Key findings include:
• High school graduation rates in Middle Appalachia have been increasing for decades and now exceed national averages.
• Appalachian culture (e.g., attitudes toward education, attachment to family and place, and commitment to the region) influences education improvement initiatives.
• The teaching force is stable, but effectiveness is a concern, especially in science, technology, engineering, and math (STEM) areas and in instructional leadership.
• Teaching externally generated, rigorous academic standards that may not resonate with all local residents is a challenge.
• Rising rates of substance abuse and childhood obesity are a concern because of the relationship among general fitness, obesity, and academic performance.

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