Medicine and Health Sciences Commons^™

The Impact Of Rurality, Underlying Cardiovascular Disease, And Socioeconomic Vulnerability On Covid-19 Outcomes In Georgia, Michael C. Morgan, Lavannya Atri, Jennifer L. Waller, Douglas Miller, Adam E. Berman

Journal of the Georgia Public Health Association

Background: COVID-19 related illnesses have been associated with an increased prevalence of cardiovascular disease sequelae and worsened socioeconomic variables. We sought to investigate the relationship between COVID-19 outcomes, underlying cardiovascular disease, and socioeconomic determinants of health in rural and non-rural counties in the state of Georgia.

Methods: COVID-19, demographic, and socioeconomic data were acquired from publicly available databases including the Center for Disease Control and Prevention’s Social Vulnerability Index (SVI). The relationship between COVID-19 outcomes and markers of cardiovascular disease burden, rurality, and socioeconomic determinants of health was assessed at the county level in Georgia through the beginning of …

Strategic Implications Of Covid-19: Considerations For Georgia’S Rural Health Providers, Bettye A. Apenteng, Linda G. Kimsey, Charles F. Owens, Samuel T. Opoku, Angela Peden, William A. Mase

Journal of the Georgia Public Health Association

Whether rural hospitals and providers have seen a surge in COVID-19 cases or a reduction in patients seeking care since the pandemic began, their financial condition has been negatively impacted. Many providers have now received some emergency funding through the Coronavirus Aid, Relief, and Economic Security Act and the Payroll Protection Program but these are likely only short-term fixes. For many, the crisis has exacerbated already existing problems. Notable among these problems are volume declines, supply chain disruptions, and workforce concerns. While these problems require immediate action, two longer-term systemic changes to rural healthcare delivery are needed to address them. …

“It Didn’T Matter What The Bill Said...”: Influences On Abortion Policy Legislative Decision-Making In Georgia, Erica Barton, Subasri Narasimhan, Dabney P. Evans

Journal of the Georgia Public Health Association

Background: In March 2019 the Georgia legislature passed HB 481 described as a “heartbeat bill”, prohibiting abortion at around six weeks gestation. Given the prevalence of anti-abortion legislation and the public health implications of abortion restrictions, we sought to understand how Georgia legislators made decisions on this early abortion ban legislation.

Methods: We conducted in-depth interviews with nine legislators from the Georgia House of Representatives who participated in the 2019 legislative session. In-depth interviews were conducted in-person and over the phone. Interview recordings were transcribed verbatim and inductive codes identified. Codes focused primarily on views of: abortion in general; specific …

Serving Their Needs: A Qualitative Examination Of Nutrition Policy Implementation In The Early Care And Education Setting, Caree J. Cotwright, Jori Hall, Nicole M. Arrington, Nathalie Celestin, Hayley Sanders, Taylor Ragan, Sarah Stotz, Leann Birch

Journal of the Georgia Public Health Association

Background: Childhood obesity is a growing problem in the United States and results in increased risk for chronic diseases such as diabetes, heart disease, and hypertension. Thirteen percent of youth in Georgia are obese. Identifying strategies to assist children in establishing healthy habits is essential to reduce the risk of childhood obesity. The Early Care and Education (ECE) setting is ideal for the implementation of obesity prevention practices. However, there are barriers present for implementing nutrition policies in this setting. This report explores the implementation of food and beverage best practices in the ECE setting and highlights barriers to and …

Improving Access To Hepatitis C Treatment For Uninsured Patients In Southeast Georgia, Bonzo K. Reddick, Marianna O'Ree

Journal of the Georgia Public Health Association

Background: In this brief report, we discuss enhancing access to hepatitis C treatment for uninsured patients in Southeast Georgia.

Methods: Through our screening program for hepatitis C virus (HCV) infections in a local safety net emergency department, the Comprehensive AIDS Resources Emergency (CARE) Initiative studied the rates of linkage to care for newly diagnosed patients with HCV and sought ways to improve linkage to care for those who did not have health insurance.

Results: Our multidisciplinary team partnered with a local federally qualified health center (FQHC) and a wholesale laboratory service to offer affordable care options, thus increasing the percent …

Examining The Effectiveness Of A Nutrition Education Intervention For Hispanic Participants, Ginnefer O. Cox, Britt Rotberg, Melanie K. Ng, Sarah T. Henes, Silvia Q. Giraudo

Journal of the Georgia Public Health Association

Background: The Expanded Food and Nutrition Education Program (EFNEP) Food Talk nutrition education curriculum in the state of Georgia was specifically tailored towards Hispanic EFNEP participants in order to test the effectiveness of the intervention in the Hispanic population.

Methods: 455 Hispanic EFNEP individuals ages 18-61 in the state of Georgia participated in the data collection. Measures collected include a 24 hour diet recall, and a food behavior checklist to compare consumption and food behavior practices both before and after nutrition education intervention.

Results: Measurable objectives of the study include statistically significant (p<.001) in fruit, vegetable and milk consumption and consumption of fruits, vegetables and milk group foods closer to the recommended levels of USDA MyPlate guidelines for the nutrition education intervention group. Results also showed statistically significant (p<.0001) improvements in nutrition-related behaviors.

Conclusion: This study supports a nutrition intervention …

Maternal Mortality Among African American Women In The State Of Georgia, Causes, Policy, And Ethical Considerations, Zahra Shahin, Isabella Hardwick, Nancy Jeffery, Jalisa Jordan, William A. Mase

Journal of the Georgia Public Health Association

Background

The U.S. is currently one of thirteen countries where maternal mortality rates (MMR) is worse now than it was fifteen years ago. Reducing maternal mortality is one of the significant challenges facing the health system in the United States, especially in the State of Georgia, which has one of the highest MMR in the nation. The purpose of this review is to explore the causes, policy, and ethical contextual factors contributing to increased maternal mortality rates among African American women in the State of Georgia. Also, identifying and addressing weaknesses and gaps that exist in the healthcare system and …

Impact Of School Tobacco-Free Policy And Tobacco Risk Education On Youth Cigarette And E-Cigarette Use, Vahe Heboyan, Bruce Riggs

Journal of the Georgia Public Health Association

Background: Smoking rates have declined over the last half-century, however, e-cigarette use has more than tripled in the recent years. Tobacco-risk education and tobacco-free policies are critical policy instruments to help prevent youth tobacco use. This study evaluates the impact of these policies on youth cigarette and e-cigarette use.

Methods: Data from the 2013/2015 Georgia Youth Tobacco Survey (GYTS) is used to test for statistical differences in tobacco use status across school-based tobacco control policies and estimate their impact on cigarette and e-cigarette use. Data includes 5,285 participants representing 2013 middle school (n=2,099), 2013 high school (n=1,775), and 2015 high …

Redefining Our Understanding Of The Impact Of Firearm-Related Injury In The State Of Georgia: A White Paper By The Violence Prevention Task Force Of Iprce, Omar K. Danner Md, Lauren Hudak Md, Mph, Rana Bayakly Mph, Carol Koplan Md, Alexander Kelly, Sharon L. Nieb Phd, Msw, Sheryl L. Heron Md, Mph

Journal of the Georgia Public Health Association

Abstract: Background: Firearm-related injury is a crisis that afflicts vulnerable populations of all ages, ethnicities, races and gender. The purpose of this white paper is to delineate the impact of firearm-related violence on the health and well-being of citizens and communities across Georgia based on the available literature and data. The aim of this white paper is to examine and characterize the currently available data on the impact of firearm violence and injury from a statewide perspective, principally as it relates to the National Violent Death Reporting System (NVDRS) report for Georgia.

Materials and method: We performed a literature review …

Making The Case For Community Health Workers In Georgia, Gail G. Mccray, Berneta L. Haynes, Adrianne S. Proeller, Christopher E. Ervin, Arletha D. Williams-Livingston

Journal of the Georgia Public Health Association

Background: Community Health Workers (CHW) can be an important and evidence-based response to reduce unnecessary morbidity and mortality in chronic diseases like asthma, heart disease, diabetes, cancers, HIV, and maternal/child health, and mental health. Georgia’s urban and rural diverse populations are at high risk from many of these conditions. Largely the outcomes in controlling these health issues are nonmedical and include social determinants of health, i.e., access to care, transportation, inadequate housing, and health literacy. CHWs can increase the capacity of individuals, families, and communities to improve their health. Historically, concerns of CHWs on healthcare teams to address these issues …

Improving The Public’S Health Through Sustained, Multidisciplinary Academic And Community Partnerships: The Msm Model, Desiree A. Rivers Phd, Carla Durham Walker Ma, Ashley K. Mitchell Drph, Msph, Shirleta Lawrence, Carey Roth Bayer Edd, Med, Bsn, Rn, Cse

Journal of the Georgia Public Health Association

Background: To meet the growing needs of communities with increased chronic conditions, decreased access to health services, and a changing sociocultural environment, there is a critical need for community-oriented physicians equipped with the skills to attend to the health of underserved populations. The Morehouse School of Medicine Community Health Course’s (CHC) purpose is to inculcate service-learning and public health techniques to equip community-oriented physicians with empathy and tools to effectively engage diverse communities and provide care that addresses the social determinants of health to achieve health equity. The purpose of this practice note is to discuss CHC multidisciplinary strategies used …

Fitnessgram Assessment Results In Five Rural Counties Of Georgia, Tara L. Underwood, Jimmie H. Smith Jr, Dawood H. Sultan

Journal of the Georgia Public Health Association

Background: Childhood obesity continues to be more prevalent in the United States (US) than ever before. Youth who reside in rural areas tend to experience higher risks of obesity and overweight status, mainly due to barriers to physical activity. Even though the US federal government has mandated a daily requirement of physical activity for all school-age children, the majority of youth from rural communities tend to not achieve the recommended Health Fitness Zone (HFZ) goals.

Methods: The FITNESSGRAM is the instrument that has been used to measure and report students’ physical activity and body mass index (BMI) based …

Effects Of Centeringpregnancy On Pregnancy Outcomes And Health Disparities In Racial Groups Versus Traditional Prenatal Care, Adrianne M. Smith, Mehak Zainab, Brad Lian

Journal of the Georgia Public Health Association

Background: Group prenatal care has been shown to be effective in reducing health disparities in pregnancy outcomes between racial/ethnic groups. Here, we assess the effectiveness of CenteringPregnancy, a group prenatal care program offered as an alternative to traditional prenatal care.

Purpose: Our multidisciplinary team assessed the effectiveness of an innovative prenatal program intended to improve health outcomes for infants and mothers and reduce health disparities among populations.

Methods: A retrospective cohort study was conducted to examine differences with respect to several pregnancy outcomes such as low birth weight

Results: There were no statistically significant differences between the groups on pregnancy …

Leveraging Community Health Worker Program To Improve Healthcare Access For Sickle Cell Disease In Georgia, Jeanette H. Nu'man, Milford Greene

Journal of the Georgia Public Health Association

A five-year project, Access to Care was developed and implemented by the Sickle Cell Foundation of Georgia (SCFG) leveraging community resources and partnerships to increase access and improve the quality of healthcare and healthcare coordination in an adult sickle cell disease (SCD) population in underserved and rural areas of Georgia. The project is comprised of three phases: (Phase 1) the Community Health Worker Program - to improve the health outcomes of individuals living with SCD through healthcare coordination; (Phase 2) the CME-accredited Provider Training Program - to increase the knowledge of non-specialty providers in Georgia to increase provider capacity and …

The Movement From Research Translation To Community Transformation, Tabia H. Akintobi

Journal of the Georgia Public Health Association

The theme of this special issue is Moving Translational Approaches to Community Transformation. Its emphasis is on the work of multidisciplinary teams that implement and assess the impact of translational research, policy, practice and educational initiatives on the transformation of community/population health in the State of Georgia. Research on team science, the science of team science, is designed to foster understanding of the factors that interact to influence success of research teams. Cross- disciplinary teams and related research, that prioritizes the integration of concepts, theories, approaches from more than one discipline, are more likely to collaborate. Translational research …

Bridge Builders To Health Equity: The High School Community Health Worker Training Program, Arletha D. Williams-Livingston, Christopher E. Ervin, Gail G. Mccray

Journal of the Georgia Public Health Association

Background: During the summers of 2016- 2019, Morehouse School of Medicine (MSM) with the support of community partners, developed, piloted and implemented an innovative Community Health Worker Training Program for High School students (HSCHW). Training high school community health workers can impact health and social disparities in underserved populations and demonstrates pipeline of future workers in community health and other health careers. The program has achieved promising outcomes, and access to the program model has been requested many universities and community-based organizations.

Method: The HSCHW training consists of summer classroom instruction, field instruction and monthly continuing education during the school …

Utilization Of A Community-Based Participatory Approach To Design And Implement A Peer-Led Parenting Pilot Intervention To Influence Child Nutritional And Physical Activity Behaviors, Tabia K. Henry Akintobi, Phd, Mph, David Satcher, Victor Ede, Mbbs, Glenda Wrenn, Md, Cassandra Bolar, Phd, Aneeqah Ferguson, Evonne Perdue, Martha Okafor, Kisha Holden, Leroy Reese, Phd

Journal of the Georgia Public Health Association

Parents and primary child guardians within the household play critical roles in shaping their children’s nutritional and physical activity behaviors, which are among the individual-level determinants of childhood obesity and other chronic conditions. There are well-established correlations between race, socioeconomic status and the risk for obesity calling for both contextually- and individual-centered interventions that are community-driven. The Using Quality Parenting (UQP) pilot intervention was a peer-led, parenting education intervention developed in collaboration with community residents in Atlanta, Georgia to influence child nutritional and physical activity behaviors in African American low socioeconomic status communities. A community-based participatory research (CBPR) framework was …

Racial Segregation As A Social Determinant Of Health: Evidence From The State Of Georgia, Simon Medcalfe, Catherine P. Slade, Divesia Lee

Journal of the Georgia Public Health Association

Background: Despite decades of research, determining the causes of racial disparities in health remains a pernicious problem in the public health arena. Challenges include further refining definitions of health as well as expanding frameworks for social determinants of health to include relevant and related predictors. Racial segregation as a social determinant of health is understudied but of growing interest in the discourse on health disparities. This paper explores empirically the relationship between racial segregation and other predictors of social determinants of health and their collective impact on health outcomes defined in both objective and subjective terms.

Methods: Ordinary least squares …

Lessons Learned In The Early Stages Of A Community-Academic Partnership To Address Health Disparities In A Rural Community, Tiffany R. Washington, Brian M. Rivers, L. Sherrié Raleigh, Natalie D. Hernandez, Mindy Le, A. Keith Green, Jeffery Lawrence, Henry N. Young

Journal of the Georgia Public Health Association

In rural Georgia, African American men are burdened by chronic health diseases such as cancer, diabetes, and cardiovascular disease. Community-academic partnerships that leverage community-based participatory research (CBPR) principles can facilitate the adaptation and translation of multilevel programs to address chronic disease prevention and management in rural areas. The objective of this study was to explore key components of the CBPR process that bolstered the early stages of a partnership established between rural-residing community leaders and academic partners in Georgia. Qualitative methodology was used to collect and assess data regarding the initial engagement between the community and academic partners. Findings indicate …

Insights In Health Administration Education: Understanding The Role Of Personality In Teamwork, Lesley A. Clack, Erica Droste

Journal of the Georgia Public Health Association

Background: Developing a health promotion program plan requires attention to the links between objectives, activities, and overall program goals. Instructors developed the “Connecting the Dots” worksheet to help students establish these linkages.

Methods: The “Connecting the Dots” worksheet included six questions pertinent to the students’ health promotion program plans. The worksheet was given to the students in a flipped classroom setting. Evaluation of the effectiveness of the tool was based upon group presentations at the end of the semester.

Results: Students developed more viable program plans that included stronger links between objectives and corresponding program activities.

Conclusions: The “Connecting the …

Characteristics Of The Health Information Technology Workforce In Georgia, Imaobong Ekpo, Emmanuel Akowuah, Bettye Apenteng, Samuel Opoku

Journal of the Georgia Public Health Association

Background: Advancement in medical technology, as well as the Health Information Technology for Economic and Clinical Health Act, has in part influenced the demand for health information technology (HIT) workers. While other sectors have experienced a tremendous increase in the information technology workforce, the health sector lags in this regard. The aim of this study was to describe the characteristics of the HIT workforce in Georgia, relative to surrounding states and the United States.

Methods: The supply of the HIT workforce in Georgia, surrounding states, and the United States was estimated using data from the 2014-2016 American Community Survey (ACS). …

Experiences Of Violence Among Female West African Asylum Seekers In Atlanta: A Qualitative Analysis, Kathleen E. Curtis, Dabney P. Evans

Journal of the Georgia Public Health Association

Background: As the world faces the greatest number of displaced persons in history, it is urgent for countries offering refuge and asylum to understand the needs of these vulnerable populations. Asylum seekers face great uncertainty in the US legal system, and female asylum seekers often face additional challenges. The Atlanta Asylum Network (AAN) facilitates access to low or no-cost physical, psychological and gynecological evaluations to enable a fair and complete judicial process. The purpose of this analysis is to assess the presence of various types of violence experienced by a population of female West African asylum seekers, and to make …

Implementing Mindfulness Practices With Parents Of Young Children In A Low-Socioeconomic Status Neighborhood, Andrew T. Roach, Josephine Mhende, Brian A. Barger, Douglas A. Roberts

Journal of the Georgia Public Health Association

Background: The purpose of this study was to investigate whether instruction in mindfulness practices would results in improved self-reported mindfulness and reduced depression, anxiety, and family stress in parents of young children living in a low socioeconomic status (SES) neighborhood.

Methods: The study utilized a pretest-posttest group design to evaluate the effectiveness of the Mindfulness Ambassador Council-Interactive curriculum with attendees in a parent support program. Participants (n=15) were recruited from families with young children who received support from a community-based organization in one low-SES neighborhood in Atlanta. Mental health assessments, measures of family stress and parenting competency, and a demographic …

Examining The Characteristics Of Physicians That Leave Georgia After Medical School Training, Emmanuel Akowuah, Imaobong Ekpo, Samuel Opoku, Bettye Apenteng

Journal of the Georgia Public Health Association

Background: We sought to examine the characteristics of physicians who leave Georgia after graduating from a Georgia medical school.

Methods: Using the 2017 National Physician Compare data merged with the 2015-2016 Area Resource File, we compared the individual and practice location characteristics of physicians who went to medical school in Georgia and practice in the state to those who left.

Results: Less than half of physicians who had their medical school training in Georgia still practice here; those who leave are typically specialists practicing in older, affluent and less racially diverse counties.

Conclusions: Strategies to retain physicians in Georgia after …

Use Of Complementary And Alternative Medicine Among People With Cardiovascular Diseases In Southeast Georgia, Chimuanya Okoli, Stacy Carswell, Sewuese Akuse, Kelly Sullivan

Journal of the Georgia Public Health Association

Background: Heart disease is a leading cause of death in the United States. Proper treatment of patients with cardiovascular disease is essential and can be challenged by non-disclosed use of complementary or alternative treatments. The objective of this study was to assess which demographics were associated with complementary and alternative medicine (CAM) use and if education affects the use of CAM.

Methods: A cross-sectional survey was conducted among a stratified random sample of residents of Southeastern Georgia. Sampling was stratified by urban/rural residence in order to reach sufficient rural residents. Participants that indicated they had been diagnosed with hypertension or …

How Breastfeeding Behavior Is Affected By The Breastfeeding Perspectives Of Fathers In Georgia (Usa), Les'shon Irby, Emily Graybill, Cassandra White

Journal of the Georgia Public Health Association

Background: Father support has recently been associated with increasing breastfeeding rates, but research is limited on how the American father’s perspectives of breastfeeding influence breastfeeding behavior. The aim of the study was to investigate the perspectives of fathers residing in Georgia on breastfeeding and to understand if it contributed to mothers’ decisions to breastfeed.

Methods: We conducted 10 semi-structured, in-depth interviews with parents of ever-breastfeed infants who were at least six months of age.

Results: Mothers often led the decision-making process to breastfeed based on her prepartum knowledge of breastfeeding. Many fathers had no prepartum opinion on breastfeeding, and their …

The Ethics Of Parental Refusal To Vaccinate: Costs, Community Safety, And Individual Rights, Olatanwa Adewale, Carla Cooper, Pascal Felix, Ashley K. Mitchell, Justin Savage, William A. Mase

Journal of the Georgia Public Health Association

Background: According to the World Health Organization (WHO), vaccination has reduced the burden of infectious diseases to a significant extent. In recent times, however, the focus has been more on vaccine safety rather than effectiveness. As with any other public health program, immunizations and associated policies are designed to protect the health of the public. Compared to minor risks of side effects of vaccination, the risk of infection often rationalizes the use of vaccination. In states like Georgia, with fewer outbreaks associated with non-vaccination, the need to access community immunity remains constant. Though some articles have assessed parental refusal of …

Living Arrangement: A Contributor To Vascular Disease In Asymptomatic African American Women, Meldra Hall, Elizabeth Ofili, Rigobert Lapu-Bula, Ernest Alema-Mensah, Stephanie Miles-Richardson

Journal of the Georgia Public Health Association

Background: Diminished social support has shown to lead to worse cardiovascular outcomes and since cardiovascular disease (CVD) is the leading cause of death in the United States (U.S.), it is critical to non-invasively study its precursor- vascular disease (VD). Assessing the impact social support has on vascular outcomes can unveil potential CVD susceptibilities in at-risk populations. African American women exhibit the greatest burden of CVD morbidity and mortality; therefore, the purpose of this study is to examine the association between living arrangement/social support and impaired vascular function in asymptomatic African American women.

Methods: Vascular function was assessed by a non-invasive …

Participatory Process For Implementing A Colorectal Cancer Screening Intervention: An Action Plan For Local Sustainability, Selina A. Smith, Joyce Q. Sheats, Sandra J. Hamilton, Mary S. Whitehead, Ernestine Delmoor, Thomas Britt, Cassandra Harris, Janette Robinson-Flint, Cheryl Johnson, Corliss Mckeever, Connie L. Sorrell, Vincent R. Green, John W. Harmon, Dorothy L. Reddic, Jane Giddens-Cabarrus, Shirley Gordon-Seay, Benjamin E. Ansa, Daniel S. Blumenthal

Journal of the Georgia Public Health Association

Background: Rigid protocols can hamper translation of evidence-based interventions from research to real-world settings. This investigation aimed to develop procedures for modifying the study protocol of a community-based participatory research (CBPR) project and to analyze the theoretical constructs that underlie this process.

Methods: The research project is a dissemination and implementation study of the Educational Program to Increase Colorectal Cancer Screening (EPICS), an evidence-based intervention targeting African Americans in the United States. The study is being conducted in a partnership with community coalitions in 15 different cities. Each site initially presented unique issues that required modification of the study protocol. …

Social Media Usage And Influenza Beliefs, Risk Perceptions And Behavioral Intentions Among Students At A University In Southeastern Us, Jingjing Yin, Pei-Ling Tseng, Kotwoallama Reine Zerbo, Zion Tsz Ho Tse, Levi Ross, Isaac Chun-Hai Fung

Journal of the Georgia Public Health Association

Background: To document social media usage for the retrieval of health information among college students; and to understand the beliefs, risk perceptions and behavioral intentions among participants who retrieved CDC influenza information via social media.

Methods: We conducted an online survey to a convenience sample of students at a university in Southeastern United States during Spring 2015. The survey was self-administered and every matriculating student received an electronic invitation to participate at least once.

Results: A total of 930 students completed the online survey. Most participants (n=905, 97.3%) reported that they had used a social networking site in the previous …