Hollows as sampling units for community-based participatory research in appalachia: The mountain air project

Beverly A. May, Kathryn M. Cardarelli, Roy Silver, W. Jay Christian, Nancy E. Schoenberg, Steven R. Browning

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: In rural Appalachia, numerous geographical, historical, and socioeconomic barriers undermine health. We describe a community/academic partnership that leveraged local assets to implement an on-the-ground enumeration approach to enrolling participants, ultimately achieving an 82.1% response rate in a cross-sectional study of adult respiratory disease. We sought to discuss challenges addressed while establishing an accurate sample frame and a broadly accepted data collection procedure. Methods: Innovative and established epidemiologic methods (household enumeration) were combined within a community-based participatory research (CBPR) framework. Community members partnered with researchers to identify an appropriate, novel sampling unit: hollows. Members of two community advisory boards (CABs) provided extensive guidance, and community health workers (CHWs) administered surveys and spirometry from randomly selected households. Results: Most hollows (28/40) had participation rates of more than 80%. The sample (N = 972) was representative of the study area. Conclusions: Investigators seeking to recruit hard-to-reach populations may consider on-the-ground enumeration guided by community partners.

Original languageEnglish
Pages (from-to)401-410
Number of pages10
JournalProgress in Community Health Partnerships: Research, Education, and Action
Issue number4
StatePublished - Dec 1 2019

Bibliographical note

Publisher Copyright:
© 2019 Johns Hopkins University Press.


  • Appalachian Hollows
  • Appalachian Region
  • Community health partnerships
  • Environmental Health
  • Health disparities
  • Respiratory Tract Diseases
  • Rural Health

ASJC Scopus subject areas

  • Health(social science)
  • Education
  • Sociology and Political Science


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