• Analysis of hypertension control rates among participants in the Georgia Hypertension Management and Outreach Program

      Byers, Sara; O'connor, Jean; Powell-Threets, Kia; Padgett,Kia; Hallow, Melissa; University of Georgia, Emory University, Georgia Department of Health (Georgia Public Health Association, 2017)
    • Association between air temperature and heart disease death rates in Georgia counties

      Hart, John (Georgia Public Health Association, 2016-07-19)
      Background: In this ecological study, global warming theory was tested on a local level, in Georgia. The hypothesis was that warmer counties would be associated with higher death rates. Methods: Heart disease death rates (HDDR) for 2008-2010 by Georgia county were compared to air temperature, also by county for the same years. Three race categories for HDDR were studied: black, white, and all races. Since there is evidence that living at higher land elevations provides a protective effect against heart disease, land elevation by county was included as a second predictor. Results: Correlation analyses revealed low strength, statistically significant correlations with white and all races HDDR as follows: direct for air temperature and indirect for land elevation. Correlations for blacks were negligible strength and statistically non-significant. Thus, multiple linear regressions (MLRs) were considered appropriate for whites and all race HDDR. In MLRs, temperature and elevation essentially cancelled each other relative to HDDR, resulting in statistically non-significant regression coefficients for each in both race categories (p > 0.15). This may have in part been due to the slight collinearity that was observed between the two predictors (variance inflation factor = 10.6 for both predictors in both race categories). The study is limited by: a) its (ecological) design, where individual exposures are unknown; and b) the-less-than ideal regression model that revealed slight collinearity between the predictors. Further research is required to verify these findings. Conclusions:
    • Community-based participatory research principles for the African American community

      Smith, Selina A.; Whitehead, Mary S.; Sheats, Joyce Q.; Ansa, Benjamin E.; Coughlin, Steven S.; Blumenthal, Daniel S. (Georgia Public Health Association, 2015)
      Background: Numerous sets of principles have been developed to guide the conduct of community-based participatory research (CBPR). However, they tend to be written in language that is most appropriate for academics and other research professionals; they may not help lay people from the community understand CBPR. Methods: Many community members of the National Black Leadership Initiative on Cancer assisting with the Educational Program to Increase Colorectal Cancer Screening (EPICS) had little understanding of CBPR. We engaged community members in developing culturally-specific principles for conducting academic-community collaborative research. Results: We developed a set of CBPR principles intended to resonate with African-American community members. Conclusions: Applying NBLIC-developed CBPR principles contributed to developing and implementing an intervention to increase colorectal cancer screening among African Americans.
    • A cross sectional study of mostly African-American men examining mental health and child behavior

      Jackson, Matt; Osborne, Melissa; Self-Brown, Shannon; Georgia State University (Georgia Public Health Association, 2016)
      Background: Home visiting receives bipartisan support at both the state and federal level, because several models have demonstrated significant results in both reduction of child maltreatment as well as parenting behavior modification. Yet, parenting research and services lack further engagement and involvement as a primary component. That is, even though research has shown that fathers play an integral role in child development, there is very little research done in which fathers are the primary focus; most of this research focuses on mothers. When it comes to serving children who are victims of child abuse and neglect, this is a problem at both the programmatic and legislative level. Methods: This study took place within the context of a broader NIH funded trial to examine the efficacy of an adapted (technologically enhanced) version of an evidence-based parenting program, SafeCare, for fathers. This was a cross-sectional examination of the results from a survey in which mostly African-American, at-risk fathers (n=84), reported on – using putative measures – parenting practices, mental health, and behavior of their children. This initial assessment used linear regression to examine the association between fathers’ mental health and their child’s externalizing and internalizing problem behaviors. Results: On average, higher levels of father depression and anxiety corresponded to higher scores for child behavior problems. That is, there was a significant correlation between the fathers’ anxiety and depression and the child’s problem behaviors. Conclusions: These findings suggest a need for acknowledging the father’s role in child development as well as any potential external factors that might have a pernicious effect on the father’s mental state[s]. In addition, more attention should be given to separating data within studies that examine both mothers and fathers in order to assess individual effects by each parent.
    • Determinants of adherence to nutrition-related cancer prevention guidelines among African American breast cancer survivors

      Ramierz, Lindsey; Chung, Yunmi; Yoo, Wonsuk; Fontenot, Brittney; Ansa, Benjamin E.; Whitehead, Mary; Smith, Selina; Augusta University (Georgia Public Health Association, 2016)
      Background: Mortality rate for breast cancer is higher among African American (AA) women than for women of other racial/ethnic groups. Obesity, also higher among AA women, may increase the risk of breast cancer development and recurrence. Lifestyle factors such as healthy nutrition can reduce the rate of obesity and breast cancer. This study examined the determinants of adherence to nutrition-related cancer prevention guidelines among AA breast cancer survivors. Methods: AA breast cancer survivors (n=240) were recruited from a breast cancer support group to complete a lifestyle assessment tool for this cross-sectional study. Chi-square test and ordinal logistic regression analysis were used to examine the relationship between adherence to nutrition-related cancer prevention guidelines and potential predictors of adherence. Results: Majority of the survivors met the guideline for red and processed meat (n=191, 83.4%), but did not meet the guideline for fruits and vegetables (n=189, 80.4%). For survivors with annual household incomes < $25,000, the odds of meeting or partially meeting the guideline for fruits and vegetables was 75.4% less than for participants with incomes > $50,000 (OR= 0.25, 95% CI: 0.08, 0.80). Poor physical functioning (OR= 38.48, 95% CI: 2.26, 656.58), sleep disturbances (OR= 60.84, 95% CI: 1.61, 2296.02), and income > $50,000 (OR= 51.02, 95% CI: 1.13, 2311.70) were associated with meeting the guideline for red and processed meat. Conclusions: Many AA breast cancer survivors are not meeting the nutrition-related cancer prevention guidelines. For this population, more interventions that enhance access to and consumption of healthy diets are needed.
    • Sexual health education in Georgia: A role for reducing sexually transmitted infections among adolescents

      Gates, Madison L.; Walker, Veronica; Webb, Nancy C.; Georgia Regents University (Journal of the Georgia Public Health Association, 2015)
      Background: In Georgia, sexually transmitted infections (STIs) are a substantial health issue, particularly among young adults in vulnerable and minority populations. The United States Preventive Services Task Force recommends that sexually active adolescents and at-risk adults receive behavioral counseling and education in primary care settings, community organizations, departments of health, and schools Methods: The present approach used in Georgia for educating adolescents at high risk for STIs about these diseases was assessed. The data collected included standards for sexual health education, survey results from educators and students, and observations from a pilot study with adolescents detained by the juvenile justice system. Results: In Georgia, most health educators for middle (87.3%) and high (93.8%) schools have health and/or physical education backgrounds. They indicated a need for further education about STIs. For grades 6-12, 24% of students reported that they had not received HIV/AIDS education during the academic year. Preliminary observations from a study with juvenile detainees indicate that this population has limited knowledge about STIs, their effects and modes of transmission. Conclusion: Sexual health education, including that for HIV/AIDS, is essential to curtail the STI crisis, and educational endeavors should be culturally sensitive and evidence-based. In Georgia, many citizens, including teachers, are not adequately equipped to make informed decisions regarding STI risk. Georgia, home to the Centers for Disease Control and Prevention, is in a unique position to adapt evidence-based sexual health interventions for its population.
    • Violence Related Injuries among Individuals Admitted to a Level I Trauma Center in Atlanta, 2011-2013

      Akinleye, Fahruk O.; Morehouse School of Medicine (Georgia Public Health Association, 2016)
      Background: Violence related injuries (VRIs) are a major public health problem in the United States (US). According to the Centers for Disease Control and Prevention (CDC), homicide is the 11th leading cause of death in the US and the third leading cause of death among persons aged 15-24 years old. Among African Americans aged 10-34, homicide is the leading cause of death and is the fifth leading cause of death among those 35-44 years old. One form of homicide that can result in injury resulting in death is firearm violence. The objective of this study is to assess the rates of VRIs among African American males who have been admitted to a Level I trauma center serving metropolitan Atlanta, Georgia. Methods: A retrospective analysis of trauma patients admitted to a level 1 trauma center for VRIs over a 3 year period from 2011 to 2013. Data were obtained from the Grady Memorial Hospital (GMH) trauma registry, which serves metropolitan Atlanta, GA. De-identified variables selected included gender, race/ethnicity, age, type of VRI, and year of admission. All analyses were conducted utilizing SAS version 9.2. Results: Of the total number of patients (n=2859) the majority were male (89%), African- American (80%) and between the ages of 20-40 years (61%). The majority of patients (55%) were admitted to the hospital for gunshot wounds followed by assault (33%) and stab wounds (12%). The numbers of VRI patients admitted were similar in each of the years 2011, 2012, and 2013, which represent 31%, 35%, and 34% of the total, respectively. Conclusions: Statistically significant differences were observed between gender, race and age with respect to all VRIs included in the analyses, particularly among African American males. Policy makers may consider targeting interventions accordingly to address VRIs. Further research is needed to identify other factors potentially associated with VRIs.