Other Public Health Commons^™

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 …

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, …

Advancing Interoperability Through Governance And Sustainability: A Qualitative Comparative Case Study Of State Health Information Exchanges In The United States, Karterria Finkley

College of Graduate Studies: Theses & Dissertations

This study presents a comprehensive comparative analysis of state-level Health Information Exchanges (HIEs) across all 50 U.S. states and the District of Columbia, examining how governance structures, consent frameworks, funding models, and technical infrastructure influence interoperability maturity, sustainability, and adoption. Guided by Systems Theory and Donabedian’s Structure Process Outcome framework, the research employs a mixed-methods comparative case design integrating systematic documentary review, qualitative thematic analysis, and a policy-anchored analytic scoring methodology. Structural and policy characteristics were operationalized through standardized ordinal (1-5) metrics and aggregated into composite indices representing governance capacity, consent inclusivity, financial sustainability, and technical readiness. This approach enabled …

Assessing And Advancing Pandemic Emergency Preparedness In New York City's Hospitals: A Strategic Management Toolkit Integrating Policy Analysis, Risk Assessment, And Stakeholder Insight, Irrem Jamal

College of Graduate Studies: Theses & Dissertations

This dissertation examines pandemic emergency preparedness in New York City hospitals, which were severely strained during COVID-19, revealing critical gaps between documented plans and operational readiness. Using a multimethod approach combining a survey of 20 stakeholders across city hospitals, semi-structured interviews, and document analysis of policy frameworks and after-action reports, the study identifies a persistent "documentation-execution paradox": while 80% of respondents confirmed clear pandemic plans, only 45% expressed confidence in staffing adequacy, 55% in surge planning realism, and just 45% confirmed regular drills. Qualitative analysis revealed workforce as the single greatest yet most underinvested vulnerability, supply chain fragility rooted in …

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 …

Exploring The Impact: Eating Disorder Treatment And Mortality In The United States, Brittany Tolbert

College of Graduate Studies: Theses & Dissertations

This study explores adolescent eating disorder trends in the United States between 1999-2013, identifies national eating disorder mortality trends, and analyzes data for in-patient adolescent hospital admissions. Additionally, this study uses public-facing data for residential eating disorder treatment centers to explore issues related to insurance coverage, gender inclusivity, and evidence-informed treatment practices. The findings will highlight gaps in data collection and policy, support advocacy, and contribute to the research into eating disorder prevalence, prevention, treatment outcomes, and economic impact, leading to greater visibility to promote change.

Exploring The Impact Of Covid-19 And The Role Of The Church On African Americans’ Mental Well-Being In South Georgia, Adrian D. Lewis

College of Graduate Studies: Theses & Dissertations

The emergence of COVID-19 in 2020 disrupted the social dynamics of communities in the United States. Furthermore, public health mandates led to closures that changed how populations access faith. Historically, African Americans have utilized the church to cope with societal stressors. This study will explore the history of church utilization in the African American community, assess how COVID-19 public health mandates led to church closures for the first time in recent history and impacted this marginalized population, and provide a qualitative perspective on the quality of life during the closures and what changed after the closures for African Americans in …

Evaluation Of The Navy Shipshape Program At A Large Navy Military Treatment Facility: A Comprehensive Swot Analysis Approach, Nia Nur Maye

College of Graduate Studies: Theses & Dissertations

The increasing problem of obesity among Navy service members (SMs) is a public health concern that impacts operational readiness and health risks. To combat obesity, the Navy has an official weight management initiative called ShipShape. This project aimed to conduct a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis of ShipShape at a large Military Treatment Facility (MTF) in Portsmouth, Virginia. This program evaluation aimed to identify the internal and external factors that influenced the program's effectiveness to propose suggestions for improvement. Using quantitative and qualitative methods, the evaluation focused on conducting a paired t-test to analyze changes in Body Mass …

Addressing Breast Health Disparities Among Recent, Established African-Born Immigrant Women And Second-Generation Americans In Prince George County, Maryland, Omolola Okunromade

College of Graduate Studies: Theses & Dissertations

Background: Breast health disparities and underutilization of screening methods are major concerns in the United States (US), particularly affecting Black women who experience lower survival rates and advanced diagnoses. Despite the rapid growth of the African-born immigrant population, breast health among this group in the US is notably under-examined. This study aims to investigate the breast health knowledge and practices of first-generation African-born immigrants and second-generation immigrant women of African descent, aiming to understand the distinctive attributes of this group and the impact of acculturation on this public health issue.

Methods: Interviews were conducted among First Generation African immigrants and …

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

College of Graduate Studies: Theses & Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

Using The Cipp Model Of Evaluation On A Health Disparities Curriculum Delivered To Medical Residents In 12 Residency Programs, Gauri K. Shevatekar

College of Graduate Studies: Theses & Dissertations

Background: Although the Accreditation Council for Graduate Medical Education (ACGME) has provided educational directives on health disparities education during residency program for the medical residents, there is paucity of curricula focused on disparities education within the graduate medical education.

Objective: The purpose of this study was to evaluate a Health Disparities Curriculum (HDC) that was delivered to twelve residency programs at a College of Medicine.

Methodology: The study employed a cross-sectional study design. Stufflebeam’s Context-Input-Process-Product (CIPP) model was utilized as theoretical framework to assess whether the curriculum achieved its stated goals and objectives, the teaching and learning processes, and the …

Evolving Roles And Responsibilities Of Public Health, Allison Foster

Georgia Public Health Association Annual Meeting & Conference

Since 2008, over 10,000 public health professionals have become Certified in Public Health (CPH). Periodically, the NBPHE conducts a Job Task Analysis survey to gain an understanding of the roles and responsibilities of the public health workforce. With that information, the main areas of focus on the CPH exam are updated.

In the summer of 2022, the National Board of Public Health Examiners launched a newJob Task Analysis process. The comprehensive set of responses will demonstrate the scope of public health responsibilities on a region-by-region basis.

Current domains of the CPH exam are: Communications, Leadership, Law and Ethics, Public Health …

What Could Go Wrong? Patient And Hospital Characteristics Associated With Pediatric Quality Of Inpatient Care And Pediatric Adverse Events, Michael H. Samawi

College of Graduate Studies: Theses & Dissertations

This study aims to analyze associations between hospital and patient characteristics with pediatric adverse events (PAE) in the inpatient hospital setting, utilizing the framework of pediatric quality indicators (PDIs) from the Agency for Healthcare Research and Quality (AHRQ) indicators. Three PDIs were identified and utilized for this purpose: NQI 03 Neonatal Blood Stream Infection, PDI 09 Postoperative Respiratory Failure, and PDI 10 Postoperative Sepsis. The data used for the study is based on an analysis of discharge data from the Healthcare Cost and Utilization Project (HCUP) Kid’s Inpatient Databases (KID) for the year 2019. The findings contribute to the growing …

Exploring Relationship Among Programmatic Expertise, Work Engagement, And Turnover Intentions Across Different Generation Cohorts In State And Local Governmental Public Health Agencies, Stephanie L. Irvin

College of Graduate Studies: Theses & Dissertations

This study examined the relationship among public health programmatic competencies, work engagement, and turnover intentions among state and local public health workers. It also explored the moderating role of generational cohorts in these relationships. It employed a quantitative secondary data analysis using the 2021 PHWINS survey, a collaboration between the de Beaumont Foundation and The Association of State and Territorial Health Officials. The study's principal findings shed light on critical relationships within the public health workforce: Firstly, an increase in programmatic expertise among public health professionals is linked to increased work engagement, particularly notable within the Millennial cohort. Secondly, a …

Health Communications Trial With A Resistant Population To Increase Public Health Compliance During A Pandemic, Alison Amoroso, Carlos A. O. Pavao, Russel E. Luke, Jennifer Mccoy, Sean Richey, Shenandoah Evans

Journal of the Georgia Public Health Association

Background: Georgia has among the worst rates of COVID-19 hospitalization and death rates in the nation. Many identifying as politically conservative resist public health mitigation measures, similar to populations in other politically conservative geographical areas. There are limited peer-reviewed public health communications designed for this population. We aimed to determine if an intervention using a fear appeal approach with efficacy during a pandemic can positively affect knowledge, attitude, perception, and/or behavior (KAP) in Georgia with this population.

Methods: We delivered online video stimuli tailored to the geocultural characteristics of the target population. designed to stimulate fear, encourage efficacy, and counter …

The Microbial Load On Used Disposable Face Masks: Exploring Sustainable Disinfection Methods, Clara Ray

GS4 Student Scholars Symposium

Face masks have become common-place in public settings since the onset of the global COVID-19 pandemic, with many people choosing to wear masks in order to mitigate the risk of becoming infected with viral or bacterial infections. Two of the most widely-available types of masks are cloth masks, which may be reused if cleaned properly, and disposable surgical masks. Despite the fact that surgical masks are intended for one-time use, many people chose to store and re-wear them. The purpose of this study was to determine the changes in biological contamination on surgical face masks after daily wear and overnight …

Becoming A Public Health Professional: Millennials’ Perspective On Organizational Assimilation And Professional Identity, Tony K. Winters

College of Graduate Studies: Theses & Dissertations

ABSTRACT

Public health must confront the ongoing challenge of workforce transitions and the impending exodus of existing employees. The millennial generation rises as an option to fill this workforce gap. Using the Socialization Resource Theory as a framework and qualitative data from in-depth interviews with 27 millennial professionals from federal, state, local, and non-governmental public health agencies, this study describes (a) the organizational assimilation (OA) process for millennial public health professionals, (b) explores the impact of OA on professional identity, and (c) describes how the OA process may impact the retention of public health professionals.

The results from this study …

Perception Of Health Care Access In Rural Georgia: Findings From A Community Health Needs Assessment Survey, Elisa M. Childs, Tiffany R. Washington

Journal of the Georgia Public Health Association

Background: Limited access to health care services has been cited as a barrier to care for individuals who live in rural areas, contributing to significant health disparities in this population. While perception of services has been cited as a determinant of utilization of health services, it is unknown how perception of services influences health care access in rural areas. The paucity of studies specific to areas in the United States that are medically underserved, necessitated this study and its quantification of the issues that are relevant to individuals living in rural Georgia.

Methods: This study examined the perception of health …

Factors Associated With Intention To Disclose Concussive Symptoms In Active Duty Soldiers, Carly Beck

College of Graduate Studies: Theses & Dissertations

Background: Concussion disclosure is a heavily researched topic, and while previous literature has explored predictors of concussion disclosure in numerous populations, research within the active duty Soldier population is limited. This study further explored predictors of concussion disclosure to a medical professional or leadership in the active duty Solider population through the lens of the Theory of Planned Behavior. Methods: A cross-sectional electronic survey was distributed to 181 active duty Soldiers. Descriptive statistics were used to report frequency of high intention to disclose concussive symptoms among demographics, and a multivariate regression model was used to assess significant predictors of intention …

Grant Application For The Hearts And Hands Clinic, Christine Cooper, Ariellah Ward

Eagle Showcase: Excellence in Service-Learning

During our service-learning course on public health funding and grant writing, we had the opportunity to work at the Hearts and Hands Clinic. During the pandemic, many families lost their income and healthcare insurance. Thus, facing uncertainties about where to obtain medical care. The clinic wanted to expand its existing chronic care program to an underserved community in Evans County. Our task was to prepare a grant application for the clinic to secure the funding needed to help vulnerable adults better manage their chronic disease and prevent further complications. Engaging in this applied experience allowed us to improve our implementation …

Perceptions Of Covid-19 In College Students: Effect On Emotional Well-Being, Mikayla N. Murphy

Honors College Theses

This study explores the connection between emotional well-being of college students and the COVID-19 pandemic. Many physical distancing practices have negatively affected emotional well-being, such as increased time alone and screen time. A purposive sample of convenience was utilized to collect information on the emotional well-being of a selected group of students at two time points: January through March 2020 and January/February 2021. Students from the Honors College were selected as the study population. The survey questions were administered electronically through Qualtrics software, Version: February 2021. Of the 101 survey responses obtained between January 27 and February 22, 2021, 89 …

"Who's The Man?" Examining The Relationships Between Black Masculinity, Perceived Social Support, And Sexual Behavior In Black Male College Students, James Thomas

College of Graduate Studies: Theses & Dissertations

Introduction: Sexual health disparities in college-aged Black men remains a critical public health issue. Black men are likely to have an earlier sexual debut, acquire sexually transmitted infections (STIs) and HIV at higher rates, and enter fatherhood at earlier ages than their White counterparts. Previous research has identified masculinity and perceived social support as predictors of sexual risk behavior for men in the U.S. However, when exploring masculinity’s influence on sexual behavior, studies that are culturally sensitive to Black men’s experiences and perspectives on manhood are few. The purpose of this study was to explore the relationship between Black masculinity, …

Identifying Strategies To Increase The Recruitment And Retention Of Minority Males In The Public Health Workforce: A Two-State Comparative Case Study Approach, Melicent R. Miller

College of Graduate Studies: Theses & Dissertations

Non-White males have higher rates of morbidity and mortality from chronic health conditions as compared to Whites. An essential element for achieving success in eliminating health disparities is to increase the presence of racial/ethnic minorities (i.e., people of color) within public health careers. One of the most important competencies for a public health professional is the ability to work in culturally and racially diverse populations. Yet, individuals are significantly more likely to receive their care and experience greater satisfaction from providers that are of the same racial or ethnic background. The racial/ethnic composition of the health professions workforce continues to …

An Exploration Of Depression In African American Adults With Sickle Cell Disease: Symptoms, Coping Strategies And The Potential Benefits Of Religiosity, Delores P. Quasie-Woode

College of Graduate Studies: Theses & Dissertations

Depressive symptoms in adults with Sickle Cell Disease (SCD) often go unrecognized and untreated. SCD is one of the most common inherited hemoglobin disorders in the United States, affecting 1 in 365 African Americans. Individuals with SCD and co-morbid Depression lead to high hospitalization rates and healthcare utilization. The objective of this study is to explore depressive symptoms and preferred coping strategies among African American Adults with SCD. Furthermore, the aim is to explore the acceptability of religiosity among those who self-identify as religious.

Interviews were conducted with 30 African American adults, recruited during their hematology appointment at the Center …

“It Didn’T Matter What The Bill Said...”: Influences On Abortion Policy Legislative Decision-Making In Georgia, Erica Barton, Subasri Narasimhan, Dabney P. Evans

Journal of the Georgia Public Health Association

Background: In March 2019 the Georgia legislature passed HB 481 described as a “heartbeat bill”, prohibiting abortion at around six weeks gestation. Given the prevalence of anti-abortion legislation and the public health implications of abortion restrictions, we sought to understand how Georgia legislators made decisions on this early abortion ban legislation.

Methods: We conducted in-depth interviews with nine legislators from the Georgia House of Representatives who participated in the 2019 legislative session. In-depth interviews were conducted in-person and over the phone. Interview recordings were transcribed verbatim and inductive codes identified. Codes focused primarily on views of: abortion in general; specific …

Perceptions Of Local Board Of Health Effectiveness In Georgia, Amber Erickson

College of Graduate Studies: Theses & Dissertations

Objective: The purpose of this study is to examine the perceptions of the local board of health chairpersons in Georgia on their engagement in six governance functions and examining the challenges faced and facilitators perceived by local boards of health in performing the governance functions properly. Methods: For this descriptive mixed method study design, a survey was administered to all local board of health chairpersons and key informant interviews were conducted with a small selection of board of health chairpersons. Descriptive statistics were produced for recoded survey data variables and themes from qualitative data collected through the surveys and interviews …

Assessing Hotel Employee Knowledge On Risk Factors And Risk Management Procedures For Microbial Contamination Of Hotel Water Distribution Systems, Brandon Leftwich

College of Graduate Studies: Theses & Dissertations

Background: Compromised hotel water supply lines by neglect or by physical and structural damage can lead to exposure of harmful pathogens to guests and staff. To reduce the risk of having contaminated water in a hotel plumbing system, some facilities may incorporate a water safety plan (WSP). WSPs are not mandatory for hotels in many US states, including the state of Georgia. As such, many hotel personnel are uninformed of WSPs and the precautions to take if their hotel water system is compromised. The purpose of this study was to identify hotel personnel’s knowledge and practices of WSPs through a …

Assessing Public Health Workforce Informatics Competencies: A Study Of Three Health Departments In Metro Atlanta, Olatanwa Adewale

College of Graduate Studies: Theses & Dissertations

Background: There is a need for the public health workforce to be current and versatile in technology usage. Public health leveraging technology usage in service delivery has the potential to improve efficiency and bring it to the forefront in the provision of healthcare services. The purpose of this study was to assess public health workforce informatics competencies in select Atlanta health districts and determine the correlates of public health informatics proficiency.

Methods: A 10-item instrument adapted from the recommendations of a Working Group document by the Centers for Disease Control and Prevention and the 2015 Informatics Capacity and …

Overall Microbial Activity On Shopping Carts Handles: Relationship With Ambient Temperature, Relative Humidity, Moisture, And Ultraviolet Radiations, Grayson Rentz, Atin Adhikari

GS4 Student Scholars Symposium

Goals and Objectives: Microbial contamination in shopping cart handles were previously reported but how the microbial load in shopping cart handles vary in different seasons and its relationship with ambient temperature (T), relative humidity (RH), surface moisture, and ultraviolet radiations (UV) are largely understudied. This study aims at exploring microbial loads on shopping cart handles in three grocery stores during fall and winter and its relationship with real-time T, RH, moisture, and UV levels.

Theoretical Framework: Most of us do not realize that microbes are often present on many common stuffs outdoors. When we touch shopping cart handles by bare …

Exploring The Factors Associated With Social Media Use In Local Health Departments, Suzanne Lamarca Madden

College of Graduate Studies: Theses & Dissertations

Background: The health system in the United States is rapidly advancing, including newer technologies, newer ways of delivering essential public health services and population health. Approximately 70% of the public uses social media as a communication tool, which makes it an ideal platform for dissemination of information. Local health departments (LHDs) are accountable for assuring ten essential public health services, including informing, educating, and empowering people about health issues. Previous research showed less than 70% of LHDs are adequately performing this essential service. The purpose of this study was to examine what factors impact the use of social media by …