jGPHA Volume 5 (2015-2016)http://hdl.handle.net/10675.2/6087252024-03-15T16:43:51Z2024-03-15T16:43:51ZQuality Rated childcare programs and social determinants of health in rural and nonrural GeorgiaWebb, Nancy C.Gates, Madison L.http://hdl.handle.net/10675.2/6214862019-08-30T07:18:05Z2016-01-01T00:00:00ZQuality Rated childcare programs and social determinants of health in rural and nonrural Georgia
Webb, Nancy C.; Gates, Madison L.
Background: Early childhood is linked to school readiness and early school achievement. Through its Quality Rated (QR) program, which was designed to improve the quality of care in early childhood programs, the state of Georgia has been a trailblazer in funding universal preschool and in improving the quality of childcare programs. We have assessed differences in the availability of QR childcare programs in Georgia to learn if, in rural versus non-rural counties, there is a relationship between QR childcare programs and health-related outcomes. Methods: This cross-sectional study evaluated county-level data to evaluate the relationship between QR childcare programs and social determinants of health. County-level data for Georgia were extracted from the Georgia Department of Early Care and Learning, County Health Rankings and Roadmaps, and the Georgia Juvenile Justice Data Clearinghouse. Results: Counties without QR childcare programs had child mortality rates 3.5 times higher than those for the state overall. Other differences in health-related outcomes included, but were not limited to, teen birth rates, low birth-weight babies, children in poverty, housing problems, and food insecurity. Conclusions: It is now appropriate to address the prevalence of health disparities in rural areas of Georgia and focus on some of the disparities through the QR early childhood programs and other state agencies. Empowering rural communities to address health disparities may be the most favorable path toward diminishing these inequalities.
2016-01-01T00:00:00ZCharacteristics of rural users of emergency medical services in Georgia: A populationbased studyTurner, NannetteChen, HueyMorosanu, Lilianahttp://hdl.handle.net/10675.2/6214852019-08-30T07:15:44Z2016-01-01T00:00:00ZCharacteristics of rural users of emergency medical services in Georgia: A populationbased study
Turner, Nannette; Chen, Huey; Morosanu, Liliana
Background: Emergency medical services (EMS) are an essential part of health care. Appropriate information about EMS usage in rural areas will allow effective utilization of EMS resources for their intended purpose, and at the state level, drive the adoption of better EMS policies to ensure and maintain equitable access to these health services in rural areas. Methods: The present study, performed by analyzing data from the Georgia Emergency Medical Services Information System (GEMSIS), describes the population using EMS in rural Georgia. Distributions of rural EMS transports are reported, along with usage for selected population groups based on race, gender, age groups, and primary impressions recorded by emergency medical personnel (EMP). Results: The groups with the highest rates of EMS use were African Americans, females, and the elderly. In 2014, about twice as many African Americans used EMS as compared to Whites. Rural use of EMS increased with age, with the elderly having the highest percentage of users. About 31% of all transports were for emergency conditions; the remaining 69% were for non-emergencies. The most frequent health complaints were those for altered physical conditions and traumatic injuries. Conclusions: The findings of this study can guide decision in planning future services and ensuring appropriate access to EMS in rural Georgia.
2016-01-01T00:00:00ZImplementation and evaluation of the Carrera Program for delaying teen sex in GeorgiaTucker, TressaLangley, Maryhttp://hdl.handle.net/10675.2/6214842019-08-30T07:14:36Z2016-01-01T00:00:00ZImplementation and evaluation of the Carrera Program for delaying teen sex in Georgia
Tucker, Tressa; Langley, Mary
Background: In three geographic areas in Georgia, rural, micropolitan, and urban, Morehouse School of Medicine (MSM) implemented the evidence-based Children’s Aid Society Carrera Program at community organizations with Boys and Girls Clubs (BGCs) as the comparison group. This study attempted to replicate the findings of reduced teen pregnancy and birth found for the New York Carrera Program. Methods: For this longitudinal study with a quasi-experimental design, the sample included 400 youth who were in 6th or 7th grade. A total of 220 were enrolled in the intervention group and 180 in the comparison group. The study was performed in the fall of 2012, 2013, and 2014. The following data sources were utilized: paper-and-pencil surveys, daily attendance, component attendance, observation forms, focus groups, and interviews. There was one analytic sample (N = 204) for the primary research questions. Data were pooled separately across the intervention and the comparison sites. A hierarchical logistic regression model was used to test for program impact. Covariates included selected demographic variables, site geography (urban vs. rural), and previous sexual history. For answering the two primary research questions the 0.025 significance level was used to adjust for multiple comparisons. Results: After one year of the intervention, the Carrera group was significantly lower in “ever had sex” than the BGC group. At years two and three, however, there were no appreciable differences between these two groups, a result possibly due to implementation issues, particularly attendance. Conclusions: When implemented with fidelity, Carrera can have a positive effect, even in rural communities. Programs should seek to achieve the required intervention dosage and address the reasons why teen pregnancy is often higher in these communities.
2016-01-01T00:00:00ZHuman papillomavirus-associated cancers in Georgia, 2008-2012Solomon, IreneMcNamarea, ChrissyBayakly, Rana Ahttp://hdl.handle.net/10675.2/6214832019-08-30T07:11:08Z2016-01-01T00:00:00ZHuman papillomavirus-associated cancers in Georgia, 2008-2012
Solomon, Irene; McNamarea, Chrissy; Bayakly, Rana A
Background: High-risk human papillomaviruses (HPV) cause most anal, vaginal, vulvar, penile, and oropharyngeal cancers, and virtually all cervical cancers. In 2014, in Georgia (GA), fewer than half of adolescent females and males aged 13-17 years received the three doses of the HPV vaccine. Increasing vaccination coverage among this age group, education of adolescents in regard to HPV risks, and cervical cancer screening of adults can prevent HPV-associated cancers. Methods: The incidence of HPV-associated cancers for 2008-2012 in GA was obtained from GA Comprehensive Cancer Registry data. Case definitions for HPV-associated cancers were based on standard definitions of the Centers for Disease Control and Prevention (CDC). Data for anatomic sites known to have HPV-associated cancers, including the cervix, vulva, vagina, penis, anus, and oropharynx, were analyzed. Also derived were ageadjusted rates, age-specific incidence rates, the percentage of each cancer found attributable to HPV, and ageadjusted incidence rates by geography. Results: During 2008-2012, a total of 6,056 HPV-associated cancers were diagnosed (males, 2,408; females, 3,648). Of these, 4,629 cancers were attributable to HPV (males, 1,574; females, 3,055). The most common cancers attributable to HPV were oropharyngeal cancers among males (1,182); and cervical cancers (1,862) among females. Females living in smaller urban counties had a higher cervical cancer incidence rate than females living in metropolitan counties and metro areas (1 million or more population). Males living in rural counties had a lower oropharyngeal cancer incidence compared to the state incidence rate. Conclusions: Since HPV vaccination at age 11-12 years can prevent HPV-related cancers in adulthood, clinicians should promote HPV vaccination along with routine immunizations to adolescents. Surveillance of HPVassociated cancers using GA cancer registry data is needed to track future changes in incidence data due to administering the HPV vaccine, increasing cervical cancer screening, and educating youth in GA about HPV risk factors.
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