consisting mostly of different toys) that must be held constant from test to test. The ADOS, although an effective protocol to diagnose autism, was impossible to implement in the context of the pandemic. There was no standardized norm of scores that accounted for practitioner-to-patient interactions under the mandates of social distancing, masked faces, or the use of virtual platforms. As such, use of the ADOS and the ability to assess children for autism using this method came to an unprecedented halt. To complicate matters further, children who were experiencing social isolation due to the pandemic were being referred for autism evaluations more than ever before. For these reasons, the BHWC needed an autism assessment that fit the constraints of the pandemic. Rebecca and Dr. Gouge used the

Childhood Autism Rating Scale (CARS) to create a BHWC hybrid protocol to deliver autism assessments through HIPAA Zoom. The CARS consists of 15 domains, with each domain consisting of seven behavioral score anchors. The practitioner uses the CARS to score each social bid presented to the child, but it is up to the practitioner to create the social bids. This allows practitioners a greater degree of freedom than the ADOS. There are no standardized materials or scripts; rather, the CARS offers a very standardized scoring methodology, which allows the practitioner more innovation in administering an autism assessment. The practitioner creates novel scenarios to elicit social bids from the child, and then scores them using the CARS scoring protocol. Dr. Gouge explained that “the CARS gives you a way to score the assessment, but the burden is on you to elicit all of the observations.” Because of this, the CARS “requires a great deal of skill and sophistication. If you are unsuccessful in eliciting the observation, you lose the ability to score the data point and ultimately might miss the mark on your

Left, Rebecca Otwell-Dove, Right, Dr. Natasha Gouge, (photography above and below) by Jeremy Gouge

diagnostic formulation,” added Dr. Gouge. Rebecca’s scholarly task was to create an interview that would elicit enough novel social bids to use the CARS scoring system. She asked herself, “What kind of prompt do I need to come up with that would allow us an opportunity to observe a behavior and score this item?” She experimented with bids such as virtual

tic-tac-toe, or having children create a social story based off of a Norman Rockwell painting. She created a master interview document, which detailed the social bids that would be scored using the CARS. And, because there are two versions of the CARS (a standard form and a high functioning form), Rebecca completed this customized process for two separate populations. The master interview document will be used to train additional graduate students working at the BHWC so that more families can receive autism assessments via telehealth. If there was a theme to Rebecca’s work at ETSU, it would be adapting to any situation in order to provide care for a population. On top of this labor-intensive project, she is working to complete a dissertation study examining the impact of COVID-19 on caregivers (both biological and non-biological) who have had infants in the neonatal intensive care unit (NICU) during the ongoing pandemic. She is hoping to shed light on the impact of COVID-19-specific stress and NICUspecific stress on caregiver global health outcomes (physical, mental, and social health), parental bonding, and parental self-efficacy—a currently unfilled area of research.

Rebecca Otwell-Dove

After graduation and completion of her current internship year at the Virginia Treatment Center for Children/ Children’s Hospital of Richmond at Virginia Commonwealth University, Rebecca hopes to continue working as a clinical psychologist in pediatric primary healthcare treating children and families in the Tri-Cities region. Rebecca is thankful for the opportunity to work with Dr. Gouge, whose mentorship has influenced the trajectory of her career. Rebecca and Dr. Gouge would also like to give a special thanks to Julia Najm and Meg Clingensmith—two additional doctoral students within the psychology program who assisted in various supportive aspects of this project—as well as a UNC TEACCH and Dr. Mary Van Bourgondien (creator of the CARS-HF and facilitator of CARS CE training that informed this project). Because the course of the pandemic is unknown, and it may be some time before normalcy returns to the clinical setting, it is increasingly important for primary healthcare providers to adapt and serve as many people as possible. Rebecca and Dr. Gouge have responded to the challenges of COVID-19 by creating an adaptable autism assessment process at ETSU’s BHWC that can be delivered through HIPAA Zoom. Because of this, they are continuing to serve the families of the TriCities region.

Where are they now? Kris Truelsen BA in Bluegrass, Old Time, and Country Music Studies; MA in Appalachian Studies Department of Appalachian Studies Graduate: 2015 Why did you choose ETSU for your education? Before moving to Johnson City, I was living in Chicago and just getting my feet wet as a performer. I had a deep desire to grow both musically and professionally at the time, but I hadn’t found a clear path to make it happen. After learning about the Bluegrass, Oldtime, and Roots music program at ETSU while at a music festival, I quickly applied to the program and made the trip down for an audition. Three months later I relocated to Johnson City to pursue a music career, and I haven’t looked back.

What is your current position and/or research? I am the Program Director for Radio Bristol, a non-commercial FM radio station housed in the Birthplace of Country Music Museum in Bristol, Virginia, and I am also a founding member of Bill and the Belles, an internationally touring string band.

What does this position/research entail? As Program Director, I oversee all programming at Radio Bristol including our on-air shows and live events. Our station is a working exhibit within the Birthplace of Country Music Museum, and we also have an intimate performance theater where we host a variety of

shows in front of live audiences. Our staff consists of over 30 volunteers that contribute their time and efforts to make Radio Bristol the unique station it is. Since 2015, we have quickly become one of the leading platforms, not only in our region, but also across the United States for roots music listeners. Our mission is focused on celebrating the diversity of American roots music and bringing further awareness to the talented and often underrepresented voices of our region. Outside of shaping and managing programming, I host a syndicated PBS television show called Farm and Fun Time that is viewed in over 20 million homes in the South. I also tour internationally with my band, Bill and the Belles, a band I started while in grad school at ETSU!

Country Music. Eventually, my internship grew into a full time job with the organization. Through my studies at ETSU, I learned that hard work does, in fact, pay off. The incredibly demanding schedule I had during graduate school prepared me for the demands I was soon to face as a professional. I juggle what at times amounts to two full-time jobs as both Program Director for Radio Bristol and a touring musician. Believe me—it’s not for the faint of heart. Thanks to my education, I was better prepared to handle this immense workload, and I have been able to sustain and grow both careers over the past seven years.

How did your time at ETSU prepare you for this career?

The adage, “Don’t sweat the small stuff”, seems particularly fitting while working towards your graduate degree. Finding balance and ease during graduate studies can at times seem impossible, but stick with it. It’s worth it.

As a graduate student in the Appalachian Studies program, I was given the opportunity to intern with Birthplace of

What advice would you offer current or future graduate students?

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