Medicine and Health Sciences Commons^™

Retention And Predictors Of Attrition Among Children Living With Hiv On Antiretroviral Therapy (Art) In Côte D’Ivoire Between 2012 And 2016, F. Traore-Toure, Gina D. Etheredge, Gulzar H. Shah, C. Brennan

Department of Health Policy and Community Health Faculty Publications

Background: In Côte d’Ivoire a retrospective national-level cohort study conducted in 2009 indicated that 77%, 72% and 75% of children living with HIV (CLHIV) remained in care at 12, 36, and 48 months after starting ART, respectively. The CDC-sponsored Improving HIV Surveillance and Program Evaluation in Côte d’Ivoire project assessed retention progress since that study.

Methods and materials: A retrospective review of medical records was conducted using 2-stage cluster sampling. HIV care and treatment centers (CTC) were sampled based on patient caseload, then records of patients under 15 years of age who initiated ART between 2012–2016 were randomly …

Hiv Clinical Stage Progression Of Patients At 241 Outpatient Clinics In Democratic Republic Of Congo: Disparities By Gender, Tb Status And Rurality, Gina D. Etheredge, Raimi Ewetola, Gulzar H. Shah, L. Maluantesa, Kristie C. Waterfield, A. Mulenga, A. Kilundu

Department of Health Policy and Community Health Faculty Publications

Background: HIV clinical care programs are increasingly cognizant of the importance of customizing services according to patients’ clinical stage progression (WHO's four-tiered staging) and other risk assessments. Understanding factors associated with Persons Living with HIV (PLHIV) patients’ progression through the treatment cascade and clinical stages is essential for programs to provide patient-centered, evidence-based services.

Methods and materials: To analyze patient characteristics associated with disease progression stages for PLHIV on antiretroviral therapy (ART), this quantitative study used data, from January 2014–June 2019, from 49,460 PLHIV on ART from 241 HIV/AIDS outpatient clinics in 23 health zones in Haut-Katanga and …

Tb/Hiv Coinfection And Patient Outcomes: Evidence From 241 Clinics In The Democratic Republic Of Congo, Gulzar H. Shah, Raimi Ewetola, Gina D. Etheredge, L. Maluantesa, Kristie C. Waterfield, L.-K. Lukusa

Department of Health Policy and Community Health Faculty Publications

Background: To provide efficient, equitable, patient-centered, and evidence-based services to people living with HIV/AIDS (PLWH), it is critical for the intervention programs to understand the nature of barriers to effective treatment and additional risks faced by PLWH with tuberculosis (TB) coinfection. This study analyzes two aspects of TB coinfection in PLWH: (a) variation in TB/HIV coinfection by demographic and clinical characteristics of patients; and (b) risks of negative outcomes such as death, loss to follow up, and higher viral load among PLWH with TB coinfection compared to those without such coinfection.

Methods and materials: This quantitative study used …

An Exploration Of Depression In African American Adults With Sickle Cell Disease: Symptoms, Coping Strategies And The Potential Benefits Of Religiosity, Delores P. Quasie-Woode

Electronic Theses and Dissertations

Depressive symptoms in adults with Sickle Cell Disease (SCD) often go unrecognized and untreated. SCD is one of the most common inherited hemoglobin disorders in the United States, affecting 1 in 365 African Americans. Individuals with SCD and co-morbid Depression lead to high hospitalization rates and healthcare utilization. The objective of this study is to explore depressive symptoms and preferred coping strategies among African American Adults with SCD. Furthermore, the aim is to explore the acceptability of religiosity among those who self-identify as religious.

Interviews were conducted with 30 African American adults, recruited during their hematology appointment at the Center …

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

Department of Health Policy and Community Health Faculty Publications

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. …

The Rise In Use Of Emotional Support Animals By College Students: The Impact Of Parenting Styles, Misty G. Smith, Samantha Ballard, Jill Willis

Georgia Journal of College Student Affairs

As the generational context of higher education shifts, a rise of Emotional Support Animals (ESA) and mental health concerns are present for students on college campuses. While previous studies have aimed to address the relevancy and controversy of ESAs in higher education as well as their effectiveness in supporting individuals, less research has explored underlying factors that contribute to the use of an ESA. The purpose of this study was to explore the parenting behaviors of parents/caregivers of students with ESAs in comparison to parents/caregivers of students without ESAs. An embedded mixed methods design was used. Participants completed the Parenting …

Less Talking, More Empathy: How To Use Emojis To Help People Feel Good, Farhana Nusrat, Yanliu Huang

Association of Marketing Theory and Practice Proceedings 2021

Text therapy is an affordable and convenient form of counselling that allows clients to text with a Therapist. It is quite common for therapists to use emojis while talking to their clients via texts. In this study, we examine how use of emojis in the context of text therapy impacts clients’ overall counselling experience. In two studies, we show that using emojis with concise messages (vs. long messages) lead to greater clients’ overall satisfaction, higher willingness to pay, and increased positive word of mouth.

Supporting Student-Athlete Mental Health: Ncaa Division I Coaches' Experiences, Perceived Role, And Barriers, Kelsey Kinnamon

Electronic Theses and Dissertations

The opportunity for coaches to play an important role in supporting student-athlete mental health has been increasingly identified (Biggin et al., 2017; Gulliver et al., 2013; Henrikson et al., 2020). Findings suggest that coaches have the potential to help identify athletes who may benefit from mental health services, as well as foster an environment supportive of mental health and help-seeking (Bapat et al., 2009; Bissett et al., 2020). Recommendations have been set forth regarding how coaches may best engage in their role of supporting mental health, however, the literature lacks evidence of what collegiate coaches are actually doing to support …

Blood Transfusion: Knowledge, Perspectives, And Experiences Of Individuals With Sickle Cell Disease, Raymona H. Lawrence, Ashley Singleton, Jane Branscomb

Department of Health Policy and Community Health Faculty Publications

Patient voice and perspective were needed to inform effective, comprehensive strategies for reducing preventable transfusion-associated complications. This report presents the results of interviews with sickle cell disease (SCD) patients and implications for strategies to reduce transfusion complications in this population. Twenty-two participants were recruited from 2 comprehensive SCD treatment centers in Georgia and interviewed regarding knowledge about transfusions and potential complications, attitudes about data storage and sharing, and the transfusion experience. Participants had general knowledge of physiology, blood products, and blood transfusions, including knowing the risk of complications, but varied in comprehension of complex health information and level of misinformation. …

Publication Of Data Collection Forms From Nhlbi Funded Sickle Cell Disease Implementation Consortium (Scdic) Registry, Jeffrey Glassberg, Elizabeth A. Linton, Katrina Burson, Tabitha Hendershot, Joseph Telfair, Julie Kanter, Victor R. Gordeuk, Allison A. King, Cathy L. Melvin, Nirmish Shah, Jane S. Hankins, Axel Yannick Epié, Lynne D. Richardson

Department of Health Policy and Community Health Faculty Publications

Background: Sickle cell disease (SCD) is an autosomal recessive blood disorder affecting approximately 100,000 Americans and 3.1 million people globally. The scarcity of relevant knowledge and experience with rare diseases creates a unique need for cooperation and infrastructure to overcome challenges in translating basic research advances into clinical advances. Despite registry initiatives in SCD, the unavailability of descriptions of the selection process and copies of final data collection tools, coupled with incomplete representation of the SCD population hampers further research progress. This manuscript describes the SCDIC (Sickle Cell Disease Implementation Consortium) Registry development and makes the SCDIC Registry baseline …

Formative Research To Design A Culturally-Appropriate Cancer Clinical Trial Education Program To Increase Participation Of African American And Latino Communities, Jennifer Cunningham-Erves, Claudia Barajas, Tilicia Mayo-Gamble, Caree R. Mcafee, Pamela Hull, Maureen Sanderson, Juan Canedo, Katina Beard, Consuelo H. Wilkins

Department of Health Policy and Community Health Faculty Publications

Background: Addressing knowledge deficiencies about cancer clinical trials and biospecimen donation can potentially improve participation among racial and ethnic minorities. This paper describes the formative research process used to design a culturally-appropriate cancer clinical trials education program for African American and Latino communities. We characterized community member feedback and its integration into the program.

Methods: We incorporated three engagement approaches into the formative research process to iteratively develop the program: including community-based organization (CBO) leaders as research team members, conducting focus groups and cognitive interviews with community members as reviewers/consultants, and interacting with two community advisory groups. An …

Engagement Of Community Stakeholders To Develop A Framework To Guide Research Dissemination To Communities, Jennifer Cunningham-Erves, Tilicia Mayo-Gamble, Yolanda Vaughn, Jim Hawk, Mike Helms, Claudia Barajas, Yvonne Joosten

Department of Health Policy and Community Health Faculty Publications

Background: Dissemination of research findings to past study participants and the community-at-large is important. Yet, a standardized process for research dissemination is needed to report results to the community. Objective: We developed a framework and strategies to guide community-academic partnerships in community-targeted, dissemination efforts.

Methods: From 2017 to 2019, a community-academic partnership was formed in Nashville, Tennessee, and iteratively developed a framework and strategies for research dissemination using cognitive interviews. A deductive, constant comparative analysis was conducted on interview responses to examine framework and strategy content. Feedback was used to finalize the framework and strategies for the evaluation. …

Effect Of Influenza Vaccination On Mortality And Risk Of Hospitalization In Elderly Individuals With And Without Disabilities: A Nationwide, Population-Based Cohort Study, Yu-Chia Chang, Ho-Jui Tung, Yu-Tung Huang, Chin-Te Lu, Ernawaty Ernawaty, Szu-Yuan Wu

Department of Health Policy and Community Health Faculty Publications

Purpose: The effects of influenza vaccines are unclear for elderly individuals with disabilities. We use a population-based cohort study to estimate the effects of influenza vaccines in elderly individuals with and without disabilities. Methods: Data were taken from the National Health Insurance Research Database and Disabled Population Profile of Taiwan. A total of 2,741,403 adults aged 65 or older were identified and 394,490 were people with a disability. These two groups were further divided into those who had or had not received an influenza vaccine. Generalized estimating equations (GEE) were used to compare the relative risks (RRs) of …

A Scoping Review Of Theoretical Models And Conceptual Frameworks Used In Public Health Services And Systems Research (Phssr) Literature, Zahra Shahin, Anna Messick, Jenna Harris, Kristie C. Waterfield, Gulzar H. Shah

Department of Health Policy and Community Health Faculty Publications

Objectives

Theoretical models and conceptual frameworks are often used to design research methods. This study aims to provide an overview of the application of theoretical models and conceptual frameworks in Public Health Services and Systems Research (PHSSR). We also examine how the integration of such terms in research can improve intervention designs and support the decision-making process within the field of public health practice.

Methods

A scoping review was conducted using publications from public health journals to identify relevant articles in the field of PHSSR. The eligibility of studies was determined after performing evaluations through a full-text review of each …

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

Department of Health Policy and Community Health Faculty Publications

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 …

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 …

Associations Among Knowledge, Attitudes, And Practices Toward Palliative Care Consultation Service In Healthcare Staffs: A Cross-Sectional Study, Li-Chun Huang, Ho-Jui Tung, Pei-Chao Lin

Department of Health Policy and Community Health Faculty Publications

Background

The palliative care consultation service (PCCS) of the National Health Insurance payments has been promoted in Taiwan since 2011, although few studies have been conducted on healthcare staffs’ knowledge, attitudes, and practices regarding PCCS in Taiwan; consequently, the main objective of this study was to explore any correlations regarding the above by cross-sectional design using convenience sampling.

Methods

A total of 210 healthcare staff members were enrolled from a regional hospital from June 1, 2018, to September 30, 2018. Questionnaire items on the Palliative Care Consultation Service Inventory (KAP-PCCSI) were used to measure healthcare staff’s knowledge, attitudes, and practices …

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

Department of Health Policy and Community Health Faculty Publications

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). …

Unveiling The Mask:Sexual Trauma's Impact On Academic Achievement, Behavior, And Self-Identity, Teshaunda Hannor-Walker, Sarah Kitchens, Lacey Ricks

National Youth Advocacy and Resilience Conference

Sexual trauma is an unfortunate but a common and often masked experience for many students in America. While sexual trauma in itself is not a mental health disorder, it can become a risk factor for many academic and mental health problems. Trauma-informed schools can play an important role in helping students deal with the aftercare of a traumatic experience.

Examining The Effects Of Energy Drinks On Academic Performance, Alyssa P. Roberson

Electronic Theses and Dissertations

Reports of energy drink (ED) consumption have grown among the United States population. Research suggests reasons for consumption vary across populations, including increased attention and enhanced endurance performance. However, ED consumers could suffer from negative effects of ED, including health problems, caffeine overdose, and death. Energy drink consumption is also linked to substance use. Despite risks of consuming ED, heavy use of EDs remains among college students, often to help with academic performance; however, research has not examined effects of ED consumption on perceived and actual academic performance. This study evaluated relationships among ED consumption, self-efficacy, and academic performance in …

Are Chronic Inflammatory Diseases Associated With Trauma Exposure And Gender? An Empirical Analysis Of Self-Reported Trauma And Health Histories Of Men And Women, Meghan Lacienski

Electronic Theses and Dissertations

A growing body of research indicates an association between trauma, inflammation, and chronic inflammatory disease; however, the mechanisms of this relationship are not fully understood, and the salience of potential risk factors, such as cumulative effects of trauma, trauma type, and gender, remain unclear. Trauma is associated with poor mental and physical health, such as PTSD, depression, and chronic inflammatory conditions, and this association may be stronger when certain risk factors are considered (Brody, Pratt, & Hughes, 2018; Groer, Kane, Williams, & Duffy, 2014; Husky, Mazure, & Kovess-Masfety, 2018; Kilpatrick et al., 2013). For example, sexual trauma and multiple traumatic …

Potential Biases And Social Stigmas Toward Mental Health On Georgia Southern’S Campus, Brandi N. Hawkins

Honors College Theses

Aims: The purpose of this study is to examine the potential biases and social stigmas toward mental health on Georgia Southern’s campus. The research questions explored are as follows: (1) Are there mental health biases on campus? (2) Are there any differences between college, class status, marital status, race, age, or gender in terms of mental health bias? (3) Do students feel as though there are available resources on campus? (4) Do students feel comfortable reaching out for help?

Methods: Data was collected from 350 undergraduate students over the age of 18 via a Likert-style questionnaire. The questionnaire …

Adapting Medical Guidelines To Be Patient-Centered Using A Patient-Driven Process For Individuals With Sickle Cell Disease And Their Caregivers, Robert M. Cronin, Tilicia Mayo-Gamble, Sarah-Jo Stimpson, Sherif M. Badawy, Lori E. Crosby, Jeannie Byrd, Emmanuel J. Volanakis, Adetola A. Kassim, Jean L. Raphael, Velma Mcbride Murry, Michael Debaun

Department of Health Policy and Community Health Faculty Publications

Background: Evidence-based guidelines for sickle cell disease (SCD) health maintenance and management have been developed for primary health care providers, but not for individuals with SCD. To improve the quality of care delivered to individuals with SCD and their caregivers, the main purposes of this study were to: (1) understand the desire for patient-centered guidelines among the SCD community; and (2) adapt guideline material to be patient-centered using community-engagement strategies involving health care providers, community -based organizations, and individuals with the disease.

Methods: From May–December 2016, a volunteer sample of 107 individuals with SCD and their caregivers gave …

2491: Parental Concerns About Child Participation In S Reflect A Need To Move Beyond Traditional Notions Of Trust And Race, Jennifer Cunningham-Erves, Tilicia Mayo-Gamble, Consuelo H. Wilkins

Department of Health Policy and Community Health Faculty Publications

OBJECTIVES/SPECIFIC AIMS: The objective of this study was to identify factors influencing parental willingness of adolescent participation in clinical trials. METHODS/STUDY POPULATION: We applied community engaged research principles to conduct a theory-based, cross-sectional study of parental willingness. Parents (N=307) were given a survey from November 2014 to April 2015. Factors influencing parental willingness were identified using binary logistic regression. SPSS version 22.0 was used to perform analyses, and p

Differences In Mental Health Education Across Baby Boomers, Generation X, And Millennials, Ashlyn M. Avera

Honors College Theses

There is no denying that mental illness has gained a strong prevalence in the United States. According to the National Alliance on Mental Illness, approximately one in five adults in the United States experiences a mental illness in any given year. Although mental health stigmas have played a role in the past, it does not mean they must continue to play the same role in the future. Research is now looking toward ways to decrease mental health stigma through increasing mental health knowledge. This study examines the starting point for which a society becomes literate in mental health. Using a …

2484: Establishment Of The Tennessee-Sickle Cell Disease Network As A Mechanism For Engaging A Rare Disease Population In Patient Centered Outcomes Research, Tilicia Mayo-Gamble, Velma Mcbride Murry, Michael R. Debaun

Department of Health Policy and Community Health Faculty Publications

OBJECTIVES/SPECIFIC AIMS: Despite the high prevalence of individuals diagnosed with sickle cell disease (SCD) in Tennessee, comprehensive care and education for patients with SCD is not as widely available as healthcare services for individuals managing other chronic illnesses. We aimed to engage SCD stakeholders in patient-centered outcomes research (PCOR) as a mechanism for advancing care and translational research for this rare disease population. METHODS/STUDY POPULATION: Through a partnership with the Sickle Cell Foundation of Tennessee, we implemented Community Health Ambassadors to systematically engage patient partners with SCD and their caregivers, aged 18–50 from rural and urban communities throughout Tennessee, in …

Using The Roc Curve To Measure Association And Evaluate Prediction Accuracy For A Binary Outcome, Jingjing Yin, Robert L. Vogel

Biostatistics Faculty Publications

This review article addresses the ROC curve and its advantage over the odds ratio to measure the association between a continuous variable and a binary outcome. A simple parametric model under the normality assumption and the method of Box-Cox transformation for non-normal data are discussed. Applications of the binormal model and the Box-Cox transformation under both univariate and multivariate inference are illustrated by a comprehensive data analysis tutorial. Finally, a summary and recommendations are given as to the usage of the binormal ROC curve.

Using Ranked Auxiliary Covariate As A More Efficient Sampling Design For Ancova Model: Analysis Of A Psychological Intervention To Buttress Resilience, Rajai Jabrah, Hani Samawi, Robert Vogel, Haresh Rochani, Daniel Linder

Biostatistics Faculty Publications

Drawing a sample can be costly or time consuming in some studies. However, it may be possible to rank the sampling units according to some baseline auxiliary covariates, which are easily obtainable, and/or cost efficient. Ranked set sampling (RSS) is a method to achieve this goal. In this paper, we propose a modified approach of the RSS method to allocate units into an experimental study that compares L groups. Computer simulation estimates the empirical nominal values and the empirical power values for the test procedure of comparing L different groups using modified RSS based on the regression approach in analysis …

Goal Orientation, Motivational Climate, And Exercise As Predictors Of Eating Disorder Risk Factors Among College Students, Carly Wahl

Electronic Theses and Dissertations

College is a transition period in a young adult’s life in which eating disorder symptomology is especially prevalent. Additionally, motivation-based factors such as goal orientation and motivational climate can influence these eating disorder-like behaviors, especially in a physical activity setting. The present study aimed to examine how goal orientation, motivational climate, and exercise could be used to predict a college students’ eating disorder symptomology. Participants included 276 college-aged males and females from a university in the southeastern United States. These participants had experience using the university recreation activity center and were recruited from a required healthful living course. Each participant …

Examining Preference Of Home-Based Telemental Health Among Rural Veterans, Paige Dixon

Electronic Theses and Dissertations

Rural veterans face significant disparities to health care that have resulted in lower physical and mental health related quality of life when compared to their urban counterparts (Weeks et al., 2006). Such disparities are further complicated by the six-fold increase in prevalence of mental health diagnoses among Operation Enduring Freedom and Operation Iraqi Freedom veterans (Seal et al., 2009). These rising rates are particularly relevant to rural veterans as they represent 41% of the overall Veteran Health Administration enrollees, but only 19% of the general population (U.S., Department of Veterans Affairs, 2012; U.S. Census Bureau, 2014). Rural veterans face three …