This fall season in the High Country of North Carolina has been one of great beauty. The changing of the leaves are not only picturesque; they offer one of the most prevalent signs of transition that we experience. It’s expected and anticipated each year. Perhaps because of this, I also find it to be a time of reflection. And as we pull together our collective notes from one another here at the IHHS to analyze the prior year and peer into the year ahead, such reflection is definitely warranted. 

As we summarize in the “pages” below, we have a lot to be proud of this past year regarding the training and experiences we have provided for our students and the services and support we have offered to our community. We also have much for which we are thankful: the collaborations we have across our community with organizations such as the Area Agency on Aging and all of the regional senior centers, the Hunger and Health Coalition, the Community Care Clinic, High Country Community Health, the Appalachian Regional Health System, Parent to Parent, the Watauga Compassionate Community Initiative, the Omar Carter Foundation, and our regional public schools. There are too many to name, so I shouldn’t have started this list! There are others locally who have supported us with funding and financial support, such as the Women’s Fund of the Blue Ridge, Holy Cross Episcopal Church, Curtis Media Group, and others. Point being, the Blue Cross NC Institute for Health & Human Services has definitely been able to make a regional impact this past year, but we could not have done it without the support of all the other great organizations who are also striving to make a collective contribution to a healthy, prosperous future.

One of our major focuses this year was creating an improved methodology for assessing all of our programs to ensure that we are doing the best we can to train students, create a collaborative education network across the region, and serve individuals in various capacities. We have a wide variety of programs and experiences and serve different people in different ways. Training a student in a field experience at a camp is different than determining if a cognitive assessment of a client is successful. This is a work in progress, but our results so far are encouraging in that across all of our programs, the people we are serving in these various ways report that activities are meeting or exceeding expectations (97%), that they feel positive about the experiences (99%), and that staff are knowledgeable (99%) and engaged (99.4%). We are continuing this goal in the current fiscal year and examining ways to dive deeper into the role of assessment and how we can better gauge the perception of experience and support from those we serve.

Thank you to all of you who contribute to what we do in some way and to those who contribute to the region in other ways. We hope you will enjoy reviewing some of our most salient successes of the year. If you see an opportunity to join us…for an event, a volunteer opportunity, a program, or anything else, please reach out to us. The goal of the IHHS is to create and sustain a community that focuses on learning and improving the health and well-being of the High Country and beyond. We welcome everyone in this effort.

Gary H. McCullough

Executive Director

Before diving into the summaries from our various programs, we’d like to introduce a few new people who we are excited to have in the IHHS.

Amber Chapman

Fall Prevention Project Manager

Amber is an Appalachian State University Alumni with a background in federal and state programming, older adult health and wellness, and advocacy. Amber is the Fall Prevention Project Manager with App State’s Institute for Health and Human Services. She is managing their 3 year Federal Grant to support Fall Prevention for older adults throughout the High Country. Her focus is on implementing and expanding access to evidence based fall prevention in our rural region. As a Board Certified Tai Chi for Arthritis and Fall Prevention Instructor and A Matter of Balance Master Trainer she is involved with providing programming, coordinating involvement with students and the community, and creating sustainable pathways to ensure older adults have access to these programs. 

Amber grew up just down the mountain and considers the High Country home. She has a passion for bringing communities together, advocacy, and the health and wellness of older adults. Amber has been recognized both nationally and throughout the state for her work at the High Country Area Agency on Aging and the North Carolina Fall Prevention Coalition. As a former long term care ombudsman and direct care specialist, Amber brings a variety of talents and skills to the IHHS. In her spare time, she enjoys spending time with family and friends, fitness, and trying to keep up with her two dogs Layla and Atlas. Amber is excited to expand the reach of IHHS and continue to strengthen relationships with the community, health care providers, and community based organizations

Mary Strong is a two-time graduate of Appalachian State University. She is a licensed clinical social worker at App States’ Blue Cross NC Institute for Health and Human Services Interprofessional Clinic. Mary provides integrated counseling and case management within IHHS-affiliated clinics, facilitates the IHHS Monthly Case Conferences, and is a member of the Beaver College of Health Sciences IPE Committee. She supervises, mentors, and instructs BSW and MSW interns placed in the clinic and creates interprofessional collaboration opportunities. Mary is a recipient of the 2019 Staff Excellence Award which recognizes staff members' exemplary service, commitment, collegiality, and leadership to the university community.

Mary worked as a mental health clinician and ultimately as the Team Lead for Daymarks Assertive Community Treatment Team (ACTT) of Watauga and Avery Co. She is an advocate for mental health reform, disability inclusion, and social justice. She enjoys being part of a team that serves the university as well as the local community members. Mary is an artist and a beekeeper who enjoys the serenity of the river, all critters and playing as hard as she works. She is often adventuring with her wife Yvonne and toy poodle Layla.

Kate Divoll

IHHS University Program Associate

Kate Divoll is a graduate of University of Florida and recent transplant from Key West, Florida. Her background is in both Non-Profit and construction management. She served as Program Director for the Bahama Village Music Program, offering free programming, individual instruction, and group classes to over 200 children per week. Kate then transitioned into the construction industry, overseeing the building and renovation of homes throughout historic downtown Key West with her father and business partner.

Kate hopes to bring these skills to her new position as University Program Associate at the IHHS. In her spare time, Kate is a freelance illustrator. She enjoys long walks with her partner and their dog, Annie.

This past year, we were able to reintroduce the much-needed Girls on the Run program to our school-based sites and added enhancements to address social-emotional learning (SEL) deficits that girls experienced over the past year-and-a- half.



Prior to COVID-19, adolescent girls were already prone to heightened rates of physical inactivity and poor social-emotional outcomes compared to their male peers. During the transition to adolescence, girls’ physical activity levels begin to decrease dramatically compared to that of boys. By age 14, girls are dropping out of sports at two times the rates of boys, placing them at a higher risk for poor mental and physical health outcomes.

Research now indicates COVID-19 exacerbated girls’ health disparities and increased physical inactivity rates. Additionally, disruptions to girls’ typical routines have led to heightened stress levels, greater feelings of isolation and loneliness, and higher rates of depression among this population. Lastly, as girls more than boys tend to define themselves in relation to others, greater rates of isolation and disconnection experienced during COVID-19 have had a more detrimental impact on girls’ mental health. These troubling realities demonstrate an even stronger need for Girls on the Run within the High Country, as the program has a strong, demonstrated impact in increasing girls’ physical activity levels and social-emotional outcomes.

GOTR-HC follows positive youth development best practices, which emphasize nurturing internal strengths and abilities within children to build their confidence and decision-making skills. Girls on the Run intentionally focuses on “Social and Emotional Learning” (SEL) throughout the curriculum as it plays a critical role in promoting positive mental health among youth. SEL skills learned through Girls on the Run - such as how to manage emotions, establish boundaries, develop confidence, and resolve conflict - are skills that girls can use now, and in the future, to cope with life challenges.



Unlike traditional athletic programs, GOTR also cultivates the positive benefits of physical activity and running while consciously mitigating the risk of unhealthy attitudes around body image and food that girls are particularly vulnerable to, in addition to harmful habits like negative self-talk and poor self-esteem that are prevalent among adolescent girls. Staff and coaches work to promote strong mind-body awareness within each girl, walking (and running) alongside them on their path to building confidence, deepening their self-efficacy, and accelerating their sense of independence to make responsible decisions as they move into adolescence.

Hub for Autism and Neurodiversity



The Hub for Autism and Neurodiversity continued goals to provide educational outreach for regional families impacted by autism and other developmental disabilities. A series of hybrid in-person/virtual workshops targeted parents, faculty, students, teachers, providers, and people with disabilities. Educational sessions were developed and designed to cover both a wide variety of topics and a wide format delivery. Approximately 130 people attended sessions that included:

1)   Daily Transitions and Change: Why it’s hard, What makes It Easier

2)   Autism 101 

3)   Essential Visual Supports for Your Child On the Spectrum

4)   Visual Supports Make It - Take It

5)   After the Diagnosis: Get Answer, Get Started, Get Going

6)   ABA -- Is it Right for Your Child?

7)   Summer Fun- Tips for Understanding Kids on the Spectrum for Camp Counselors, Coaches and others. 

Nutrition Outreach and Research

In collaboration with faculty in the departments of Nutrition and RMPE, the “Fuel Your Game” project was undertaken to provide nutrition education to high school student athletes. Two cohorts of students attended three classes each, held on Sunday afternoons. In addition to learning about macronutrients, nutrient timing, supplements, and disordered eating, students also created healthy snacks during each class and heard life-experience stories from college student athletes who attended some of the sessions. Students and volunteers who attended all three sessions received gift cards from Clean Eatz. Twenty-three students were in the first cohort and seventeen students registered for the second cohort

Healthy Heart Collaborative

Through a collaboration with the Appalachian Regional Healthcare System and the American Heart Association, the IHHS began offering CPR certification in August 2021. The IHHS Community Outreach program organized AHA CPR instructor training, developed registration portals, and served as liaison between the ‘students’ CPR requests and AHA coordinators at the ARHS.  



Between Aug. 16, 2021 and June 30, 2022, we received 211 program inquiries from AppState Faculty, Staff, and Students, and community members. These CPR ‘students’ inquired about Heartcode Certification (135 inquiries), Heartsaver First Aid CPR/AED certification (69 inquiries), and Heartsaver Pediatric First Aid CPR/AED certification (7 inquiries). 

Once online training was completed, 171 ‘students’ received hands-on skills check off testing by IHHS and BCHS instructors in the following areas: Heartcode BLS certification (129 tested), Heartsaver First Aid CPR/AED certification (39 tested), and Heartsaver Pediatric First Aid CPR/AED certification (3 tested). What began as a program to serve the essential needs of our BCHS faculty, staff, and students has grown into a CPR training program in demand across AppState University and the greater community. 

Aging Academy

As part of the Aging Well Program, an educational outreach effort was started to target folks in the community as well as ASU faculty, staff, and students. Presentations were developed by members of the Aging Well Committee and held on the 2nd Friday of the month during the spring semester. The program was advertised via the Aging Well collaboration and all community partners shared with their constituents. The following classes were offered:



1. Exploration of Falls and Keys to Prevention
2. Never Too Soon, Planning for Retirement
3. Living Longer and Happier
4. Understanding Memory

This year’s sessions have already begun and we look forward to another year of collaborative learning.

The Community Health and Fitness Assessment Program

Dr. Marco Meucci and students continue to offer the Community Health and Fitness Assessments to provide individuals with very specific information on their physical fitness. Lab visits give detailed information on body composition, blood pressure & arterial stiffness, gait and balance, and metabolic measures. In 2021-2022, forty participants completed the assessments and eight students helped conduct the assessments as part of their training. 



For additional information, visit: https://phes.appstate.edu/laboratories/exercise-physiology-laboratory

Taking Care of Our Own

The IHHS continues to proudly support the Appalachian State University community with the services of Health Promotion for Faculty & Staff and Counseling for Faculty & Staff. Below are updates on these programs that support the physical and mental health of our colleagues across the university.

Preventive Screenings

    During the 2021-2022 year, Health Promotion for Faculty and Staff (HPFS) set goals to increase the number of preventive screenings available to faculty and staff. In the past, HPFS offered two, 3-day events that provided mammography screenings to 135 participants. With so many people behind on their preventative screenings due to COVID closures, Novant Health Breast Center of Winston Salem offered to come to campus to provide more screening appointments on a monthly basis. HPFS began hosting monthly on-campus Mammogram screenings in June. This will translate this coming year to 253 individual appointments, almost double from the previous year. A post-event comment stated, “Thank you for offering this incredibly valuable service! This is a major perk of being an App State employee!”

     With the addition of HPFS’s certified Phlebotomist, Tracy Weston, HPFS is able to offer 2 Low-Cost Blood Screenings per month in our Varsity location and in the IHHS Interprofessional Clinic. This is an excellent resource that allows Faculty and staff the ability to monitor important screenings such as total cholesterol, A1C, Prostate, Blood Pressure, etc. In years past, approximately 80 participants could participate in monthly blood screenings. Moving forward, HPFS will serve 180 appointment slots! One participant stated this is a “...Great resource for employees to stay healthy and balanced."

One goal this past year was to reach more people with our screenings, wellness events, and increase gym participation. Technology and branding have proven to be powerful tools for our audience to connect, especially through direct e-mail, Marie’s Musings, Facebook, and campus announcement emails. This year we also worked directly with Human Resources through their new employee 90-day modules and monthly “Campus Connection Tours.” This helped us increase participation in screenings, events, and gym usage over the prior year. HPFS looks forward to continuing collaboration with IHHS, HR, and others to promote a culture of wellness on campus and throughout the High Country.

Counseling for Faculty and Staff (CFS) continued to support the Appalachian State University community by providing free counseling, training and psychoeducation to faculty and staff of the University. CFS serves full and part-time employees and their immediate family members. CFS also provided clinical services to a small number of graduate students currently enrolled in clinical mental health training programs. Though most of our services are provided face-to-face, we continue to meet with clients online, if this is their preference. 

Through counseling, people addressed a variety of concerns including depression, anxiety, parenting challenges, relationship concerns, and workplace or career issues. CFS counselors provided supportive interventions and access to additional resources to help alleviate distress and increase resilience. 

Throughout the past year, Counseling for Faculty and Staff provided breathing and meditation classes twice a week, in addition to parenting support classes, and other targeted mental health workshops. An active member of the university community, CFS provided mental health screenings at the Employee Health Fair, participated in New Faculty Orientation, and hosted an open house through Human Resources.

CFS provided 1590 counseling sessions to 290 clients with the average number of sessions per client at 5.4. Some of our favorite offerings this past year included:                                                                                                                                                                                                                                      

• Weekly breathing and meditation classes
• Caregiver Support Meetings through the Interprofessional Clinic
• Targeted trainings and educational sessions for offices across campus

Research & Scholarship 2021-2022



 We’ve had our best year in a while with respect to research and scholarship development and funding. A growing number of faculty are working with the IHHS to conduct research and training activities that will have a significant impact on the people of our region and beyond. We’ll touch on some highlights.

Jennifer Tyson

Faculty member in our Public Health program, led a team that included Dr. Adam Hege, Dr. Manan Roy, Dr. Maggie Sugg, and Dr. Martie Thompson to submit and be awarded a three year grant from Americorp of $1,038,630. “Public Health AmeriCorps in Rural Appalachia to Prepare, Mitigate, Respond, and Recover from Acute Impacts on Mental Health.” will engage students, faculty, staff, and community members in a Medical Reserve Corp to support preparedness, mitigation, response, and recovery efforts in public health and provide future AmeriCorps members to work in the public sector. This project is doing exactly what we are all here to do: provide education and training with hands-on experiences that will enhance the healthcare workforce into perpetuity. This project is underway and making a difference in our region.

Dr. Martie Thompson

Our Blue Cross Blue Shield Distinguished Professor of Public Health, has just been awarded funding ($225,000) from the Corporation for National and Community Service. She seeks to determine if and why civic engagement participation during emerging adulthood (18-26 years) predicts positive physical, mental, and behavioral health outcomes in middle adulthood. Further, this research will determine if the positive impact of civic engagement is the same for different gender and race groups. The researchers will leverage the opportunity afforded by the National Longitudinal Study of Adolescent and Adult Health study, which includes a nationally representative sample of ­over 20,000 respondents surveyed five times over the course of 22 years. In addition, Dr. Thompson continues work with the Office of Violence Against Women at Clemson University, where she worked prior to Appstate, and has recently received a subaward with Georgia State University from the National Science Foundation. We look forward to sharing more updates about her ongoing research in the coming year.

Maggie Sugg

PhD, Associate Professor in the Department of Geography and Planning, is collaborating with Dr. Jennifer Runkle at North Carolina State University on a NIH R03 grant titled, "Climate Change Impacts on Maternal Health in a Southern Birth Cohort: A Causal Analysis." The study, funded at just over $152,000 over two years, will examine which severe maternal morbidity conditions are more sensitive to climate-related changes in ambient temperature to inform the development of a population-based indicator to be used in the state- and community-based surveillance efforts.

Leah Hamilton

MSW, PhD, Associate Professor of Social Work, continues to build upon her innovative research work in minimum basic incomes, which was jump started through funding from the Hudson Up program. Her work has recently expanded with Project Community Connections, Inc and Give Directly.

In Her Hands is a community led guaranteed income pilot based in Georgia that focuses on finding solutions to financial insecurity for women of color, who experience poverty at much higher rates than other groups. The program provides an unconditional $850 a month for two years to 655 Black women in three communities across the state. This $13 million partnership between the Georgia Resilience and Opportunity Fund (GRO Fund) and GiveDirectly not only provides direct assistance to women in the community, but is crucial for continuing guaranteed income research. Research into guaranteed income has shown overwhelmingly positive effects on communities. This research is key to understanding how guaranteed income could be applied on a more national level. Read the full blog post here. 

Project Community Connections, Inc. operates similarly through the launch of a cash transfer pilot, offering an unconditional $400 per month to 150 individuals experiencing homelessness in the Atlanta, GA area for 12 months. Dr. Hamilton is partnering with the Social Policy Institute at Washington University in St. Louis to conduct a mixed methods evaluation examining how the program affects recipient wellbeing, housing, health, and long term economic stability. This important work continues to expand its reach, and we are excited about the work she is doing.

Bryan Belcher

Director of the IHHS Interprofessional Clinic, spearheaded a successful grant application to the Department of Health and Human Services’ Administration for Community Living program along with McKenzie Hellman, Becka Kappus, Kim McCullough, Jared Skinner, Amber Chapman & Zack Green (Director of the High Country Area Agency on Aging - AAA). This project, “Positively Impacting Falls Prevention in The High Country,” was awarded $552,322 over a three-year period to assess fall risk in the High Country and provide fall prevention training. This will take place as part of the ongoing Aging Well Program in the IHHS. The funding supports the expansion and implementation of evidence-based falls prevention programs in the region’s seven counties — Alleghany, Ashe, Avery, Mitchell, Wilkes, Watauga and Yancey. 

Adam Hege

PhD, Associate Professor in the Department of Public Health & Exercise Science, is collaborating with Wake Forest University's Clinical and Translational Science Institute and Take the Fight to Cancer on a pilot grant to develop a model for implementing volunteer student lay navigation at cancer health centers, with a focus on underserved Appalachian communities. Appstate and Atrium Health Wake Forest Baptist will both act as learning health systems in the aligned efforts of continuous care delivery improvement and innovation. Dr. Hege received $5,146 (total project budget of $30,000) to support his and an undergraduate research assistant's time on the project. The hope is that this pilot project will support further external funding pursuits through the National Cancer Institute.

Sandi Lane

PhD, Associate Professor in Nutrition and Health Care Management is serving as one of the four key partners in the WECARE: Workforce Engagement with Care workers to Assist, Recognize, and Educate project funded by Care at UNC-Chapel Hill School of Social Work. In partnership with Duke University and the other partners, Dr. Sandi Lane will develop the program outcomes and evaluation processes, provide subject matter expertise in the development of the assessment tools and methods, and provide technical assistance with data collection and analysis. Dr. Lane also continues her work in collaboration with Dr. Darren Liu with funding from the Foundation of the National Association of Long Term Care Administrator Boards to investigate the views and perspectives of long-term care administrators during the COVID-19 pandemic. They conducted 21 interviews with nursing homes and assisted living administrators in North Carolina and Pennsylvania. The results can be used to inform leaders, policy makers, educators, and regulatory agencies of the gaps in resources, knowledge, skills, and support and where future efforts should be focused.

Dr. Alan Needle

Associate Professor in Exercise Science and Athletic Training, is conducting research funded by the National Athletic Trainers’ Association Research & Education Foundation ($57,349). He is examining the efficacy of improving motor function in individuals with chronic ankle instability by targeting specific cortical pathways using transcranial direct current stimulation (tDCS). The hope is that these tDCS interventions will improve patient function beyond traditional efforts by correcting the underlying neurological aberrations that negatively affect motor planning.

Dr. Jill Juris

Assistant Professor in Recreation Management & Physical Education, is developing and leading the evaluation for the BRIDGE2HEALTH project, a CYFAR grant awarded to The Ohio State University and funded by the USDA's National Institute of Food and Agriculture. One of the goals of BRIDGE2HEALTH is to create community connections for teens and older adults to enhance their health promoting skills by incorporating intergenerational strategies into existing 4-H curricula.

Final Thoughts

“If we fail to adapt, we fail to move forward.”

 -- John Wooden

“Take time to deliberate; but when the time for action arrives, stop thinking and go in.”

-- Napoleon Bonaparte

Thank you for taking the time to share our reflections about this past year with us. During the time that COVID shut most of our operations down, we had plenty of time to think. This past year was definitely more of a time to adapt and move forward. We are rolling right on into the second quarter of our new year and feel so much promise about what lies ahead. With new people in new positions come new ideas and new developments. Our growth is a testament to this. This growth has also led us to realize that the IHHS needs a full time Executive Director, as the current Executive Director, Gary McCullough, also serves as an Associate Dean for the Beaver College of Health Sciences. And we have some great news…

After a nationwide search, we are pleased to announce that Dr. Laura Bogardus will be joining us as our new Executive Director. She is coming to us from Greenville, South Carolina where she works as the co-founder and President of Noble Aim Consulting, LLC, which provides strategic development consulting services to community coalitions, public/private partnerships, government organizations, and non-profit organizations. She has provided consultation to organizations and communities working to make a better place for people with disabilities to live and work and on developing and implementing inclusion strategies. Her background and skill set are ideal for the IHHS as it continues to grow its collaborations across the region to create more training opportunities for our students and have a greater impact on the health and wellness of the people of our region. She will begin work on December 5th. We look forward to sharing more information about her in an upcoming issue.  

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The more we learn how each other’s organizations and people are making a difference, the more we can explore opportunities to do so together. Here in the High Country and down the mountain in Hickory and surrounding towns, we will continue to reach out to you to participate and collaborate in the process of improving the quality of people’s lives. Please reach out to us, as well!