Public Health Commons^™

Characteristics Of Reported Symptoms Among Confirmed And Suspect Cases Of Zika Virus In Georgia, 2016, Ashton Thompson

Journal of the Georgia Public Health Association

Background: In May 2015, Zika virus was detected in Brazil. The virus has since spread through several countries in the Americas. Knowledge of the major symptoms of Zika virus infection was based on historic data from two previous outbreaks in the Pacific Islands. Currently-known Zika-specific symptoms include rash, conjunctivitis, arthralgia, and fever. Epidemiologists at the Georgia Department of Public Health (GDPH) began surveillance for travel-related Zika virus infections in January 2016. Surveillance data from GDPH contributes to better characterization of the current Zika clinical picture and more efficient triage of suspect cases for laboratory testing and prevention measures.

Methods: For …

Injection Drug Use And Hepatitis C: Interventions In Behavioral Health Settings, Marie Sutton

Journal of the Georgia Public Health Association

Background: Georgia is experiencing a crisis of injection drug use and hepatitis C virus (HCV) infection. From 2002 to 2014, the statewide drug overdose mortality rate increased, with nearly every county experiencing a significant increase in drug overdose mortality. Especially concerning is the rising HCV infection rate in people younger than 30, many of whom inject drugs. HCV incidence in young people increased over 200% in Georgia from 2006 to 2012. CDC officials have suggested “…Georgia is experiencing an expanding epidemic of heroin use that is driving an increase in injection drug use, putting many more at risk for the …

Partnership Between Academic And Public Health To Train Public Health Nurses New Chronic Diseases Protocols, Kathryn Martin, Elena Wood, Stephen Goggans, Anthony Mulloy, Shilpa Brown, Paul Wallach

Journal of the Georgia Public Health Association

Background: According to the Georgia Department of Public Health (DPH), cardiovascular disease is the leading cause of death in Georgia (29% in 2013). Diabetes (DM) and hypertension (HTN) are known risk factors for cardiovascular disease. In 2013, the prevalence of diabetes was 11% and of hypertension was 35% of the state’s adult population. There are not sufficient healthcare providers to manage these patients. To address this concern, the DPH Chronic Disease Prevention Section contracted with the Medical College of Georgia (MCG) at Augusta University to design and implement an innovative training program for Georgia public health nurses on diabetes and …

Discussion Of Public Health Education And Training, And The Needs Of The Future Public Health Workforce, Gary Nelson

Journal of the Georgia Public Health Association

Georgia enjoys a wealth of public health capacity ranging from governmental public health to academic programs as well as local, state, and internationally acclaimed organizations. Leadership is evident across public health policy, practice and research. In the closing plenary of the 2017 Annual Meeting-Faces of Public Health, GPHA engages leaders in our field in a spirited conversation on the public health workforce. The esteemed panel representing state, national, and international public health organizations will reflect on the needs of a 21st Century workforce: prepared to respond beyond emergencies and identified threats; able to adapt to an increasing complex technological, political …

Breaking The Chains: A Public Health Approach To Modern Day Slavery, Rachael Nosin

Journal of the Georgia Public Health Association

Background: Modern day slavery is a $150 billion industry and the second largest criminal enterprise, behind drug trafficking.1 Approximately 21-30 million men, women, and children are modern day slaves worldwide, and over 200 cases of human trafficking were confirmed in GA in 2016 alone.2, 3 In 2006 Georgia incorporated a statute against trafficking of persons for labor or sexual servitude into its criminal code (see O.C.G.A. § 16-5-46). The penalties for this crime are stiff, and those convicted face a minimum of 10 years in state prison and up to a $100,000 fine. This is not enough, however. There is …

C The Light! Exploring Dynamic Changes In Hepatitis C Epidemiology, Screening, And Treatment, Lesley Miller, Natasha Travis, Jennifer Lom, Shelly-Ann Fluker

Journal of the Georgia Public Health Association

Background: Hepatitis C is common, deadly and curable. A major public health epidemic, it affects close to 4 million Americans, and kills more Americans than HIV, hepatitis B and tuberculosis combined. New all-oral therapies for hepatitis C can cure over 90% of those treated with few side effects and with a short 12-week course. However, many people with hepatitis C are unaware of their infection and access to curative therapy remains limited, especially for underserved populations.

Methods: Our workshop will focus on areas of dynamic change in hepatitis C. We will discuss the changing epidemiology, focusing on the epidemic of …

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

Journal of the Georgia Public Health Association

Background: Children in Flint, Michigan were exposed to lead at unsafe levels in drinking water bringing renewed interest and national attention to an old public health problem. In Georgia, thousands of children are exposed annually to lead at unsafe levels primarily from paint in homes built before 1978. With lead poisoning typically viewed as an urban problem, rural areas are often considered lower-risk in light of similar lead poisoning risk factors, albeit on a smaller scale. The purpose of this preliminary study was to examine the prevalence of elevated blood lead levels in childrenCounty, Georgia, a county designated as lower …

Leading Together: Partnerships For A Healthier Dekalb, April Hermstad, Mj Gathings, Jen Isher-Witt, Felicia Arriaga, Corre Robinson

Journal of the Georgia Public Health Association

Background: In 2014, the DeKalb County Board of Health (DCBOH) received a three-year Racial and Ethnic Approaches to Community Health (REACH) grant to work with community partners to address health disparities among African Americans in DeKalb County. The project, called Local Efforts toward Addressing Disparities in DeKalb (LEAD DeKalb), relies on a network of partnerships to implement community-based interventions that promote healthy eating and physical activity among African Americans throughout low-income parts of DeKalb County.

Methods: The evaluation team developed an online survey to assess LEAD DeKalb staff and partner satisfaction with the partnerships created and the work completed through …

Leveraging Partnerships In Order To Increase Notifiable Disease Reporting, Jessica Grippo, Amber Erickson

Journal of the Georgia Public Health Association

Background: Notifiable disease reporting, although required by law, does not always occur. For this reason, it is crucial for local public health agencies to leverage new partnerships for reporting of notifiable diseases. Schools represent sites within communities that experience relatively high numbers of cases of notifiable disease and clusters of illness. By leveraging partnerships with schools, an increase in disease reporting can occur within communities.

Methods: DeKalb County Board of Health has developed an infectious disease protocol for the two major school systems in the county and one large private school: DeKalb County School District, City Schools of Decatur and …

Kaizen: Improving Patient Flow, Gurleen Roberts, Jack Kennedy, Catherine Smythe, Dawn Krahwinkel, Melissa Green

Journal of the Georgia Public Health Association

Background: Since Cobb & Douglas Public Health (CDPH) achieved accreditation in May 2015, efforts to mature a culture of quality have been emphasized. In addition, the Adult Health Clinic moved to a new facility in Spring 2016. This move has improved many patient flow issues, but also has had unexpected consequences that spurred interest in doing several quality improvement (QI) projects.

Methods: Rather than doing one QI project at a time, a kaizen event was held. Kaizen is a Japanese term for continuous improvement. This workshop allowed the Adult Health Team to plan seven QI projects and implement them simultaneously …

Helping Public Health Professionals Access Infectious Disease Trainings And Resources: The Region Iv Phtc Infectious Diseases Training Database, Laura M. Lloyd, Lisa Mccormick, Melissa Alperin, Michelle Carvalho, Cidney Wilson, Brita Bergland, Arti Patel, Kathleen R. Miner

Journal of the Georgia Public Health Association

Background: The Region IV Public Health Training Center (R-IV PHTC), located at Emory University’s Rollins School of Public Health, has a mission that includes providing training and educational offerings to strengthen the competency of the current public health workforce in HHS Region IV (which includes GA). Additionally, the R-IV PHTC has been charged with serving as a national resource in the area of infectious disease. To fulfill this charge, the R-IV PHTC conducted an environmental scan to identify and increase access to existing infectious disease trainings and resources currently available to the public health workforce.

Methods: From June 2015 – …

Characterizing Discrepancies In School Recovery After Disasters, Hazel Shah

Journal of the Georgia Public Health Association

Background: Academic institutions provide consistency and routine to children. When disasters damage schools, students often suffer in a variety of ways, and racial minority students are often impacted disproportionately. However, minimal research exists exploring these discrepancies. This presentation examines racial disparities in school systems affected by Hurricane Ike (2008).

Methods: This study, funded by the National Science Foundation, uses publicly available Texas Education Agency data from approximately 600 schools affected by Hurricane Ike. Schools were included in the study based on two criteria: if they were declared “disaster areas” by FEMA and if they were closed for at least 10 …

Geographic Modelling Of Sickle Cell Trait In Four Us Regions, Marian M. Tabi, Anunay Bhattacharya

Journal of the Georgia Public Health Association

Background: Many studies have been done concerning the prevalence of sickle cell trait, its incidence and screening techniques. It is most commonly observed in the Black and Hispanic population in the United States. This study used retrospective data from the Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR – December 12, 2014) to model, analyze, and substantiate the geographic distribution of sickle cell trait, its incidence, prevalence and screening in 44 states divided into 4 regions in the United States.

Methods: We conducted data modelling of geographic regions in the United States. The four regions were …

Better Nutrition By Increased Knowledge Of Food Nutritional Components, Lisa Hayworth, Tangela Hendricks, Katy Littrell, Nicole Matthews

Journal of the Georgia Public Health Association

Background: The purpose of this project was to teach nutritional concepts related to MyPlate to children and families who participate in the Boys and Girls Club of Hall County (BGCHC). MyPlate is the nutrition guide published by the US Department of Agriculture; it is a pie chart depicting a plate divided into five food groups. The educational event occurred at a fall festival sponsored by the BGCHC. The intent was to offer a fun and interactive game to allow children to learn from a hands-on experience.

Methods: Participants in the game were between 4 and 12 years of age and …

A Screening Tool For Identification Of Victims Of Commercial Sexual Exploitation Of Children, Michelle Livings, Jordan Greenbaum, Rayleen Lewis, Jeremiah D. Williams, Shannon Self-Brown, Betty S. Lai

Journal of the Georgia Public Health Association

Background: Commercial sexual exploitation of children (CSEC) and sex trafficking have only recently been recognized as problems by healthcare providers. Both UNICEF (2014) and the Institute of Medicine (2013) have stressed the need for systematic research to assist healthcare providers in the identification of victims. The aim of this poster is to describe initial findings relating to the development of a screening tool to identify CSEC victims.

Methods: Twenty-seven sites nationwide (e.g., emergency departments and specialized clinics) participated in a study to validate a screening tool for identifying CSEC victims in an outpatient setting. The study was conducted under approval …

Zika Virus Communication Preferences Of Pregnant Women: Beyond The Verbal, Mallory Ellingson, Allison T. Chamberlain

Journal of the Georgia Public Health Association

Background: Pregnant women are frequently a priority group during public health emergencies, including the current Zika virus outbreak. These women turn to prenatal care providers for health information, but providers may not have the time for discussions with every patient. Knowing alternative ways to communicate key Zika-related information to pregnant women is important.

Methods: To determine pregnant women’s preferences for obtaining Zika information from their prenatal providers, a 27-item survey was administered to 408 pregnant women at four prenatal care clinics in Atlanta between May 5th, 2016 and June 20th, 2016. The anonymous survey evaluated women’s preferences for receiving information …

Differences In Reported Benefits In Older Adults After Participation In A Nutrition Incentive Program, Miranda Cook, Rachael Kane

Journal of the Georgia Public Health Association

Background: A healthy food incentive program doubles the value of food stamp dollars at farmers’ markets, addressing financial barriers to healthy eating for low-income Supplemental Nutrition Assistance Program (SNAP), or food stamps, recipients. Older adults sometimes have more trouble purchasing and eating healthy food due to illness, a lack of social support, or mobility problems, in addition to financial reasons.

Methods: Surveys were administered to 87 SNAP recipients redeeming healthy food incentives at farmers’ markets. Data were stratified by age in order to test benefits experienced from program participation and the program’s efficacy in reducing barriers to healthy eating.

Results: …

Probiotics As A Novel Treatment Of Mastitis In Dairy Goats To Combat A Nutritional Concern, Vishal Singh

Journal of the Georgia Public Health Association

Background: The demand for goat dairy products has grown in the US and continues to increase. This is partially due to nutritional advantages that include higher protein, lower cholesterol, ease in digestibility and low fat content as compared to cows’ milk. Goat milk is also used in a variety of health and beauty products such as lotions, soaps and creams. Mastitis continues to have a negative impact on the supply of and demand for goat milk as well as contributing to lack of financial gains for farmers.

Methods: Faculty and graduate students of Department of Veterinary Science and Public Health …

Ems 2020: A Multi-Year Swot And Financial Analysis Of Georgia's Emergency Medical Services System, Charles F. Owens

Journal of the Georgia Public Health Association

Background: As Georgia’s Emergency Medical Services (EMS) system approaches 50 years in operation, the Georgia EMS Association and Georgia Southern University’s Center for Public Health Practice and Research began an evaluation of the strengths, weaknesses, opportunities, and threats facing Georgia’s EMS system.

Methods: During the first year of the study, eight meetings were held across Georgia involving EMTs, physicians, hospital administrators, emergency planners, and state policy makers to identify strengths, weaknesses, opportunities, and threats facing the system.

Results: Results obtained during the first year of this study offered valuable insight into current and future factors affecting the ability of Georgia’s …

Financing Public Health In Georgia, Dionne Denson

Journal of the Georgia Public Health Association

Background: The public health system in Georgia is carried out through a hybrid governance structure. The Department of Public Health and the county boards of health have responsibility for serving the public health needs for the Georgia citizens. Funding for the Georgia public health system is derived from a number of funding sources which include federal, state, local, and private funds.

Methods: Georgia's public health system relies on multiple funding streams to provide services. These public health services have the potential to provide a return on investment and positive impact on the local economy. In the hybrid governance structure, local …

Findings From A National Home Food Environment Survey: How Does Georgia Compare?, April Hermstad, Regine Haardorfer, Rebecca Woodruff, Ilana Raskind, Michelle Kegler

Journal of the Georgia Public Health Association

Background: Aspects of the home food environment, both social and physical, influence healthy eating and weight management practices. Healthy eating, according to the Dietary Guidelines for Americans, 2015, centers on balancing calories consumed and calories expended for weight management combined with consumption of nutrient-dense foods and drinks. Obesity and excess weight increase the risk of numerous chronic diseases including cancer, diabetes, and heart disease. With this presentation, we will explore how Georgia home food environments and eating behaviors are similar or different from the rest of the nation.

Methods: Survey participants (n=4,942) were recruited from a reputable online survey panel …

Can Summer Camp Improve Childhood Asthma Management? Outcomes From Augusta Area Asthma Camp, Terrill M. Flakes

Journal of the Georgia Public Health Association

Background: Childhood asthma is the most common chronic condition in the U.S., affecting 8.6% of children.1 Asthma is particularly an issue in Georgia where 16.2% of children have been diagnosed with this condition.2 Research suggests an association between pediatric asthma education and a decrease in emergency room visits and hospitalizations, and improved quality of life (QOL).3,4 The Augusta Area Asthma Camp, a free week-long educational day camp, was created to address a critical need for asthma education in the community by increasing parent and child knowledge and self-management of asthma symptoms while providing typical summer camp activities in a safe …

Medicaid Savings Continue In The Year After End Of Participation In The Program, Money Follows The Person, Glenn Landers, Kristi Fuller, Mei Zhou

Journal of the Georgia Public Health Association

Background: The aim of this analysis was to compare Georgia’s Medicaid expenditures for participants in the Money Follows the Person (MFP) six months before, 12 months during, and 12 months after MFP participation.

Methods: Differences in Medicaid expenditures for three populations of MFP participants (individuals with developmental disabilities, individuals with physical disabilities, and older adults) were compared by use of repeated measures t-tests.

Results: Per-member per-month Medicaid expenditures were lower across the three populations when comparing six months prior to transition from an institution to 12 months after leaving the MFP program.

Conclusions: The incorporation of features from programs such …

A Clinical Trial To Increase The Identification, Genetic Counseling Referral And Genetic Testing Of Women At Risk For Hereditary Breast And/Or Ovarian Cancer, Ceceilia Bellcross, Christine Stanislaw, April Hermstad, Christine Tallo, Chelsea Leonard

Journal of the Georgia Public Health Association

Background: Approximately 1/300 individuals in the general population are at risk for hereditary breast and ovarian cancer due to an inherited mutation in the BRCA1/BRCA2 genes. BRCA mutations are associated with dramatically increased risks for breast cancer, especially at younger ages, in addition to ovarian cancer. Enhanced screening and risk reduction strategies can significantly reduce associated morbidity and mortality. The United States Preventive Services Task Force (USPSTF) recommends identifying women at-risk for BRCA mutations for receipt of genetic counseling and if appropriate, testing. The Breast Cancer Genetics Referral Screening Tool (B-RST) is a validated screen endorsed by USPSTF to facilitate …

Student Involvement In Curriculum Development Enhances Medical Education, Jacline Griffeth, Alexandra Sawyer, Nolan Johnson, Osama Hashmi, Neha Gupta, Sarah Swartz, Kathryn Martin, Carol Nichols

Journal of the Georgia Public Health Association

Background: During the 2014 annual review of the curriculum for first year medical students at the Medical College of Georgia, the public health module was noted as an area that needed improvement. To address this concern, a Public Health Curriculum Workgroup was formed for the purpose of identifying specific areas to improve and developing a more robust and integrative curriculum. A small cohort of medical students with public health backgrounds were invited to be members of this workgroup and participate in the development and delivery of public health content to the next cohort of first year medical students. We hypothesized …

The Association Between Nutrition, Physical Activity, And Weight Status Among Adults In Georgia, Trang Nguyen, Janani R. Thapa, Donglan Zhang, Elizabeth Pullekines

Journal of the Georgia Public Health Association

Background: Obesity is classified as having a body mass index (BMI) greater than 30 and is associated with higher risks of type 2 diabetes, coronary heart diseases, hypertension, and other adverse health outcomes. In 2015, the prevalence of self-reported obesity among adults in Georgia was 30.7. The present study focused on how, in 2015, lifestyle factors, specifically nutrition and physical activity levels, related with weight status in Georgia.

Methods: The dataset used for this analysis was from the 2015 Behavioral Risk Factor Surveillance System. The association between weight status (as measured by BMI) and nutrition and physical activity levels was …

Effect Of Medicaid Status On Up-To-Date Vaccination Rates Among Two-Year-Old Children In Georgia, 2015, Fabio R. Machado, Jessica Tuttle, Cherie Drenzek

Journal of the Georgia Public Health Association

Background: The annual Georgia Immunization Study (GIS) employs a retrospective cohort design to determine the up-to-date (UTD) immunization rate of 24-month-old children in Georgia. Previous results have shown lower vaccination rates in the second year of life, particularly for DTaP. We sought to determine if a discontinuation of Medicaid coverage after the infant year contributed to lower immunization rates in the second year.

Methods: A stratified random sample of 2,002 Georgia children born in January 2013 was drawn from electronic birth records. Immunization history and Medicaid status were obtained from the Georgia Registry of Immunization Transactions and Services (GRITS). Parents …

Physician Attitudes Toward The Ethics Of Pre-Exposure Prophylaxis (Prep): Cost, Safety, And Resource Allocation, Jessica Grippo, Stacy W. Smallwood, Katherine Pincura, Tamara Wright, William A. Mase

Journal of the Georgia Public Health Association

Background: In the United States, human immunodeficiency virus (HIV) remains a substantial public health issue. There is evidence that the use of antiretroviral medications such as pre-exposure prophylaxis (PrEP) can be a safe and effective primary prevention strategy to reduce new cases of HIV infection. Provider practice behavior as it relates to prescribing PrEP and the potential impact on specific vulnerable populations needs increased attention. Few studies have evaluated the attitudes of physicians towards ethical issues related to prescribing PrEP.

Methods: The purpose of the present literature review was to evaluate provider attitudes toward the ethics of prescribing PrEP for …

Application Of A Fath-Based Integration Tool To Assess Mental And Physical Health Interventions, Donna M. Saunders, Jean Leak, Monique E. Carver, Selina A. Smith

Journal of the Georgia Public Health Association

Background: To build on current research involving faith-based interventions (FBIs) for addressing mental and physical health, this study a) reviewed the extent to which relevant publications integrate faith concepts with health and b) initiated analysis of the degree of FBI integration with intervention outcomes.

Methods: Derived from a systematic search of articles published between 2007 and 2017, 36 studies were assessed with a FaithBased Integration Assessment Tool (FIAT) to quantify faith-health integration. Basic statistical procedures were employed to determine the association of faith-based integration with intervention outcomes.

Results: The assessed studies possessed (on average) moderate, inconsistent integration because of poor …

Operational And Financial Performance Of Georgia's Critical Access Hospitals, Linda G. Kimsey, Bettye A. Apenteng, William Mase, Samuel T. Opoku, Mark Hanna, Kwabena G. Boakye, Lisa Carhuff, Charles F. Owens, Angela Peden, Stuart H. Tedders, Patricia Whaley

Journal of the Georgia Public Health Association

Background: Georgia’s Critical Access Hospitals (CAHs) face increasingly complex threats to financial sustainability, as demonstrated by the disproportionally high number of closures in comparison to other states in the nation.

Methods: Financial performance measures (including profitability, revenue, liquidity, debt, utilization, and productivity), site visits, key personnel interviews, and a revenue cycle management assessment were used to assess the strategic landscape of CAHs in Georgia, analyze financial and operational performance, and provide recommendations.

Results: For CAHs in Georgia, financial and operating performance indicators, interviews, and assessments depict a challenging operating environment, but opportunities for improvement exist through implementation of a Lean …