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There’s unironically a bunch of Appalachian cosmic horror stuff out there. In fact iirc Savage Worlds has a setting for it called Holler and Monte Cook games published a ttrpg for the Old Gods of Appalachia podcast.
If I hadn’t burned myself out on Pseudopod, Welcome to Nightvale, The Black Tapes, and Limetown, I’d be a bigger fan.
But my friends swear up and down by Old Gods. Solid writing and a good creepy blend of the mundane and surreal.