• Evaluation of trends in diabetes care in a patient-centered medical home

      Saucier, Ashley N; McMechan, Danielle; Dahl-Smith, Julie; Duffie, Carla; Hodo, Denise; Andrews, Holly E; Hobbs, Joseph; Augusta University (Georgia Public Health Association, 2017)
      Background: The patient-centered medical home (PCMH) is a model used in primary care to achieve effective management of chronic diseases. The Augusta University Health Family Medicine Center (AUFMC), a PCMH recognized by the National Committee for Quality Assurance, has implemented strategies to manage its patient population with diabetes. The present study evaluated the effects of these interventions through trend analysis of selected diabetic core measures by use of a qualified clinical data registry, the Practice Partner Research Network. Methods: For this retrospective study, de-identified data were abstracted for adult patients with diabetes for the period of 2013-2015. Process and outcome measures were determined for selected diabetic core measures, based on the 2015 American Diabetes Association and Physician Quality Reporting System of the Centers for Medicaid and Medicare (CMS). These measures included glycated hemoglobin (HbA1c), blood pressure (BP), low-density lipoprotein cholesterol (LDL), urine microalbumin (Um), diabetic foot and eye exams, and influenza and pneumococcal vaccinations. These values were analyzed by the Cochran-Armitage test for trends over time to determine the proportions of patients at the recommended goals. Results: Over time, there were increasing trends for patients who were at the goals for frequencies of HbA1c, Um, LDL, pneumococcal vaccinations, and diabetic retinal exams (p<0.01). Increasing trends were also evident for patients at goal values for HbA1c, BP, and LDL levels (p<0.01). Decreasing trends were noted, however, in the rate of diabetic foot exams (p<0.01). Conclusions: Since AUFMC achieved PCMH recognition status, efforts to improve the management of patients with diabetes have yielded positive outcomes and valuable lessons. Areas of strength include utilization of the diabetes registry, education by regular providers, tailored use of electronic health records for patient education and physician documentation, and appropriate utilization of all team members. Trend analysis indicated that targeted diabetic interventions contributed to improved outcomes in selected diabetic core measures.
    • Community-based approaches to reduce chronic disease disparities in Georgia

      Rollins, Latrice; Akintobi, Tabia Henry; Hermstad, April; Cooper, Dexter; Goodin, Lisa; Beane, Jennifer; Spivey, Sedessie; Riedesel, Amy; Taylor, Olayiwola; Lyn, Rodney; et al. (Georgia Public Health Association, 2017)
      Background: Among underserved and racial/ethnic minority populations in Georgia, there are profound health disparities and a burden of chronic diseases. Such diseases, which are preventable, are influenced by risk factors, including poor nutrition, physical inactivity, lack of quality health care, and tobacco use and exposure. Awardees of the Racial and Ethnic Approaches to Community Health (REACH) and Partnerships to Improve Community Health (PICH) are implementing community-based initiatives using evidence-based, policy, systems, and environmental approaches to reduce racial and ethnic health disparities and the chronic disease burden in underserved urban and rural Georgia communities. Methods: Within the context of a social ecological framework, the REACH and PICH awardees selected interventions. Their impact in the areas of tobacco use and exposure, chronic disease prevention and management, and nutrition are described. Results: To date, the interventions of Georgia’s PICH and REACH awardees have reached approximately 805,000 Georgia residents. Conclusions: By implementing strategies for community-based policy, systems, and environmental improvement, Georgia’s PICH and REACH awardees are reducing tobacco use and exposure; increasing access to healthy foods; and providing chronic disease prevention, risk reduction, and management opportunities for underserved communities in urban and rural Georgia communities. Their efforts to address chronic disease risk factors at various social and ecological levels are contributing to a reduction in racial/ethnic health disparities and the chronic disease burden in Georgia.
    • Chronic disease prevention as an adaptive leadership problem

      O'Connor, Jean; Georgia Department of Public Health (Georgia Public Health Association, 2017)
    • Letter to the Editor in response to “STD services delivery arrangements in Georgia county health departments”

      Moore, Kathryn; Terry, Latasha; Allen, Michelle (Georgia Public Health Association, 2017)
    • Assessing a comprehensive approach to prevent sexual violence on campus: Implications for program improvement

      Ejikeme, Chinwe; Powell, Threets Kia; Bayo, Mosi; Toddle, Kia L; O'Connor, Jean; Georgia Department of Public Health (Georgia Public Health Association, 2017)
      Background: On college campuses, sexual violence (or sexual assault) is at epidemic proportions. As many as one in four college women experience sexual assaults, most of which are not reported, likely due to the adverse reactions stemming from social norms and attitudes about rape. To prevent sexual violence on college campuses, the multi-level factors influencing it necessitate implementation of a holistic approach channeled at all levels. The present multi-method study assessed the feasibility and effectiveness of a peer educator (PE)-facilitated program implemented as part of a comprehensive sexual assault prevention program in three small Georgia colleges. Methods: Student participants (N=128) were questioned on their attitude toward rape myths, intention to rape, and likelihood to intervene in a potential rape situation. Paired t-tests for pre-/post-test scores assessed statistical differences in mean levels of outcomes at the data collection points. In addition, a qualitative assessment explored the feasibility of implementing, on campus, a long-duration program for prevention of sexual violence. Results: The findings indicated that, after exposure to the program, participants demonstrated decreased rape myth beliefs and intention to commit rape and an increased likelihood to intervene in a potential rape situation. In addition, apart from attaining regular student attendance in the 10-week sessions of the program, implementation of the “One on Four & Beyond” program proved to be feasible. Conclusions: This preliminary, multi-approach study suggests the effectiveness of a school PE-facilitated prevention program as a component of a comprehensive approach in reducing sexual violence on campus. Future studies are necessary to enhance understanding of the impact of the program.
    • The burden and social determinants of asthma for adults in the state of Georgia

      Ebell, Mark; Marchello, Christian; O'connor, Jean; University of Georgia, Georgia Department of Public Health (Georgia Public Health Association, 2017)
      Background: Asthma is a serious chronic health condition, and social determinants may affect its prevalence. Methods: Data from the Behavioral Risk Factors Surveillance Survey (BRFSS), the Georgia Asthma Call-back Survey (ACBS), and the Georgia hospital and emergency department survey for patients with a diagnosis of asthma were used. All data were from the years 2011 through 2014. SAS and SUDAAN software were used to calculate weighted prevalence estimates and to perform univariate and multivariate analyses of the association between social determinants, other risk factors, and asthma outcomes. Results: The prevalence of asthma was highest among non-Hispanic blacks, women, and persons with less than a high school education, with an annual household income below $25,000, and in rural parts of the state (south and northwest Georgia). Those without insurance for more than three years had a higher prevalence of asthma than those who had insurance or had been uninsured less than 6 months. Although the percentage without insurance declined from 2012 to 2014, more than 1 in 5 adults of working age with asthma still lacked health insurance, and more than half had been without it for more than 3 years. One-third of Georgians with asthma could not see a doctor, at least on one occasion, because of cost, and more than a third were currently paying off medical bills. Approximately one quarter did not report having a personal physician, and a similar percentage reported having more than one year since their last check-up. In multivariate analyses, women (adjusted odds ratio [aOR] 1.61), smokers (aOR 1.54), and persons with a higher BMI (aOR 1.56) were all independently associated with having asthma. Conclusions: For the state of Georgia, there are associations between social determinants, such as education, income, and geography, and the prevalence of asthma, and many patients lack access to care. Addressing social determinants, including having affordable health insurance, is necessary to improve management of asthma.
    • Efficacy of chronic disease self-management among low-income Black males with behavioral health disorders: Pilot study

      Collard, Carol; Robinson-Dooley, Vanessa; Patrick, Frances; Farabaugh, Kayla; Kennesaw State University (Georgia Public Health Association, 2017)
      Background: This study examined the effectiveness of Stanford University’s Chronic Disease Self-management Program (CDSMP) among men living with co-morbidities of chronic physical health disease and behavioral health disorders. Methods: The study was conducted at a community-based, non-profit organization in partnership with a large suburban university. Two pilot studies were completed with the population of interest. Low-income adult males with behavioral health disorders were recruited to participate in the program provided by a local behavioral health agency. Facilitators trained in the CDSMP program administered it at the agency site, and participants attended weekly meetings. Descriptive data collected included health history, demographic information, and assessments of knowledge with the Chronic Disease Self-Efficacy Scale and the Chronic Disease Self-Management Questionnaire created by the Stanford Patient Education Research Center. Due to the small sample size, n=12, the Wilcoxon signed rank test was used to evaluate before and after differences in the sample. Results: For the participants, there were increases in overall activity, stretching activities, and equipment activities. Additionally, participants experienced a decrease in the number of days affected by poor physical or mental health. However, there was no significant increase in perceived self-efficacy, a factor in patient confidence and possibly compliance. Limitations included the small sample size, lack of a control group, and convenience sampling. Conclusions: Various aspects of the program were helpful to some participants, but cultural factors made other areas less compatible for this population. A larger study, utilizing a comparison group, could generate data relevant to hypotheses based on these observations. By collecting qualitative data, focus groups could contribute to understanding the experiences and needs of the participants. Development of a curriculum for self-management of chronic disease with a focus on intercultural competence is presently of interest.
    • TEACH Kitchen: A Chronological Review of Accomplishments

      Chea, Jung Hee; Ansa, Benjamin E.; Smith, Selina A.; Augusta University (Georgia Public Health Association, 2017)
      Background: The Eating and Cooking Healthy (TEACH) Kitchen was founded at the Medical College of Georgia in 2015 as a nutrition-based intervention to combat the high prevalence of obesity and obesity-related chronic diseases in the area of Augusta, Georgia. Despite the importance of diet in the management of chronic diseases, inadequate nutrition education among patients and healthcare providers presents a barrier. The purpose of TEACH Kitchen is to address this gap. Methods: TEACH Kitchen is as a student-led initiative that promotes healthy cooking among medical students and patients with chronic diseases. Healthy nutrition and cooking classes are held during the academic year. Participants spend four weeks on each of four modules: obesity, hypertension, hyperlipidemia, and diabetes mellitus. Data collection, which began in January 2017, is currently on going. TEACH Kitchen has collaborated with Augusta University, Sodexo, and Kohl’s. Results: Currently, TEACH Kitchen has enrolled 14 patients and 6 children. Anticipated results include measurements of preand post-intervention changes in knowledge, attitudes, beliefs, and competence in nutrition, as well as differences in clinical indicators, including body mass index, blood pressure, lipid profile, and HbA1c. Conclusions: TEACH Kitchen is the first medical school-based nutrition/cooking education initiative in Augusta, Georgia. It provides patients and medical students with hands-on healthy nutrition/cooking experience with the goal of decreasing the prevalence and improving the outcome of obesity-related diseases.
    • The association between dental coverage and self-reported health in older adults

      Yang, Frances M; Kao, Solon T; Lundeen, Joran S; Augusta University (Georgia Public Health Association, 2017)
      Background: For the older population of the United States, lack of dental insurance coverage is a substantial health problem. The purpose of the present study was to examine the longitudinal relationship between dental coverage and self-reported health among older adults. Methods: The Health and Retirement Study (HRS), a nationally representative biennial cohort study of community-dwelling individuals, includes 19,595 adults (aged 50 and older) living in the United States. For the 2010, 2012, and 2014 waves, the independent variable of dental coverage and the outcome of self-reported health were examined. Results: At each time point, dental coverage for older adults had a positive association with self-reported health (parameter estimate, β=0.340, standard error (SE)=0.039, p<0.0001), controlling for sociodemographic variables of age, sex, race/ethnicity, education, and the status of edentulism. There were no significant longitudinal effects for dental coverage associated with self-reported health. Conclusions: At each time point, the results show a positive association between having dental coverage and better self-reported health of older adults. This is relevant, because, in the United States, there is an increasing population of older people.
    • Dental students develop program addressing geriatric oral health at local nursing home

      Wilson, Nancy Lyn; Ciarrocca, Katharine; Chana, Monica; Augusta University, Georgia War Veterans Nursing Home (Georgia Public Health Association, 2017)
      Background: The elderly, especially those who reside in institutions and have a minority or low-income background, often have unmet oral health needs. As life expectancy increases, so will the need for oral health providers skilled in addressing the unique challenges presented by geriatric patients. Methods: Dentists for Della is a student organization at the Dental College of Georgia that aims to improve the oral health status of residents at the Georgia War Veterans Nursing Home (GWVNH) in Augusta, Georgia. The students conduct fundraising activities so that third and fourth year students can provide needed dental treatment at no cost to the residents. Students also regularly rotate at GWVNH in order to provide tooth brushing help, denture cleanings, and head and neck examinations, including oral cancer screenings. Results: Dentists for Della has funded approximately $40,000 worth of dental work since 2013. The program also provides an educational experience valued by students: the ability to interact with patients as early as their first semester of dental school. Conclusions: Dentists for Della is a vital program which not only provides educational opportunities in institutional public health dentistry and geriatrics for dental students, it also provides a much needed safety net for Georgia veterans with no ability to access other means of dental care
    • Dental College of Georgia teams up with Richmond County Health Department to help underserved patients

      Wilson, Lyn Nancy; Peacock, Mark; Cutler, Christopher; De Stefano, Jamie; Augusta University, Richmond County Board of Public Health (Georgia Public Health Association, 2017)
      Background: The Central Savannah River Area remains, for many of the poor, a dental health care shortage area. Each year, from December to March, fourth-year dental students perform outreach with faculty to search the community for unmet dental needs, including dental caries and periodontal disease, the treatment of which is required for the Central Regional Dental Testing Service (CRDTS) Exam, the dental licensing examination. Methods: Fourth year students at the Augusta University Dental College of Georgia recruit patients for free dental pre-screenings at health fairs, community centers, the Barnyard Flea Market, and the dental school. Persons with periodontitis are invited for further screenings at the dental school where they receive a free dental examination and dental radiographs. Many of these patients present with other dental needs requiring restorations, root canals, and extractions, conditions that potentially could disqualify them from receiving periodontal therapy during CRDTS. Through a collaborative effort with the Richmond County Health Department Dental Clinic, these patients receive the treatment for their acute dental needs, while also qualifying them for the periodontics portion of the exam. Results: Regardless of their qualification status for boards, the program provides referrals for patients to the Dental College of Georgia or the Richmond County Health Department, gives patients a chance to be informed about their oral health status, and gives qualifying patients the potential to receive discounted or even free dental work. The efforts of the senior dental students represent an oral public health service effective in achieving improvements in periodontal outcomes within our community. Conclusions: This program not only benefits the future dentists of Georgia by helping provide licensing board requirements, it also introduces dental students to a more diverse population and provides exposure to public health outreach. In addition, this program offers a valuable service to underserved populations who would otherwise have limited or no access to dental care.
    • STD services delivery arrangements in Georgia county health departments

      Williams, Karmen S; Shah, Gulzar H; Peden, Angie; Livingood, Bill; Willams & Williams Consulting Group, Georgia Southern University, University of Florida (Georgia Public Health Association, 2017)
      Background: Uniformity, standardization, and evidence-based public health practice are needed to improve the efficiency and quality of services in local health departments (LHDs). Among the highest priority and most common public health services delivered by LHDs are services related to sexually transmitted diseases (STDs) and sexually transmitted infections (STIs). Objective: The purpose of this study was to examine potential variations in the delivery of sexually transmitted disease (STD) services among county health departments (CHD) in Georgia, to determine if potential variations were due to varied administrative practices, and to understand delivery arrangements so that future cost studies can be supported. Methods: Web-based surveys were collected from 134 county health departments in Georgia in 2015. Results: Screening for gonorrhea, chlamydia and syphilis occurred in all the surveyed CHDs. Sixty-eight percent of the CHDs had one or more staff who performed investigations for persons already screened positive for STDs. Partner notification services provided by the CHD staff occurred in only 35 percent of the surveyed CHDs. Conclusions: Variances regarding diagnostic methodologies, work time expenditures, and staff responsibilities likely had an influence on the delivery of STD services across Georgia’s CHDs. There are opportunities for uniformity and standardization of administrative practices.
    • Community engagement to address socio-ecological barriers to physical activity among African American breast cancer survivors

      Smith, Selina A.; Whitehead, Mary S.; Sheats, Joyce Q.; Chubb, Brittney; Alema-Mensah, Ernest; Ansa, Benjamin E.; Augusta University, SISTAAH, Institute of Public and Preventative Health, Department of Community Health and Preventative Medicine (Georgia Public Health Association, 2017)
      Background: With high rates of obesity, low levels of physical activity (PA), and lack of adherence to physical activity guidelines (PAGs) among African American (AA) breast cancer survivors (BCSs), culturally appropriate interventions that address barriers to participation in PA are needed. Methods: To develop intervention content, members of an AA breast cancer support group participated in four 1-hour focus group discussions (related to the barriers to PA, strategies for overcoming them, and intervention content), which were audiotaped, transcribed, and analyzed. Results: The support group collaborated with researchers to construct the Physical Activity Intervention Developed (PAID) to Prevent Breast Cancer, a multi-component (educational sessions; support group discussions; and structured, moderately intensive walking, strength training, and yoga), facilitated, 24-week program focused on reducing multi-level barriers to PA that promote benefits (‘pay off’) of meeting PAGs. Conclusions: Community engagement fostered trust, promoted mutuality, built collaboration, and expanded capacity of AA BCSs to participate in developing an intervention addressing individual, interpersonal, organizational, and community barriers to PA.
    • Use of a teledentistry partnership program to reach a rural pediatric population

      Scaher, Tara E; Riggs, Bruce; Augusta University (Georgia Public Health Association, 2017)
      Background: Teledentistry is “the practice of using video-conferencing technologies to diagnose and provide advice about treatment over a distance.” Teledentistry has been defined as “the practice of using video-conferencing technologies to diagnose and provide advice about treatment over a distance.” This report describes the partnership of two rural Georgia public health districts. Augusta University Dental College of Georgia’s Department of Pediatric Dentistry partnered with a private practice dentist in Georgia with the goal of increasing access to care. Methods: A partnership was created that allowed dentists in a remote location to triage dental patients seen in a school-based clinic. Results: Over 3500 children were treated in a school-based dental clinic over a five year period and triaged for referral for further treatment via a teledentisty link. Conclusions: Teledentistry provides an option to reach rural populations for whom access to dental care is an issue.
    • The role of The Dental College of Georgia in meeting the oral health needs of Georgians

      Lefebvre, Carol; Augusta University (Georgia Public Health Association, 2017)
      As the state’s only dental school, The Dental College of Georgia (DCG) takes seriously its role in meeting the oral health needs of Georgia. Georgia is the largest state in physical size east of the Mississippi River, and it continues to be one of the fastest growing states in population. In 2016, the estimated population of Georgia was 10,310,371.1 Over the past 3 years, the number of single-county or low-income Dental Health Professional Shortage Areas (DHPSAs) in Georgia has increased to 131, an increase of 50 areas in 3 years.2
    • Factors associated with the utilization of community dental services among newly incarcerated adults

      Graves, Whitney; Blanks, Hairston Starla; Caplan, Lee S.; Erwin, Katherine A; Ditler, Cynthia S; Treadwell, Henrie M; Morehouse School of Medicine, Walden University, Georgia Department of Corrections (Georgia Public Health Association, 2017)
      Background: Given the high rates of risky behaviors and health conditions among incarcerated individuals and the relationship between oral and general health, receipt of quality dental care is essential to the overall health and well-being of this population. However, few recent studies have focused on access to care and the state of oral health among incarcerated populations in the U.S. For the current study, a secondary data analysis was conducted to: 1) assess factors associated with the use of dental services among a newly incarcerated prison population in Georgia and 2) consider barriers related to utilization of dental services pre- to post-release. Methods: Descriptive statistics were calculated, and bivariate and logistic regression analyses were conducted utilizing SAS 9.2 software. Results: Thirty-one percent (n=250) of survey respondents reported having a dental visit within the past year. Survey respondents who had a regular dentist (OR: 1.9; 95% CI: 1.325, 2.697), private dental insurance (OR: 1.5; 95% CI: 1.022, 2.245), or who reported pain as the reason for their last dental visit (OR: 2.2; 95% CI: 1.556, 3.130) were more likely to have utilized dental services within the past year. Conclusions: The findings highlight the role of social and economic resources and oral health needs on utilization of dental services. Additional practice and policy efforts are needed to address gaps in the dental care continuum that affect currently and formerly incarcerated adults in Georgia.
    • A review of strategies to increase access to oral health services

      Davis, Breyana; Plasphol, Sara; Armstrong State University (Georgia Public Health Association, 2017)
      Background: Leading Health Indicators (LHIs), a subset of objectives for Healthy People 2020, were selected to communicate at-risk health issues and actions that can be taken to address them. Nationally, the number of children, adolescents, and adults who visited the dentist in the past year has decreased, suggesting that oral health continues to be a problem caused by barriers preventing access to oral health services. This review aimed to identify strategies to increase access to oral health services that will be useful in moving toward the LHI objectives. Methods: Preliminary research was conducted on the LHI via the Healthy People 2020 website. Health-related, peer-reviewed articles were selected and evaluated to determine current strategies used to increase access to oral health services that would lead to achievement of the LHI objectives. Results: Evidenced-based literature shows that economic, educational, and personal barriers prevent access to oral health services. Through health promotion and educational interventions, however, good oral health can be established. Such improvements will lead to attaining the LHI objectives in moving towards the target goals of Healthy People 2020. Conclusions: Since primary prevention and early intervention procedures lead to improved oral health, such methods can be useful in reaching the LHI objectives and the target goal of Healthy People 2020.
    • Increasing breastfeeding duration and exclusivity in a sample of rural women: A pilot study

      Chopak-Foss, Joanne; Yeboah, Felicia; Georgia Southern University (Georgia Public Health Association, 2017)
      Background: Increasing breastfeeding exclusivity and duration is an objective of Maternal and Child Health (MICH-21.4 and 21.5) of the Healthy People 2020 initiative. Breastfeeding rates differ considerably between high-income and low-income women. Methods: This was a pilot project conducted to assess the feasibility of an intervention to increase breastfeeding practices overall and to improve exclusive breastfeeding rates among a sample of rural women enrolled in the Special, Supplemental Nutrition Program for Women, Infants and Children (WIC) in a rural Georgia county. Participants were recruited from the local regional hospital (n=27). Support group meetings were offered over a four-week period and began within five days of birth. At each meeting, data were gathered on demographic characteristics, pacifier use, initiation of cup feeding, and rates of breastfeeding duration and exclusivity. Results: More than 60% of the participants breastfed exclusively for the first week, but by the end of the fourth week, that number dropped to under 45%. Conclusions: Low-income women continue to be among the most challenging group in which to improve breastfeeding duration and exclusivity rates. Public health programs need to create innovative ways in which to improve breastfeeding rates. Lessons learned from the pilot study are described and suggestions for future study are provided.
    • Social networks as predictors of colorectal cancer screening in African Americans

      Alema-Mensah, Ernest; Smith, Selina; Claridy, Mechelle D; Ede, Victor; Ansa, Benjamin E.; Blumenthal, Daniel S.; Morehouse School of Medicine, Augusta University (Georgia Public Health Association, 2017)
      Background: Early detection can reduce colorectal cancer (CRC) mortality by 15%–33%, and screening is widely recommended for average-risk adults beginning at age 50 years. Colorectal cancer mortality rates are higher in African Americans than in whites, while screening rates are somewhat lower. Individual social networks can reduce emotional and/or logistical barriers to health-promoting but distasteful procedures such as CRC screening. The aim of this study was to examine social network interactions, and their impact on CRC screening among African Americans. We hypothesized a positive association between social network index (SNI) scores and CRC screening. Methods: In a community intervention trial with four arms, we previously demonstrated the efficacy of a small group educational intervention to promote CRC screening among African Americans. This intervention outperformed a one-on-one educational intervention, a reduced out-of-pocket expense intervention, and a control condition. In the present analysis, we compared the SNI scores for participants in the small group intervention cohort with a comparison group comprised of the other three cohorts. Social networks were assessed using the Social Network Index developed by Cohen. Results: Small group participants had a significantly higher network diversity score (Mean difference 0.71; 95% CI, 0.12-1.31; p=0.0017) than the comparison group. In the second component of the SNI score - -the number of people talked to over a two week period -- the small group intervention cohort also scored significantly higher than the comparison group. (Mean difference, 9.29; 95% CI, 3.963-14.6266; p=0.0004). Conclusions: The findings suggest that social interaction and support was at least partially responsible for the relatively high post-intervention screening rate in the small group intervention participants. Education in small groups could foster strong social networks. Strong and positive network diversity and a large number of people in social networks may enhance CRC screening rates among African Americans.
    • The Eating and Cooking Healthy (TEACH) Kitchen: A Research Protocol

      White, Sashia; Alva-Ruiz, Roberto; Chen, Lucia; Conger, Jason; Kuang, Christopher; Murphy, Cameron; Okashah, Najeah; Ollila, Eric; Smith, Selina A.; Ansa, Benjamin E.; et al. (Georgia Public Health Association, 2016)
      Background: Diet-related chronic diseases, such as diabetes mellitus, hypertension, and hyperlipidemia have affected millions of individuals, resulting in disease-related complications and mortality. Strategies that may improve the outcome of chronic disease management include modification of lifestyle risk factors such as unhealthy diets. TEACH Kitchen is an experiential education program related to community nutrition, the goal of which is to teach patients management of chronic disease through dietary change. Methods: Adults (n=144) ≥18 years old and their children (n=144) 7-17 years old will complete four 2-hour sessions. Components of each session will include brief nutrition education (20 min), an interactive cooking session (1 hr), and after-dinner discussion (40 min). Pre- and post-session questionnaires will be administered to all participants for self-reported demographics, knowledge, attitude, and beliefs about healthy nutrition. Medical records will be used to collect information about adult participants’ demographics and clinical indicators (hemoglobin A1c, lipid profile, blood pressure, weight, height, and body mass index [BMI]). Descriptive analyses will be performed to determine socio-demographic characteristics using frequencies and proportions for all categorical data, and means for continuous variables. T-tests and multiple logistic regression analysis will be accomplished to compare the differences in means. Results: Differences in the pre- and post-session knowledge, attitude, and beliefs related to healthy eating will be evaluated for adults and children. The anticipated outcomes include enhanced education promoting healthy eating in the community, prevention of chronic disease complications related to poor diet, and prevention of obesity-related chronic diseases in children. Conclusions: Enhancement of chronic disease management among patients, and the prevention of obesity among children, can be accomplished through healthy cooking and diet.