Public Health Commons^™

Economic Windfalls And The Affordable Care Act: A Policy Proposal, Joshua Congdon-Hohman, Victor Matheson

Economics Department Working Papers

This paper identifies a major issue with windfall payments under either possible interpretation of the ACA as it currently stands. Several alternatives are proposed that would eliminate the windfalls. We advocate the establishment of a tort award funded “Federal Stabilization Fund” to improve the economic efficiency of future health care awards in the age of the Affordable Care Act

A Sustainable Approach To Health Systems Strengthening In Developing Countries: Lessons From The Ebola Crisis, Prince Tarnah

Capstone Collection

The research paper started with emphasizing the importance of health security as an issue of global concern under the UNDP theory of human security. The research then proceeded with a focus on the approaches to health systems strengthening and a reflection on lessons learned from the Ebola virus outbreak to answer the question: How do we approach health systems strengthening (HSS) to achieve sustainable impact? Scholarly articles, and literature from other authoritative sources on health systems strengthening, like the World Health Organization (WHO) and the US Agency for International Development (USAID), were reviewed to determine a clear definition of HSS, …

Comparison Of Two Surface Contamination Sampling Techniques Conducted For The Characterization Of Two Pajarito Site Manhattan Project National Historic Park Properties, Lopez Tammy

Graduate Theses & Non-Theses

Technical Area-18 (TA-18), also known as Pajarito Site, is located on Los Alamos National Laboratory property and has historic buildings that will be included in the Manhattan Project National Historic Park. Characterization studies of metal contamination were needed in two of the four buildings that are on the historic registry in this area, a “battleship” bunker building (TA-18-0002) and the Pond cabin (TA-18-0029). However, these two buildings have been exposed to the elements, are decades old, and have porous and rough surfaces (wood and concrete). Due to these conditions, it was questioned whether standard wipe sampling would be adequate to …

Understanding Public Health: Research, Evidence, And Practice, Johanna M. Hinman

Journal of the Georgia Public Health Association

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Reducing And Eliminating Health Disparities Through Prevention And Public Health, Daniel S. Blumenthal

Journal of the Georgia Public Health Association

N/A

Evidence To Practice: Using Data To See The Faces Of Those We Serve, David A. Ross

Journal of the Georgia Public Health Association

Evidence to Practice: Using Data to See the Faces of Those We Serve

Perinatal Health And School Trajectories, Bryan L. Williams, Arianne B. Weldon, Brenda Fitzgerald, Fran Gary

Journal of the Georgia Public Health Association

Perinatal Health and School Trajectories

Attitude Towards Research Among Undergraduate Nursing Students, Anunay Bhattacharya, Marian M. Tabi

Journal of the Georgia Public Health Association

Background: This study investigated undergraduate nursing students’ attitude towards research. It has been shown in numerous studies that there exists a negative attitude towards research among undergraduate students and this attitude acts as a barrier. This negative attitude affects the willingness and efforts of students to excel in a research course.

Methods: A 15-item pre and post-test questionnaire was administered to undergraduate nursing students to identify the factors that may have an effect on their attitude towards research. The Georgia Southern University Institutional Review Board approved the study. Statistical analysis was performed using paired sample t-test and IBM SPSS 23.0. …

Nicotine Poisoning Trends In Georgia, Oluwayomi Fabayo, Alina Chung, Ray Kenneth, Jean O'Connor

Journal of the Georgia Public Health Association

Background: Nicotine is a toxic chemical that can cause adverse health effects. Nicotine poisoning can result from exposure to tobacco and other nicotine containing products. It can cause nausea, vomiting, abdominal pain, fever, dizziness, seizures, tachycardia, hypertension and edema. Nicotine poisoning can affect both adults and children.

Methods: The Georgia Department of Public Health secured data from the Georgia Poison Center in order to analyze nicotinespecific poisoning calls, including e-cigarette poisoning calls. The data on tobacco/nicotine poisoning or exposure calls were collected from April 2009 to April 2015. The data on calls related to nicotine poisoning from e-cigarettes were collected …

Evidence-Based Strategies Identified To Increase Access To Oral Health Services To Promote A Healthier Lifestyle, Breyana D. Davis, Sara S. Plaspohl

Journal of the Georgia Public Health Association

Background: Leading Health Indicators (LHI) are a subset of Healthy People 2020 objectives, selected to communicate at- risk health issues and actions that can be taken to address them. The number of children, adolescents, and adults who visited the dentist in the past year has decreased nationally, suggesting that oral health continues to be a problem caused by barriers preventing access to oral services.

Methods: Preliminary research was conducted on the LHI via the Healthy People 2020 website. Health-related peer reviewed articles were selected and reviewed.

Results: Evidenced-based literature shows that economic, educational, and personal barriers prevent access to oral …

A Central Georgia Asthma Prevalence Assessment Of School-Age Children And Compliance With Senate Bill 472, Cheryl L.R. Gaddis, Jimmie Smith

Journal of the Georgia Public Health Association

Background: A common theme among the counties of the North Central Health District is the disparity between the number of asthma-related visits of African-American and white children ages 1-14 to the emergency department. In 2013, 858 children ages 1-14 in the district had emergency room visits related to asthma. The purpose of this study was to assess North Central Health District (NCHD) schools to determine the prevalence of self-reported asthma by parents and school age children and the adequacy of students’ access to maintenance inhalers at school, and to identify schools that qualify for Asthma Friendly School Recognition.

Methods: The …

Collecting Physiological Stress Measures In Research Among High-Risk Parents For Child Maltreatment: A Qualitative Investigation, Ashwini Tiwari, Shannon Self-Brown, Charles Robinson, Colleen Mccarty, Laura Carruth

Journal of the Georgia Public Health Association

Background: Studies on evidence-based, behavioral training programs have shown a positive reduction in self-reported stress among parents at high risk of child maltreatment (CM). However, no known studies on these programs have examined physiological biomarkers for stress, such as impaired levels of cortisol and dehydroepiandrosterone (DHEA), and telomere length. Further, no details are known regarding the feasibility of collecting biological markers from parents. This research examined qualitative findings from a multidisciplinary neurobiology and public health study that examined physiological responses to a six week, evidence-based, behavioral parenting program, among a maternal population at risk of CM perpetration in Atlanta, Georgia. …

Bridging The Gap Between Local Public Health And The Healthcare Community: The Public Health Talk, Puja Bharucha, Rachel Franklin

Journal of the Georgia Public Health Association

Background: District epidemiologists often rely on healthcare providers for medical information regarding reportable diseases in order to properly investigate cases. It becomes difficult when providers do not share patient information due to apprehension and/or lack of knowledge of HIPAA exemption laws. It is also challenging when the provider staff is not knowledgeable regarding disease specific information. When information is withheld, there is a delay in completing investigations, and high priority cases and outbreaks such as emerging infectious diseases can be missed or lost to follow up.

Methods: The Public Health Talk (The Talk) initiative was established at Cobb and Douglas …

The Effectiveness Of Text Message Reminder- Recalls On Human Papilloma Virus Vaccination Coverage In Georgia, Tamira M. Moon, Nicolle Dally, Ben Sloat, Kia Bryant, Sherrionda L. Grady

Journal of the Georgia Public Health Association

Background: Routine vaccination against Human Papilloma Virus (HPV), the main cause of cervical cancer, is recommended by the Advisory Committee on Immunization Practices for adolescents ages 11 to 12 years, yet vaccine coverage remains low. The Georgia Comprehensive Cancer Control Program and Georgia Immunization Program implemented and evaluated a textmessaging campaign aimed at improving HPV vaccination coverage, using the Georgia Immunization Registry (GRITS).

Methods: The text message reminder-recall campaign, aimed at the parents of adolescents 9 – 18 years, was launched in July 2015. A total of 208,792 adolescents in the GRITS database met the inclusion criterion, receipt of at …

Assessment Of Early Intervention Services To Better Child Outcomes Among Part C Infants And Toddlers, Brendan Ibe, Tiffany Fowles, Seema Csukas, Jackie Conner, Grace Kelley, Donna Johnson, Cynthia Bryant, Michelle Allen

Journal of the Georgia Public Health Association

Background: Early intervention services have been shown to improve child outcomes. Rapid proliferation of neural connections and circuits contribute to the rapid growth of the brain in the first three years of life. These neural circuits which create the foundation for learning are most flexible in this period and become increasingly more difficult to change thereafter. The purpose of this study is to examine the relationship between early enrollment in Georgia’s Part C birth to three early intervention program and improved child outcome ratings upon exiting the program at 3 years of age. The study used 2013 & 2014 Annual …

A Cross Sectional Study Of Mostly African- American Men Examining Mental Health And Child Behavior, Matt C. Jackson, Melissa Cowart-Osborne, Shannon Self-Brown

Journal of the Georgia Public Health Association

Background: Home visiting receives bipartisan support at both the state and federal level, because several models have demonstrated significant results in both reduction of child maltreatment as well as parenting behavior modification. Yet, parenting research and services lack further engagement and involvement as a primary component. That is, even though research has shown that fathers play an integral role in child development, there is very little research done in which fathers are the primary focus; most of this research focuses on mothers. When it comes to serving children who are victims of child abuse and neglect, this is a problem …

Domestic Violence Intervention For Latino Families: Baseline Program Evaluation Data, Jacque-Corey Cormier, Nancy Nava, Charmaine Mora, Rebecca Rodriguez

Journal of the Georgia Public Health Association

Background: In the United States, Latino families affected by domestic violence (DV) often face unique challenges influenced by changing ecologies and personal/political histories. Caminar Latino is Georgia’s first and only comprehensive DV intervention program for Latino families. The program is geared towards helping family members begin their journey towards non-violence. The purpose of this evaluation is to better understand how Caminar Latino is benefiting families within the program. Baseline data of interest included perceptions of power in the relationship among family members and whether mothers and/or youth had safety plans.

Methods: A longitudinal, quasi-experimental research design was utilized to collect …

The Influence Of Georgia’S Quality Rated System On School Readiness In Pre-School Children, Dena Phillips, Nancy C. Webb

Journal of the Georgia Public Health Association

Background: Georgia rates the quality of early childcare learning centers using a tiered quality improvement system. Georgia’s Quality Rated system (QR) designates a star level, (one star, two stars or three stars) to each center based on a portfolio of QR standards and an onsite assessment by Georgia Department of Early Care and Learning (DECAL). Childcare centers applying for QR status first submit a portfolio documenting how their practices align with QR standards centered on staff qualifications; child health, nutrition and physical activity; family engagement; holistic curricula and teacher-to-student ratios. Subsequently, an on-site assessment of the center is performed by …

Psychotropic Medications, Weight Gain And Chronic Diseases In A Correctional Setting: Impact On Women’S Health, Madison L. Gates, Elizabeth Ferguson, Thad Wilkins, Darra Balance, Wonsuk Yoo

Journal of the Georgia Public Health Association

Background: Studies with non-incarcerated populations have found a relationship between psychotropic medications and metabolic side effects, such as weight gain. Few studies have investigated the relationship between psychotropic medications associated with weight gain in prisoners, despite data showing that 73% of female and 55% of male offenders have a mental health problem and 15% have had medications prescribed.

Methods: This longitudinal study investigated the relationship among psychotropic medications and weight gain in prisoners. We hypothesized that women prescribed psychotropic medications gain more weight than men. Data were extracted from Department of Corrections’ electronic health records. All prisoners with active records …

Meeting The Public Health Workforce’S Training Priorities In Georgia And The Southeast, Laura M. Lloyd, Melissa Alperin, Michelle L. Carvalho, Kathleen R. Miner

Journal of the Georgia Public Health Association

Background: The mission of the Region IV Public Health Training Center (R-IV PHTC) is to build knowledge and skills in the public health workforce in the eight states of HHS Region IV by providing competency-based training. Workforce training needs are changing quickly and dramatically in light of new developments in public health practice and science, emerging diseases, changes in the health care environment, and the growing emphasis on inter-professional practice. Additionally, a 2014 survey conducted by the Association of State and Territorial Health Officials (ASTHO) found that at least 38% of the current public health workforce plans to retire by …

Hepatitis C And Injection Drug Use: Testing And Linkage To Care, Marie Sutton, Cole G. Youngner, Winona J. Holloway

Journal of the Georgia Public Health Association

Background: The recent outbreak of HIV infection in Indiana linked to injection drug use demonstrates the importance of timely HIV and Hepatitis C surveillance and rapid response to interrupt disease transmission. An estimated 2.7 – 3.9 million Americans have chronic hepatitis C virus (HCV) infection. Of those, 50 – 70% are unaware of their infection. People who inject drugs account for more than half of new HCV cases. Within 5 years of beginning injection drug use, 50 – 80% of injection drug users (IDUs) become infected with HCV. Since 2007, HCV-related deaths have surpassed HIV-related deaths. CDC reported 19,368 death …

Surveillance, Epidemiology, And End Results (Seer) Data For Monitoring Cancer Trends, Wonsuk Yoo, Steven S. Coughlin

Journal of the Georgia Public Health Association

Background: Monitoring cancer trends allows evaluation of the effectiveness of cancer screening or detection methods and determination of priorities in cancer control programs. Government officials and policy makers also use information on cancer trends to allocate resources for cancer research and prevention. Although data from the Surveillance, Epidemiology, and End results (SEER)-affiliated cancer registry are accessible to the public, there is a shortage of published research describing cancer incidence rates for White, Black, and other residents in Georgia. The objective of this research is to provide an overview of how to use SEER data through analysis of the incidence rate …

Community Preparedness: Expanding Existing Partnerships With Academia To Build Resilience Through Experiential Learning, Nina Cleveland, Mark Palen

Journal of the Georgia Public Health Association

Background: Sustainability and mitigation in preparedness after grant money is gone has suddenly become a hot topic in the public health emergency preparedness world. By the same token, funding provided by the Federal Emergency Management Agency (FEMA) for individual preparedness initiatives has not had the desired mitigation impacts. The question becomes, are there alternative approaches that reach more individuals to build a culture of preparedness in communities? One solution involves the leveraging of academic and regional public health partnerships with their Medical Reserve Corps Units (MRC), to train college students in individual preparedness. The purpose of this study is to …

The Effect Of A Nutrition Intervention On Parents Living In A Rural Georgia Community, Regina Elliott-Walker, Dawn M. Hayes, Emeka Oraka, Rashunda Lewis, Andre Leon

Journal of the Georgia Public Health Association

Background: Childhood obesity is a concern for public health organizations. Nearly one in four children living in rural communities are obese, and children living in rural Georgia communities are no exception. For rural communities, prevention efforts are needed to address challenges to reducing childhood obesity. The objective of the present effort was to increase the knowledge of parents in a rural community of the benefits of fruit and vegetable consumption and other healthy options.

Methods: The “We Can Energize Families” curriculum, developed by the National Heart, Lung, and Blood Institute was implemented in a rural Georgia community. Pender’s Health Promotion …

Formative Research To Develop A Lifestyle Application (App) For African American Breast Cancer Survivors, Selina A. Smith, Mary S. Whitehead, Joyce Q. Sheats, Brittney Fontenot, Ernest Alema-Mensah, Benjamin Ansa

Journal of the Georgia Public Health Association

Background: There is a proliferation of lifestyle-oriented mobile technologies; however, few have targeted users. Through intervention mapping, investigators and community partners completed Steps 1-3 (needs assessment, formulation of change objectives, and selection of theory-based methods) of a process to develop a mobile cancer prevention application (app) for cancer prevention. The aim of this qualitative study was to complete Step 4 (intervention development) by eliciting input from African American (AA) breast cancer survivors (BCSs) to guide app development.

Methods: Four focus group discussions (n=60) and three individual semi-structured interviews (n=36) were conducted with AA BCSs (40-72 years of age) to assess …

Local Efforts Toward Addressing Health Disparities In Dekalb County, Georgia, April Hermstad, Erikka Gilliam, Sedessie Spivey, Zipatly Mendoza

Journal of the Georgia Public Health Association

Background: In underserved African American communities throughout DeKalb County, the DeKalb County Board of Health (DCBOH) is implementing community-based initiatives using policy, systems, and environmental improvement approaches to reduce racial and ethnic health disparities by increasing opportunities for nutrition and physical activity.

Methods: The initiatives are being implemented in priority census tracts where the population is at least 40% African American, 30% live below federal poverty level, and 25% did not graduate from high school. Communications promote awareness of the programs, and evaluation activities document processes and outcomes.

Results: To date, implementation of five interventions has affected approximately 276,000 DeKalb …

Fulfilling Community Health Assessment Requirements: Lessons Learned From Facilitating State-Wide Community Health Forums, Ashley Walker, Angela Peden, Stuart H. Tedders, John S. Barron, Aaron Jackson, Nicholas Williams, Bethrand Ugwu

Journal of the Georgia Public Health Association

Background: A prerequisite for National Public Health Accreditation is completion of a Community Health Assessment (CHA) that presents an exhaustive profile of the population served by a particular public health agency.

Methods: The Georgia Department of Public Health (GA DPH) contracted with the Center for Public Health Practice and Research at Georgia Southern University to facilitate five state-wide community health forums.

Results: Evaluation of the forums yielded qualitative data illustrating current challenges faced by Georgians, as well as assets that could be leveraged to improve health status.

Conclusion: Lessons learned from these state-wide community health forums can be applied to …

Screening For Developmental Delay In Georgia’S Family Shelters: Formative Evaluation Of A Quality Improvement Initiative, Marvin So, Luisita G. Agbayani, Mariel K. Gutierrez, Josef T. Griffins

Journal of the Georgia Public Health Association

Background: Children in families experiencing homelessness are at elevated risk for cognitive, motor, speech, and other developmental delays. Given the prevalence of family homelessness in Georgia and across the U.S., investigating the feasibility of implementing developmental screeners while families are in shelters is warranted.

Methods: Three pilot shelters were selected for the development and implementation of Quality Improvement (QI) Teams, who used Plan-Do-Study-Act (PDSA) Cycles to make progress towards universally screening children for delay. We employed a formative evaluation to (1) characterize screening rates and shifts in shelter as a result of QI initiatives, and (2) identify barriers and facilitators …

Evaluating Public And Private Partnership To Improve Food And Language Nutrition Among Children 0-5 Years, Chinwe Ejikeme, Kia Powell-Threets, Emily Anne Vall, Laura Wagner, Luke Fiedorowicz, Audrey Idaikkadar, Jean O'Connor

Journal of the Georgia Public Health Association

Background: Racial and ethnic minority populations in Georgia experience increased rates of chronic disease and poor health and education outcomes, which can be prevented through enhanced public- private partnerships. Using the Centers for Disease Control and Prevention (CDC) evaluation framework, the Evaluation Subcommittee for the Georgia Partnership for Food and Language Nutrition Project comprised of representatives from various stakeholders affiliated with state agencies, academia, and community-based organizations developed an evaluation plan to improve the collaborative effort designed to improve food and language nutrition among children 0-5 years. The purpose of this mixed-methods study was to assess influential collaborative factors.

Methods: …

Brain Development: A Look At Four Programs In Georgia That Support Optimal Brain Development, Nancy C. Webb, Madison L. Gates

Journal of the Georgia Public Health Association

Background: Georgia is making strides to improve its early care and education system through program development within state agencies and alliances. These timely, statewide programs are focused on improving understanding of the importance of brain development.

Methods: We reviewed the mission and information provided by four Georgia agencies with the aim of developing and improving programs and educational opportunities to instruct educators, policy makers, the general public, and others about child development in the context of brain development.

Results: For young children in Georgia, the four organizations are committed to ensuring opportunities for well-being. Georgia is moving forward in its …