• Adapting a physical activity intervention for youth in a rural area: A case study

      Alfonso, Moya L.; Golquitt, Gavin; Walker, Ashley; Gupta, Akrati; Department of Community Health Behavior and Education, Jiann-Ping Hsu College of Public Health, Georgia Southern University, School of Health and Kinesiology, College of Health and Human Sciences, Georgia Southern University (Georgia Public Health Association, 2016)
      Background: Physical activity offers children and youth many well-documented positive effects on health. The present study adapted a community-based prevention marketing campaign (CBPM), VERBTM Summer Scorecard (VSS) to promote physical activity among minority youth in rural, southeast Georgia. The purpose of this paper is to describe the adaptation process, emphasizing methods used and lessons learned. Methods: A qualitative study design was used to identify social marketing concepts that informed program adaptation, including two focus groups with 12 children and two focus groups with 14 parents. Qualitative thematic data analysis was used to analyze formative research. The adapted program was implemented for three summers, from 2012 through 2014. A case study of program implementation and lessons learned is provided. Results: Formative research results suggested two changes to VSS that would be required for the program to work in this rural community - a focus on parent-child activities instead of a sole focus on youth and changes to the Scorecard that was used to track physical activity. Over the course of three years of implementation, several lessons were learned about university community partnerships (e.g., the need for a balance of power), having a program champion, and program evaluation. Conclusions: Rural communities are a unique context, with barriers to health promotion efforts that serve to contribute to negative health behaviors and resistance to change. The limited capacity of rural communities to address physical activity makes these barriers difficult to overcome, even during implementation of evidence-based practices.
    • Evaluation results of an innovative pilot program to increase access to fresh fruits and vegetables in Cobb County, GA

      Woodruff, C Rebecca; Shipley, Rebecca; Brown, Agnes F.; Coleman, Anne-Marie; Munoz, Jennifer; Honeycutt, Sally; Hermstad, April K; Loh, Lorna; Kegler, Michelle C.; Emory University (Georgia Public Health Association, 2015)
      Background: This abstract describes a public health practice initiative called the Farm Fresh Market (FFM) and presented pilot evaluation results. Methods: The FFM, developed by Cobb and Douglas Public Health, the McCleskey-East Cobb Family YMCA, and Cobb2020, sold low-cost fruits and vegetables to families living in the 30168 zip code of Austell, Georgia. The evaluation focused on documenting to what extent the FFM reached its intended population and increased perceived access to fresh fruits and vegetables among customers. A convenience sample of 100 returning FFM customers completed self-administered, written intercept surveys at the end of the 2014 market season. Results: The market served customers from a range of socioeconomic backgrounds. Most customers strongly agreed that the FFM made it easier (69%) and less expensive (79%) for them to buy fresh fruits and vegetables and easier for them (63%) and their families (64%) to eat a healthy diet. Most customers reported that they ate more vegetables (65%) and fruit (55%) as a result of shopping at the FFM and reported high levels of satisfaction with all aspects of the FFM. Conclusions: The results suggest that the FFM served customers from the local area and that the FFM may have increased perceived access to healthy food options among customers. Community-level interventions to increase access to healthy foods may play an important role in chronic disease prevention.
    • Georgia Latino enrollment in the Affordable Care Act: A qualitative, key informant analysis

      McCulloch, Audrey; Evans, P Dabney; Emory University (Georgia Public Health Association, 2016)
      Background: Prior to implementation of the Affordable Care Act (ACA) in 2010, one in three Latinos in the United States were uninsured. In Georgia, a state that established a federal Marketplace, nearly half of Latinos lacked health insurance coverage going into the initial enrollment period of October 1, 2013 to April 15, 2014. The ACA provided an opportunity for these uninsured Latinos to gain health insurance coverage, thus increasing their access to necessary medical services. The purpose of this qualitative study was to explore, from the perspective of key informants, knowledge of Georgia Latinos about the ACA and perceived barriers to enrollment in Marketplace health insurance coverage. Methods: A semi-structured interview guide based on a review of relevant literature and consideration of the study goal and aims was developed. Fourteen in-depth interviews with key informants (participants) from Georgia’s Latino community, including nonprofit leaders, health media professionals, and community health promoters, were conducted between June and September 2014. Results: Participants described perceived barriers to enrollment during the initial ACA enrollment period and made recommendations for the design and implementation of future outreach, education and enrollment strategies. Major themes that emerged involved basic health literacy, misinformation, enrollment opportunities, the importance of place and politics, and technology and language as barriers. Conclusions: To target Georgia Latinos, we provide seven recommendations for outreach, education and enrollment, including the organization of one-on-one services in locations of familiarity and comfort to Georgia Latinos and the hiring and training of Spanish-speaking enrollment professionals. When providing ACA education to Latinos, stakeholders should begin with basic health literacy concepts and education regarding the fundamentals of the United States health insurance system. The findings of this study may serve to guide future design and provision of culturally competent outreach, education and enrollment services.
    • Increased perception of mosquito problems during a stormwater restoration project

      Kelly, Rosmarie; Georgia Department of Public Health (Georgia Public Health Association, 2015)
      In 2008, a plan for improvement of the McDaniel Branch Watershed was prepared for the city of Atlanta, Department of Watershed Management. This included the construction of ponds in a kudzu-covered area at Bowen Circle. There is a perception that wetlands create mosquito problems. In point of fact, most of the vector and nuisance species in Atlanta are either container breeders or floodwater species, and do not breed in ponds. Because there is an average of 5 cases of West Nile virus (WNV) reported in Fulton County per year, most of these near Combined Sewer Overflow streams, county residents are aware of the connection between mosquitoes and WNV. As the McDaniel Branch Watershed Improvement Plan progressed, neighborhood residents became convinced that the changes being implemented in the area were increasing mosquito problems and increasing their risk of WNV infections. In Oct 2013, the Environmental Health Section of the Georgia Department of Public Health was contacted by the City of Atlanta Department of Watershed Management concerning control of mosquitoes in the ponds being created at the Bowen Circle site. It was determined that mosquito surveillance should be implemented in the area to determine if the changes to the watershed area were creating a mosquito problem. At the end of the 2014 mosquito surveillance season, it was established that there was little association between the watershed improvement project, the reported mosquito exposure, and measures of mosquito production within this neighborhood.
    • Local youth groups in Georgia working towards policy, systems, and environmental changes

      Coleman, Anne-Marie; Ray, Kenneth; Toodle, Kia; Chung, Alina; O'Connor, Jean; Georgia Department of Public Health (Georgia Public Health Association, 2016)
      Background: The Georgia Youth Tobacco Survey (YTS) is a survey of public middle school (MS) and high school (HS) students. The Georgia YTS was first conducted in 2001. According to YTS, students who attended a tobacco free schools’ youth summit were significantly more likely to be aware of students who use tobacco products (MS: 21% for smoking and 20% for smokeless tobacco; HS: 42% for smoking and 39% for smokeless tobacco) on school property than students who did not attend a tobacco free schools’ youth summit (MS: 10 % for smoking and 9 % for smokeless tobacco; HS: 32 % for smoking and 35 % for smokeless tobacco. Methods: During the fall of 2014, the Chronic Disease Prevention Section of the Georgia Department of Public Health (DPH) hosted a youth summit for youth groups across the state. In total, 149 youth and 49 adult leaders attended the summit. The youth summit provided training for middle and high school youth to become tobacco use control advocates in their communities. The youth were involved in creating the messages they would deliver to their school boards. Results: The local youth groups who attended the summit in 2014 were instrumental in four school districts adopting the model 100% Tobacco-Free Schools policy: Lowndes County Schools and Irwin County Schools (Valdosta, GA); Emanuel County Schools and Jenkins County Schools (Augusta, GA). Conclusions: These findings support the growing literature on youth involvement in advocacy work towards policy change. Youth should be recruited to work with public health professionals in building coalitions to change community norms.
    • New recreational water quality criteria and their impact on beach advisories in Coastal Georgia

      Aslan, Asli; Benevente, Sara; Georgia Southern University (Georgia Public Health Association, 2016)
      Background: To monitor pollution of marine beaches in Georgia, enterococci have been used as indicators of fecal contamination. For the 1986 Recreational Water Quality Criteria (RWQC), the beach action value (BAV) was 104 colony-forming units (CFU)/100 ml; the new RWQC, instituted in 2012, is 70 CFU/mL, a 32.6% decrease. When the beach action value is reached, authorities are to issue a beach advisory for protection of swimmer health. The present study investigated changes in compliance with the 2012 RWQC at five high-use beaches in Georgia. Methods: In the summer of 2015, samples of water were collected from five beaches at Tybee Island. Enterococci concentrations were enumerated by USEPA-approved methods. Samples exceeding the 1986 and 2012 RWQC beach action values were compared with times that advisories were posted at these beaches. Results: At these beaches, advisories were posted four times during the summer. Since, in 2015, the previous RWQC was in use, these decisions were based on the guideline value of 104 colon-forming units (CFU)/100 ml. When the new beach action value (70 CFU/100 ml) was applied, retrospectively, for samples collected at these sites, we found that the number of advisories would have been doubled if this value had been in place at that time. Conclusions: Staring from January 2016, Georgia has adopted new water quality criteria to monitor beaches. Decreasing the beach action value to 70 CFU/100 ml strengthens beach monitoring programs because it allows for better prevention from waterborne diseases, thus protecting the health of swimmers.
    • Substance use-related brief interventions with emergency department patients reduce mental health co-morbidities

      Johnson, J. Aaron; Abraham, Amanda J.; Georgia Regents University; University of Georgia (Georgia Public Health Association, 2015)
      Background: Research on screening and brief interventions (SBIs) has shown that, in addition to reducing alcohol use, interventions delivered in healthcare settings can reduce trauma readmissions, hospitalization days, driving offenses, and future healthcare utilization and costs. Mental health co-morbidities often accompany unhealthy alcohol and drug use, but few studies have examined the impact of SBIs on the mental health of patients. The present study determined if SBIs focused on reducing alcohol or drug use affected the mental health status of patients at a six-month follow-up. Methods: Participants (N=1152) were randomly sampled from patients receiving SBIs for at-risk alcohol or drug use after presenting to one of two urban emergency departments (EDs) in Georgia. Telephone follow-up interviews were completed with 698 of the original participants at six months after the intervention. Mental health co-morbidities were measured at both time points using the Global Assessment of Individual Needs Short Screener (GAIN-SS) and the SF-12. Analyses were conducted using paired samples t-tests. Results: Analyses found significant reductions in the percentage of patients reporting feelings of anxiety (45% to 33%, p<0.001), depression (52% to 37%, p<0.001), and suicidal ideation (13% to 8%, p<0.001) as well as improvements in global mental health measures (SF12 mental health score and internalizing and externalizing subscales of the GAIN-SS). Conclusions: Six months after receiving SBIs for alcohol and drug use in EDs, several measures of the mental health of participants showed significant improvements. Widespread implementation of SBIs in Georgia's EDs may affect a broad array of public health concerns, including mental health.
    • Understanding public health: Research, evidence, and practice

      Hinman, Johanna M (Georgia Public Health Association, 2016)
    • Winning the obesity battle

      Blumenthal, Daniel S.; American College of Preventive Medicine, Department of Community Health & Preventive Medicine, Morehouse School of Medicine (Georgia Public Health Association, 2016)
      There is no doubt that the United States, and especially Georgia, suffers from an obesity problem. Over a third of U.S. adults are obese (CDC, 2016a), as are about 18% of children and 21% of adolescents (CDC, 2016b). Similar percentages in each category are overweight, with a body mass index (BMI) greater than is considered healthy, but not great enough to fall into the obese category. [INTRODUCTION]