Public Health Commons^™

Assessment Of Early Intervention Services To Better Child Outcomes Among Part C Infants And Toddlers, Brendan Ibe, Tiffany Fowles, Seema Csukas, Jackie Conner, Grace Kelley, Donna Johnson, Cynthia Bryant, Michelle Allen

Journal of the Georgia Public Health Association

Background: Early intervention services have been shown to improve child outcomes. Rapid proliferation of neural connections and circuits contribute to the rapid growth of the brain in the first three years of life. These neural circuits which create the foundation for learning are most flexible in this period and become increasingly more difficult to change thereafter. The purpose of this study is to examine the relationship between early enrollment in Georgia’s Part C birth to three early intervention program and improved child outcome ratings upon exiting the program at 3 years of age. The study used 2013 & 2014 Annual …

A Cross Sectional Study Of Mostly African- American Men Examining Mental Health And Child Behavior, Matt C. Jackson, Melissa Cowart-Osborne, Shannon Self-Brown

Journal of the Georgia Public Health Association

Background: Home visiting receives bipartisan support at both the state and federal level, because several models have demonstrated significant results in both reduction of child maltreatment as well as parenting behavior modification. Yet, parenting research and services lack further engagement and involvement as a primary component. That is, even though research has shown that fathers play an integral role in child development, there is very little research done in which fathers are the primary focus; most of this research focuses on mothers. When it comes to serving children who are victims of child abuse and neglect, this is a problem …

Domestic Violence Intervention For Latino Families: Baseline Program Evaluation Data, Jacque-Corey Cormier, Nancy Nava, Charmaine Mora, Rebecca Rodriguez

Journal of the Georgia Public Health Association

Background: In the United States, Latino families affected by domestic violence (DV) often face unique challenges influenced by changing ecologies and personal/political histories. Caminar Latino is Georgia’s first and only comprehensive DV intervention program for Latino families. The program is geared towards helping family members begin their journey towards non-violence. The purpose of this evaluation is to better understand how Caminar Latino is benefiting families within the program. Baseline data of interest included perceptions of power in the relationship among family members and whether mothers and/or youth had safety plans.

Methods: A longitudinal, quasi-experimental research design was utilized to collect …

The Influence Of Georgia’S Quality Rated System On School Readiness In Pre-School Children, Dena Phillips, Nancy C. Webb

Journal of the Georgia Public Health Association

Background: Georgia rates the quality of early childcare learning centers using a tiered quality improvement system. Georgia’s Quality Rated system (QR) designates a star level, (one star, two stars or three stars) to each center based on a portfolio of QR standards and an onsite assessment by Georgia Department of Early Care and Learning (DECAL). Childcare centers applying for QR status first submit a portfolio documenting how their practices align with QR standards centered on staff qualifications; child health, nutrition and physical activity; family engagement; holistic curricula and teacher-to-student ratios. Subsequently, an on-site assessment of the center is performed by …

Psychotropic Medications, Weight Gain And Chronic Diseases In A Correctional Setting: Impact On Women’S Health, Madison L. Gates, Elizabeth Ferguson, Thad Wilkins, Darra Balance, Wonsuk Yoo

Journal of the Georgia Public Health Association

Background: Studies with non-incarcerated populations have found a relationship between psychotropic medications and metabolic side effects, such as weight gain. Few studies have investigated the relationship between psychotropic medications associated with weight gain in prisoners, despite data showing that 73% of female and 55% of male offenders have a mental health problem and 15% have had medications prescribed.

Methods: This longitudinal study investigated the relationship among psychotropic medications and weight gain in prisoners. We hypothesized that women prescribed psychotropic medications gain more weight than men. Data were extracted from Department of Corrections’ electronic health records. All prisoners with active records …

Meeting The Public Health Workforce’S Training Priorities In Georgia And The Southeast, Laura M. Lloyd, Melissa Alperin, Michelle L. Carvalho, Kathleen R. Miner

Journal of the Georgia Public Health Association

Background: The mission of the Region IV Public Health Training Center (R-IV PHTC) is to build knowledge and skills in the public health workforce in the eight states of HHS Region IV by providing competency-based training. Workforce training needs are changing quickly and dramatically in light of new developments in public health practice and science, emerging diseases, changes in the health care environment, and the growing emphasis on inter-professional practice. Additionally, a 2014 survey conducted by the Association of State and Territorial Health Officials (ASTHO) found that at least 38% of the current public health workforce plans to retire by …

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 …

Surveillance, Epidemiology, And End Results (Seer) Data For Monitoring Cancer Trends, Wonsuk Yoo, Steven S. Coughlin

Journal of the Georgia Public Health Association

Background: Monitoring cancer trends allows evaluation of the effectiveness of cancer screening or detection methods and determination of priorities in cancer control programs. Government officials and policy makers also use information on cancer trends to allocate resources for cancer research and prevention. Although data from the Surveillance, Epidemiology, and End results (SEER)-affiliated cancer registry are accessible to the public, there is a shortage of published research describing cancer incidence rates for White, Black, and other residents in Georgia. The objective of this research is to provide an overview of how to use SEER data through analysis of the incidence rate …

Community Preparedness: Expanding Existing Partnerships With Academia To Build Resilience Through Experiential Learning, Nina Cleveland, Mark Palen

Journal of the Georgia Public Health Association

Background: Sustainability and mitigation in preparedness after grant money is gone has suddenly become a hot topic in the public health emergency preparedness world. By the same token, funding provided by the Federal Emergency Management Agency (FEMA) for individual preparedness initiatives has not had the desired mitigation impacts. The question becomes, are there alternative approaches that reach more individuals to build a culture of preparedness in communities? One solution involves the leveraging of academic and regional public health partnerships with their Medical Reserve Corps Units (MRC), to train college students in individual preparedness. The purpose of this study is to …

The Effect Of A Nutrition Intervention On Parents Living In A Rural Georgia Community, Regina Elliott-Walker, Dawn M. Hayes, Emeka Oraka, Rashunda Lewis, Andre Leon

Journal of the Georgia Public Health Association

Background: Childhood obesity is a concern for public health organizations. Nearly one in four children living in rural communities are obese, and children living in rural Georgia communities are no exception. For rural communities, prevention efforts are needed to address challenges to reducing childhood obesity. The objective of the present effort was to increase the knowledge of parents in a rural community of the benefits of fruit and vegetable consumption and other healthy options.

Methods: The “We Can Energize Families” curriculum, developed by the National Heart, Lung, and Blood Institute was implemented in a rural Georgia community. Pender’s Health Promotion …

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 …

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 …

Fulfilling Community Health Assessment Requirements: Lessons Learned From Facilitating State-Wide Community Health Forums, Ashley Walker, Angela Peden, Stuart H. Tedders, John S. Barron, Aaron Jackson, Nicholas Williams, Bethrand Ugwu

Journal of the Georgia Public Health Association

Background: A prerequisite for National Public Health Accreditation is completion of a Community Health Assessment (CHA) that presents an exhaustive profile of the population served by a particular public health agency.

Methods: The Georgia Department of Public Health (GA DPH) contracted with the Center for Public Health Practice and Research at Georgia Southern University to facilitate five state-wide community health forums.

Results: Evaluation of the forums yielded qualitative data illustrating current challenges faced by Georgians, as well as assets that could be leveraged to improve health status.

Conclusion: Lessons learned from these state-wide community health forums can be applied to …

Screening For Developmental Delay In Georgia’S Family Shelters: Formative Evaluation Of A Quality Improvement Initiative, Marvin So, Luisita G. Agbayani, Mariel K. Gutierrez, Josef T. Griffins

Journal of the Georgia Public Health Association

Background: Children in families experiencing homelessness are at elevated risk for cognitive, motor, speech, and other developmental delays. Given the prevalence of family homelessness in Georgia and across the U.S., investigating the feasibility of implementing developmental screeners while families are in shelters is warranted.

Methods: Three pilot shelters were selected for the development and implementation of Quality Improvement (QI) Teams, who used Plan-Do-Study-Act (PDSA) Cycles to make progress towards universally screening children for delay. We employed a formative evaluation to (1) characterize screening rates and shifts in shelter as a result of QI initiatives, and (2) identify barriers and facilitators …

Evaluating Public And Private Partnership To Improve Food And Language Nutrition Among Children 0-5 Years, Chinwe Ejikeme, Kia Powell-Threets, Emily Anne Vall, Laura Wagner, Luke Fiedorowicz, Audrey Idaikkadar, Jean O'Connor

Journal of the Georgia Public Health Association

Background: Racial and ethnic minority populations in Georgia experience increased rates of chronic disease and poor health and education outcomes, which can be prevented through enhanced public- private partnerships. Using the Centers for Disease Control and Prevention (CDC) evaluation framework, the Evaluation Subcommittee for the Georgia Partnership for Food and Language Nutrition Project comprised of representatives from various stakeholders affiliated with state agencies, academia, and community-based organizations developed an evaluation plan to improve the collaborative effort designed to improve food and language nutrition among children 0-5 years. The purpose of this mixed-methods study was to assess influential collaborative factors.

Methods: …

Brain Development: A Look At Four Programs In Georgia That Support Optimal Brain Development, Nancy C. Webb, Madison L. Gates

Journal of the Georgia Public Health Association

Background: Georgia is making strides to improve its early care and education system through program development within state agencies and alliances. These timely, statewide programs are focused on improving understanding of the importance of brain development.

Methods: We reviewed the mission and information provided by four Georgia agencies with the aim of developing and improving programs and educational opportunities to instruct educators, policy makers, the general public, and others about child development in the context of brain development.

Results: For young children in Georgia, the four organizations are committed to ensuring opportunities for well-being. Georgia is moving forward in its …

Colon Cancer Knowledge, Screening Barriers, And Information Seeking In Northeastern Georgia, Jeffrey K. Springston, Su-I Hou

Journal of the Georgia Public Health Association

Background: The present study assessed utilization of colorectal cancer (CRC) screening and knowledge, barriers, and information-seeking among adults in northeastern Georgia.

Methods: A total of 245 people aged 40 years and older from selected rural, suburban, and small towns in northeastern Georgia participated in this cross-sectional survey.

Results: Respondents aged 50 years and older were more likely to think that they “don’t need screening at their current age” as compared with those in their 40s. Higher information-seeking correlated with lower screening barriers (p

Discussion: Respondents generally had a low level of knowledge about CRC. Individuals with lower perceived screening barriers …

A Preliminary Examination Of Elevated Blood Lead Levels In A Rural Georgia County, R. Christopher Rustin, Yu Sun, Chris Calhoun, Christy Kuriantnyk

Journal of the Georgia Public Health Association

Background: Rural areas are often viewed as lower risk for lead poisoning and toxic exposures seriously impacting development of the brain and central nervous system; this report examines the prevalence of elevated blood lead levels for childrenCounty, GA.

Methods: Lead surveillance data from the Georgia Department of Public Health (DPH) were analyzed using SAS®v-9.3 to calculate the prevalence of elevated blood lead levels (≥5ug/dL) among those children in Ben Hill County who had been tested for lead; the results were compared to Georgia and national data.

Results: A preliminary analysis of 2010-2015 screening data for Ben Hill County indicates that …

Assessment Of Medical Needs Of The Hispanic Community In Macon-Bibb County, Georgia, Kim Bélanger-Giguère, Jose Pino, Brad Lian

Journal of the Georgia Public Health Association

Background: Little is known about the health concerns and issues among the Hispanic community in growing, mid-sized cities, such as Macon, Georgia.

Methods: A questionnaire on general health-related issues was given to a sample of 125 Hispanic participants.

Results: The top health concerns of the Hispanic community were diabetes, obesity, and dental hygiene; the most common factors preventing Hispanics from receiving medical treatment were the lack of insurance, language barriers, and copayments or deductibles being too high.

Conclusions: Lack of higher education and the inability to communicate effectively in English may be manifested as difficulties in finding proper information about …

Exploration Of Barriers And Facilitators To Publishing Local Public Health Findings: A Mixed Methods Protocol, Selina A. Smith, Nancy C. Webb, Daniel S. Blumenthal, Bobbie Willcox, Darra Ballance, Faith Kinard, Madison L. Gates

Journal of the Georgia Public Health Association

Background: Worldwide, the US accounts for a large proportion of journals related to public health. Although the American Public Health Association (APHA) includes 54 affiliated regional and state associations, little is known about their capacity to support public health scholarship. The aim of this study is to assess barriers and facilitators to operation of state journals for the dissemination of local public health research and practices.

Methods: A mixed methods approach will be used to complete the 12-month study. Affiliate websites will be accessed through the APHA membership portal to evaluate organizational infrastructure and ascertain the presence/absence of a journal. …

Improved Estimation Of Optimal Cut-Off Point Associated With Youden Index Using Ranked Set Sampling, Jingjing Yin, Hani M. Samawi, Daniel Linder

Biostatistics: Faculty Publications

A diagnostic cut-off point of a biomarker measurement is needed for classifying a random subject to be either diseased or healthy. However, the cut-off point is usually unknown and needs to be estimated by some optimization criteria. One important criterion is the Youden index, which has been widely adopted in practice. The Youden index, which is defined as the maximum of (sensitivity + specificity −1), directly measures the largest total diagnostic accuracy a biomarker can achieve. Therefore, it is desirable to estimate the optimal cut-off point associated with the Youden index. Sometimes, taking the actual measurements of a biomarker is …

Engaging African Americans In Developing An Intervention To Reduce Breast Cancer Recurrence: A Brief Report, Selina A. Smith, Mary S. Whitehead, Joyce Q. Sheats, Brittney Fontenot, Ernest Alema-Mensah, Benjamin Ansa

Journal of the Georgia Public Health Association

Background: To develop a culturally appropriate lifestyle intervention, involvement of its intended users is needed.

Methods: Members of an African American (AA) breast cancer support group participated in two 4-hour guided discussions, which were audiotaped, transcribed, and analyzed to guide the content.

Results: The support group collaborated with researchers to develop 24 experiential nutrition education sessions using a social cognitive framework and incorporating self-regulation skills (goal-setting, self-monitoring, problem-solving, stimulus control) and social support to enhance self-efficacy for changes in dietary intake.

Conclusions: Community engagement fostered autonomy, built collaboration, and enhanced the capacity of AA breast cancer survivors to participate in …

Assessment Of Distress, Unmet Needs, And Receipt Of Care Plans Among Cancer Survivors In Georgia, Cam Escoffery, Angie Patterson, Nancy M. Paris, Logan Kirsch, Cassiopeia Frank, Jean O'Connor

Journal of the Georgia Public Health Association

Background: Cancer survivors have distinctive healthcare needs. The Survivorship Working Group of the Georgia Cancer Control Consortium conducted an assessment to understand the physical, psychological, practical, and spiritual needs of adult cancer survivors; patient perceptions regarding patient-provider communications; and their perceived need for services.

Methods: In 2014, a convenience sample of Georgia cancer survivors completed a paper or online survey about the presence of and distress associated with unmet physical, emotional, spiritual, and practical needs, and receipt of assistance in those areas. They were also asked about receipt of cancer treatment and survivorship care plans.

Results: Survivors were primarily female, …

Integrating Food And Language Nutrition To Reach Georgia’S Children In Early Care And Education Environments, Jean O'Connor, Chinwe Ejikeme, Maria Fernandez, Kia Powell-Threets, Audrey Idaikkadar, Christi Kay, Emily Anne Vall, Kimberly Ross, Brenda Fitzgerald

Journal of the Georgia Public Health Association

Background: Educational attainment and health are mutually reinforcing outcomes. Good health supports children in the achievement of academic milestones, such as grade-level reading, and is associated with higher socio-economic status, longer life expectancy, and lower lifelong chronic disease. Improving health outcomes and increasing the potential for high educational attainment is necessary for reducing disparities, improving population health, and reducing morbidity. Early childhood and associated settings present opportunities to address lifelong health.

Methods: To guide the development of programs to reach large numbers of children, we reviewed the literature associated with interventions during early childhood to promote healthy food consumption patterns …

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 …

Syphilis In Georgia, 2009-2014, Kathryn Moore, Leonardo Parker, Joy Wells

Journal of the Georgia Public Health Association

Background: In the period of 2002-2014, Georgia has ranked among the top three states in the United States for rates of primary and secondary syphilis cases, creating a continuing need to analyze the data and to plan and implement disease prevention efforts.

Methods: The present effort involved analysis of data from Georgia’s electronic disease reporting system, State Electronic Disease Surveillance System (SendSS), including demographic characteristics by year for the period of 2009-2014 and behavioral data obtained from interviews with communicable disease specialists.

Results: In Georgia, from 2009-2014, primary and secondary syphilis, the infectious stages of the disease, were seen most …

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 …

The Importance Of Early Brain Development, Brenda Fitzgerald

Journal of the Georgia Public Health Association

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87th Annual Georgia Public Health Association Meeting & Conference Report, Dianne Mcwethy, Regina Abbott, Christy Sims, Brian Morgan, Nicholle Harrison, Angela Peden, David Gowan

Journal of the Georgia Public Health Association

The 87th Annual Meeting of the Georgia Public Health Association (GPHA) was held in Atlanta, Georgia, on March 22-23, 2016, with pre-conference (March 21st) and post-conference (March 23rd) Executive Board meetings. As Georgia’s leading forum for public health researchers, practitioners, and students, the annual meeting of the GPHA brings together participants from across the state to explore recent developments in the field and to exchange techniques, tools, and experiences. In recent years the venue for the GPHA annual conference has been Atlanta, with the 2017 GPHA Annual Meeting and Conference also scheduled to be held in Atlanta. Several new initiatives …

Partnership Approach To Establishing Tobacco-Free Colleges And Universities In Georgia, Anne-Marie L. Coleman, Kenneth Ray, Kia Toodle, Alina Chung, Jean O'Connor

Journal of the Georgia Public Health Association

Background: Smoking rates in young adults ages 18-24 have been steadily declining since 2011 (2011:25.0%, 2012:22.3%, 2013:16.5% (BRFSS). The Georgia Department of Public Health (GDPH) partnered with the Georgia Board of Regents to adopt the 100% Tobacco Free Colleges/Universities policy.

Methods: The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based surveillance system, administered by the GDPH in collaboration with the CDC. The survey began in 1984 with 15 states participating, including Georgia. The data from this survey were used to inform key shareholders of smoking prevalence to encourage policy adoption as a method of decreasing tobacco use. The GDPH …