The Great Smoky Mountains Study (GSMS) is a longitudinal, population-based community survey of children and adolescents in North Carolina. The study is part of a collaborative effort between Duke University and the North Carolina State Division of Developmental Disabilities, Mental Health and Substance Abuse Services. The collaborative study started in 1992 and continues today, although involvement by the State of North Carolina is minimal. Funding is provided by the National Institute on Aging and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Important goals of the study were to estimate the number of youth with emotional and behavioral disorders; investigate the persistence of those disorders over time; examine the need for, and use of, services for emotional and behavioral disorders; and identify possible risk factors for developing emotional and behavioral disorders. Drawing from 11 counties in western North Carolina, the screening sample consisted of 4,500 children: 1,500 each aged 9, 11, and 13 years at baseline. The study included both urban and rural sectors, and all the agencies that provide child mental health services in the area. This region is also home to a fairly large American Indian population, and 349 of the youth in the study are enrolled members of the Eastern Band of the Cherokee Nation. These youths represent a population that has been under-represented in mental health research across the country.
The GSMS has provided policy-relevant information in the areas of: 1) need for mental health services, 2) risks for emotional and behavioral disorders, 3) outcomes of serious emotional disorders, 4) use of mental health services across sectors and 5) effectiveness of mental health services among cohorts.
COVID-19 Supplemental Data Collection (2020). To explore the impact of the COVID-19 pandemic on substance use among adults, parents, and young children, participants in both Fast Track and the Great Smoky Mountains Study were surveyed about their personal behavior in Spring 2020. In Study 1, FT (n = 287) participants were surveyed at current ages 32-36 and GSMS (n = 348) GSMS participants were surveyed at current ages 35-40. The results show a strong impact of the pandemic on increasing reported substance use and abuse problems, internalizing and externalizing behaviors, sleep problems, and interpersonal and household disruption. In Study 2, participants who had been interviewed prior to the pandemic onset were re-interviewed after onset to test within-person change as well as the well-being and behavior of their children (FT n = 119, GSMS n = 108). Findings show an adverse impact of the pandemic onset on increasing substance abuse problems and a reduced use of harsh discipline by parents, especially among low-income families. In Study 3, participants who were interviewed prior to the pandemic onset (FT n = 337, GSMS n = 678) were compared with participants interviewed after onset as a natural experiment (FT n = 96, GSMS n = 86). As with the first two studies, the natural experiment revealed a significant impact of the pandemic onset on increasing substance-use problems and household disruption.
The Great Smoky Mountains Study of Rural Aging (2021). This ongoing multi-million dollar award provides funds to collect data to augment the longitudinal GSMS, creating a national data resource called the Great Smoky Mountains Study of Rural Aging (GSMS-RA). This study is contributing knowledge about early determinants of the aging experience in a rural context. The study team will locate, recontact and assess 80%+ of the GSMS participants, now in their early 40’s, with a 120-minute in-home assessment, including collection of demographic and socioeconomic and attitudinal information, neurocognitive tasks, and biomeasure collection. PIs will maximize access and use of the GSMS-RA for a new audience of users, scientists, and potential collaborators. The project brings together longstanding GSMS researchers (William Copeland and Kenneth Dodge) with new collaborators who have led large-scale data collection projects in middle and later adulthood (Joseph Hotz and Kathleen Cagney). The study design is methodologically innovative in gathering high-quality data on everyday life via GPS monitoring and an EMA design coupled with actigraphy and rural context profiles via a combination of Census and other administrative data, systematic social observations, and participant/neighbor surveys.
Intervention Impacts on Child Wellbeing and Parenting across Generations (2024). This study tests the hypothesis that intervention delivered to parents in one generation (G1) will lead to better parenting by their children (G2) when they grow up to become parents, and intervention delivered to G2 children will lead to better adjustment in their offspring (G3). The Great Smoky Mountains Study (GSMS) is a longitudinal study of three representative cohorts of children (aged 9, 11, and 13) living in 11 counties in North Carolina (n=1420), with oversampling of American Indian children (n=349), followed into their 30s. Three years after the start of the study, an income supplement was given to every member of the Eastern Band of Cherokees following a casino opening, creating a natural experiment. The GSMS has documented positive effects of this income shock on G1 parenting and G2 children’s adjustment as participants grew into young adults. We are now measuring G2 parenting and G3 behavior at the same ages that intervention effects had been documented in the prior generation.