Public Health Commons^™

Sociodemographic And Biometric Factors Associated With Eating Behaviors Among African American Women Aged 18-74, Takiyah J. Thomas, Jammie M. Hopkins, Riba Kelsey-Harris, Folashade Omole, Ernest Alema-Mensah

Journal of the Georgia Public Health Association

Background: Obesity is a growing problem in the United States and is disproportionately increasing among African Americans. The objective of this study is to examine the sociodemographic and biometric factors associated with eating behaviors among African American women.

Methods: We analyzed data from the 2009-2010 dietary screener and weight history questionnaire from the National Health and Nutrition Examination Survey. Multivariable analyses were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) to determine the association between six specific eating behaviors and different sociodemographic and biometric factors. Analyses were conducted using SAS 9.4.

Results: The analyses show …

Mental Health Outcomes, Parenting Skills And Family Functioning Of Adult And Family Treatment Court Participants, Carolyn A. Malone, Jessica S. Rogers, Wendy P. Guastaferro, Daniel J. Whitaker

Journal of the Georgia Public Health Association

Background: Parental substance use places children at risk for poor social, emotional, and behavioral outcomes. Many parents with substance use disorders (SUD) are treated through accountability drug courts including adult drug courts (ADC) through the criminal justice system and family drug treatment courts (FTC) through the child welfare system. Little is known about the children of parents who participate in treatment through adult drug courts, which could serve as an important treatment venue for improving child outcomes. Children treated through family treatment courts are often the center of treatment. This research compared outcomes of parents and children involved in adult …

Living Arrangement: A Contributor To Vascular Disease In Asymptomatic African American Women, Meldra Hall, Elizabeth Ofili, Rigobert Lapu-Bula, Ernest Alema-Mensah, Stephanie Miles-Richardson

Journal of the Georgia Public Health Association

Background: Diminished social support has shown to lead to worse cardiovascular outcomes and since cardiovascular disease (CVD) is the leading cause of death in the United States (U.S.), it is critical to non-invasively study its precursor- vascular disease (VD). Assessing the impact social support has on vascular outcomes can unveil potential CVD susceptibilities in at-risk populations. African American women exhibit the greatest burden of CVD morbidity and mortality; therefore, the purpose of this study is to examine the association between living arrangement/social support and impaired vascular function in asymptomatic African American women.

Methods: Vascular function was assessed by a non-invasive …

Ethical Approaches To Mandating Influenza Vaccinations For Local Health Department Workforce In Georgia, Melicent R. Miller, Maureen K. Akubu-Odero, Lashauna L. Hunt, Stephanie L. Irvin, Catherine T. Palmer, William A. Mase

Journal of the Georgia Public Health Association

Background: The seasonal influenza illness occurs every year in the United States during the cooler months from October to April, sometimes lasting longer. Although certain populations are more susceptible to this condition, data have shown that otherwise healthy individuals have experienced alarming rates of morbidity and mortality associated with these infections. Despite the CDC’s recommendation for influenza vaccination for all HCWs, compliance have been lagging among local health departments’ workforce. This practice arguably exposes a wide cross section of the U.S. population to the flu, while being served in these facilities. The utilitarian approach provides a framework to examine the …

Chronic Disease Prevention As An Adaptive Leadership Problem, Jean O'Connor

Journal of the Georgia Public Health Association

This is an invited editorial.

Response To “Std Services Delivery Arrangements In Georgia County Health Departments”, Kathryn Moore

Journal of the Georgia Public Health Association

This is a Letter to the editor.

Community-Based Approaches To Reduce Chronic Disease Disparities In Georgia, Latrice Rollins, Tabia Henry Akintobi, April Hermstad, Dexter Cooper, Lisa Goodin, Jennifer Beane, Sedessie Spivey, Amy Riedesel, Olayiwola Taylor, Rodney Lyn

Journal of the Georgia Public Health Association

Background: Among underserved and racial/ethnic minority populations in Georgia, there are profound health disparities and a burden of chronic diseases. Such diseases, which are preventable, are influenced by risk factors, including poor nutrition, physical inactivity, lack of quality health care, and tobacco use and exposure. Awardees of the Racial and Ethnic Approaches to Community Health (REACH) and Partnerships to Improve Community Health (PICH) are implementing community-based initiatives using evidence-based, policy, systems, and environmental approaches to reduce racial and ethnic health disparities and the chronic disease burden in underserved urban and rural Georgia communities.

Methods: Within the context of a social …

Assessing A Comprehensive Approach To Prevent Sexual Violence On Campus: Implications For Program Improvement, Chinwe Ejikeme, Kia Powell-Threets, Mosi Bayo, Kia L. Toddle, Jean O'Connor

Journal of the Georgia Public Health Association

Background: On college campuses, sexual violence (or sexual assault) is at epidemic proportions. As many as one in four college women experience sexual assaults, most of which are not reported, likely due to the adverse reactions stemming from social norms and attitudes about rape. To prevent sexual violence on college campuses, the multi-level factors influencing it necessitate implementation of a holistic approach channeled at all levels. The present multi-method study assessed the feasibility and effectiveness of a peer educator (PE)-facilitated program implemented as part of a comprehensive sexual assault prevention program in three small Georgia colleges.

Methods: Student participants (N=128) …

Efficacy Of Chronic Disease Self-Management Among Low-Income Black Males With Behavioral Health Disorders: Pilot Study, Carol Collard, Vanessa Robinson-Dooley, Frances Patrick, Kayla Farabaugh

Journal of the Georgia Public Health Association

Background: This study examined the effectiveness of Stanford University’s Chronic Disease Self-management Program (CDSMP) among men living with co-morbidities of chronic physical health disease and behavioral health disorders.

Methods: The study was conducted at a community-based, non-profit organization in partnership with a large suburban university. Two pilot studies were completed with the population of interest. Low-income adult males with behavioral health disorders were recruited to participate in the program provided by a local behavioral health agency. Facilitators trained in the CDSMP program administered it at the agency site, and participants attended weekly meetings. Descriptive data collected included health history, demographic …

The Burden And Social Determinants Of Asthma For Adults In The State Of Georgia, Mark Ebell, Christian Marchello, Jean O'Connor

Journal of the Georgia Public Health Association

Background: Asthma is a serious chronic health condition, and social determinants may affect its prevalence.

Methods: Data from the Behavioral Risk Factors Surveillance Survey (BRFSS), the Georgia Asthma Call-back Survey (ACBS), and the Georgia hospital and emergency department survey for patients with a diagnosis of asthma were used. All data were from the years 2011 through 2014. SAS and SUDAAN software were used to calculate weighted prevalence estimates and to perform univariate and multivariate analyses of the association between social determinants, other risk factors, and asthma outcomes.

Results: The prevalence of asthma was highest among non-Hispanic blacks, women, and persons …

Evaluation Of Trends In Diabetes Care In A Patient-Centered Medical Home, Ashley N. Saucier, Danielle Mcmechan, Julie Dahl-Smith, Carla Duffie, Denise M. Hodo, Holly E. Andrews, Joseph Hobbs

Journal of the Georgia Public Health Association

Background: The patient-centered medical home (PCMH) is a model used in primary care to achieve effective management of chronic diseases. The Augusta University Health Family Medicine Center (AUFMC), a PCMH recognized by the National Committee for Quality Assurance, has implemented strategies to manage its patient population with diabetes. The present study evaluated the effects of these interventions through trend analysis of selected diabetic core measures by use of a qualified clinical data registry, the Practice Partner Research Network.

Methods: For this retrospective study, de-identified data were abstracted for adult patients with diabetes for the period of 2013-2015. Process and outcome …

Teach Kitchen: A Chronological Review Of Accomplishments, Jung Hee Chae, Benjamin E. Ansa, Selina A. Smith

Journal of the Georgia Public Health Association

Background: The Eating and Cooking Healthy (TEACH) Kitchen was founded at the Medical College of Georgia in 2015 as a nutrition-based intervention to combat the high prevalence of obesity and obesity-related chronic diseases in the area of Augusta, Georgia. Despite the importance of diet in the management of chronic diseases, inadequate nutrition education among patients and healthcare providers presents a barrier. The purpose of TEACH Kitchen is to address this gap.

Methods: TEACH Kitchen is as a student-led initiative that promotes healthy cooking among medical students and patients with chronic diseases. Healthy nutrition and cooking classes are held during the …

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 …

Hepatitis C And Hiv Screening, Merry L. Perry

Journal of the Georgia Public Health Association

Background: Chronic hepatitis C virus (HCV) affects more than 3 million people in the United States. Current HCV treatment offers a shorter treatment interval with fewer adverse reactions as well as improved cure rates of 96%. The increasing rates of hepatitis C infections in adults have been accompanied by multifaceted adverse health outcomes. The purpose of this screening program is to identify HCV-infected individuals, which will lead to clinical interventions and treatment that will improve health outcomes compared to no screening.

Methods: The Centers for Disease Control and Prevention guidelines recommend that anyone with risk factors should be screened for …

Triple-Negative Breast Cancer In Georgia: Burden, Disparities, And Connections To Georgia's Breast Cancer Genomics Project, Alissa K. Berzen, Rana Bayakly

Journal of the Georgia Public Health Association

Background: Triple negative breast cancer (TNBC) is typically aggressive and unresponsive to traditional cancer treatment, and disproportionately affects young and Black women. Approximately 60%-80% of breast cancers in women with the breast cancer gene (BRCA) mutation are TNBC, and children of a parent with a BRCA mutation have a 50% chance of inheriting it. Current guidelines recommend women diagnosed with TNBC receive genetic testing and counseling. Georgia’s Breast and Cervical Cancer Program (BCCP) routinely screens clients for increased risk of genetic mutation via an online screening tool.

Methods: Using data from the Georgia Comprehensive Cancer Registry (GCCR) for 2010-2013, we …

Coliphage As An Indicator Of The Quality Of Beach Water To Protect The Health Of Swimmers In Coastal Georgia, Javier Gallard-Gongora, Kathryn Munck, Jeff Jones, Asli Aslan

Journal of the Georgia Public Health Association

Background: Gastrointestinal disease affects millions of people in the United States and places a substantial economic burden upon healthcare systems. Recreational waters polluted with fecal material are a main source for transmission of gastrointestinal disease. Georgia beaches are monitored for the presence of fecal indicator bacteria, but these bacteria are not well associated with enteric viruses. The United States Environmental Protection Agency (US EPA) has recently proposed coliphage (a virus of Escherichia coli) as an alternative indicator of fecal contamination in recreational waters. The present study compares fecal indicator bacteria and coliphage concentrations at two Georgia beaches with adjacent creeks …

Randomness And Inference In Medical And Public Health Research, Matt Hayat, Tom Knapp

Journal of the Georgia Public Health Association

Background: The purpose of this study was to provide a basis for describing the types of randomness used and statistical inferences reported in the medical and public health research literature.

Methods: A study was conducted to quantify the types of research designs and analyses used and reported in medical and public health research studies. A stratified random sample of 198 articles from three top-tier medical and public health journals was reviewed, and the presence or absence of random assignment, random sampling, p-values, and confidence intervals, as well as type of research design, were quantified.

Results: Random sampling was used in …

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 …

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 …

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 …

Analysis Of Hypertension Control Rates Among Participants In The Georgia Hypertension Management And Outreach Program, Sara Byers, Jean O'Connor, Kia Powell-Threets, Brittany Taylor, Kia Padgett, Melissa K. Hallow

Journal of the Georgia Public Health Association

Background: This study utilized health department electronic medical records retrospectively to evaluate hypertension control rates achieved by the Georgia Hypertension Management and Outreach Program (HMOP), an education, screening, and treatment control program that provides services, including blood pressure screening and assessment, referral to physicians, counseling, educational material, disease case management, and treatment.

Methods: Hypertension control rates after at least 6 months of study participation were determined for patients participating in the program for at least 6 months between 2010 and 2014, and for African American and uninsured subgroups.

Results: The overall hypertension control rate was 61.1%, above the 2012 national …

Utilization Of The "Connecting The Dots" Worksheet To Engage Undergraduate Students In Health Promotion Program Planning, Raymona H. Lawrence, Ashley D. Walker

Journal of the Georgia Public Health Association

Background: Developing a health promotion program plan requires attention to the links between objectives, activities, and overall program goals. Instructors developed the “Connecting the Dots” worksheet to help students establish these linkages.

Methods: The “Connecting the Dots” worksheet included six questions pertinent to the students’ health promotion program plans. The worksheet was given to the students in a flipped classroom setting. Evaluation of the effectiveness of the tool was based upon group presentations at the end of the semester.

Results: Students developed more viable program plans that included stronger links between objectives and corresponding program activities.

Conclusions: The “Connecting the …

A Multi-County Health District's Journey To Accreditation: The Challenges And Benefits, Tara Echols

Journal of the Georgia Public Health Association

Background: In September 2011, the Gwinnett, Newton, and Rockdale Health Departments began to discuss accreditation. We regarded accreditation as a way to highlight our strengths and identify areas for quality and performance improvement as well as an opportunity to improve our capacity for greater accountability, increased efficiency and improved process flow. We further viewed it as a means to successfully carry out our mission, and effectively deliver the core functions and ten essential public health services.

Methods: With financial backing from Healthcare Georgia Foundation and technical assistance from Georgia Southern University, the Gwinnett, Newton and Rockdale County Health Departments began …

After Initial Accreditation - The Phab Annual Report, Gurleen Roberts, Emily Frantz, Jack Kennedy

Journal of the Georgia Public Health Association

Background: Cobb & Douglas Public Health (CDPH) was the first health district in Georgia to achieve accreditation by the Public Health Accreditation Board (PHAB) (accredited on May 12, 2015). Since then, two additional health districts, DeKalb (3-5) and Gwinnett, Newton, and Rockdale County Health Departments (3-4), have achieved accreditation. Efforts are underway among health districts statewide to become accredited, yet, little is known about life after accreditation. This presentation will highlight CDPH’s approach to submitting the PHAB Annual Report, which is required of health departments in order to maintain their accreditation status.

Methods: CDPH will provide an overview of the …

A Unified Integrated Public Health Approach: Zika Response, Betsy T. Kagey, Jennifer Burkholder

Journal of the Georgia Public Health Association

Background: Zika virus planning in Georgia has involved many units within the Georgia Department of Public Health (GDPH). Their roles and responsibilities include identifying potential vectors, alerting and educating the public on how to ‘tip n toss’, preparing and testing for Zika virus infection at the Georgia Public Health Laboratory (GPHL), monitoring travelers, including pregnant women, infected with Zika virus, direct messaging for pregnant women, mothers of newborns and women who are considering pregnancy, and education on sexual transmission for men and women.

Methods: With no locally transmitted case of Zika virus infection within Georgia, the focus has been on …

Tailoring A Hybrid Program For Reducing Health And Education Disparities In Georgia Communities: Outcomes Of Listening Sessions, Chinwe Ejikeme

Journal of the Georgia Public Health Association

Background: Minorities in Georgia experience increased rates of chronic disease and poor health and education outcomes. In the general population in 2013, about 35% of adolescents were either overweight or obese and approximately 13% of children 2-4 years old were obese, with minorities accounting for higher rates. In 2010, 23% of students from low-income families, comprising a higher proportion of minorities, scored at or above proficient level for reading at the end of third grade. Targeting children 0-5 years, Georgia Department of Public Health developed an integrated curriculum to train Early Childcare Educators (ECEs) to increase their knowledge and skills …

Implementation Of The Safecare Model In Georgia For Preventing Child Maltreatment, Dan Whitaker, Theresa L. Glasheen

Journal of the Georgia Public Health Association

Background: The SafeCare model is a behaviorally-based parenting model used in the prevention of child maltreatment. SafeCare targets three proximal risk factors for child neglect and abuse: parent-child interactions, home safety, and child health. SafeCare is one of only a few evidence-based practices for preventing child neglect, the dominant problem in child welfare, accounting for over 75% of child maltreatment cases. SafeCare has been broadly implemented in several states in the US, including Georgia, and is disseminated by the National SafeCare Training and Research Center (NSTRC) at Georgia State University. The presentation will (1) describe SafeCare and associated data, (2) …

Coastal Septic Tank Inventory: Data Resources For Future Wastewater Management Planning, Jessica Alcorn

Journal of the Georgia Public Health Association

Background: The US Environmental Protection Agency estimates that more than one in five homes are served by decentralized wastewater treatment systems—commonly known as septic tanks. In coastal areas where it is impossible to extend sewer service due to either financial or hydrogeological constraints, septic tanks are an integral part of wastewater treatment. When maintained adequately and installed under appropriate conditions, septic tanks remove excess nutrients and dangerous pathogens from wastewater. As coastal infrastructure is increasingly threatened by recurrent flooding, extreme weather events, and future sea level rise, coastal communities will need to assess the adequacy of their wastewater management systems …