• 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.
    • Georgia’s rural hospital closures: The common-good approach to ethical decision-making

      Bastian G., Randi; Garner, Marcus; Barron S., John; Akowuah A., Emmanuel; Mase A. William; Jiann-Ping Hsu College of Public Health, Department of Health Policy and Management, Georgia Southern University (2016)
      ABSTRACT Background: Critical access hospitals provide several essential services to local communities. Along with the functions associated with providing necessary medical care, they also offer employment opportunities and other economic benefits to the communities they serve. Since 2010, the number of rural hospitals closures has steadily increased. The common-good approach to ethical decision-making provides a framework that aids in evaluation of the effects that hospital closures have on rural residents and communities. Methods: This analysis includes results of a systematic overview of peer-reviewed literature to address the following research questions: 1) How have state policies and the adoption of Medicaid expansion influenced the viability or rural hospitals? 2) What are the ethical implications of Medicaid expansion and state policy reform/adoption pertaining to viability of rural hospitals? and 3) What are the ethical implications of critical access hospitals closures on rural communities in Georgia? Information related to these questions is presented, along with tactics to addressing these in an ethical manner. Results: This descriptive analysis shows that the largest number of state-specific closures have occurred in states with a federal exchange and which chose not to expand Medicaid. Characteristics of the state of Georgia and the counties with recent closures show that these counties typically have smaller populations with a high minority presence, lower education and income levels, and higher numbers of medically uninsured. Conclusions: The common-good approach to ethical decision-making is suitable for evaluating the ethical implications of policy-level decisions impacting the closure of critical access hospitals serving the rural communities of Georgia.