Public Health Commons^™

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 …

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 …

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 …

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 …

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; …

Healthfulness Of Fast-Food And Full-Service Restaurants In 16 Georgia Counties After Mandatory Menu Labeling, Janani Rajbhandari-Thapa, Donglan Zhang, Nicole Katapodis, Dana Alvin, Melanie Andrews

Journal of the Georgia Public Health Association

Background: Despite that the effect of menu labeling on consumer choices has been studied, there are gaps in the research on the healthfulness of the restaurant food environment post-mandatory menu labeling, specifically in the Southern United States. This study aims to assess the healthfulness of fast-food and full-service chain restaurant environments after compliance with mandatory menu labeling.

Methods: The healthfulness of 46 representative fast-food and full-service chain restaurants in 16 Georgia counties was examined using the Nutritional Environment Measures in Restaurants (NEMS-R) survey. The scores were compared between full-service and fast-food restaurants using t-tests across several healthfulness measures such as …

Addressing The Stigma Associated With Antiquated Blood Donation Policies And Donor Eligibility For Msm, Jay S. Pickern, Helena R. Costakis

Journal of the Georgia Public Health Association

The crises of blood product shortages pose real health risks and threats to the greater population in the United States (U.S.). Current U.S. blood donation policies continue to restrict or limit donations from willing and healthy individuals on the basis of sex, classified as men who have sex with men (MSM). This essay explores the historical progression of the current blood donation policy through the lens of enacted stigmatization and stigma consciousness for MSM, identifies implications of the current policy, explores the impact of the current policy and proposed changes, and calls for action to modernize the current blood donation …

Implementation Of A Virtual Nurse Residency Program For Public Health Nurses: A Pilot Study, Ashlie L. Pullen

Journal of the Georgia Public Health Association

Implementation of a Virtual Nurse Residency Program for Public Health Nurses: A Pilot Study

Background: Nursing retention is a growing concern for many healthcare organizations. One of the Georgia Department of Public Health’s goals is to improve the recruitment and retention rates of public health nurses in the state. In this cohort study of nurses with less than 18 months of experience in public health, pre and post-tests were conducted to measure stress, confidence, job satisfaction, and public health core competencies.

Methods: The participants took part in asynchronous and synchronous online content led by public health professionals. These two modules …

Identifying Community-Engaged Translational Research Collaboration Experience And Health Interests Of Community-Based Organizations Outside Of Metropolitan Atlanta, Breanna B. Greteman, Latrice Rollins, Ph.D., Msw, Allisen Penn, Alison C. Berg, Eric J. Nehl, Nicole Llewellyn, Amber Weber, Melissa George, Darrell Sabbs, Mohamed Mubasher, Tabia H. Akintobi

Journal of the Georgia Public Health Association

Background: While rural health research has increased over the last two decades, there is limited understanding of the self-reported health priorities and research interests of rural and suburban community-based representatives and residents. These insights can be used to inform more successful intervention strategies that are responsive to the lived experiences of local residents and leaders who are the gatekeepers to buy-in and sustainability of community engaged research. The Georgia Clinical and Translational Science Alliance, a collaboration between four academic institutions includes a Community Engagement Program (CE) designed to facilitate community-academic research partnerships. This study aimed to assess the health priorities, …

Health Communications Trial With A Resistant Population To Increase Public Health Compliance During A Pandemic, Alison Amoroso, Carlos A. O. Pavao, Russel E. Luke, Jennifer Mccoy, Sean Richey, Shenandoah Evans

Journal of the Georgia Public Health Association

Background: Georgia has among the worst rates of COVID-19 hospitalization and death rates in the nation. Many identifying as politically conservative resist public health mitigation measures, similar to populations in other politically conservative geographical areas. There are limited peer-reviewed public health communications designed for this population. We aimed to determine if an intervention using a fear appeal approach with efficacy during a pandemic can positively affect knowledge, attitude, perception, and/or behavior (KAP) in Georgia with this population.

Methods: We delivered online video stimuli tailored to the geocultural characteristics of the target population. designed to stimulate fear, encourage efficacy, and counter …

Selective Participation In Syphilis Partner Services And Implications For Control Efforts, Fulton County, Georgia, 2013-2015, Sarah Hamid, Udodirim N. Onwubiko, David P. Holland, Allison T. Chamberlain

Journal of the Georgia Public Health Association

Background. Partner services is an important component of syphilis control, but not all persons with syphilis participate, limiting the strategy’s potential effectiveness and possibly introducing selection biases into analyses of risk factors for reinfection. This study aimed to describe demographic and clinical differences between partner-services participants and non-participants in Fulton County, Georgia, and to assess the association between participation and syphilis re-diagnosis.

Methods. Using surveillance data, we identified primary and secondary syphilis cases in Fulton County with a first diagnosis in 2013-2015. We compared the distributions of demographic and clinical characteristics between participants and non-participants using chi-squared tests. …

Perception Of Health Care Access In Rural Georgia: Findings From A Community Health Needs Assessment Survey, Elisa M. Childs, Tiffany R. Washington

Journal of the Georgia Public Health Association

Background: Limited access to health care services has been cited as a barrier to care for individuals who live in rural areas, contributing to significant health disparities in this population. While perception of services has been cited as a determinant of utilization of health services, it is unknown how perception of services influences health care access in rural areas. The paucity of studies specific to areas in the United States that are medically underserved, necessitated this study and its quantification of the issues that are relevant to individuals living in rural Georgia.

Methods: This study examined the perception of health …

Cyberbullying In Middle School Students: An Intervention Using An Educational Mobile Application For Caregivers: A Pilot Study, Gregory C. Claxton

Journal of the Georgia Public Health Association

Cyberbullying among middle school students is a growing problem that is shown to affect psychological development in middle school youth which can result in self-harm and suicide. Evidence suggests more frequent communication between children and their caregivers is a protective factor against cyberbullying. The KnowBullying app is designed to increase caregiver and student communication to prevent bullying. This study examines the effectiveness of the KnowBullying app regarding enhanced caregiver and child communication and cyberbullying experience reduction in middle school students. Five students and nine caregivers were given surveys before and after the caregivers downloaded and used the KnowBullying app. The …

Epidemiological Models, Parameters, And Prediction Of The Covid-19 Outbreak In A Southwest Georgia Hotspot, Daniel F. Linder, William M. Sewell Iii, Jack D. Owens, Jim Franklin, Mark Miller, Casey Newton, Priyank Shah

Journal of the Georgia Public Health Association

Background: We investigate epidemiological models, their parameters, and the models’ predictive performance of daily new cases during the first three weeks of the SARS-CoV-2 outbreak in a southwest Georgia hotspot.

Methods: We fit stochastic versions of the classical SIR, a network-based SIR, an SEIR model with two different priors on the latent period rate parameter, and a simple doubling time model to SARS-CoV-2 patients’ date of hospital admission and length of symptoms data from the Phoebe Putney Health System.

Results: The estimated basic reproductive numbers and 95% Bayesian credible intervals for each of the models were: 1.98 (1.63, 2.45) for …

Can Mini Grant Programs Address Community Health Improvement Plans In Rural Areas? A Local Evaluation, Kelley Ditzel, Cameron Watts

Journal of the Georgia Public Health Association

Background: In the rural community of Hancock County, Georgia, it became apparent in the summer of 2017 that outside help was necessary to address the failing health and education problems plaguing this area. The North Central Health District received Healthcare Georgia Foundation grant leading to the creation of the Hancock Health Improvement Partnership (HHIP) composed of 11 community leaders who developed the Community Health Improvement Plan to positively impact their county.

Methods: This evaluation was conducted to report the efficacy of the mini grant program developed by the HHIP, particularly how grants could best improve organizational capacity, incentivize community collaborations, …

An Analysis Of Georgia Mothers Who Gave Birth In 2015 And 2016 Without Receiving Prenatal Care, Joncel Stephens, Shanta R. Dube, Merrilee Gober

Journal of the Georgia Public Health Association

Background: The present study characterizes the population of women residing in the state of Georgia who did not receive prenatal care before giving birth to a live infant. The association between mother’s place of residence (rural/non-rural) and preterm delivery was also examined.

Methods: This study examined data obtained from the Georgia Department of Public Health which includes data for 7,062 mothers who did not receive prenatal care before giving birth to a live infant in Georgia in the years 2015 and 2016. Data on the resulting births was also studied. Descriptive analyses of the following variables were used …

Elderly Educated Blacks And The Influence Of Exercise Identity, Self-Determination, And Social Determinants Of Health On Physical Activity, George Leonard Shaw Jr., Miles Anthony Irving

Journal of the Georgia Public Health Association

ABSTRACT:

Background: This study examined the influence of socio-economic status (SES), exercise self-definition, and self-determination variables on physical activity participation among African American retirees.

Methods: Both African American men and women, of at least 60 years of age, were surveyed. All participants lived independently. The data collected included demographic, Godin Leisure-Time Physical Activity Questionnaire (LTPA), Exercise Self-Definition Questionnaire (ESD), Behavioral Regulations Exercise Questionnaire-2 (BREQ-2), and Basic Psychological Needs Satisfaction in Exercise Scale (BPNES). The findings and analysis were conducted using data from149 participants.

Results: Only gender was a statistically significant predictor of physical activity participation in the study. Based on …

Impact Of Public Health Nurse Training On Their Perception To Provide Hypertension And Diabetes Care To Patients In Their Communities., Stephen Goggans, Jean O'Connor, Elena A. Wood, Elizabeth Sacksteder Laclair, Kathryn Martin, Paul Wallach

Journal of the Georgia Public Health Association

To evaluate the impact of protocol training by a medical school and public health department on nurses’ perceptions to deliver care to patients with hypertension and diabetes.

Training was delivered using the Georgia Diabetes and Hypertension Nurse protocols for public health nurses. A survey was developed and distributed post training to participants. The training included lectures, workshops, case discussions, simulation, and physical examination practice on standardized patients. Participants were asked about perceptions, both before and after training completion regarding frequency in changing practice and confidence in treating hypertension and diabetes for six items.

Perceived levels of confidence for all questionnaire …

Addressing Maternal Mental Health Among Black Perinatal Women In Atlanta, Georgia: A Cbpr Approach, Natalie Hernandez, Sherilyn Francis, Brielle Evans, Andrea G. Parker, Jemea Dorsey, Danette Mclaurin Glass, Mica Whitfield, Elise Blasingame, Pamela Braxton, Rasheeta Chandler

Journal of the Georgia Public Health Association

Background: Perinatal mood and anxiety disorders (PMADs) are the most common complication of pregnancy, affecting up to 1 in 5 childbearing women, with higher rates among low-income minority women. One in seven women suffer from perinatal depression. This study aimed to (1) assess the mental and emotional health challenges of underserved Black perinatal women in Atlanta, Georgia (GA) and (2) examine local priorities and sources of care for mental health among underserved women in Atlanta, GA.

Methods: A community-based participatory research partnership between Morehouse School of Medicine (MSM) and the Center for Black Women’s Wellness (CBWW)’s Atlanta Healthy Start Community …

“Someone You Love” Documentary: Using Narratives In Entertainment Media To Increase Hpv Vaccination In Georgia, Gabrielle C. Darville- Sanders, Jann Macinnes, Kelsey Schwarz

Journal of the Georgia Public Health Association

Background: Although HPV is the most common sexually transmitted disease in the United States, vaccination rates are still lagging among adolescents and young adults. Entertainment-education is a popular strategy for incorporating educational messages into entertainment media. With popular shows on television now integrating health messages into their narrative, there are more opportunities to influence knowledge, attitude and health behaviors. Objective: To (a) determine the effectiveness of the HPV narrative included in the “Someone You love” documentary on HPV risk perception, vaccine self-efficacy and behavioral intention for HPV vaccine uptake on college students and (b) assess the immediate impact of the …

Barriers And Facilitators To Conducting Physical Activity Interventions In Children's Camps, Silvia Q. Giraudo, Jordan Merideth, Barbara M. Grossman

Journal of the Georgia Public Health Association

Background: Previous research has sought to uncover various behavior factors that contribute to childhood physical activity, but have primarily relied on quantitative methods or within the context of schools. Summer day camps offered potential for increasing activity of youth, but research is required to determine how best to convert camp activity into outreach interventions.

Methods: The University of Georgia Institutional Review Board (IRB) approved all methods and procedures prior to the start of the study (STUDY00004692, MOD00005513). A total of 112 campers ages 9-13 participated in the data collection. This research used semi-structured interviews, surveys, and observations to …

Role Of Community-Level Health Behaviors And Social Determinants Of Health In Preventable Hospitalizations, Elizabeth Ayangunna, Kingsley A. Kalu, Gulzar H. Shah

Journal of the Georgia Public Health Association

Background

Hospitalizations contribute significantly to the country’s health expenditures. There are factors in addition to clinical care that determines whether a community can prevent hospitalizations from certain medical conditions.

Purpose

The purpose of this paper is to explain the role of community-level health behaviors and social determinants of health (SDoH) in preventable hospitalizations.

Methods

This study used secondary data from the 2021 County Health Rankings for 8 states in HHS Region 4--Georgia, Florida, North Carolina, South Carolina, Alabama, Mississippi, Florida, and Tennessee. Descriptive analyses and multivariate linear regression were computed to examine the association between the dependent variable- preventable hospitalizations …

Barriers To Hiv Related Services Among Men Who Have Sex With Men (Msm) In Rural Georgia, Jordan D. Helms, Alvin Tran, Neal Carnes, Eric J. Nehl

Journal of the Georgia Public Health Association

Background: Gay, bisexual, and men who have sex with men (MSM) living in the Southeastern United States are at high risk of contracting HIV, and those in rural communities experience challenges in accessing HIV prevention and treatment.

Methods: Seven health care workers and 17 MSM in rural health care districts participated in semi-structured interviews. A theory-informed thematic analysis approach was used to summarize and compare perspectives between health care workers and MSM participants.

Results: Stigma, insufficient resources, and social structures of rural life emerged as barriers to accessing HIV-related services

Conclusions: Overcoming these barriers are necessary to reduce HIV infection …

Air Pollutant Levels And Asthma Emergency Room Visits In A Highly Populous Us Urban County During 2018-19, Osaremhen Ikhile, Jingjing Yin, Atin Adhikari

Journal of the Georgia Public Health Association

Objective: Air pollutants are linked to asthma exacerbation. The study purpose was to demonstrate an association between air pollutants levels and asthma emergency room (ER) visit trends in a highly populated US urban county in Georgia during 2018-2019.

Methods: Time series analyses were conducted for the variations in daily numbers of children and adult asthma emergency room visits and changes in daily mean PM_2.5, daily mean PM₁₀ concentrations, daily max 1-hour SO₂ concentrations, daily max 1-hour NO₂ concentrations, daily max 8-hour ozone concentrations, and airborne pollen loads for 2018 to 2019 and potential trends were …

The Impact Of Rurality, Underlying Cardiovascular Disease, And Socioeconomic Vulnerability On Covid-19 Outcomes In Georgia, Michael C. Morgan, Lavannya Atri, Jennifer L. Waller, Douglas Miller, Adam E. Berman

Journal of the Georgia Public Health Association

Background: COVID-19 related illnesses have been associated with an increased prevalence of cardiovascular disease sequelae and worsened socioeconomic variables. We sought to investigate the relationship between COVID-19 outcomes, underlying cardiovascular disease, and socioeconomic determinants of health in rural and non-rural counties in the state of Georgia.

Methods: COVID-19, demographic, and socioeconomic data were acquired from publicly available databases including the Center for Disease Control and Prevention’s Social Vulnerability Index (SVI). The relationship between COVID-19 outcomes and markers of cardiovascular disease burden, rurality, and socioeconomic determinants of health was assessed at the county level in Georgia through the beginning of …

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

Journal of the Georgia Public Health Association

Whether rural hospitals and providers have seen a surge in COVID-19 cases or a reduction in patients seeking care since the pandemic began, their financial condition has been negatively impacted. Many providers have now received some emergency funding through the Coronavirus Aid, Relief, and Economic Security Act and the Payroll Protection Program but these are likely only short-term fixes. For many, the crisis has exacerbated already existing problems. Notable among these problems are volume declines, supply chain disruptions, and workforce concerns. While these problems require immediate action, two longer-term systemic changes to rural healthcare delivery are needed to address them. …

Barriers To Purchasing Narcan® In Georgia: A Survey Of Pharmacy Staff, Thomas E. Griner, Sheryl Strasser, Stacie Kershner, Ashli Owen-Smith, Matthew J. Hayat

Journal of the Georgia Public Health Association

Background: In Georgia, recent measures have expanded public access to naloxone-containing products like Narcan® to combat opioid-related overdose deaths. Although laypersons may legally purchase naloxone products without a prescription for use during opioid-related overdose events, barriers may remain.

Methods: We conducted an anonymous telephone survey to investigate three potential barriers to purchasing naloxone (Narcan®) in Georgia: availability, price, and working knowledge of legal requirements among pharmacy representatives. We surveyed pharmacy representatives in select Georgia counties with high volumes or high rates of poisoning deaths compared with other counties. We also compared responses among chain and non-chain representatives. Descriptive statistics are …

Campus Recreation And Fitness Center Utilization During The Covid-19 Pandemic, Keagan Kiely, William A. Mase, Bridget F. Melton, Haresh Rochani

Journal of the Georgia Public Health Association

Background

The impact of the COVID-19 pandemic has far reaching effects for college students' health and physical activity behaviors. This analysis focuses on university student fitness center usage pre and during the COVID-19 pandemic. Researchers hypothesized a reduction in fitness center utilization when comparing Fall 2019 to Fall 2020 utilization rates.

Methods

Patterns of the recreation center and fitness center utilization during the COVID-19 pandemic are compared to pre-pandemic patterns of a matched time period in the previous academic year in an observational study. Overall utilization was evaluated using secondary data from the university’s recreation center data system. Six weeks …

The Interplay Of Policy, Behavior, And Socioeconomic Conditions In Early Covid-19 Epidemiology In Georgia, Mallory J. Harris, Ella Tessier-Lavigne, Erin Mordecai

Journal of the Georgia Public Health Association

Publishing Note: This article has been published in its peer-reviewed and accepted form as a post-print version. The fully formatted version of the article will be published on this record when it is available.

ABSTRACT

Background: As COVID-19 began to spread worldwide, local socioeconomic and health factors and nonpharmaceutical interventions may have affected epidemiological outcomes. To investigate the associations between public health orders, behavior, and population factors, and early epidemic dynamics, we investigated variation among counties in the U.S. state of Georgia. There, a large early outbreak occurred in March 2020 with varying levels of local nonpharmaceutical interventions prior to …