Community Health and Preventive Medicine Commons^™

Exploring Acculturation And Its Role In Substance Abuse Behaviors Among Refugee Populations In Bowling Green, Ky: An Interactive Learning Experience Through Provider’S Perspectives., Aishwarya Potluri

College of Graduate Studies: Theses & Dissertations

Substance use among refugee populations is an emerging public health concern shaped/influenced by cultural, social, and structural factors associated with resettlement. This qualitative study explored providers’ perspectives on substance use behaviors among refugees in Bowling Green, Kentucky. Using Health Behavior Theory with acculturation as a contextual construct, semi-structured interviews were conducted with 10 providers working with refugee-serving organizations. Data collected through the interviews was analyzed using thematic analysis in NVivo. The findings indicate that substance use is being influenced by peer exposure, occupational stress, and the increased availability of substances in the United States. Providers identified cultural stigma surrounding mental …

Exploring The Impact Of Adverse Childhood Experiences On Preventive Healthcare Utilization In Rural Georgia, Ryan R. Traylor

College of Graduate Studies: Theses & Dissertations

This study examines the relationship between Adverse Childhood Experiences (ACEs) and preventive healthcare use among adults in Georgia, specifically within rural populations facing structural barriers. Using 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) data, the research analyzes associations between ACE exposure, rural residence, and preventive care outcomes, including physical exams and flu vaccinations. Guided by an intersectionally adapted version of Andersen’s Behavioral Model of Health Services Use, the study evaluates how predisposing factors, enabling resources, and perceived barriers relate to healthcare engagement. Logistic regression analyses assess the correlation of ACE exposure, cost barriers, provider access, and sociodemographics with preventive …

Trends Among Suspected Opioid Overdose Emergency Medical Service (Ems) Incidents In Georgia From 2019-2023, Ashton Harris

College of Graduate Studies: Theses & Dissertations

Opioid overdoses remain a problem in the United States, underscoring the need for additional surveillance tools to monitor trends in opioid overdoses. Emergency Medical Services (EMS) data is a timely surveillance method that captures more potential overdoses than hospitals by representing the pre-hospital setting. Research questions in the study assess EMS responses to suspect opioid overdose incidents from 2019-2023 in Georgia to encompass the following characteristics: timeframe (pre, during, post-pandemic), urban versus rural counties, race/ethnicity, categorical type of first responder, mean dosage of naloxone in milligrams administered, and death. 84,359 records meeting the inclusion criteria were initially retrieved from the …

What Is The Evolving Role Of Nurses In Telehealth As Future Healthcare Professionals?, Emma G. Lowry

Honors College Theses

Telehealth has evolved into an essential component of healthcare delivery in today's world, something that occurred alongside the COVID-19 pandemic. As healthcare professionals, nurses must be adequately prepared and equipped to use the tools for telehealth. This paper examines the evolving role of nurses in telehealth by assessing undergraduate nursing students’ and practicing nurses’ knowledge, attitudes, and perceived competencies. Data will be collected through a Qualtrics survey utilizing the Awareness, Knowledge, Attitude, and Skills (AKAS) Scale for Telemedicine, supplemented by interviews with telehealth practitioners to provide qualitative context. It is expected that variations in proficiency and attitudes, from previous biased …

From Vision To Impact: Strategic Planning For The South Health District, Jason D. Butler Jr

College of Graduate Studies: Theses & Dissertations

This study presents a community health assessment and strategic planning process for the South Health District (SHD), a rural, multi-county public health district.  Using a mixed-methods approach, quantitative surveys and qualitative data from County Nurse Managers, County Boards of Health, and internal staff were integrated with secondary sources to identify community health priorities and organizational gaps.  Broad stakeholder engagement through surveys, SWOT workshops, and town-hall meetings ensured credibility and contextual relevance.

Findings revealed challenges in behavioral health, substance abuse, chronic disease, access to preventive services, transportation, workforce capacity, communication, and infrastructure.  Four strategic issues—Communication, Workforce Development and Retention, Purpose-Driven District, …

Exploring Psychological Safety And Workforce Experiences Among Employees In Recovery Community Organizations In The Southern United States: A Qualitative Study, Claire-Lorentz Ugo-Ike

College of Graduate Studies: Theses & Dissertations

This qualitative study explored how employees in Recovery Community Organizations (RCOs) in the Southern United States experience psychological safety and how these experiences shape employee well-being and their intentions to stay or leave their organizations. Guided by Edmondson’s Psychological Safety Theory and the Job Demands-Resources (JD-R) model, the study examined how leadership practices, workplace culture, and the emotional demands of recovery support work shape employees’ perception of safety, support, and sustainability in the workforce. Semi-structured interviews were conducted with 19 RCO employees working in various peer support roles. Thematic analysis identified five major themes: (1) leadership behaviors shape psychological safety …

Targets To Increase Hiv Pre-Exposure Prophylaxis (Prep) Uptake Among Communities In Northeast Georgia, Kaley E. Parchinski, Molly Hirsh, Andrew Cheng, Nia Kalifa, Manvi Manyam

Journal of the Georgia Public Health Association

Background: This study seeks to identify targets to increase HIV pre-exposure prophylaxis (PrEP) uptake in Athens-Clarke County, GA, a non-urban area with high HIV burden and poor PrEP utilization.

Methods: A cross sectional survey of adults attending HIV outreach screenings in Athens, GA between November 2022 and March 2023 describes participant demographics and validated scales measuring PrEP knowledge, attitudes, stigma, descriptive norms, and intentions.

Results: Of 136 total participants, key demographic groups included Black (N=84, 61.8%), Latinx (N=10, 8.1%), LGBTQ+ (N=25, 18.4%), and persons who use injection drugs (N=19, 15%); overall, less than half of the PrEP knowledge items were …

Perspectives Of African American And Hispanic/Latino Individuals On Hiv Molecular Cluster Detection, Maxwell Richardson, Brendan H. Pulsifer, Jane Yoon Scott, David Holland, Eleanor W. Garlow, Pascale Wortley, Daniel Mauck, Jenna Gettings, Valeria Cantos, Masonia Traylor, Eric Rangel, David Folkes, Carlos Saldana

Journal of the Georgia Public Health Association

Background: Responding to HIV clusters detected using molecular data has been shown to reduce transmission and improve testing, treatment, and prevention. However, there are varied opinions about the use of cluster detection activities, and some advocates have raised concerns about patient consent, data security, and the potential for HIV criminalization. Incorporating the perspectives of marginalized populations that are disproportionately affected by HIV is essential to understanding the diversity of those perspectives, yet it is often overlooked in the literature. Thus, our study seeks to highlight the perspectives of Black/African American and Hispanic/Latino individuals in the Southern United States on HIV …

The Role Of Horizontal Gene Transfer In Antibiotic Resistance Amidst Prevalent Community And Healthcare-Associated Mrsa Rates, Gabrielle Nascimento

Honors College Theses

In recent decades, cases of community-acquired MRSA (CA-MRSA) and healthcare-associated MRSA (HA-MRSA) have been on the rise. The ability of antibiotic resistance to transfer between microorganisms greatly expands its threat to the effective treatment and containment of bacterial infections. The mecA gene is found on a mobile cassette within the Staphylococcal cell and encodes for PBP2a, an alternate version of penicillin-binding protein (PBP) with less binding affinity for β-lactam antibiotics, increasing resistance to the effects of antibiotics. The goal of this research is to investigate the horizontal transfer of the mecA gene between various Staphylococcus species as well as to …

Barriers To Seeking Medical Care And Their Effects Among Fat Patients With A Fat Liberation Praxis In The United States, Christina Seiko Cook

College of Graduate Studies: Theses & Dissertations

Weight stigma and weight bias have significant effects on the health of individuals (Alberga et al., 2019; Pearl, 2018; Puhl & Heuer, 2010; Schwartz et al., 2003; Udo et al., 2016). These biases can show up in the form of fatphobia or anti-fat bias. Physicians who hold anti-fat bias can affect their relationship with their patients, leading to poorer health outcomes and worse patient experiences for larger-bodied and fat people (Phelan et al., 2015). The purpose of this study is to contribute to the current literature regarding the positive and negative experiences of fat patients with a fat liberation praxis …

Barriers To Help-Seeking Behavior For Maternal Mental Health Disorders: Application Of The Health Belief Model, Tobi F. Oloyede, Joanne Chopak-Foss

Journal of the Georgia Public Health Association

Perinatal mood and anxiety disorders (PMADs) have become a leading cause of maternal mortality due to suicide among women in the first year following pregnancy. Although the profile for new mothers who die by suicide is predominantly white, disparities exist between Black and White women in their seeking help for perinatal and/or post-natal mood disorders. For Black, Indigenous, and People of Color (BIPOC), there are differences in the perceptions of the benefits of seeking help for PMADs. The COVID-19 pandemic exacerbated maternal mental health disorders in the United States particularly for women who live in communities with limited access to …

93rd Annual Georgia Public Health Association Meeting And Conference Report, Jimmie H. Smith Jr, Angela Peden, Patrina L. Bowles

Journal of the Georgia Public Health Association

The 93^rd Annual Meeting and Conference of the Georgia Public Health Association (GPHA) was held in Jekyll Island, Georgia, at the Jekyll Island Convention Center, on May 3-5, 2023. The goal of the 2023 Georgia Public Health Association Annual Meeting and Conference was to assemble emerging public health professionals, current practitioners, academicians, governing entities, and community stakeholders for educational opportunities and networking to support the vision and mission of GPHA.

The theme for the 2023 Georgia Public Health Association Annual Meeting and Conference theme was selected by the GPHA Executive Board during a meeting in the early fall of …

Let's Talk About Sex & Prep: District 2 Does!, Chrissa M. Shaffer

Georgia Public Health Association Annual Meeting & Conference

Defining what a PrEP Service Program entails and how it could benefit your district or county health center. Discussing methods that have been used to set up PrEP Services within a district – including training, resources, and promotion. Identifying the challenges and working through them. Reviewing the results of the PrEP Services over the past year, and the ongoing goals to encourage and increase our PrEP Services.

Factors Associated With Hepatitis C-Related Hospitalizations And Inpatient Mortality In The United States, Pre- And Post-Onset Of The Covid-19 Pandemic, Christina R. Samuel

College of Graduate Studies: Theses & Dissertations

Background: Hepatitis C is a significant public health problem in the United States and imposes a substantial burden on the healthcare system. Previous research shows that the COVID-19 pandemic response efforts have overshadowed hepatitis C testing and treatment measures in health care settings across the country. The purpose of this study was to describe and examine the factors associated with hepatitis C-related hospitalizations and inpatient mortality in the United States, pre- and post-onset of the COVID-19 pandemic. Methods: Data were obtained from the 2019-2020 National Inpatient Sample database. The study population included persons aged ≥18 years with hepatitis C-related inpatient …

Social And Structural Determinants Of Health As Predictors Of Covid-19 Vaccine Hesitancy Among Older Adults In The United States, Kingsley Kalu

College of Graduate Studies: Theses & Dissertations

Background: Although vaccination is one of the greatest accomplishments in public health, some people, especially older adults, are reluctant to take vaccines. This study examined the association between the social and structural determinants of health and COVID-19 vaccine hesitancy among older adults in the United States.

Methods: Secondary data from the Health and Retirement Study (HRS) was used. The HRS participants were 65 years and older, and the sample size was 2311. Multinomial multivariable logistic regression models were conducted for this study.

Results: The study shows that social determinants of health (marital status, educational level) and structural determinants of health …

Can We Talk About Sex? Exploring Teacher Preparedness Of Comprehensive Sex Education Delivery In Southeast Georgia, Tanya Jules

College of Graduate Studies: Theses & Dissertations

In 2022, the CDC estimated that youth and adolescents between the ages of 15 through 24 accounted for almost half of the 2.5 million cases of sexually transmitted infections in the United States. Teachers who deliver accurate sexual health information increase the accessibility of pertinent details to adolescents during crucial years of cognitive development, which could decrease adverse sexual health outcomes among youth. The utilization of a Comprehensive Sex Education (CSE) curriculum addresses all parts of sexual health by covering topics ranging from physical, biological, emotional, and social aspects of sexuality. However, educators who provide sexual health education must follow …

An Integrated Evidence-Based Approach To Provide A Practicum-Based Learning Experience To Students, Dziyana Nazaruk, Joseph Telfair, Jamie S. Cromley, Joanne Chopak-Foss, Ana M. Palacios

Health Policy & Community Health: Faculty Publications

Background

Due to the challenges created by the COVID-19 pandemic, the public health field has an exceptional opportunity not only to address current challenges but also to rebuild and expand the workforce. Objectives

The main objective of this presentation is to highlight the 2018-2022 academic year's progress of the practice-based learning experience of the JPH College of Public Health at Georgia Southern University in Georgia, USA. The College serves more than 59, mostly rural counties, and involves diverse practicum preceptors, students, and existing professionals from the USA and other countries. The College provides a unique opportunity for students to develop …

Strengths, Weaknesses, Opportunities And Threats Of A Community-Based Egg Program In Rural Honduras, Lilly Karsa, Dziyana Nazaruk, G. Ramos, L. Manship, Ana M. Palacios

Health Policy & Community Health: Faculty Publications

Background

Young children living in poor rural areas in Honduras are susceptible to suffering from undernutrition. About 1 in every 4 children under age 5 have stunting. Stunting during early childhood has negative consequences on an individual's life that can have short-term and lasting effects. This study's purpose was to explore the perceptions of the mothers of children that participate in a community-based nutrition-agriculture program that offers 1 egg daily to all children ages 6 to 24 months in 13 communities. Methods

Using community-engaged methods, we implemented a SWOT analysis to identify strengths, weaknesses, opportunities, and threats using a semi-structured …

Clinical And Demographic Attributes Of Patients With Diabetes Associated With The Utilization Of Telemedicine In An Urban Medically Underserved Population Area, Lisa Ariellah Ward, Gulzar H. Shah, Kristie C. Waterfield

Health Policy & Community Health: Faculty Publications

Marginalized populations often experience health disparities due to the significant obstacles to care associated with social, economic, and environmental inequities. When compared with advantaged social groups, these populations frequently experience increased risks, poorer health outcomes, and reduced quality of life (QoL). This research examines the clinical and demographic characteristics—age, gender, and race—related to patients with varying stages of type 2 diabetes mellitus (T2DM), comparing the utilization of telemedicine (TM) with traditional healthcare face-to-face (F2F) appointments in an urban medically underserved population area (UMUPA). A logistic regression model, was used to analyze retrospective electronic patient health records (EHRs) from 1 January …

Transformative Approach To Developing A Sustainable Interprofessional Education Program, Tilicia Mayo-Gamble, Jane Nester, Paula Tillman, Sandhya Lohani, Padmini Shankar, Pamela Mahan

Journal of the Georgia Public Health Association

Background: The ability to offer and sustain interprofessional collaboration and education (IPE) in an academic setting could potentially serve as a training model for other academic institutions to implement programs that will increase the number of practice-ready, culturally competent healthcare professionals. We designed, implemented, and evaluated an Area Health Education Center (AHEC) Scholars Program to train culturally competent interdisciplinary students to provide quality, patient-centered healthcare in rural and underserved communities post-graduation.

Methods: Two cohorts of students (Cohort 1, n = 15, Cohort 2, n = 14) were recruited into a two-year longitudinal program with 80 hours of didactic learning and …

Use Of Advance Directives In Us Veterans And Non-Veterans: Findings From The Decedents Of The Health And Retirement Study 1992–2014, Ho-Jui Tung, Ming-Chin Yeh

Health Policy & Community Health: Faculty Publications

Evidence shows that older patients with advance directives such as a living will, or durable power of attorney for healthcare, are more likely to receive care consistent with their preferences at the end of life. Less is known about the use of advance directives between veteran and non-veteran older Americans. Using data from the decedents of a longitudinal survey, we explore whether there is a difference in having an established advance directive between the veteran and non-veteran decedents. Data were taken from the Harmonized End of Life data sets, a linked collection of variables derived from the Health and Retirement …

Evaluation Of Feasibility And Acceptability Of A Web-Based Diabetes Prevention Program (Dpp) For Diabetes Risk Reduction In Chinese Americans In New York City, Ming-Chin Yeh, Wincy Lau, Claire Anselmo Keady, Margrethe Horlyck-Romanovsky, Ho-Jui Tung, Lu Hu, Grace X. Ma, Judith Wylie-Rosett

Health Policy & Community Health: Faculty Publications

Introduction: Intensive lifestyle intervention remains an effective modality to reduce diabetes incidence and delay the progression to type 2 diabetes. The primary aim of this study was to pilot-test the feasibility and acceptability of a culturally and linguistically tailored web-based DPP intervention among Chinese Americans with prediabetes living in New York City.

Methods: Thirteen Chinese American participants with prediabetes were recruited to complete a 1-year web-based Diabetes Prevention Program (DPP) lifestyle intervention. Quantitative and qualitative measures such as retention rate and data collected from web-based questionnaires and focus groups were collected and analyzed to assess study feasibility and …

Improving Healthcare Experiences For Transgender And Intersex Populations, Destiny S. J. Lee, Joanne Chopak-Foss

Journal of the Georgia Public Health Association

Intersex is an umbrella term for individuals who are born with sex characteristics that do not typically fall into male or female categories. Individuals who are intersex make up about 1.7% of the United States population today and are identified within the lesbian, gay, bisexual, transgender, and intersex (LGBTQIA+) community. Many people who are intersex identify as transgender, which relates to the social process of gender change, as they develop into adults. In Georgia, approximately 4% of the population identify as LGBTQIA+. The purpose of this paper is to increase awareness of the perceived discrimination from healthcare providers, non-inclusive organizational …

The Effects Of Multiple Micronutrient Fortified Beverage And Responsive Caregiving Interventions On Early Childhood Development, Hemoglobin, And Ferritin Among Infants In Rural Guatemala, Alysse J. Kowalski, Victor Alfonso Mayen, Silvia De Ponce, Kaley B. Lambden, Nick Tilton, Lisa M. Villanueva, Ana M. Palacios, Greg A. Reinhart, Kristen M. Hurley, Maureen M. Black

Health Policy & Community Health: Faculty Publications

Undernutrition and a lack of learning opportunities can jeopardize long-term growth and development among infants in low- and middle-income countries. We conducted a 6-month 2 × 2 cluster-randomized trial to assess the effects of multiple micronutrient-fortified beverages and responsive caregiving interventions among infants 6–18 months in 72 community sectors in southwest Guatemala. We administered baseline and endline assessments of childhood development (Bayley Scales of Infant and Toddler Development) and socioemotional development (Brief Infant Toddler Socio-Emotional Assessment) and measured ferritin and hemoglobin on a subsample. The trial was analyzed using linear mixed models. At the baseline, the mean age (SD) was …

A Process Evaluation Of The Green Period Pantry Project, Gabi Wiggill

Honors College Theses

Introduction: The Green Period Pantry (GPP) was a health promotion initiative that was implemented in collaboration with the Office of Student Wellness and Health Promotion. It was created using $48,000 in grant money applied for and received from Sustain Southern as part of the Sustainability Fee Grants at Georgia Southern University. The purpose of the project was to supply students who experienced menstruation with reusable menstrual hygiene products. Another purpose was to describe the process from idea inception to implementation through collaboration with the Office of Student Wellness and Health Promotion. Results: A total of 3,506 units of reusable Menstrual …

Editorial: Assessing And Addressing Health Inequities And Disparities: The Role Of Health Informatics, Gulzar H. Shah, Anjum Khurshid, Joanne Chopak-Foss

Health Policy & Community Health: Faculty Publications

No abstract provided.

Radical Youth Work: A Community Based Approach To Working With Youth, Young Adults And Families, Weston J. Robins

National Youth Advocacy & Resilience Conference

Eternal Strength Center for Radical Youth Work is a blended community center with customizable mental health therapeutic support for youth, young adults and families. Providing humanistic and person centered psychotherapy and counseling, alongside experiential therapies and community engagement we support families and youth struggling with anxiety, depression, substance abuse, self harm, suicidality and other challenges on their developmental growth journey.

A Nationwide Study Of The “July Effect” Concerning Postpartum Hemorrhage And Its Risk Factors At Teaching Hospitals Across The United States, Zahra Shahin, Gulzar H. Shah, Bettye Apenteng, Kristie Cason Waterfield, Hani M. Samawi

Health Policy & Community Health: Faculty Publications

Objective To assess the “July effect” and the risk of postpartum hemorrhage (PPH) and its risk factors across the U.S. teaching hospitals. Method This study used the 2018 Nationwide Inpatient Sample (NIS) and included 2,056,359 of 2,879,924 single live-birth hospitalizations with low-risk pregnancies across the U.S. teaching hospitals. The International Classification of Diseases, Tenth Revision (ICD-10) from the American Academy of Professional Coders (AAPC) medical coding was used to identify PPH and other study variables. Multivariable logistic regression models were used to compare the adjusted odds of PPH risk in the first and second quarters of the academic year vs. …

Determinants Of Child Stunting, Wasting, And Underweight: Evidence From 2017 To 2018 Pakistan Demographic And Health Survey, Maryam Siddiqa, Gulzar H. Shah, Tilicia Mayo-Gamble, Amber Zubair

Health Policy & Community Health: Faculty Publications

Child malnutrition persists in low-resource countries such as Pakistan, indicating an urgent need for interventions and policies aimed to address this critical population health issue. The World Health Organization Global Target 2025 includes the reduction of malnourishment in the form of stunting, wasting, and low weight. This study aims to examine the prevalence of factors associated with three measures of child malnutrition, i.e., stunting, wasting, and low weight in Pakistan. This study uses a secondary data analysis design based on data from Pakistan Demographic and Health Survey (2017-18) that used a two-stage cluster sampling approach. National level data covering urban …

Effectiveness Of Telemedicine In Diabetes Management: A Retrospective Study In An Urban Medically Underserved Population Area (Umupa), Lisa Ariellah Ward, Gulzar H. Shah, Jeffery A. Jones, Linda Kimsey, Hani M. Samawi

Health Policy & Community Health: Faculty Publications

This paper examines the efficacy of telemedicine (TM) technology compared to traditional face-to-face (F2F) visits as an alternative healthcare delivery service for managing diabetes in populations residing in urban medically underserved areas (UMUPAs). Retrospective electronic patient health records (ePHR) with type 2 diabetes mellitus (T2DM) were examined from 1 January 2019 to 30 June 2021. Multiple linear regression models indicated that T2DM patients with uncontrolled diabetes utilizing TM were similar to traditional visits in lowering hemoglobin (HbA1c) levels. The healthcare service type significantly predicted HbA1c % values, as the regression coefficient for TM (vs. F2F) showed a significant negative association …