Great Smoky Mountains Study (*)

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 continued until 2015.

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 multimillion dollar award will collect data to augment the longitudinal GSMS, creating a national data resource, the Great Smoky Mountains Study of Rural Aging (GSMS-RA), for the study of early determinants of the aging experience in a rural context, capturing the full arc of a life with intimate detail about living and aging in a rural environment. 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.

Data Collection Category
Longitudinal Surveys
Last Year of Data
2015, 2020
Birth Year
Age Range at Last Data Collection
Biomarkers/ Administrative or Other Data Elements
Duke Principal Investigator(s)
Primary Funding Agency
National Institute of Mental Health, the National Institute of Drug Abuse, and the United States Department of Education Safe and Drug Free Schools Program