Public Health Commons^™

Murine Typhus In Georgia: Historical Context And A Probable Case Of Resurgence Where Previously-Thought Eradicated, Giovanni Mella-Velazquez, Christopher He, Bolanle Akinsola, Judson Miller

Journal of the Georgia Public Health Association

Background: Murine typhus, caused by Rickettsia typhi, is a flea-borne illness historically endemic to the southeastern United States, with initial cases reported in Atlanta, Georgia in 1913. Following vector control efforts, incidence declined significantly, and the disease was removed from the nationally notifiable disease list in 1987. While recent cases have been reported in select regions, murine typhus has not been documented in Georgia for decades. We present a pediatric case in Atlanta that may represent the first reported instance in nearly 40 years, suggesting possible reemergence in the Southeast.

Methods: We conducted a case report analysis of a pediatric …

Diabetes Mortality In Georgia: Disparities, Social Determinants, And Rural-Urban Differences (2019-2021), Gwendolyn H. Cattledge, Temilola N. Luwoye, Gloria Elizabeth B. Ogionwo, Nyshanti B. Ross, Zachary M. Bremmer

Journal of the Georgia Public Health Association

Background: Diabetes mellitus remains a significant public health challenge globally and, in the U.S., notably impacts mortality. Georgia specifically faces a substantial burden, with disparities observed across populations and counties. Understanding the patterns and underlying drivers of diabetes-related deaths statewide is crucial for effective public health intervention.

Methods: This cross-sectional study analyzed age-adjusted diabetes mortality rates in Georgia from 2019-2021, using data from the Georgia Department of Public Health's OASIS and the CDC's Social Vulnerability Index (SVI) 2020. The study aimed to detail the distribution of mortality rates across counties, explore the role of social determinants of health, and analyze …

Are Accountability Courts In Georgia A Cost-Effective Public Health Policy Alternative?, Brian D. Graves, Orion Mowbray, Leaanne Derigne, Holly Lynde, Angel Ellis, Rachel Meyer

Journal of the Georgia Public Health Association

Background: This study evaluates the cost-effectiveness of accountability courts in Georgia, presenting them as a viable alternative in public health policy.

Methods: The research utilized survey data collected from 37 court programs across 40 distinct accountability court programs; it was conducted by the University of Georgia’s Carl Vinson Institute of Government in collaboration with the Council of Accountability Court Judges. The analysis includes a comparative assessment of cost savings, benefits, and differences among various court types, specifically focusing on drug courts, DUI courts, mental health courts, family treatment courts, and veterans treatment courts.

Results: Results reveal that …

Environmental Predictors Of County-Level Drowning Rates In Georgia, Jeff Turner

Journal of the Georgia Public Health Association

Background: Recent increases in drowning rates, both nationally and within Georgia, have led to renewed interest in the individual, situational/behavioral, and environmental characteristics that impact drowning. This study examines the association between two environmental characteristics, natural surface water coverage and public pools, on drowning fatalities and drowning-related ER visits by county in Georgia

Methods: We gathered county-level data on drowning fatalities and drowning-related ER visits and the number of public pools from the Georgia DPH, surface water coverage from the US Census Bureau, and demographic measures from the CDC. We conducted a linear regression analysis to identify how …

Defining Evidence-Based Practices From A Practitioner Perspective: An Analysis Of How The Peer Assisted School Transition (P.A.S.T.) Project Fits Within The Evidence-Based Practices Continuum, Afiya King, Hillarie Wise, Nakia Cross, Donna Dent, Andrew Jordan Williamson, Maysa Osman, Carlos A O Pavao

Journal of the Georgia Public Health Association

Background: This study examines the implementation and evaluation of the Peer Assisted School Transition (P.A.S.T.) Project, an evidence-informed, peer-led intervention designed to prevent substance misuse among youth during key educational transitions. The study explores the effectiveness of the program in strengthening protective factors, reducing risk factors, and enhancing skills related to substance misuse prevention.

Methods: A mixed-methods evaluation design was employed. Quantitative data were collected through pre- and post-surveys administered to fifth- and eighth-grade students to assess changes in knowledge, attitudes, and skills. Qualitative data were collected through focus groups, interviews, and observations to provide contextual insight into program implementation …

Peer-Peer Mentoring In Undergraduate Medical Education (Ume): Scoping Review Of Us-Based Medical Schools, Sakshi Sehgal, Jordon Brinkley, Andrea Kadima, Sydney Wright, Nicole Winston Ms, Pharmd, Edd

Journal of the Georgia Public Health Association

Background: Mentorship plays a formative role in undergraduate medical education (UME) From shaping professional outcomes to developing longitudinal personal relationships, various forms of mentorship can influence student progress meaningfully, particularly for students from underrepresented or marginalized backgrounds. Though faculty-student mentorship has been readily investigated, limited knowledge exists regarding peer-peer mentorship structures, particularly within UME in the American medical education model. This scoping review sought to investigate existing peer-peer mentorship models, as well as report on the need for further mentorship within this realm in UME.

Methods: This scoping review employed Arksey and O’Malley’s framework. We conducted a systematic and comprehensive …

The Role Of Social Determinants Of Health In Hydroxyurea Adherence Among Persons With Sickle Cell Disease: A Systematic Review, Doreen O. Ugwu, Lori L. Vick, Terika Williams, Aurela Nikaj, Seyi Omeh, Benjamin Becerra Dr., Tilicia Mayo-Gamble

Journal of the Georgia Public Health Association

Objective: Georgia has one of the highest prevalences of sickle cell disease (SCD). For Georgians living with SCD, inadequate medication adherence is associated with important clinical outcomes. One important area that is understudied in SCD is the impact of social determinants of health (SDoH) on medication adherence. A foundational understanding of SDoH is needed to introduce, inform and carry out programs and interventions designed to facilitate hydroxyurea adherence through the state of Georgia.

Method: We conducted a systematic literature review to synthesize the literature on SDoH addressed in studies to improve hydroxyurea adherence in persons with SCD. SDoH were based …

94th Annual Georgia Public Health Association Meeting And Conference Report, Angela H. Peden, Beverley Townsend, Patrina L. Bowles, Sarah L. Mosley

Journal of the Georgia Public Health Association

The 94th Annual Meeting and Conference of the Georgia Public Health Association (GPHA) was held in Jekyll Island, Georgia, at the Jekyll Island Convention Center, on May 1-3, 2024. The goal of the 2024 Georgia Public Health Association Annual Meeting and Conference was to assemble public health professionals, students, County Board of Health members, and stakeholders for networking and educational opportunities to support the mission and vision of GPHA.

The theme for the 2024 Georgia Public Health Association Annual Meeting and Conference was selected by the GPHA Executive Board during a meeting in the early fall of 2023: “Lighting the …

Rates And Predictors Of Intention To Get Preventive Screenings Among Individuals In Recovery From Substance Use Disorders, Afsha Hossain, Ban A. Majeed, Lia Pierson Bruner

Journal of the Georgia Public Health Association

Background: Individuals with substance use disorders (SUDs) are at greater risk for chronic disease but often face barriers to access and uptake of preventive screenings, so the aim of this study was to identify rates and predictors for intention to get preventive screenings among residents at two recovery centers.

Methods: We used a cross-sectional survey (N=95, response rate 51%) to determine previous screening rates and the intention to get recommended preventive screenings among residents of two long-term recovery programs in Athens, GA, using bivariate analysis with chi-square to look for associations with intention.

Results: Prior use of preventive health services …

Rural Georgia Hospital Covid-19 Virus Patient Outcomes, Susan P. Smith, Neeraj Dayama, Morgan E. House, Debra Flores, Sharon Hunt, April Dukes, Steven Gautney

Journal of the Georgia Public Health Association

Background: The Coronavirus disease 2019 (COVID-19) has led to over 1.2 million deaths in the United States. Given the staggering scale of the pandemic, rural hospitals faced heightened challenges due to limited resource availability and underlying patient characteristics.

Methods: In this context, we examined patient and hospital-related factors associated with inpatient mortality due to COVID-19. This study is a retrospective chart review of patient outcomes of patients who were hospitalized in a Southwest Georgia rural hospital with COVID-19 during the initial onset of the outbreak and over the following 23 months of the pandemic. Patient demographics, other characteristics, …

Covid-19 Vaccine Acceptance Among People Who Smoke In Rural Southwest Georgia: Perspectives And Influencing Factors, Shadé Owolabi, Helen Singer, Katherine Reilly, Łucja T. Bundy Ma-Edm, J.K. Veluswamy, Carla Berg, Regine Haardörfer, James Hotz, Ajay Gehlot, Michelle Kegler

Journal of the Georgia Public Health Association

Background: The COVID-19 vaccine is a critical tool in reducing COVID-19 related morbidity and mortality. Unfortunately, vaccine hesitancy is an ongoing public health challenge, especially in certain geographic areas and sub-populations. This study assessed factors associated with COVID-19 vaccine uptake and hesitancy among individuals who smoke in rural communities in southwest Georgia, one of the first COVID-19 “hot spots” in the U.S.

Methods: We conducted qualitative interviews (n=23) using a semi-structured interview guide, informed by the Integrated Behavioral Model (IBM), that assessed vaccine-related behavior, intention to be vaccinated, perceived risk, social norms, attitudes, and environmental barriers and facilitators …

White Nose Syndrome In Bats And Infant Mortality In Georgia, Rhys Medcalfe, Sean Medcalfe, Simon Medcalfe

Journal of the Georgia Public Health Association

Background: White nose syndrome (WNS) is a disease in bats caused by the fungus Pseudogymnoascus destructans that can result in bat mortality rates of over 90%. WNS was discovered in Georgia in 2012 in 3 counties but has continued to spread to 14 counties as of 2023, with P. destructans detected in a further seven. Biodiversity loss has been linked to human health outcomes including infant mortality. Understanding the link between WNS, biodiversity loss, and infant mortality in Georgia is important because Georgia ranks 42^nd out of the 50 states for infant mortality rate.

Methods: Using panel data from …

Prevalence Of Well Water Contaminants In Georgia From 2010-2022, Angelique B. Willis, Suhasini Ramisetty-Mikler, Christine E. Stauber, Uttam Kumar Saha

Journal of the Georgia Public Health Association

Background: Safe, reliable, and clean drinking water sources are a basic necessity. More than 1.7 million individuals rely on private wells for drinking water in Georgia and are confronted with water quality challenges stemming from chemical contamination as private wells are not under mandated regulations as public water supplies. In Georgia, previous studies suggested that the variation of soil and rock in a physiographic province (region) plays an essential role in the quality of private well water. There is a need to understand the distribution of these chemical contaminants above the federal Maximum Contaminant Level (MCL) and how different geologies …

Impact Of The Online Nutrition Intervention On Health Indicators For Diabetes, Cardiovascular Disease, And Obesity In Senior Populations, Indira Karibayeva, Padmini Shankar, Gulzar H. Shah

Journal of the Georgia Public Health Association

Background: This study evaluated the effects of an online nutrition intervention program, Food Fitness First, Inc.®, on health indicators for diabetes, cardiovascular disease and obesity among senior center participants.

Methods: Thirty individuals aged over 60 completed the 3-month Food Fitness First program, which included initial counseling and 12 educational sessions utilizing the Diabetes FOOD SPIRAL® book and bifold. Pre- and post-treatment assessments measured various health parameters.

Results: Results showed significant improvements in Favorable Fitness Factor (FFF) score, which encompasses four key domains: Nutrition, Exercise, Health/Disease, and Lifestyle. FFF factor difference was equal to 13.63, with 95% CI [11.22; 16.03;]. …

Targets To Increase Hiv Pre-Exposure Prophylaxis (Prep) Uptake Among Communities In Northeast Georgia, Kaley E. Parchinski, Molly Hirsh, Andrew Cheng, Nia Kalifa, Manvi Manyam

Journal of the Georgia Public Health Association

Background: This study seeks to identify targets to increase HIV pre-exposure prophylaxis (PrEP) uptake in Athens-Clarke County, GA, a non-urban area with high HIV burden and poor PrEP utilization.

Methods: A cross sectional survey of adults attending HIV outreach screenings in Athens, GA between November 2022 and March 2023 describes participant demographics and validated scales measuring PrEP knowledge, attitudes, stigma, descriptive norms, and intentions.

Results: Of 136 total participants, key demographic groups included Black (N=84, 61.8%), Latinx (N=10, 8.1%), LGBTQ+ (N=25, 18.4%), and persons who use injection drugs (N=19, 15%); overall, less than half of the PrEP knowledge items were …

The Importance Of Country Of Origin In Vaccine Messaging For H-2a Farmworkers, Anna M. Scheyett, Maria Bowie, Virginia Brown, Andrea Scarrow

Journal of the Georgia Public Health Association

Background: H-2A farmworkers are disproportionately vulnerable to COVID-19 and understanding their beliefs regarding COVID-19 vaccines is important for public health outreach, yet to date little research has examined the influence of country of origin (COO) on the vaccine beliefs of this uniquely transient population.

Methods: Three focus groups (N=30) were held with H-2A farmworkers in South Georgia to explore their beliefs on COVID-19 vaccines, using thematic analyses to identify COO influences on these beliefs.

Results: Family in COO influenced worker vaccine beliefs through direct advice, commonly held beliefs in COO about harmful government agendas via vaccines increased worker vaccine fears, …

Associations Between Atmospheric Ozone, Pm2.5 And Prevalence Of Diabetes In Georgia, United States, Kingsley A. Kalu, Jingjing Yin, Atin Adhikari

Journal of the Georgia Public Health Association

Objective:

This study examines the association between two air pollutants (PM_2.5 and ozone), and the prevalence of adult diabetes mellitus in relation to various confounding factors.

Methods:

We collected diabetes prevalence data from the 2015 County Health Ranking and Georgia Health Data Hub. A negative binomial regression analysis was conducted to examine the associations between the county-level dependent variable “adult diabetes” (for adults aged> 18 years diagnosed with Type 1 and Type 2 diabetes) and two independent county-level variables: percentage of days ³ NAAQS for ozone and PM_2.5 concentration levels while controlling for confounders.

Results:

At the county …

Perspectives Of African American And Hispanic/Latino Individuals On Hiv Molecular Cluster Detection, Maxwell Richardson, Brendan H. Pulsifer, Jane Yoon Scott, David Holland, Eleanor W. Garlow, Pascale Wortley, Daniel Mauck, Jenna Gettings, Valeria Cantos, Masonia Traylor, Eric Rangel, David Folkes, Carlos Saldana

Journal of the Georgia Public Health Association

Background: Responding to HIV clusters detected using molecular data has been shown to reduce transmission and improve testing, treatment, and prevention. However, there are varied opinions about the use of cluster detection activities, and some advocates have raised concerns about patient consent, data security, and the potential for HIV criminalization. Incorporating the perspectives of marginalized populations that are disproportionately affected by HIV is essential to understanding the diversity of those perspectives, yet it is often overlooked in the literature. Thus, our study seeks to highlight the perspectives of Black/African American and Hispanic/Latino individuals in the Southern United States on HIV …

Effect Of Covid-19 Vaccination On Covid-19 Mortality By Age In Georgia, Brennan Bogdanovich, Mckenzie E. Maloney, James Pollock, Lane Langston, Brittany Ange, Jack Yu

Journal of the Georgia Public Health Association

Purpose: The COVID-19 epidemic led to significant morbidity and mortality globally, especially among the elderly. Because SARS-CoV-2 is a novel viral pathogen, there was a lack of preventative and treatment options. Availability of effective vaccines has been an important factor in determining the epidemic trajectory. Analyzing the effects of the vaccines in reducing mortality across age groups is important for guiding future public health responses. The objective of this study was to determine the association between age and COVID-19 mortality pre- and post-vaccination periods amongst Georgians.

Methods: This cross-sectional study used COVID-19 case numbers, COVID-19 deaths, age at time of …

Barriers To Help-Seeking Behavior For Maternal Mental Health Disorders: Application Of The Health Belief Model, Tobi F. Oloyede, Joanne Chopak-Foss

Journal of the Georgia Public Health Association

Perinatal mood and anxiety disorders (PMADs) have become a leading cause of maternal mortality due to suicide among women in the first year following pregnancy. Although the profile for new mothers who die by suicide is predominantly white, disparities exist between Black and White women in their seeking help for perinatal and/or post-natal mood disorders. For Black, Indigenous, and People of Color (BIPOC), there are differences in the perceptions of the benefits of seeking help for PMADs. The COVID-19 pandemic exacerbated maternal mental health disorders in the United States particularly for women who live in communities with limited access to …

Racial Residential Segregation And Covid-19 Health Outcomes: Evidence From The State Of Georgia, Palak Patel, Simon Medcalfe, Catherine P. Slade

Journal of the Georgia Public Health Association

ABSTRACT

Background:

According to the Georgia Department of Public Health (GDPH), the state of Georgia reported 563,658 cumulative COVID-19 cases and 9,845 total deaths in 2020. Decades of research on racial disparities in health outcomes suggest we should not be surprised with the disproportionate number of cases, hospital visits, and deaths of non-white and Black Georgia residents. Racial disparities in health are often defined by a Social Determinants of Health (SDOH) model. One understudied SDOH is racial residential segregation. In this study we explore the relationship between racial residential segregation and COVID-19 health outcomes. Our paper addresses critical challenges for …

An Epiq Mass Shelter Training For Public Health Nurses In Georgia To Improve Core Competencies In Disaster Preparedness: A Pilot Study, Ashlie L. Pullen, Sonya Shinhoster

Journal of the Georgia Public Health Association

Background: Research shows that nurses are often ill-prepared for disaster response. A survey conducted by the Georgia Department of Public Health Office of Nursing in April of 2021, demonstrated that 45% of the public health nurses surveyed had never deployed to a mass congregate shelter, and 43% reported they had no formal training related to emergency preparedness or mass sheltering. The purpose of this pilot study was to measure public health nurses’ improvement in familiarity with emergency preparedness and disaster response core competencies as defined by the Emergency Preparedness Information Questionnaire (EPIQ) after a focused educational program and tabletop workshop. …

Understanding The Role Of Perceived Racial Discrimination On Adolescent Mental Health During The Covid-19 Pandemic, Jill V. Klosky, Delia Lang, Briana Woods-Jaeger, Julie Gazmararian

Journal of the Georgia Public Health Association

Abstract

Background: Adolescent mental health declined during the COVID-19 pandemic. Racial discrimination, which may negatively affect adolescent mental health, has increased. This study sought to understand whether pre-pandemic reports of racial discrimination predicted changes in adolescent depression, anxiety, and self-esteem from before to during the COVID-19 pandemic.

Methods: Two online surveys were administered at two public high schools in semi-rural, north-central Georgia; one in Spring 2020, just before the closing of public schools due to COVID-19; the other to the same students in Fall 2020.

Results: Most participants were White (62%) and the majority (88%), reported the same or better …

93rd Annual Georgia Public Health Association Meeting And Conference Report, Jimmie H. Smith Jr, Angela Peden, Patrina L. Bowles

Journal of the Georgia Public Health Association

The 93^rd Annual Meeting and Conference of the Georgia Public Health Association (GPHA) was held in Jekyll Island, Georgia, at the Jekyll Island Convention Center, on May 3-5, 2023. The goal of the 2023 Georgia Public Health Association Annual Meeting and Conference was to assemble emerging public health professionals, current practitioners, academicians, governing entities, and community stakeholders for educational opportunities and networking to support the vision and mission of GPHA.

The theme for the 2023 Georgia Public Health Association Annual Meeting and Conference theme was selected by the GPHA Executive Board during a meeting in the early fall of …

Is The Public Aware Of Water Quality Monitoring And Safety Notifications On Beaches?, Asli Aslan, Jeffery A. Jones, Dziyana Nazaruk, Sibel Zeki

Journal of the Georgia Public Health Association

Recreational water-related activities have important public health benefits, however, pollution at beaches may have serious health risks. Although there is a substantial amount of research and policies in place at federal and state levels, oftentimes these efforts may not be well translated to the public. This paper evaluates the effectiveness of routine water quality monitoring and warning systems in Georgia, USA. A survey was conducted among 238 beachgoers in Georgia, asking about awareness of water quality monitoring and warning signs for beach advisories. Surveys were collected directly at beaches as well as through an online questionnaire. Results show that more …

Transformative Approach To Developing A Sustainable Interprofessional Education Program, Tilicia Mayo-Gamble, Jane Nester, Paula Tillman, Sandhya Lohani, Padmini Shankar, Pamela Mahan

Journal of the Georgia Public Health Association

Background: The ability to offer and sustain interprofessional collaboration and education (IPE) in an academic setting could potentially serve as a training model for other academic institutions to implement programs that will increase the number of practice-ready, culturally competent healthcare professionals. We designed, implemented, and evaluated an Area Health Education Center (AHEC) Scholars Program to train culturally competent interdisciplinary students to provide quality, patient-centered healthcare in rural and underserved communities post-graduation.

Methods: Two cohorts of students (Cohort 1, n = 15, Cohort 2, n = 14) were recruited into a two-year longitudinal program with 80 hours of didactic learning and …

Comparing Particulate Matter Exposures During Two Work Shifts In A Large University Dining Commons Kitchen, Shalom Emmanuel, Atin Adhikari

Journal of the Georgia Public Health Association

Objective: Cooking emits a huge concentration of indoor air pollutants, including particulate matter (PM). Exposure to PM can lead to long-term adverse respiratory effects among workers engaged in cooking. Only a few studies have measured cooking-related air pollutants in large school cafeterias where young student workers are frequently employed. The objective of this research was to compare stationary exposures to PM from cooking during two work shifts at a very large university dining commons kitchen.

Methods: Number concentrations of PM of varying aerodynamic sizes (1, 2.5, 5, and 10 µm) were measured at the back kitchen, DC grill, and …

Anxiety And Depression And Associated Factors Among A Sample Of Semi-Rural High School Students In Georgia, Raul Perez Zarate, Yi-Ting Hana Lee, Jean A. Welsh, Julie A. Gazmararian

Journal of the Georgia Public Health Association

Background: Anxiety and depression can affect adolescents’ health and current literature lacks studies of youths living in non-urban settings.

Methods: We used chi-square and t-tests on data collected from self-administered online surveys, completed by 9^th-grade students (n=222) attending a large, semi-rural public high school in the state of Georgia, to assess the prevalence of symptoms of anxiety and depression and associated factors.

Results: Almost half of the students self-reported anxiety (43%) or depression (55%) and students who self-reported either condition were more likely to report poorer sleep hygiene, sleepiness, race-related mistreatment, and higher stress.

Conclusions: Our findings suggest …

Improving Healthcare Experiences For Transgender And Intersex Populations, Destiny S. J. Lee, Joanne Chopak-Foss

Journal of the Georgia Public Health Association

Intersex is an umbrella term for individuals who are born with sex characteristics that do not typically fall into male or female categories. Individuals who are intersex make up about 1.7% of the United States population today and are identified within the lesbian, gay, bisexual, transgender, and intersex (LGBTQIA+) community. Many people who are intersex identify as transgender, which relates to the social process of gender change, as they develop into adults. In Georgia, approximately 4% of the population identify as LGBTQIA+. The purpose of this paper is to increase awareness of the perceived discrimination from healthcare providers, non-inclusive organizational …

Evaluating Pulp Therapy Provided By Medicaid-Participating Pediatric And General Dentists In Georgia From 2010-2019, Michelle Zin, Beau Meyer, Michael Milano

Journal of the Georgia Public Health Association

Abstract

Background: The purpose of this study was to evaluate reimbursable pulp therapy trends in primary teeth performed by general and pediatric dentists.

Methods: Aggregate Medicaid claims data from 2010-2019 were obtained from the state of Georgia’s Department of Community Health. Two different primary dentition pulp therapy rates were compared between general and pediatric dentists: procedures per provider and children treated per provider. Descriptive statistics, poisson regression, and correlational analysis were performed.

Results: Pulp therapy utilization for procedures per provider and children treated per provider decreased (Incidence rate ratio (IRR)=0.97, 95% confidence interval (CI): 0.95 to 0.99; …