Public Health Commons^™

Implementation And Evaluation Of The Carrera Program For Delaying Teen Sex In Georgia, Tressa Tucker, Mary Langley

Journal of the Georgia Public Health Association

Background: In three geographic areas in Georgia, rural, micropolitan, and urban, Morehouse School of Medicine (MSM) implemented the evidence-based Children’s Aid Society Carrera Program at community organizations with Boys and Girls Clubs (BGCs) as the comparison group. This study attempted to replicate the findings of reduced teen pregnancy and birth found for the New York Carrera Program.

Methods: For this longitudinal study with a quasi-experimental design, the sample included 400 youth who were in 6th or 7th grade. A total of 220 were enrolled in the intervention group and 180 in the comparison group. The study was performed in the …

Using The Exercise Is Medicine® On Campus Platform To Assess College Students’ Practice Of Physical Activity In A Rural Setting, Bridget Melton, Jazmin A. Williamson, Helen Bland, Jian Zhang

Journal of the Georgia Public Health Association

Background: The college setting offers public health educators and exercise scientists a favorable environment to implement wide-spread change in levels of physical activities. With over two-thirds of all adults in the U.S. now categorized as obese or overweight (CDC, 2015), it has become necessary to increase physical activity levels on college campuses. Exercise is Medicine® on Campus (EIM®-OC) is a national initiative to increase physical activity on college campuses by creating an environment to change the subjective norm of diminished exercise movement and fitness among adults. The purpose of the present study was to use the EIM®-OC platform to assess …

Engaging Rural Georgians In Internal Revenue Service (Irs)-Mandated Community Health Needs Assessments, Raymona H. Lawrence, Dziyana Nazaruk, Marie Denis-Luque, Stuart Tedders

Journal of the Georgia Public Health Association

Background: On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law. The law became effective on March 23, 2012. The ACA stipulates that non-profit hospitals must demonstrate benefit to their communities through the process of community health needs assessments (CHNAs). Failure to comply with this law may result in loss of non-profit status or large fines. This report describes strategies for engaging rural communities in Internal Revenue Service (IRS)-mandated CHNAs.

Methods: Public health practitioners from Georgia Southern University’s Jiann Ping Hsu College of Public Health collaborated with 18 rural, non-profit hospitals to …

Capital And Technical Assistance Needs Of Georgia’S Health-Related Nonprofits: An Exploratory Study, Jerry B. Daniel, Cherysh Green-Caldwell

Journal of the Georgia Public Health Association

Background: Nonprofit organizations, particularly those related to health and human services, are involved in addressing needs of the American population. They provide an array of services in small and large communities throughout the United States. Compared to for-profit organizations, health-related nonprofits are increasing in number. Despite having a substantial share of the health care market, nonprofit organizations face difficulties delivering services to those in need. The difficulties faced by rural nonprofits may be greater than those for their urban counterparts. The impetus for this study came from Healthcare Georgia Foundation’s goal of strengthening nonprofits to address the burgeoning health inequities …

Improving Rural Access To Care: Recommendations For Georgia’S Health Care Safety Net, Karen Minyard, Chris Parker, John Butts

Journal of the Georgia Public Health Association

Background: In Georgia, the safety net provides health care services to vulnerable populations scattered across 74 urban and 85 rural counties. In rural communities, the safety net is challenged with longstanding gaps in service provision and persistent difficulty in making services accessible. The rural safety net in Georgia is vulnerable.

Methods: An environmental scan was conducted of the Georgia rural safety net to assess who it serves, its providers, and how care is accessed in light of the Affordable Care Act (ACA). The scan included analysis of population-based census and health databases and a literature review to inform recommendations.

Results: …

Quality Rated Childcare Programs And Social Determinants Of Health In Rural And Non-Rural Georgia, Nancy C. Webb, Madison L. Gates

Journal of the Georgia Public Health Association

Background: Early childhood is linked to school readiness and early school achievement. Through its Quality Rated (QR) program, which was designed to improve the quality of care in early childhood programs, the state of Georgia has been a trailblazer in funding universal preschool and in improving the quality of childcare programs. We have assessed differences in the availability of QR childcare programs in Georgia to learn if, in rural versus non-rural counties, there is a relationship between QR childcare programs and health-related outcomes.

Methods: This cross-sectional study evaluated county-level data to evaluate the relationship between QR childcare programs and social …

Live Wholly Journazine Spring 2016, Andrews University

Publications

The University Health & Wellness Team is delighted to launch the new LIVE WHOLLY Journazine: a blend of a journal and magazine about health, fitness and wellness! The purpose of this Journazine is to communicate current, evidence-based and practical information and tips. In addition, it will feature elements related to the Andrews University community, locally and globally, to inspire all to make positive health and wellness changes!

An Analysis Of Women’S Access To Acute Opioid Detoxification Services In Maine: Identifying The Barriers To Treatment, Karen E. Conley

Muskie School Capstones and Dissertations

The lack of treatment facilities and services for opioid use disorder in Maine, combined with an increased prevalence of addiction, creates a potential for health inequity between men and women that may be intensified by barriers in access to care. This capstone study utilized detoxification screening inquiry forms and data obtained from the Milestone Foundation’s acute opioid detoxification program to assess and categorize barriers to access by gender. A barriers model was developed based on existing literature and was to identify potential associations among and between the known barriers to accessing treatment. Barriers were described as internally or externally based, …

Uncovering Local Trends In Genetic Effects Of Multiple Phenotypes Via Functional Linear Models, Olga A. Vsevolozhskaya, Dmitri V. Zaykin, David A. Barondess, Xiaoren Tong, Sneha Jadhav, Qing Lu

Biostatistics Faculty Publications

Recent technological advances equipped researchers with capabilities that go beyond traditional genotyping of loci known to be polymorphic in a general population. Genetic sequences of study participants can now be assessed directly. This capability removed technology-driven bias toward scoring predominantly common polymorphisms and let researchers reveal a wealth of rare and sample-specific variants. Although the relative contributions of rare and common polymorphisms to trait variation are being debated, researchers are faced with the need for new statistical tools for simultaneous evaluation of all variants within a region. Several research groups demonstrated flexibility and good statistical power of the functional linear …

Around Campus

DePaul Magazine

Center for Community Health Equity Launches; Sustainability the Focus of the 2015 Vincent de Paul Lecture; The Women's Center Celebrates 20 Years with Feminist Editor; Craft of Composing Panel Addresses the Vocation of Writing; Third Annual Horror of the Humanities Unmasks the Monstrosities of Daily Life; DePaul Basketball Enjoys Game-Changing Groundbreaking Day; Bruno Marks 30th Season Coaching the Game He Lovers; Late-Season Rally Propels Men's Soccer to Postseason; Women's Soccer Qualifies for Sixth BIG EAST Tournament; Wyatt Excels On and Off the Field; Preseason Honors the BIG EAST; Polish Scholar Reflects on Solidarity Movement and Catholicism; The Sentencing Project Director …

The Interrelations Between Spiritual Well-Being, Pain Interference And Depressive Symptoms In Patients With Multiple Sclerosis, Sheri A. Nsamenang, Jameson K. Hirsch, Raluca Topciu, Andrew D. Goodman, Paul R. Duberstein

ETSU Faculty Works

Depressive symptoms are common in individuals with multiple sclerosis (MS), and are frequently exacerbated by pain; however, spiritual well-being may allow persons with MS to more effectively cope with pain-related deficits in physical and role functioning. We explored the associations between spiritual well-being, pain interference and depressive symptoms, assessing each as a potential mediator, in eighty-one patients being treated for MS, who completed self-report measures: Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, Pain Effects Scale, and Center for Epidemiologic Studies Depression Scale Revised. At the bivariate level, spiritual well-being and its subscale of meaning and peace were negatively associated …

Inquiry Into The Implementation Of Bush’S Executive Order 13211 And The Impact On Environmental And Public Health Regulation, Elizabeth Ann Glass Geltman, Gunwant Gill, Miriam Jovanovic

Publications and Research

Executive Order 13211, promulgated in 2001, requires the federal government to consider the impact of federal action on energy independence as part of the George W. Bush’s National Energy Policy. This law review examines whether EO 13211 was used to curtail environmental protection and natural resource conservation. The article begins with a review of the procedure required of federal agencies under EO 13211 and its associated documents. The paper then examines case law and published federal rulemaking proceedings and examines how federal agencies apply tests to evaluate the potential energy effect. The study concludes that EO 13211 strikes a reasonable …

Re-Inventing Adherence: Toward A Patient-Centered Model Of Care For Drug-Resistant Tuberculosis And Hiv, Max R. O'Donnell, A. Daftary, M. Frick, Y. Hirsch-Moverman, K. R. Amico, M. Senthilingam, A. Wolf, J. Z. Metcalfe, P. Isaakidis, J. L. Davis, J. R. Zelnick, J.C.M. Brust, N. Naidu, M. Garretson, David Bangsberg, N. Padayatchi, G. Friedland

OHSU-PSU School of Public Health Faculty Publications and Presentations

BACKGROUND—Despite renewed focus on molecular tuberculosis (TB) diagnostics and new antimycobacterial agents, treatment outcomes for patients co-infected with drug-resistant TB and human immunodeficiency virus (HIV) remain dismal, in part due to lack of focus on medication adherence as part of a patient-centered continuum of care.

OBJECTIVE—To review current barriers to drug-resistant TB-HIV treatment and propose an alternative model to conventional approaches to treatment support.

DISCUSSION—Current national TB control programs rely heavily on directly observed therapy (DOT) as the centerpiece of treatment delivery and adherence support. Medication adherence and care for drug-resistant TB-HIV could be improved by fully implementing team-based patient-centered …

Advancing The Knowledge Of Organic Farming Data In New Mexico: Health And Injury Surveillance Systems, Virginia Sedore

Population Health

While the concept and practice of organic farming has been around since the mid-1800s, there is little data currently being collected on injury, illness, or fatality within the organic farming population, leaving the health risks unknown. This paper intends to look at the surveillance systems currently in place to collect injury and illness data as it relates to organic farmers, and in particular, the New Mexico organic farmer. Evaluations of the current surveillance systems were conducted, and organic farmer demographics were analyzed using rate ratio comparisons of United States(U.S.), Texas, and New Mexico. The results show that the current surveillance …

The Relationship Between Physical Activity And Diet And Young Children's Cognitive Development: A Systematic Review, Pooja S. Tandon, Alison Tovar, Avanthi T. Jayasuriya, Emily Welker, Daniel J. Schober, Kristen Copeland, Dipti A. Dev, Ashleigh L. Murriel, Dima Amso, Dianne S. Ward

Department of Child, Youth, and Family Studies: Faculty Publications

Objective. Given the high prevalence of suboptimal nutrition and low activity levels in children, we systematically reviewed the literature on the relationship between physical activity and dietary patterns and cognitive development in early childhood (six months to five years).

Methods. In February 2016, we conducted two different searches of MEDLINE, PsycINFO, and ERIC. Each search included either physical activity (including gross motor skills) or diet terms, and neurocognitive development outcome terms. Included studies were in English, published since 2005, and of any study design in which the physical activity or diet measure occurred prior to age five.

Results. For physical …

Urgent Care And Emergency Department Visits In The Pediatric Medicaid Population., Amanda Montalbano, Jonathan Rodean, Juhi Kangas, Brian R. Lee, Matt Hall

Manuscripts, Articles, Book Chapters and Other Papers

Background: Urgent care (UC) is one of the fastest growing venues of health care delivery. We compared clinical and cost attributes of pediatric UC and emergency department (ED) visits that did not result in admission.

Methods: Our study examined 5 925 568 ED and UC visits of children under 19 years old in the 2010 through 2012 Marketscan Medicaid Multi-State Database. Basic demographics, diagnoses, severity, and payments were compared. Between ED and UC visits, χ(2) tests were used for proportions and Wilcoxon rank-sum tests were used for continuous variables.

Results: The UC and ED had the same most common diagnoses. …

The Relationship Between Food Deserts, Farmers’ Markets And Food Assistance In Georgia Census Tracts, Andrea M. Brace, Todd L. Matthews, Bobbi Finkelstein, Daniela Beall

Journal of the Georgia Public Health Association

Background: Due to inadequate resources and limited access to healthy foods, residents of food deserts struggle to maintain a well-balanced, nutritious diet. These factors increase the risk of developing obesity and diet-related chronic diseases. Local farmers’ markets serve as community-level interventions, bringing healthy food to food deserts. Over the past two decades, farmers’ markets have been growing in numbers nationally. The present study explores the relationship between food deserts, placement of farmers’ markets, and availability of food assistance programs in Georgia.

Methods: Data are from the 2014 USDA Food Desert Atlas and the USDA Farmers’ Market Directory. Farmers’ market addresses …

The Effect Of Luck On The Retention Of Head Coaches In The Nfl, Alexander Steen

Masters Theses

his investigation considers the impact of the concept of luck on coaching retention in the National Football League (NFL). The head coach of an NFL team is often under intense scrutiny to perform in a high profile position. Due to a small inventory of games each season, there is the potential for luck to influence whether or not a season is viewed a success. This study seeks to measure the impact of luck for a given NFL team while attempting to correlate with the retention or release of the head coach.

Treatment And Prevention Of Human Rotavirus (Hrv) In Developing Countries: The Potential Of Avian Immunoglobulin Y, Christa Brown

Senior Honors Theses

Rotavirus gastroenteritis is a leading cause of childhood mortality, killing ~1400 children younger than five daily, primarily through severe diarrheal dehydration. Eighty-five percent of this mortality occurs in developing countries where rotavirus vaccines are not widely implemented and are only partially effective. In those countries, it has proven difficult to implement the recommended supportive therapies like oral rehydration therapy (ORT) on a wide scale due to lack of both medical infrastructure and private economic investment combined with cultural bias against ORT. IgY targeting human rotavirus (anti-HRV IgY) shows potential as a passive immunotherapy that reduces rotavirus-associated morbidity and mortality, augments …

Evaluation Of A Diabetes Prevention Program For Rural Citizens, Barbara B. Kawulich, Diana Mindrila, Gina Brandenburg

Journal of the Georgia Public Health Association

Background: Georgia has one of the highest rates of diabetes in the US. Obesity and inactivity contribute to the onset of this disease. Tanner Health System addressed the obesity epidemic in three rural counties of Georgia through a 16-week diabetes prevention program (DPP) for 176 residents. This study evaluated the effectiveness of the DPP.

Methods: The multiple methods design of this project used pre- and post-surveys from January/February, 2014, classes to determine diabetes-related lifestyle factors, 11 mid-point telephone interviews, and focus groups with 17 members to identify lifestyle changes that were implemented. Additionally, initial and final measurements of body mass …

The United Nations Sustainable Development Goals: Achieving The Vision Of Global Health With Justice, Eric A. Friedman, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

We are resolved to free the human race from the tyranny of poverty and want and to heal and secure our planet” (UN General Assembly, 2015, September 25, preamble). So pronounces the 2030 Agenda, the United Nations declaration on the Sustainable Development Goals (SDGs), adopted on September 25, 2015, succeeding the Millennium Development Goals (MDGs). If achieved, the SDGs will secure an improved level of health, development, and global justice. However, if the international community fails to live up to its commitments, an untold number of people will likely perish prematurely, people’s opportunities to thrive will be cut off, social …

Paediatric Tuberculosis In Bhopal, Madhya Pradesh, India: Dots, Diagnosis, And Determinants, Emma Klein

Independent Study Project (ISP) Collection

Tuberculosis (TB) is one of the world’s largest public health challenges, and it has a disproportionate impact on India. In children, TB is a serious but understudied illness due to the complexity of case-notification and relative lack of public health importance. This study took place over the course of one month in Bhopal, Madhya Pradesh, India. In a mixed method study consisting of 53 quantitative patient interviews and qualitative interviews with healthcare providers, social determinants of TB in this setting were investigated as well as challenges faced at all stages of healthcare delivery. Malnutrition and housing were the most severe …

Georgia Latino Enrollment In The Affordable Care Act: A Qualitative, Key Informant Analysis, Audrey Mcculloch, Dabney P. Evans

Journal of the Georgia Public Health Association

Background: Prior to implementation of the Affordable Care Act (ACA) in 2010, one in three Latinos in the United States were uninsured. In Georgia, a state that established a federal Marketplace, nearly half of Latinos lacked health insurance coverage going into the initial enrollment period of October 1, 2013 to April 15, 2014. The ACA provided an opportunity for these uninsured Latinos to gain health insurance coverage, thus increasing their access to necessary medical services. The purpose of this qualitative study was to explore, from the perspective of key informants, knowledge of Georgia Latinos about the ACA and perceived barriers …

Women’S Views On The Challenges And Solutions In Preventing The Gendered Spread Of Hiv In Masxha, Cato Manor, Paige Mcmahon

Independent Study Project (ISP) Collection

Despite numerous national prevention efforts, South Africa remains at the epicenter of the HIV/AIDS epidemic. The burden of the epidemic is extremely heterogeneous, with province, race, gender, age, and socioeconomic status serving as key variables in determining HIV prevalence rates. Black African women are disproportionately affected by the epidemic, with those between the ages of 20 and 34 having an HIV prevalence rate of 31.6%, the highest in the country (Shisana et al., 2014). The purpose of this study was to engage with black African women about the challenges they believe women face in protecting themselves against HIV, and potential …

Needle Exchange Programs And Hiv/Aids: A Comparison Of The Use Of Harm Reduction Methods In Switzerland And The United States Of America, Margaret House

Independent Study Project (ISP) Collection

This paper explores the connections between needle exchange programs and rates of HIV/AIDS in Switzerland and the United States of America. While these two countries are very similar in their general political philosophies, they have some key cultural and historical differences which has shaped their responses to HIV/AIDS and injection drug use. Switzerland’s unique experience with a very open injection drug use scene in the 1980s guided this country to a more pragmatic, harm reduction-based response. By contrast, United States responded to the AIDS epidemic that struck violently in the 1980s with a mix of fear and denial. Though both …

A Precarious Paradigm: Seeking Alternatives To Public-Private Partnerships In Health, A Case For The Code, Lena Mininberg

Independent Study Project (ISP) Collection

Background: Breastfeeding is an unparalleled source of nutrition for infants and young children and is recommended as the best practice universally by the World Health Organization (WHO). The benefits in human health and development that result from exclusive and sustained breastfeeding have enormous economic development potential. Because of the non-legally binding nature of the International Code of Marketing of Breastmilk Substitutes (the Code), and shifting socio-cultural norms, breastfeeding rates are at an alarming low. In order to progress towards the Sustainable Development Goals, breastfeeding practices must be protected, promoted, and supported worldwide.

Objective: This research paper explores implementing strong measures …

Capacity Building Of Health Workforce: Investigation Of Training Process For Community Health Volunteers (Chvs) Serving Refugee Populations In Host Communities, As Perceived By Participants And Trainers, Jerusalem Hadush

Independent Study Project (ISP) Collection

The health system in the Hashemite Kingdom of Jordan, which hosts 1.4 million refugees from the Syrian Arab Republic—more than 636,000 of whom are registered with UNHCR—is over-extended (UNHCR, 2016). Non-governmental organizations fill gaps in service delivery by injecting health personnel to deliver care, however, nationals and refugees must be integrated in the response to ensure sustainable health care delivery (UNHCR Handbook for Emergencies, 2007). Leveraging the capacities of lay citizens and refugees by task shifting and training CHVs can alleviate the increased health burden. Research into training programs is significant because the quality of training is directly related to …

Healthcare Access For Syrian Refugees Lacking Legal Documentation In Jordan, Caroline Flynn

Independent Study Project (ISP) Collection

The purpose of this study is to analyze the access and utilization of health care services by Syrian refugees lacking documentation. This study focuses on the current procedures utilized by healthcare providers for addressing lack of legal documentation in their Syrian refugee patients, as well as broader policies and strategies for addressing the status and protection of these undocumented individuals. This study grapples with the relationship between legal documentation and access to services. The increased costs and barriers to healthcare that come with stateless and refugee status may influence health outcomes and socioeconomic opportunities that impact these individuals for the …

The Need For Culturally-Tailored Smartphone Applications For Weight Control, Stephen S. Coughlin, Dale Hardy, Lee S. Caplan

Journal of the Georgia Public Health Association

Background: Approximately 35% of U.S. adults are obese, and this rate is expected to increase by almost 50% by 2030. New media such as smartphone applications (apps) provide a useful and low-cost way to disseminate weight control information. For many culturally distinctive population subgroups, however, there is currently an absence of research-tested smartphone apps for weight control.

Methods: In this commentary, we highlight the need for culturally tailored smartphone apps for weight control and offer recommendations for further research by providing two specific examples: 1) the characteristic dietary patterns and absence of smartphone apps for weight loss for Hispanic Americans, …

Factors Associated With Body Mass Index Among African American Breast Cancer Survivors, Selina A. Smith, Mechelle D. Claridy, Mary S. Whitehead, Joyce Q. Sheats, Wonsuk Yoo, Ernest Alema-Mensah, Benjamin E. Ansa, Ronald L. Braithwaite

Journal of the Georgia Public Health Association

Background: Weight gain after diagnosis and treatment is common among breast cancer survivors (BCSs). Little information exists regarding associations between body mass index (BMI) and lifestyle factors and health-related quality of life (HR-QoL) among African American (AA) BCSs. The present study sought to determine associations between BMI, dietary intake, and physical activity as lifestyle modification strategies and HR-QoL among AA BCSs.

Methods: For this cross-sectional study, a lifestyle assessment tool was administered to 195 AA BCSs. Possible predictor variables included socio-demographic and medical characteristics, dietary intake and physical activity patterns, and physical health. The outcome variable was BMI.

Results: Many …