Medicine and Health Sciences Commons^™

The Mentoring Cycle: A Two-Way Exchange, Sara S. Plaspohl

Journal of the Georgia Public Health Association

This article is an invited editorial for the special supplement for the Journal of the Georgia Public Health Association featuring student-mentored research.

The Association Of Stress With Anxiety And Depression: Evidence From A Community Health Needs Assessment, Nicole La Tournous, Grace Bagwell-Adams

Journal of the Georgia Public Health Association

Background: Mental illness affects approximately 1 in 5 Americans, making mental health an important area of study for public health. Much research has been conducted on two of the most prevalent mental health disorders, anxiety and depression. However, the association of stress with these disorders, especially specific types of stress (e.g., financial, health, relationship), has been under-studied at the local level. This study aimed to gain insight into the relationship between stress, anxiety, and depression in Athens-Clarke County, Georgia.

Methods: Data collected in the 2015 Athens-Clarke County Community Health Needs Assessment were analyzed using linear regression models to explore the …

Predictors Of Mammogram And Pap Screenings Among Us Women, Sewuese Akuse, Koren Tate, Tiffany Addison, Tierra Drayton, Deborah Kanda, Kelly Sullivan

Journal of the Georgia Public Health Association

Background: The most common cancers among women are breast and cervical cancer. Although early detection of cancer has been shown to increase the likelihood of survival, many women are not screened for these cancers as often as practice guidelines recommend. The objective of this study was to examine the mammography and Papanicolaou (Pap) smear screening practices among women within the United States, and to determine predictors of screening.

Methods: Data from the 2012 and 2014 Behavioral Risk Factor Surveillance System were used. The association between demographic predictors (age, marital status, education level, employment status, income, health insurance, and medical cost …

Black College Women Sexual Health Peer Education At Clark Atlanta University, Clarissa Francis, Josephine Bradley, Christopher Bass, Karla Scipio, Ronald Braithwaite

Journal of the Georgia Public Health Association

Background: This research was based on the premise that various factors, such as social determinants, cultural competency, use of statistics and location, contribute to the efficacy of the transmission of sexual health education. In the United States, African American women account for 60% of the cases of human immunodeficiency virus (HIV) of women. Considerable research has noted the high rates of HIV among African-American women. The present research, however, focused exclusively on Black college women at Clark Atlanta University (CAU).

Methods: A mixed method approach using surveys and participant observation in an exploratory case study was used to evaluate responses …

Planning A National-Level Data Collection Protocol To Measure Outcomes For The Colorectal Cancer Control Program, Anamika Satsangi, Amy Degroff

Journal of the Georgia Public Health Association

Background: The Colorectal Cancer Control Program (CRCCP) of the Centers for Disease Control and Prevention (CDC) funded 30 grantees to partner with health systems with the goal of increasing screening for colorectal cancer (CRC).

Methods: Evaluators applied CDC’s Framework for Program Evaluation to design a national level outcome evaluation for measuring changes in CRC screening rates in partner health systems.

Results: The resulting evaluation design involves the collection and reporting of clinic-level CRC screening rates supplemented by various tools to support the reporting of high quality, reliable data.

Conclusions: The CRCCP evaluation represents a strong design to measure the primary …

Associations Between Major Depression, Health-Risk Behaviors, And Medication Adherence Among Hiv-Positive Adults Receiving Medical Care In Georgia, Rachel Culbreth, Shanta R. Dube, David Maggio

Journal of the Georgia Public Health Association

Background: There are approximately 1.2 million people in the United States living with HIV, and 25.6% of HIV-positive adults suffer from depression. The purpose of this study is to examine the contribution of depression to substance use and medication adherence among HIV-positive adults receiving medical care for HIV in Georgia.

Methods: Secondary data with a probability sample of 775 HIV-positive adults who took part in the 2009-2013 Georgia Medical Monitoring Project (MMP) were analyzed. Descriptive analyses and multivariate logistic regressions were conducted to assess relationships between depression and current cigarette smoking, injection drug use, other non-injection drug use, and medication …

Air Pollution, Physical Activity, And Markers Of Acute Airway Oxidative Stress And Inflammation In Adolescents, Emily Pasalic, Matthew J. Hayat, Roby Greenwald

Journal of the Georgia Public Health Association

Background: The airway inflammatory response is likely the mechanism for adverse health effects related to exposure to air pollution. Increased ventilation rates during physical activity in the presence of air pollution increases the inhaled dose of pollutants. However, physical activity may moderate the relationship between air pollution and the inflammatory response. The present study aimed to characterize, among healthy adolescents, the relationship between dose of inhaled air pollution, physical activity, and markers of lung function, oxidative stress, and airway inflammation.

Methods: With a non-probability sample of adolescents, this observational study estimated the association between air pollution dose and outcome measures …

The Eating And Cooking Healthy (Teach) Kitchen: A Research Protocol, Sashia White, Roberto Alva-Ruiz, Lucia Chen, Jason Conger, Christopher Kuang, Cameron Murphy, Najeah Okashah, Eric Ollila, Selina A. Smith, Benjamin E. Ansa

Journal of the Georgia Public Health Association

Background: Diet-related chronic diseases, such as diabetes mellitus, hypertension, and hyperlipidemia have affected millions of individuals, resulting in disease-related complications and mortality. Strategies that may improve the outcome of chronic disease management include modification of lifestyle risk factors such as unhealthy diets. TEACH Kitchen is an experiential education program related to community nutrition, the goal of which is to teach patients management of chronic disease through dietary change.

Methods: Adults (n=144) ≥18 years old and their children (n=144) 7-17 years old will complete four 2-hour sessions. Components of each session will include brief nutrition education (20 min), an interactive cooking …

Sexual Risk-Taking Among At-Risk Alcohol And Drug Users Presenting To Emergency Departments, Rebecca Howell, Aaron Johnson

Journal of the Georgia Public Health Association

Background: Alcohol use is linked to increased sexual risk-taking, including unprotected sexual contacts, and illegal drug use is associated with an increased likelihood of sexual risk-taking and at-risk alcohol use. Risky sexual behavior is co-morbid with anxiety, depression, and mood disorders. The purpose this study was to identify factors associated with sexual risk-taking among adult, at-risk alcohol or drug users presenting to emergency departments (EDs).

Methods: Data were derived from self-report surveys conducted with a random sample of ED patients screening positive for at-risk alcohol or drug use. As part of an alcohol and drug assessment completed by a health …

The Influence Of Georgia’S Quality Rated System On School Readiness In Preschool Children, Radhika B. Patel, Nancy C. Webb

Journal of the Georgia Public Health Association

Background: Initially launched in 2012, the Quality Rated (QR) program in Georgia is a policy tool for assessing, improving, and communicating the quality of early childhood education and care. Star level designations – zero-star, one-star, two-star, and three-star – are assigned based on a portfolio of QR standards and an onsite Environment Rating Scales observation. In the present study, we used QR data to determine if childcare quality measures (QR ratings) are linked with the readiness of children to enter kindergarten.

Methods: QR data were collected from one-star, two-star, and three-star childcare learning centers (n = 16) located within Child …

An Assessment Of Data Related To Inspections Of Risk Factors For Public Swimming Pools, Shanita Shack, Maurice Redmond, Christopher Rustin

Journal of the Georgia Public Health Association

Background: The Georgia Department of Public Health (DPH) is mandated to ensure that public swimming pools are safe for those who use them. This mandate is carried out by the DPH and local environmental health professionals through regulations and inspections. In 2015, legislation was introduced proposing to reduce the authority of the DPH to inspect certain pool types (apartments, subdivision, condominiums) and thus reduce regulatory protections in place for swimmers. To ensure that the DPH had current information on the risks associated with pools, the EH team, with assistance from a graduate student, analyzed inspection data to evaluate risk factors …

The Zika Virus In The United States: A Comprehensive Review, Daniel R. Lindsey, Martin H. Greenberg

Journal of the Georgia Public Health Association

Background: With a series of outbreaks spanning the globe, the Zika virus has transitioned, in a short time, from an obscure virus to a public health emergency. Locally transmitted Zika has reached the United States, leading to increased concern regarding further transmission and the potential impact on public health.

Methods: The present study was conducted to examine the propagation and effects of Zika in the United States by reviewing published literature regarding Zika in conjunction with updates from the Centers for Disease Control and Prevention. To gauge the regional response, including prevention and control efforts, interviews were conducted with public …

Educational Attainment And Self-Rated Health Among African-Americans In Pitt County, Nc, Eeshwar K. Chandrasekar, Zimo Z. Banta, Kathleen R. Ragan, Michelle M. Schmitz, Sherman A. James

Journal of the Georgia Public Health Association

Background: To help fill the knowledge gap regarding relationships between educational attainment and self-rated health (SRH) in minority populations, we analyzed the data of a community-based cohort of African-Americans residing in Pitt County, NC, between 1988 and 2001.

Methods: Data from the Pitt County Study (a community-based, longitudinal survey of risk factors for hypertension and related disorders disproportionately affecting African-Americans) were used to explore associations between educational attainment and SRH, stratified by sex, in a cohort of individuals from 1988 (n=1,773), 1993 (n=1,195), and 2001 (n=1,117) using continuous, ordinal, and binary correlated data analyses.

Results: For males and females with …

How Can We Promote Mentored Student Research In Georgia?, Nancy C. Webb, Selina A. Smith

Journal of the Georgia Public Health Association

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Determinants Of Adherence To Nutrition- Related Cancer Prevention Guidelines Among African American Breast Cancer Survivors, Lindsey A. Ramirez, Yunmi Chung, Wonsuk Yoo, Brittney Fontenot, Benjamin E. Ansa, Mary S. Whitehead, Selina A. Smith

Journal of the Georgia Public Health Association

Background: Mortality rate for breast cancer is higher among African American (AA) women than for women of other racial/ethnic groups. Obesity, also higher among AA women, may increase the risk of breast cancer development and recurrence. Lifestyle factors such as healthy nutrition can reduce the rate of obesity and breast cancer. This study examined the determinants of adherence to nutrition-related cancer prevention guidelines among AA breast cancer survivors.

Methods: AA breast cancer survivors (n=240) were recruited from a breast cancer support group to complete a lifestyle assessment tool for this cross-sectional study. Chi-square test and ordinal logistic regression analysis were …

Does Actual Overweight Or Perception Of Overweight Elevate Suicide Risk In Bullied Vs. Non-Bullied Students?, Ashley Kalle, Yunmi Chungs, Wonksuk Yoo

Journal of the Georgia Public Health Association

Background: For individuals in Georgia aged 10-14 and 15-24, suicide is the third leading cause of death. Those who are overweight are often bullied by their peers, and being bullying can lead to higher risks of suicidality. There is, however, mixed evidence about the relationship between high weight and suicide. Weight perception may be a stronger predictor of suicide than actual weight. The aim of the present study was to examine, in a national sample of high school students, the interaction between weight and bullying on suicide outcomes.

Methods: A secondary data analysis was performed with data from the 2015 …

Association Between Intimate Partner Violence And Mentally Unhealthy Days In Women In The U.S., Danielle Broadnax, Reinetta Thompson Waldrop, Mechelle D. Claridy, Elaine Archie Booker, Ernest Alema-Mensah

Journal of the Georgia Public Health Association

Background: In the United States (U.S.), intimate partner violence (IPV) is a serious public health concern, mainly affecting the health and well-being of women. The objective of this study was to identify the IPV and socio-demographic factors associated with mentally unhealthy days among women in the U.S. of ages ≥18 years.

Methods: Data for this study were obtained from the 2007 Behavioral Risk Factor Surveillance System. Multivariable analyses were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) for factors associated with IPV and 14 or more mentally unhealthy days per month. Analyses were conducted using …

Engaging Homeless Service Providers In Educational Efforts During A Tuberculosis Outbreak In Atlanta, Preetha Nandi, Mary Claire Worrell, Tom Andrews, Rose-Marie Sales, Jeff Mcmichael, Kristen H. Hamptom, Neela D. Goswami

Journal of the Georgia Public Health Association

Background: During an outbreak of tuberculosis (TB) in the homeless population of metropolitan Atlanta, education of homeless service providers (HSPs) about the implementation of local infection control measures was imperative to limiting the spread of TB and to preventing future outbreaks.

Methods: By use of educational sessions and teaching posters, two interventions were designed to focus educational efforts from November 2014 to August 2015: 1) a spatially-targeted approach that identified HSPs within an area of Fulton County, GA (which includes downtown Atlanta) with high TB case density (cases per square mile) from 2009 – 2014, and 2) an organizational meeting …

Violence Related Injuries Among Individuals Admitted To A Level I Trauma Center In Atlanta, 2011-2013, Fahruk O. Akinleye, Gemechu Gerbi, Omar Danner, Elaine Archie-Booker, Stephanie Miles-Richardson

Journal of the Georgia Public Health Association

Background: Violence related injuries (VRIs) are a major public health problem in the United States (US). According to the Centers for Disease Control and Prevention (CDC), homicide is the 11th leading cause of death in the US and the third leading cause of death among persons aged 15-24 years old. Among African Americans aged 10-34, homicide is the leading cause of death and is the fifth leading cause of death among those 35-44 years old. One form of homicide that can result in injury resulting in death is firearm violence. The objective of this study is to assess the rates …

Intersecting Motivations For Leaving Abusive Relationships, Substance Abuse, And Transactional Sex Among Hiv High-Risk Women, Naomi S. David, Sophia A. Hussen, Dawn L. Comeau, Ameeta S. Kalokhe

Journal of the Georgia Public Health Association

Background: Women bear a significant burden of the HIV epidemic in the United States. Women classified as ‘HIV high-risk’ often bring co-existing histories of intimate partner violence (IPV), drug use, and transactional sex. To help inform future comprehensive HIV prevention strategies, we aimed to explore common motivating reasons and barriers to leaving and/or terminating engagement in each of these riskpromoting situations.

Methods: Between August and November 2014, in-depth interviews were conducted with 14 HIV high-risk women in Atlanta, Georgia who had experienced IPV in the previous 12 months, and used drugs and/or engaged in transactional sex in the previous five …

A Central Georgia Asthma Prevalence Assessment Of School-Age Children And Compliance With Senate Bill 472, Cheryl L.R. Gaddis, Jimmie Smith

Journal of the Georgia Public Health Association

Background: A common theme among the counties of the North Central Health District is the disparity between the number of asthma-related visits of African-American and white children ages 1-14 to the emergency department. In 2013, 858 children ages 1-14 in the district had emergency room visits related to asthma. The purpose of this study was to assess North Central Health District (NCHD) schools to determine the prevalence of self-reported asthma by parents and school age children and the adequacy of students’ access to maintenance inhalers at school, and to identify schools that qualify for Asthma Friendly School Recognition.

Methods: The …

A Region-Wide Field Placement Program Built On The Foundation Of Mentorship And Professionalism, Carvalho L. Michelle, Laura M. Lloyd, Melissa Alperin, Kathleen R. Miner

Journal of the Georgia Public Health Association

Background: The Region IV Public Health Training Center (R-IV PHTC) provides public health students from the eight states of HHS Region IV with essential practice experiences that demonstrate the value of working with underserved populations. The Pathways to Practice Scholars field placement program is built on a foundation of mentorship, professionalism, and community.

Methods: Sixteen student scholars (13 graduate; 3 undergraduate) were selected to work during May-August 2015 in practiceoriented agencies serving underserved populations. Each scholar received a $1500 living allowance. Seven of 16 accepted an internship outside the state of their university. In conjunction with mentors, Scholars developed work …

The Evidence For And From Accreditation, Kaye Bender

Journal of the Georgia Public Health Association

Background: Public health department accreditation administered by the Public Health Accreditation Board (PHAB) began in 2007 after a series of policy briefs, field demonstration initiatives, and completion of a national feasibility study.

Methods: Evidence for accreditation was gathered from both national and state-based standards that had been tested and evaluated. Evidence from accreditation was obtained from surveys and focus groups.

Results: Preliminary analyses have indicated that the accreditation program is having its intended impact, although longitudinal analyses are planned for the future when a larger number of health departments can respond to surveys over time.

Conclusions: PHAB will continue to …

Nicotine Poisoning Trends In Georgia, Oluwayomi Fabayo, Alina Chung, Ray Kenneth, Jean O'Connor

Journal of the Georgia Public Health Association

Background: Nicotine is a toxic chemical that can cause adverse health effects. Nicotine poisoning can result from exposure to tobacco and other nicotine containing products. It can cause nausea, vomiting, abdominal pain, fever, dizziness, seizures, tachycardia, hypertension and edema. Nicotine poisoning can affect both adults and children.

Methods: The Georgia Department of Public Health secured data from the Georgia Poison Center in order to analyze nicotinespecific poisoning calls, including e-cigarette poisoning calls. The data on tobacco/nicotine poisoning or exposure calls were collected from April 2009 to April 2015. The data on calls related to nicotine poisoning from e-cigarettes were collected …

Reducing And Eliminating Health Disparities Through Prevention And Public Health, Daniel S. Blumenthal

Journal of the Georgia Public Health Association

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Collecting Physiological Stress Measures In Research Among High-Risk Parents For Child Maltreatment: A Qualitative Investigation, Ashwini Tiwari, Shannon Self-Brown, Charles Robinson, Colleen Mccarty, Laura Carruth

Journal of the Georgia Public Health Association

Background: Studies on evidence-based, behavioral training programs have shown a positive reduction in self-reported stress among parents at high risk of child maltreatment (CM). However, no known studies on these programs have examined physiological biomarkers for stress, such as impaired levels of cortisol and dehydroepiandrosterone (DHEA), and telomere length. Further, no details are known regarding the feasibility of collecting biological markers from parents. This research examined qualitative findings from a multidisciplinary neurobiology and public health study that examined physiological responses to a six week, evidence-based, behavioral parenting program, among a maternal population at risk of CM perpetration in Atlanta, Georgia. …

Hepatitis C And Injection Drug Use: Testing And Linkage To Care, Marie Sutton, Cole G. Youngner, Winona J. Holloway

Journal of the Georgia Public Health Association

Background: The recent outbreak of HIV infection in Indiana linked to injection drug use demonstrates the importance of timely HIV and Hepatitis C surveillance and rapid response to interrupt disease transmission. An estimated 2.7 – 3.9 million Americans have chronic hepatitis C virus (HCV) infection. Of those, 50 – 70% are unaware of their infection. People who inject drugs account for more than half of new HCV cases. Within 5 years of beginning injection drug use, 50 – 80% of injection drug users (IDUs) become infected with HCV. Since 2007, HCV-related deaths have surpassed HIV-related deaths. CDC reported 19,368 death …

Formative Research To Develop A Lifestyle Application (App) For African American Breast Cancer Survivors, Selina A. Smith, Mary S. Whitehead, Joyce Q. Sheats, Brittney Fontenot, Ernest Alema-Mensah, Benjamin Ansa

Journal of the Georgia Public Health Association

Background: There is a proliferation of lifestyle-oriented mobile technologies; however, few have targeted users. Through intervention mapping, investigators and community partners completed Steps 1-3 (needs assessment, formulation of change objectives, and selection of theory-based methods) of a process to develop a mobile cancer prevention application (app) for cancer prevention. The aim of this qualitative study was to complete Step 4 (intervention development) by eliciting input from African American (AA) breast cancer survivors (BCSs) to guide app development.

Methods: Four focus group discussions (n=60) and three individual semi-structured interviews (n=36) were conducted with AA BCSs (40-72 years of age) to assess …

New Recreational Water Quality Criteria And Their Impact On Beach Advisories In Coastal Georgia, Asli Aslan, Sara Benevente

Journal of the Georgia Public Health Association

Background: To monitor pollution of marine beaches in Georgia, enterococci have been used as indicators of fecal contamination. For the 1986 Recreational Water Quality Criteria (RWQC), the beach action value (BAV) was 104 colonyforming units (CFU)/100 ml; the new RWQC, instituted in 2012, is 70 CFU/mL, a 32.6% decrease. When the beach action value is reached, authorities are to issue a beach advisory for protection of swimmer health. The present study investigated changes in compliance with the 2012 RWQC at five high-use beaches in Georgia.

Methods: In the summer of 2015, samples of water were collected from five beaches at …

Local Efforts Toward Addressing Health Disparities In Dekalb County, Georgia, April Hermstad, Erikka Gilliam, Sedessie Spivey, Zipatly Mendoza

Journal of the Georgia Public Health Association

Background: In underserved African American communities throughout DeKalb County, the DeKalb County Board of Health (DCBOH) is implementing community-based initiatives using policy, systems, and environmental improvement approaches to reduce racial and ethnic health disparities by increasing opportunities for nutrition and physical activity.

Methods: The initiatives are being implemented in priority census tracts where the population is at least 40% African American, 30% live below federal poverty level, and 25% did not graduate from high school. Communications promote awareness of the programs, and evaluation activities document processes and outcomes.

Results: To date, implementation of five interventions has affected approximately 276,000 DeKalb …