Public Health Commons^™

Advocating For Pregnant Women In Prison: Georgia Can Do Better, Nancy Webb, Madison Gates

Journal of the Georgia Public Health Association

Background: Women are the fastest growing segment of the U.S. prison populace and approximately 1 in 25 were pregnant when they were incarcerated. However, women, including pregnant women, are receiving unacceptable health care in correctional systems. Further, many correctional systems lack policies to protect the best interest of incarcerated women, mothers and their children.

Methods: We reviewed the literature on pregnant women in prison and found that corrections has been slow in making changes and adapting facilities for women, especially related to pregnancy, parenting skills and nurseries. It has been suggested the parent-infant attachment and the involvement incarcerated parents have …

The Care Continuum For People Living With Hiv In Georgia: How Can We Raise The Bar?, Jane Kelly, Deepali Rane, C. Drenzek

Journal of the Georgia Public Health Association

Background: Viral suppression (VS) improves quality of life and longevity for people living with HIV (PLWH) and reduces viral transmission, but is achieved by only a minority of PLWH in Georgia.

Methods: By use of the Georgia HIV/AIDS surveillance database, the HIV Care Continuum was stratified by age.

Results: Retention in care and VS generally increased with increasing age, with the exception of adolescents (aged 13-18 years), who had the highest retention and VS. Differences by sex, race and transmission category persisted across age groups. Among persons retained in care, the proportion achieving VS also generally increased with age. Linkage …

Perceptions Of Hiv/Aids Testing Among Urban And Rural African American Church Members, Roblena E. Walker

Journal of the Georgia Public Health Association

Background: The prevalence of the human immunodeficiency virus (HIV) continues to affect African Americans (AA) disproportionately. The purpose of this mixed methods study, guided by the health belief model, was to examine associations linking church and ambient social environment with knowledge and perceptions of HIV/AIDS testing amongst urban and rural AA church members.

Methods: Multiple regressions and t tests were used to compare perceptions of HIV/AIDS testing and knowledge of HIV/AIDS among 236 participants selected from two AA churches located in a large city (n = 122) and in a rural town (n =114) in the Southern U.S.

Results: The …

Reflections On Mental Health Advocacy Across Differing Ecological Levels, Nancy J. Thompson, Robin E. Mcgee, Elizabeth R. Walker, Leslie C. Munoz

Journal of the Georgia Public Health Association

Background: According to the World Health Organization, mental health advocacy is comprised of a range of actions designed to change aspects of attitudes and structures that impede the achievement of positive mental health in populations.

Methods: According to the World Health Organization, mental health advocacy is comprised of a range of actions designed to change aspects of attitudes and structures that impede the achievement of positive mental health in populations.

Results: We have proposed interventions and advocacy effort for each ecological level. Project UPLIFT, a distance-delivered intervention for mental health is presented as an example of an effort that can …

Increased Perception Of Mosquito Problems During A Stormwater Restoration Project, Rosmarie Kelly

Journal of the Georgia Public Health Association

In 2008, a plan for improvement of the McDaniel Branch Watershed was prepared for the city of Atlanta, Department of Watershed Management. This included the construction of ponds in a kudzu-covered area at Bowen Circle. There is a perception that wetlands create mosquito problems. In point of fact, most of the vector and nuisance species in Atlanta are either container breeders or floodwater species, and do not breed in ponds. Because there is an average of 5 cases of West Nile virus (WNV) reported in Fulton County per year, most of these near Combined Sewer Overflow streams, county residents are …

From The Editor: State Journals Of Public Health, Mckinley Thomas

Journal of the Georgia Public Health Association

State Journals of Public Health

Extending Hiv Prevention: People Living With Hiv/Aids (Plwha) Strategize To Reduce Stigma And Promote Hiv Testing, Tiffiany M. Cummings Aholou, Su-I Hou, Tanisha S. Grimes

Journal of the Georgia Public Health Association

Strategies to reduce acquired immunodeficiency syndrome (AIDS)‐related stigma are paramount to promoting effective HIV prevention. As in the case of HIV antibody testing, despite the benefits of early detection, links to care, and risk behavior modification, nearly 250,000 people are unaware of their HIV status. AIDS‐related stigma has impeded such efforts due to discrimination, ignorance and other forms of stigma. These issues related to stigma and HIV testing are magnified when placed in the context of the rural Deep South region of the United States, where the incidence of HIV/AIDS are growing at alarming rates. The purpose of this paper …

Hiv Rates In The State Of Georgia: A Growing Threat Among Predominantly African American Populations, Swati Raychowdhury, Stuart H. Tedders

Journal of the Georgia Public Health Association

Background: US rates of HIV/AIDS continue to rise with over 55% of new cases identified in southern states in 2003. The objective of this study was to determine the magnitude of HIV/AIDS cases in rural southeast Georgia in comparison to urban areas of the state.

Methods: County level data was acquired using OASIS. Rates of HIV infections by gender and race (black vs. white) were aggregated over a five year period (2000–2005) and indirectly adjusted using Georgia as the standard. Rates for rural counties, (populations less than 35,000), were statistically compared to urban rates (α = 0.05).

Results: HIV infections …

Social And Economic Determinants Of Infant Ill Health In 159 Georgia Counties: A Comparison Study, Angela Peden, Alison Scott, John G. Peden

Journal of the Georgia Public Health Association

Prematurity and low birth weight (LBW) are important causes of infant morbidity in Georgia and the United States. Georgia county-level data were used to explore the relationships between prematurity and LBW and two social and economic determinants of health: race and poverty status. Spearman rank correlations and Friedman and Wilcoxon signed rank tests were used. Prematurity and LBW were positively associated with poverty status and the presence of large African American populations. While causation cannot be inferred from correlative data, this analysis highlights the need to consider the role of social and economic factors in infant morbidity. It also highlights …

Impact Of Chlamydia And Gonorrhea In Georgia: An Urban / Rural Comparison (2000-2004), Swati Raychowdhury, Stuart H. Tedders, Sarah K. Jones

Journal of the Georgia Public Health Association

Background: In 2005, 33,562 cases of chlamydia and 15,860 cases of gonorrhea were reported in the State of Georgia, respectively corresponding to 3.4% and 4.7% of all cases reported nationally (CDC, 2005). Disparities of infection with respect to race and gender are evident for both diseases. The objective of this study was to determine the magnitude of chlamydia and gonorrhea in rural Georgia compared to urban areas of the state.

Methods: County level data necessary for analysis were acquired using the Georgia Division of Public Health’s Online Analytical Statistical Information System database (GDHR, 2007). Rates of infection by gender and …

Assessing The Validity Of Statistical Inferences In Public Health Research: An Evidence-Based, ‘Best-Practices’ Approach, Karl E. Peace, Anthony V. Parrillo, Charles J. Hardy

Journal of the Georgia Public Health Association

Like many fields, public health has embraced the process of evidence-based practice to inform practice decisions and to guide policy development. Evidence-based practice is typically dependent upon generalizations made on the bases of the existing body of knowledge – assimilations of the research literature on a particular topic. The potential utility of scientific evidence for guiding policy and practice decisions is grounded in the validity of the research investigations upon which such decisions are made. However, the validity of inferences made from the extant public health research literature requires more than ascertaining the validity of the statistical methods alone; for …

Quantitative Data Analysis Of Multiple Factors Associated With Low Birth Weight In Bibb County, Georgia, Haley D. Jackson, Yudan Wei, Fan Chen

Journal of the Georgia Public Health Association

Objective: This study aims to identify and evaluate significant risk factors associated with low birth weight in Bibb County, Georgia.

Methods: Data used in this study was obtained from the Georgia Department of Human Resources’ Vital Records Offices. The sample consists of 2,346 white and black or African American women giving birth in Bibb County, Georgia in 2005. Logistic regression was used to analyze the risk factors associated with low birthweight in Bibb County, Georgia. The multiple factors analyzed as independent variables included maternal race, maternal education, maternal age group, socioeconomic status, marital status, maternal tobacco use during pregnancy, maternal …

Social, Economic And Health Costs Of Unintended Teen Pregnancy: The Circle Of Care Intervention Program In Troup County, Georgia, Andrea M. Brace, Michael Hall, Barry P. Hunt

Journal of the Georgia Public Health Association

Unintended teenage pregnancy in the United States is a public health concern with ramifications that include a variety of social, economic and health costs. It has been estimated that adolescents giving birth before the age of 18 cost the United States at least $9.1 billion dollars annually (NCPTUP, 2008). Latest available national data indicate a slight increase in rates of unintended teen pregnancy after a 15 year period of steady decline. The unintended teen pregnancy rate in Troup County, Georgia in 2006 was 51.9/1,000 which was higher than the national average of 41.9/1,000(Kids Count, 2008). The purpose of this study …

Health Literacy Levels Among Adult Support Group Members And The General Adult Public : A Focus Group Approach, Daniel R. Czech, June Alberto, A. Barry Joyner

Journal of the Georgia Public Health Association

Health literacy has been identified as lacking in 47% of Americans (The National Academies, 2004). While health literacy reports of studies conducted in the southern section of the United States are available (DeWalt et al., 2004; Kennen et al. 2005), this research team found limited research that provides health literacy levels of the southeast, rural Georgia population. The purpose of this exploratory study was to examine and compare health literacy of health-related support group members and non group members in southeast Georgia utilizing a focus group methodology developed by Kreuger (1994). After Institutional Review Board approval at a local university, …

Infant Mortality Trends Among Georgia Residents, 1995-2003: Targeting Healthy People’S 2010 Goals, Diana Sturges, Laura Gunn, Padmini Shankar, Shrikrishna Shroff

Journal of the Georgia Public Health Association

Population-based trends in infant mortality among Georgia Residents between 1995 and 2003 were assessed on characteristics such as race, birth weight, neonatal and post-neonatal periods, and cause of death. A statistical analysis was conducted to show that the Georgia infant mortality rate (IMR) remained constant throughout the study period and averaged 8.67 per 1,000 live births. The analysis revealed racial disparities, with an IMR ranging from 6.03 in white infants to 13.76 in black infants, with less than one percent (0.86%) change, on average, among the differences between black and white mortality rates across the nine-year period. The disparities were …

Risk Factors For Hiv Transmission Among Hispanic Men Who Have Sex With Men In Atlanta, Valerie A. Hepburn, Denyse N. Nanan

Journal of the Georgia Public Health Association

This study assessed and compared demographic factors, psychosocial factors, health seeking behavior, and sexual practices of two convenience samples of Hispanic/Latino gay men and men who have sex with men (MSM) in the metropolitan Atlanta region. The aim was to obtain data on emerging HIV/AIDS patterns in this group. Bilingual surveys were conducted in 2000 and 2006 at local gay bars. Discrepancies observed between HIV/AIDS knowledge and sexual behaviors in 2000 were replicated in 2006. Contrary to expected improvements due to enhanced HIV/AIDS education and awareness, risk behavior for HIV/STDs increased significantly between 2000 and 2006. These findings should inform …

The Breast And Cervical Cancer Prevention And Treatment Act (Bccpta) In Georgia: Women Covered And Medicaid Costs In 2003, E. Kathleen Adams, Sarah C. Blake, Cheryl Raskind-Hood, Linien Chien, Mei Zhou, Jonathan Liff, William Eley

Journal of the Georgia Public Health Association

The Breast and Cervical Cancer Prevention and Treatment Act (BCCPTA) provided states with an optional Medicaid eligibility category for uninsured women with breast and/or cervical cancers. The BCCPTA is the first and only such effort to use a population-based public health screening program, the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to provide a pathway to publicly funded health insurance for otherwise uninsured low-income women. Georgia was one of the first states to adopt the BCCPTA and was one of only twelve states that provided Medicaid eligibility to women screened by non-NBCCEDP providers. We use 2003 Georgia Medicaid …

Clinicians’ Perception Of Inmates’ Satisfaction With Mental Health Services, Jerry B. Daniel, Wynne S. Korr

Journal of the Georgia Public Health Association

A growing body of literature addresses the mental health needs of prison inmates; however, very little research has examined mental health services among this population. Based on the Behavioral Model of Health Services Use (Andersen Model), the current study examined clinicians’ perception of inmates’ satisfaction with mental health services. The study’s main objective was to identify the effect of three major groups of predictor variables (predisposing, enabling, and need) on clinicians’ perception with inmates’ satisfaction with mental health services. The study utilized an exploratory, survey methodology. Although only a few variables were found to be statistically significant in the multivariate …

Modifying And Validating A Quality Of Life Measure To Fit Your Patient Population, Michelle R. Johnson, J Ross Maclean, Rebecca L. Rogers, Donna M. Fick, Andre Kallab

Journal of the Georgia Public Health Association

Introduction: A well-developed quality of life (QoL) instrument is valuable in identifying the burden of illness. We were interested in exploring whether existing QoL instruments were suitable for patients in our medical setting and, if not, whether this could be rectified by adapting an existing valid and reliable instrument to meet the specific needs of our patient population. For the purposes of this study, we chose to evaluate the quality of life of patients with breast cancer. Specifically, we were interested in two aspects of QoL in women with breast cancer. The first was whether existing instruments were pertinent to …

Multi-Level Evaluation Of A Perinatal Health Program In Rural Southeast Georgia, Swati Raychowdhury, Stuart H. Tedders, Greta O'Steen, Sarah Jones

Journal of the Georgia Public Health Association

Problem: Infant mortality has declined steadily in the past decade, however, significant disparities associate with lack of adequate perinatal health services and barriers to access disproportionately impact women residing in rural areas. In Georgia, data suggest significant challenges with respect to birth outcomes, and this problem seems to be exacerbated in rural regions of state. The objective of this presentation is to report on the impact of a regional perinatal health care collaborative implemented in rural southeast Georgia.

Method: Analysis of pre-intervention and post-intervention birth outcomes (gestational age, birth weight and infant mortality) served as the focal point programmatic evaluation. …

Relationship Of Fruit And Vegetable Servings And Self-Reported Diabetics In The Southeast And Northeast, Marylen Rimando, Faye Lopez, Haritha Battula

Journal of the Georgia Public Health Association

According to the American Diabetes Association, most diabetic patients are not consuming the recommended 3-5 servings of vegetables and 2-4 servings of fruits a day. This study examined fruit and vegetable servings of self-reported diabetics (N=35,407) in select southeastern and northeastern states using Behavioral Risk Factor Surveillance System (BRFSS) 2005 data. The estimate for both fruit and vegetable servings and self-reported diabetes was determined using multivariate logistic regression, adjusting for sociodemographics and geographic region. The results indicated a significant difference between fruit and vegetable servings for diabetics and non-diabetics (p<0.0001). A higher percentage of diabetics in the northeast consumed more than three servings of fruit and vegetables when compared to diabetics in the southeast. Respondents in the northeast were 21% more likely to consume five or more servings of fruit and vegetables and 16% less likely to be diabetic than those in the southeast after adjusting for age, race, sex, and geographic region. In conclusion, diabetics in the northeast consumed more servings of fruit and vegetables than did those in the southeast. Multiple factors influence fruit and vegetable consumption and diabetes and should be considered when developing targeted nutritional interventions. Diabetes educators, nurses, and physicians can encourage diabetic patients to consume more fruit and vegetables and motivate them to continue eating fruit and vegetables.

Historical Critique Of The Leading Causes Of Death In The United States, Mckinley Thomas

Journal of the Georgia Public Health Association

Historical Critique of the Leading Causes of Death in the United States

A Needs Assessment Of Hypertension In Georgia, Faye Lopez, Marylen Rimando, Harshali Khapekar

Journal of the Georgia Public Health Association

Hypertension is a leading cause of stroke, coronary artery disease, heart attack, and heart and kidney failure in the United States. In Georgia, the percentage of those with hypertension and related diseases remain above the national average. The aim of this paper is to offer a basic review of hypertension including physical complications of the disease and to provide statistics regarding the scope of hypertension in the state of Georgia. Additionally, the paper provides insights on current hypertension programs such as the National High Blood Pressure Education Program (NHBPEP) and Dietary Approaches to Stop Hypertension (DASH). In conclusion, a statewide …

Racial Differences In Perception Of Breast Cancer Risk In Rural Southeast Georgia, Stuart H. Tedders, Anthony V. Parrillo, Karl E. Peace, Jannell R. Knight

Journal of the Georgia Public Health Association

A university-public health collaborative was formed to more fully understand cancer risk among rural women in Georgia. Objectives: This study sought to gain an understanding of racial differences with regard to behavioral risk, perception of breast cancer risk, and perception of barriers to screening. Design: Differences in subjects’ risk and risk perception were assessed by creating, piloting, and administering a written survey at local health departments. Sample: A purposive sample of females enrolled in breast and cervical cancer screening programs in four rural counties in southeast Georgia (n = 147) were surveyed. Subjects were randomly invited to participate. Incentives were …

Care Quality For Adult Medicaid Beneficiaries With Type 2 Diabetes Varies By Primary Care Provider Subspecialty, Robert M. Mayberry, Rita Finley, Ernest Alema-Mensah, Trobiand A. Davis

Journal of the Georgia Public Health Association

The Georgia Medicaid primary care case management (PCCM) program, phased in over the 1994-1997 period, has now given way to a capitated managed care model of regional care management organizations (CMOs). Using Georgia Medicaid eligibility and provider claim data for 1996-1998, this study investigated diabetes care quality and whether it varied by primary care provider subspecialty in a longitudinal follow-up of newly diagnosed adults with type 2 diabetes during the early phase of the PCCM program. Results indicated that the quality of diabetes care was suboptimal and varied significantly by PCP subspecialty, with patients seen by generalists least likely to …

Pregnancy And Delivery Costs In Georgia Medicaid: Pccm Versus Fee-For-Service Enrollees, Chery Raskind-Hood, Kathleen E. Adams, Ernest Alema-Mensah, Robert M. Mayberry

Journal of the Georgia Public Health Association

This study examines the enrollment, resource utilization, and prenatal care cost patterns among pregnant black and white women in Georgia’s PCCM program, Georgia Better Health Care (GBHC), compared with those acquiring pregnancy and delivery services through Georgia’s Fee for Service (FFS) sector. Birth certificate data from 1998 were linked with Medicaid enrollment and claims data from 1997 and 1998 to construct a retrospective pregnancy history for each Medicaid woman giving birth in Georgia hospitals in 1998. Total payments for pregnancy and delivery services and on the total number of prenatal care visits were derived for each woman in the sample. …

Meeting Public Health Challenges, Mckinley Thomas

Journal of the Georgia Public Health Association

Meeting Public Health Challenges

A Worldwide Crisis: Inappropriate Antibiotic Use And Resistant Bacterial Infections, P. Anna Vickery, James Wilde

Journal of the Georgia Public Health Association

A Worldwide Crisis: Inappropriate Antibiotic Use and Resistant Bacterial Infections

Sexually Transmitted Infections: Perceived Knowledge Versus Actual Knowledge, Heather Ferguson, Richard Topolski, Marc Miller

Journal of the Georgia Public Health Association

Sexually transmitted infections (STIs) continue to be a serious problem, with potentially severe consequences. Past research has found that people may not seek out treatment for STIs because they do not know what symptoms to look for (Greenberg et al., 2002). The present study investigated many aspects of STI knowledge, including perceived knowledge and actually knowledge. Moreover, this study added a novel and applied aspect to the assessment of STI knowledge: visual knowledge. Overall, participants performed poorly on the actual STI knowledge, however, those who rated their knowledge as high performed significantly better than those who rated their knowledge as …

An Examination Of Adolescents’ Knowledge And Attitudes Related To Heart Disease, Nutrition, Physical Activity, And Media Influences And The Adoption Of A Healthy Lifestyle, Melissa Schenkman, Randolph Martin, Susan Butler

Journal of the Georgia Public Health Association

The present pilot study aimed to determine the attitudes, beliefs, behaviors, and degree of knowledge among adolescents related to healthy eating, exercise, heart disease, the influence of television, and possible factors in modifying their attitudes toward adopting a healthy lifestyle. Juniors and seniors from two private high schools (N=62) in metro Atlanta were surveyed. The study was based on the Social Cognitive Theory and the Health Belief Model. The research questions examined the impact of nutrition and heart disease knowledge on physical activity behavior, and the impact of television media exposure on eating habits. A 36-question cross-sectional survey compiled from …