Public Health Commons^™

A Clinical Trial To Increase The Identification, Genetic Counseling Referral And Genetic Testing Of Women At Risk For Hereditary Breast And/Or Ovarian Cancer, Ceceilia Bellcross, Christine Stanislaw, April Hermstad, Christine Tallo, Chelsea Leonard

Journal of the Georgia Public Health Association

Background: Approximately 1/300 individuals in the general population are at risk for hereditary breast and ovarian cancer due to an inherited mutation in the BRCA1/BRCA2 genes. BRCA mutations are associated with dramatically increased risks for breast cancer, especially at younger ages, in addition to ovarian cancer. Enhanced screening and risk reduction strategies can significantly reduce associated morbidity and mortality. The United States Preventive Services Task Force (USPSTF) recommends identifying women at-risk for BRCA mutations for receipt of genetic counseling and if appropriate, testing. The Breast Cancer Genetics Referral Screening Tool (B-RST) is a validated screen endorsed by USPSTF to facilitate …

Breast Cancer Screening In Patients With Newly Diagnosed Lung And Colorectal Cancer: A Population-Based Study Of Utilization, Gelareh Sadigh, Ruth C. Carlos, Kevin C. Ward, Jeffrey M. Switchenko, Renjian Jiang, Kimberly E. Applegate, Richard Duszak Jr.

Radiology Faculty Publications

Purpose—To assess breast cancer screening utilization in Medicare beneficiaries with colorectal and lung cancer versus cancer-free controls.

Methods—Female fee-for-service Medicare beneficiaries who were ≥ 67 years old and diagnosed with lung or colorectal cancer between 2000 and 2011 and who reported to a Surveillance, Epidemiology, and End Results (SEER) registry (case group) were followed for 2 years after their diagnoses, unless death, a diagnosis of breast cancer, or the end of 2013 came first. A similar number of cancer-free controls were individually matched to cases by age, race, registry region, and follow-up time. Screening utilization was defined as …

Intergenerational Music Therapy : Bridging The Generational Gap Through Community-Based Music Making., Michael R. Detmer, Petra Kern, Jill Jacobi-Vessels, Kristi M. King

Faculty and Staff Scholarship

No abstract provided.

Maternal Distraction During Breast- And Bottle Feeding Among Wic And Non-Wic Mothers, Alison K. Ventura, Simone Teitelbaum

Kinesiology and Public Health

Objective: To explore the prevalence and correlates of maternal distraction during infant feeding within a sample of mothers enrolled or not in the Special Supplemental Nutrition Program for Woman, Infants, and Children (WIC).

Design: Mothers kept diaries of their infants’ feeding patterns.

Participants: Mothers (n = 75) with infants aged ≤6 months.

Main Outcome Measures: Within the diaries, mothers recorded what else, if anything, they did during the feeding. Mothers also completed questionnaires on demographics, feeding styles, and infant temperament and eating behaviors.

Analysis: Mothers’ responses were coded into thematic categories. Feedings were classified as distracted when the mothers reported …

Student Involvement In Curriculum Development Enhances Medical Education, Jacline Griffeth, Alexandra Sawyer, Nolan Johnson, Osama Hashmi, Neha Gupta, Sarah Swartz, Kathryn Martin, Carol Nichols

Journal of the Georgia Public Health Association

Background: During the 2014 annual review of the curriculum for first year medical students at the Medical College of Georgia, the public health module was noted as an area that needed improvement. To address this concern, a Public Health Curriculum Workgroup was formed for the purpose of identifying specific areas to improve and developing a more robust and integrative curriculum. A small cohort of medical students with public health backgrounds were invited to be members of this workgroup and participate in the development and delivery of public health content to the next cohort of first year medical students. We hypothesized …

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 …

The Choose H2o Challenge #Ich2oose: Piloting A Health Communication Campaign To Encourage Teens In Rural New Mexico To Drink More Water, Emily A. Lilo

Communication ETDs

This dissertation explains the process of designing, implementing, and evaluating a two-tiered health campaign on social media and in a rural New Mexico high school. The Choose H2O Challenge was an 8-week contest to engage youth in examining their beverage consumption habits, to increase awareness about the health risks of sugary beverages, the benefits of water, and the influence of beverage marketing on their choices. The goals were to change the culture of beverage consumption at the school by making it fun to drink more water, and to encourage teens to become health messengers to their families and friends. This …

Effect Of Medicaid Status On Up-To-Date Vaccination Rates Among Two-Year-Old Children In Georgia, 2015, Fabio R. Machado, Jessica Tuttle, Cherie Drenzek

Journal of the Georgia Public Health Association

Background: The annual Georgia Immunization Study (GIS) employs a retrospective cohort design to determine the up-to-date (UTD) immunization rate of 24-month-old children in Georgia. Previous results have shown lower vaccination rates in the second year of life, particularly for DTaP. We sought to determine if a discontinuation of Medicaid coverage after the infant year contributed to lower immunization rates in the second year.

Methods: A stratified random sample of 2,002 Georgia children born in January 2013 was drawn from electronic birth records. Immunization history and Medicaid status were obtained from the Georgia Registry of Immunization Transactions and Services (GRITS). Parents …

Invited Article, Prabha Adhikari Dr

Manipal Journal of Nursing and Health Sciences

No abstract provided.

Mental Illness Stigma, Socially Acceptable Treatment, And Barriers To Health, Frances Renee Gellert

Independent Study Project (ISP) Collection

This paper discusses the topic of mental illness stigma and treatment in Uganda as explored through internship in the Social Work Department at Butabika National Referral Mental Hospital. The objectives of this project were to complete a meaningful internship while exploring causes of mental illness in Uganda, contradictions between traditional and modern approaches to treatment, and the affect of stigma on mental well-being. The internship included a total of 120 hours at Butabika Hospital. Individual research using documentary and literature review methods accompanied the internship. Butabika Hospital did not consent to the completion of formal research at, so any conclusions …

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 …

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 …

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) …

Mock Me! A Guide To Developing A First Rate Training Tool On A Second Rate Budget, Galen Baxter

Journal of the Georgia Public Health Association

Background: Working closely with county Environmental Health Specialists through the Standardization Process, a critical need was identified. Assistance was needed in prioritizing inspections based on risk levels identified in restaurant kitchens during inspections. Additionally, more training was needed to help them identify other areas in food service establishments that require further assessment.

Methods: Tight budget constraints prevented the purchase of expensive training equipment; however, with a little creativity and team work, a mock kitchen made entirely out of cardboard, tape and a couple of aluminum pans was created as a portable, handson training tool that could be easily transported around …

Georgia's Critical Access Hospitals: Financial Performance And Process Improvement, William A. Mase, Bettye A. Apenteng, Lisa Carhuff, Mark Hanna, Kwabena G. Boakye, Linda G. Kimsey, Samuel T. Opoku, Charles F. Owens, Stuart H. Tedders, Patricia Whaley

Journal of the Georgia Public Health Association

Background: Georgia’s Critical Access Hospitals (CAH) are in crisis. Within the last 2 years, four CAHs have closed their doors due to failed financial and operational performance. Evidence points to the risk that several more are on the brink of closure. CAH closures have far-reaching impact on residents. Negative impacts include the extra distance that patients must travel to seek care, the displacement of health professionals and the unravelling of the entire fabric of the communities these hospitals serve. We hope to help participants understand the financial and operational challenges of CAHs, and to identify realistic strategies to enhance the …

Enhancing The Future Public Health Workforce Through Competency-Based Student Field Placements, Michelle L. Carvalho, Laura M. Lloyd, Melissa Alperin, Lisa Mccormick, Kathleen R. Miner

Journal of the Georgia Public Health Association

Background: The Public Health Workforce Interest and Needs (PHWINS) 2014 survey from ASTHO (Association of State and Territorial Health Officials) demonstrated a dramatic need for succession planning and retention of the future public health workforce. To address this need, the Region IV Public Health Training Center’s (R-IV PHTC) Pathways to Practice Scholars Program places students from accredited schools and programs of public health into practical field placement positions across eight states. Skill- and competency-based student field placements reinforce the value of working with medically underserved areas/populations (MUA/Ps) through public health agencies. Field placements use adult learning theory through experiential learning …

Trends In Hiv Testing Among Adults In Georgia: Analysis Of The 2011-2015 Brfss Data, Benjamin Ansa

Journal of the Georgia Public Health Association

Background: Georgia is ranked fifth highest among states for rates of HIV diagnosis. About 4% of persons living with HIV infection in the United States reside in Georgia, and almost 19% of these people do not know their HIV status. The present study examined the trends and associated factors of HIV testing among adults in Georgia between 2011 and 2015.

Methods: The 2011-2015 Behavioral Risk Factor Surveillance System (BRFSS) data were analyzed.

Results: A total of 31,094 persons aged ≥18 years were identified who responded to the question “Have you ever been tested for HIV?” Overall, there were 11,286 (44.2%) …

Associations Between Multi-Level Contextual Factors And Mental Health Service Utilization In Adolescents With Comorbid Depression And Substance-Use: Moderating Role Of School Connectedness On Racial/Ethnic Disparities In Service Utilization, Kate Thornton

Journal of the Georgia Public Health Association

Background: Comorbid depression and substance use has been a prevalent issue in adolescent health. Although rates have remained relatively stable, their level is still alarming and efforts to see a decrease have led leaders and organizations to call for research to better understand factors related to both depression and substance use as well as how these factors may change when these disorders occur together.

Methods: Data from the National Survey on Drug Use and Health (NSDUH) were utilized to pursue the research objectives for this study. The NSDUH is an ongoing cross-sectional survey of the civilian and non-institutionalized population of …

Solo Practice Physicians In Georgia, Fedelis Mutiso, Emmanuel Akowuah, Samuel T. Opoku, Bettye A. Apenteng

Journal of the Georgia Public Health Association

Background: Office-based physicians can practice in a solo or group setting. Solo physician practices are staffed by a single physician who is responsible for all the care of the patients. Physicians in solo practices are also responsible for the infrastructure, personnel and investment cost of their practices. Further, evidence suggests that physicians in solo practices are more likely to be dissatisfied with their medical career compared to those in group practices. Given these challenges, current trend suggests a shift away from solo physician practices. However, there are still physicians in solo practices in Georgia but little is known about them. …

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 …

Anthropometric Indices For Non-Pregnant Women Of Childbearing Age Differ Widely Among Four Low-Middle Income Populations, K Michael Hambidge, Nancy F. Krebs, Ana Garcés, Jamie E. Westcott, Lester Figueroa, Shivaprasad S. Goudar, Sangappa Dhaded, Omrana Pasha, Sumera Aziz Ali, Antoinette Tshefu

Community Health Sciences

Background: Maternal stature and body mass indices (BMI) of non-pregnant women (NPW) of child bearing age are relevant to maternal and offspring health. The objective was to compare anthropometric indices of NPW in four rural communities in low- to low-middle income countries (LMIC).
Methods: Anthropometry and maternal characteristics/household wealth questionnaires were obtained for NPW enrolled in the Women First Preconception Maternal Nutrition Trial. Body mass index (BMI, kg/m²) was calculated. Z-scores were determined using WHO reference data.
Results: A total of 7268 NPW participated in Equateur, DRC (n = 1741); Chimaltenango, Guatemala (n = 1695); North …

Alcohol And Substance Use Knowledge, Attitudes, Subjective Norms, Self-Efficacy, Perceived Behavioral Control, And Behavioral Intentions Among Omani College Students, Muna S. Bait Ajzoon

Health Services Research Dissertations

Alcohol and/or substance use among college students is a serious public health issue. In Oman, studies addressing college student’s alcohol and/or substance use are limited. The purpose of this study was to identify knowledge, attitudes, subjective norms, self-efficacy, and perceived behavioral control associated with alcohol and/or substance usage patterns among Omani college students (OCSs); identify behavioral intentions for alcohol and/or substance use among OCSs; and facilitate the development of culturally relevant evidenced-based interventions for Omani young people by communicating study findings to policymakers and healthcare program leaders.

A cross-sectional design used an online survey completed by college students from Oman …

Protective Factors Against Peer And Social Media Sex Messages: The Moderating Role Of Parental Influences On African American Emerging Adult Students' Sexual Behaviors, Jacqueline Eunice Haywood

Psychology Theses & Dissertations

The most recent research on risky sexual behaviors is primarily based on adolescent, predominately White, or multiple race (e.g., African American and White) samples. There is a paucity of literature focused exclusively on African Americans, particularly African American emerging adults between the ages of 18 and 25. Given the increased risk for sexually transmitted infections (STIs) for college aged African Americans, it is important to understand factors that may decrease engaging in risky sexual behaviors that are specific to this group. The current study examined the roles of parental warmth and communication about sex as protective factors. Participants (n = …

Rsv Associated Hospitalizations In Children In Karachi, Pakistan: Implications For Vaccine Prevention Strategies, Syed Asad Ali, Mohammad Tahir Yousafzai, Rabbia Waris, Fatima Jafri, Fatima Aziz, Imran Naeem Abbasi, Anita K. M. Zaidi

Department of Paediatrics and Child Health

Major progress is being made in vaccines against Respiratory Syncytial Virus (RSV), with multiple vaccine candidates currently in the clinical phase of development. Making an investment case for public sector financing of RSV vaccine will require estimation of burden, cost-effectiveness, and impact. The aim of this study is to determine the proportion, age distribution and clinical spectrum of RSV associated hospitalizations in children in Karachi, Pakistan. A three years prospective study was conducted at the Aga Khan University Hospital in Karachi, a city of 20 million in south Pakistan, from August 2009 to June 2012. Children less than five years …

Age And Sex Normalization Of Intestinal Permeability Measures For The Improved Assessment Of Enteropathy In Infancy And Early Childhood: Results From The Mal-Ed Study, Margaret N. Kosek, Gwenyth O. Lee, Richard L. Guerrant, Rashidul Haque, Gagandeep Kang, Tahmeed Ahmed, Pascal Bessong, Syed Asad Ali, Shahida Qureshi, Anita K. M. Zaidi

Department of Paediatrics and Child Health

Objectives: The aim of the study was to describe changes in intestinal permeability in early childhood in diverse epidemiologic settings.
Methods: In a birth cohort study, the lactulose:mannitol (L:M) test was administered to 1980 children at 4 time points in the first 24 months of life in 8 countries. Data from the Brazil site with an incidence of diarrhea similar to that seen in the United States and no growth faltering was used as an internal study reference to derive age- and sex-specific z scores for mannitol and lactulose recoveries and the L:M ratio.
Results: A total of 6602 tests …

Mchd Student Health Centers Needs Analysis - Needs Assessment, Bill J. Wright, Re Buckley, Fanny Rodriguez, Jt Thompson, Kristen Dulacki, Natalie Royal Kenton

Articles, Abstracts, and Reports

No abstract provided.

Analisis Biaya Dan Faktor-Faktor Penentu Inefisiensi Layanan Hemodialisis Pada Pasien Gagal Ginjal Kronik Rumah Sakit Rk Charitas Palembang Tahun 2016, Noer Triyanto Rusli

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Enactment of JKN in hospital changes the payment system from retrospective payment (fee for service) into prospective payment (INA-CBG's). As a healthcare facility, RK Charitas Hospital has a role to provide not only quality but also to consider cost effective of services. This study aimed to analyze costs and identify the determinants of the inefficiency of hemodialysis services in patients with chronic renal failure at RK Charitas Hospital. This is a descriptive analysis research using primary and secondary data. Approach of cost analysis is Activity Based Costing (ABC) with "Bottom Up" method. ABC method is used to allocate costs by …

Analisia Kinerja Rumah Sakit Umum Daerah Dr. H. Abdul Moeloek Provinsi Lampung Tahun 2011- 2013 Berdasarkan Balanced Scorecard, Laisa Muliati

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

RSUDAM as public sector organizations BLUD status, health services should be held responsible, effective and efficient. It required comprehensive tools as a form of accountability to the community or the owner. Balanced scorecard by many nonprofits regarded as a comprehensive measuring tool. Namely the customer perspective, financial, internal business process perspective and the perspective of growth and learn. to analyze the performance of RSUDAM years 2011-2013 based balanced scorecard.The data analysis univariate analysis (descriptive). Data processing with methods of qualitative and quantitative studies of secondary data research activities in 2011-2013 show that: 1) The performance of the customer's perspective: Patient …