• E-cigarette use among undergraduate liberal arts and health sciences students: A study protocol

      Dicks, Vivian; Stone, Rebecca; Georgia Regents University (Georgia Public Health Association, 2015)
      Background: Electronic cigarettes (e-cigarettes) are battery operated devices that deliver nicotine as an inhaled vapor. Use of E-cigarettes has gained in popularity since 2007, and their use is often promoted as a safer alternative to tobacco smoking. A concern among public health experts is whether e-cigarettes can be used as an alternative method for tobacco cessation or whether they lead to nicotine dependence and use of other tobacco products. Several studies have shown a higher prevalence of use of e-cigarettes among young adults between the ages of 18 and 25, but varying results on the association between their use and perceptions of harm. For the present survey, this age group was selected because, in this group, addiction to tobacco and the likelihood for adverse effects would be lower. Thus, for this group, the chances of not starting or consideration for quitting would be higher. The purpose of this study is to investigate the knowledge, attitudes, and beliefs about using tobacco products, smoking, and e-cigarettes among undergraduate students on liberal arts and health sciences campuses of a university. Methods: Participants will be invited via email and directed to a secure website where the survey can be completed anonymously. To assess knowledge, attitudes, and beliefs, the survey will include validated questions based on recommendations by the World Health Organization ((2000) appendix A)). Anticipated Results: We anticipate that the results will show an improvement in the behavioral aspect among undergraduates at the liberal arts and health sciences campuses. We also expect that results will show an improvement in knowledge among liberal arts students but less improvement in knowledge for health sciences students. Finally, we predict an overall improvement in attitudes about tobacco use and e-cigarette use.
    • Early Extubation in Infancy and Early Childhood Following Heart Surgery: Outcome Analysis and Predictors of Failure

      Esquivel, Raquel; Geister, Emma; Crethers, Danielle; Weatherholt, Danalynn; Sanchez, Maria Gabriela; Munoz, Gustavo; Biological Sciences, Medical College of Georgia (Augusta University Libraries, 2020-05-05)
      This item presents the abstract for a poster presentation at the 21st Annual Phi Kappa Phi Student Research and Fine Arts Conference.
    • 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.
    • Ebola: Working through fear

      Fitzgerald, Brenda; Georgia Department of Public Health (Georgia Public Health Association, 2015)
    • Educational attainment and self-rated health among African-Americans in Pitt County, NC

      Chandrasekar, Eeshwar; Banta, Zimo; Ragan, Kathleen; Schmitz, Michelle; James, Sherman; Emory University (Georgia Public Health Association, 2016)
      Background: To help fill the knowledge gap regarding relationships between educational attainment and self-rated health (SRH) in minority populations, we analyzed the data of a community-based cohort of African-Americans residing in Pitt County, NC, between 1988 and 2001. Methods: Data from the Pitt County Study (a community-based, longitudinal survey of risk factors for hypertension and related disorders disproportionately affecting African-Americans) were used to explore associations between educational attainment and SRH, stratified by sex, in a cohort of individuals from 1988 (n=1,773), 1993 (n=1,195), and 2001 (n=1,117) using continuous, ordinal, and binary correlated data analyses. Results: For males and females with less than a high school education, the odds of reporting poor or fair health (compared to excellent, very good, or good health) were 2.75 (95% CI: 1.54-4.91) and 1.78 (95% CI: 1.15-2.75) times greater, respectively, than among those who completed a college degree or higher. Conclusions: Across all analyses, individuals with lower educational attainment reported lower SRH scores, and the association differed by sex. Social support may be a factor in these differences. More research is needed, however, to assess relationships between educational attainment, social support, and SRH for African-Americans and other minority populations.
    • The effect of a nutrition intervention on parents living in a rural Georgia community

      Elliot-Walker, Regina; Hayes, Dawn; Oraka, Emeka; Lewis, Rashunda; Leon, Andre; Brenau University (Georgia Public Health Association, 2016)
      Background: Childhood obesity is a concern for public health organizations. Nearly one in four children living in rural communities are obese, and children living in rural Georgia communities are no exception. For rural communities, prevention efforts are needed to address challenges to reducing childhood obesity. The objective of the present effort was to increase the knowledge of parents in a rural community of the benefits of fruit and vegetable consumption and other healthy options. Methods: The “We Can Energize Families” curriculum, developed by the National Heart, Lung, and Blood Institute was implemented in a rural Georgia community. Pender’s Health Promotion Model, which encompasses the theory of persons taking a self-management approach in their health lifestyle, provided the framework. Participating in the study were 21 parents who had at least one child between the ages of 9-13. Outcome measures, adapted from the 16 measures relevant to the original “We Can Energize Families” objectives, were assessed, incorporating measures related to energy balance, portion size, healthy eating, physical activity, and screen time. Paired-T tests were used to evaluate increases in parents’ knowledge of the benefits of consumption of fruits and vegetables. Statistical significance was determined at p < 0.05. Results: There were improvements in 9 of the 16 measures, including knowledge of research and energy balance; attitudes regarding energy balance, portion size, and healthy eating; and behaviors regarding healthy eating, healthy food, physical activity, and screen time. However, improvements were not evident for behaviors related to portion size, knowledge or attitudes pertaining to physical activity, or attitudes regarding screen time. Conclusions: Particularly in rural communities, parents can contribute to prevention of childhood obesity. The present results demonstrate
    • Effect of Medicaid status on up–to-date vaccination rates among two-year-old children in Georgia, 2015

      Machado, Fabio; Tuttle, Jessica; Drenzek, Cherie; Georgia Department of Health (Georgia Public Health Association, 2017)
      Background: The annual Georgia Immunization Study (GIS) employs a retrospective cohort design to determine the up-to-date (UTD) immunization rate of 24-month-old children in Georgia. Previous results have shown lower vaccination rates in the second year of life, particularly for DTaP. We sought to determine if a discontinuation of Medicaid coverage after the infant year contributed to lower immunization rates in the second year. Methods: A stratified random sample of 2,002 Georgia children born in January 2013 was drawn from electronic birth records. Immunization history and Medicaid status were obtained from the Georgia Registry of Immunization Transactions and Services (GRITS). Parents and providers of children inadequately immunized according to the Advisory Committee on Immunization Practices’ (ACIP) immunization schedule were contacted for additional information. UTD immunization rates were compared among participants based on Medicaid status (Medicaid both years, first year only, second year only, never on Medicaid). The relationship between Medicaid status and specific immunizations was also explored. Reasons for loss of Medicaid among children who were not UTD were sought via parent interview. Significance testing was performed using Chi-Square tests in SAS version 9.4. Results: Children covered by Medicaid both years or never covered by Medicaid were more likely to be UTD by 24 months (90.4% and 84.5%, respectively) than children no longer covered by Medicaid in their second year of life (49.2%). These children also demonstrated a significantly lower immunization rate for the 4th DTaP dose (p<0.0001). Conclusions: A discontinuation of Medicaid coverage after the first year of life was associated with a lower UTD immunization rate among 24 month old children, particularly the 4th DTaP dose. Although reasons for discontinuation of Medicaid were beyond the scope of this study, lower vaccination levels among this group may reflect a lack of understanding of vaccine support services, and deserves further examination.
    • The effectiveness of text message reminder-recalls on Human Papilloma Virus vaccination coverage in Georgia

      Moon, Tamira; Dally, Nocolle; Sloat, Ben; Bryant, Kia; Grady, Sherrionda; Georgia Department of Health (Georgia Public Health Association, 2016)
      the Advisory Committee on Immunization Practices for adolescents ages 11 to 12 years, yet vaccine coverage remains low. The Georgia Comprehensive Cancer Control Program and Georgia Immunization Program implemented and evaluated a text-messaging campaign aimed at improving HPV vaccination coverage, using the Georgia Immunization Registry (GRITS). Methods: The text message reminder-recall campaign, aimed at the parents of adolescents 9 – 18 years, was launched in July 2015. A total of 208,792 adolescents in the GRITS database met the inclusion criterion, receipt of at least one dose of the three-dose series HPV vaccine. We determined the rate of HPV vaccine series completion for adolescents with a valid parent/guardian mobile phone number and for those without. Results: A total of 9,711 text messages were successfully sent to parents of adolescents 9 – 18 years. HPV vaccine series completion was 16% among adolescents whose parent/guardian received a text message as compared to 7% among those who did not. Conclusions: Text message reminder-recalls have a positive effect on HPV vaccine series coverage for adolescents in Georgia. Text messaging reminder-recalls may be an effective strategy to improve HPV vaccination coverage statewide.
    • 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.
    • EMS 2020: A multi-year SWOT and financial analysis of Georgia’s emergency medical services system

      Owens, Charles; Georgia Southern University (Georgia Public Health Association, 2017)
      Background: As Georgia’s Emergency Medical Services (EMS) system approaches 50 years in operation, the Georgia EMS Association and Georgia Southern University’s Center for Public Health Practice and Research began an evaluation of the strengths, weaknesses, opportunities, and threats facing Georgia’s EMS system. Methods: During the first year of the study, eight meetings were held across Georgia involving EMTs, physicians, hospital administrators, emergency planners, and state policy makers to identify strengths, weaknesses, opportunities, and threats facing the system. Results: Results obtained during the first year of this study offered valuable insight into current and future factors affecting the ability of Georgia’s EMS system to provide effective care to an expanding population. Conclusions: Quality of care, financial solvency, community paramedicine models, and reimbursement strategies were discussed and numerous strategies were evaluated to improve EMS operations in both urban and rural populations.
    • Engaging African Americans in developing an intervention to reduce breast cancer recurrence: A brief report

      Smith, Selina A.; Whitehead, Mary S.; Sheats, Joyce Q.; Fontenot, Brittney; Alema-Mensah, Ernest; Ansa, Benjamin E.; Augusta University (Georgia Public Health Association, 2016)
      Background: To develop a culturally appropriate lifestyle intervention, involvement of its intended users is needed. Methods: Members of an African American (AA) breast cancer support group participated in two 4-hour guided discussions, which were audiotaped, transcribed, and analyzed to guide the content. Results: The support group collaborated with researchers to develop 24 experiential nutrition education sessions using a social cognitive framework and incorporating self-regulation skills (goal-setting, self-monitoring, problem-solving, stimulus control) and social support to enhance self-efficacy for changes in dietary intake. Conclusions: Community engagement fostered autonomy, built collaboration, and enhanced the capacity of AA breast cancer survivors to participate in developing a lifestyle intervention.
    • Engaging homeless service providers in educational efforts during a tuberculosis outbreak in Atlanta

      Nandi, Preetha; Worrell, Mary Claire; Andrews, Tom; Sales, Rose-Marie; McMichael, Jeff; Hampton, Kristen H; Goswami, Neela D.; Emory University; Georgia Department of Health; University of North Carolina (Georgia Public Health Association, 2016)
      Background: During an outbreak of tuberculosis (TB) in the homeless population of metropolitan Atlanta, education of homeless service providers (HSPs) about the implementation of local infection control measures was imperative to limiting the spread of TB and to preventing future outbreaks. Methods: By use of educational sessions and teaching posters, two interventions were designed to focus educational efforts from November 2014 to August 2015: 1) a spatially-targeted approach that identified HSPs within an area of Fulton County, GA (which includes downtown Atlanta) with high TB case density (cases per square mile) from 2009 – 2014, and 2) an organizational meeting approach that included scheduled meetings of professionals who had regular contact with homeless individuals at risk of TB infection. Results: Of the 18 HSPs targeted in the identified high-TB density area, 9 engaged in educational activities, and 9 were closed at time of contact or unreachable by email or phone. Through organizational meetings, 36 additional facilities were reached. Conclusions: The HSPs with successful contact were amenable to educational efforts, and a combination of spatially targeted and organizational meeting approaches with teaching aids was feasible in developing sustainable TB educational programs in the homeless community
    • Engaging rural Georgians in Internal Revenue Service (IRS)-mandated community health needs assessments

      Lawrence, H Raymona; Nazaruk, Dziyana; Denis-Luque, Marie; Tedders, Stuart H.; Georgia Southern University, Georgia College and State University (Georgia Public Health Association, 2016)
      ABSTRACT Background: On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law. The law became effective on March 23, 2012. The ACA stipulates that non-profit hospitals must demonstrate benefit to their communities through the process of community health needs assessments (CHNAs). Failure to comply with this law may result in loss of non-profit status or large fines. This report describes strategies for engaging rural communities in Internal Revenue Service (IRS)-mandated CHNAs. Methods: Public health practitioners from Georgia Southern University’s Jiann Ping Hsu College of Public Health collaborated with 18 rural, non-profit hospitals to complete community-specific CHNAs. Quantitative and qualitative data were gathered from primary and secondary data sources to provide a comprehensive assessment of the needs and the assets of each of the communities. Results: The project team assisted 18 rural, non-profit hospitals in assessing the needs of their communities. Technical reports provided to the hospitals described the issues discovered during the assessment. Hospitals were empowered to utilize the information to prioritize community- specific issues and to develop comprehensive plans for implementation. Conclusions: The CHNA process provides an opportunity to strengthen relationships between public health services and hospitals as well as between hospitals and the communities they serve. Hospitals need to identify and engage diverse sectors of the community in order to comprehensively assess the needs and assets of communities to address the social determinants of health and to reduce health inequities/disparities.
    • Enhancing the future public health workforce through competency-based student field placements

      Carvalho, Michelle; Lloyd, Laura; Alperin, Melissa; McCormick, Lisa; Mitner, Kathleen; Emory University (Georgia Public Health Association, 2017)
      Background: The Public Health Workforce Interest and Needs (PHWINS) 2014 survey from ASTHO (Association of State and Territorial Health Officials) demonstrated a dramatic need for succession planning and retention of the future public health workforce. To address this need, the Region IV Public Health Training Center’s (R-IV PHTC) Pathways to Practice Scholars Program places students from accredited schools and programs of public health into practical field placement positions across eight states. Skill- and competency-based student field placements reinforce the value of working with medically underserved areas/populations (MUA/Ps) through public health agencies. Field placements use adult learning theory through experiential learning to build essential skills from the Council on Linkage (COL) core competencies. Methods: Host agencies include state and local health departments, Area Health Education Centers, primary care settings, and community organizations in one of eight southeastern states serving MUA/Ps. Agencies propose practical projects using COL domains. Proposals are converted to job postings. Once an agency selects a student, the team collaboratively develops a detailed work plan using specific COL competencies. Results: A brief overview of evaluation findings will be shared but are not the focus of this workshop. Evaluation instruments included a pre-survey, work plan, mid-term survey, final evaluation, and alumni survey. Students submit a final report, reflection summary, webinar presentation and/or abstract worthy of submission to a professional conference. Findings demonstrated increases in students’ perceived ability to perform core competencies and future plans to work in MUA/Ps. Conclusions: This program builds leadership and real-world experience in the future workforce while serving immediate needs of public health agencies. The workshop focuses on interactive discussion about processes and tools to create COL competency-based field placement position descriptions and detailed work plans. Participants can engage in dialogue about developing student positions which enhance their work while training the future workforce.
    • Escape from a Life of Secrets and Emergence of Psychopathy from a Mask of Sanity

      Sivised, Vittika; Department of English and Foreign Languages (Augusta University Libraries, 2016-10-11)
      This paper explores the progression of psychopathy within the main character of Jim Thompson’s The Killer Inside Me. Lou Ford hides behind a social mask depicting a kindhearted oaf to conceal the psychopathic and violent personality that lies beneath. Throughout the novel, Lou Ford’s psychopathic personality begins to surface as he progresses from mere verbal jabs to murder as he tries to escape from his past and his obligations to his father. These obligations that he has put upon himself keep him from leaving the town; however, as he destroys the chains that bind him to the town by murdering those who represents these chains, his psychopathic personality, which is his real personality, grows in strength, and soon, the truth of his violent nature is known by the rest of the characters. In the end, to truly escape from the town, Lou Ford commits his final act: suicide. This act of suicide frees him from the past and he was able to be who he always was, a psychopath.
    • Establishing a GFP Marker in Zebrafish to Study the Localization of Tinagl1

      Blackburn, Helena; Biological Sciences, Cellular Biology and Anatomy (Augusta University Libraries, 2020-05-05)
      This item presents the abstract for a poster presentation at the 21st Annual Phi Kappa Phi Student Research and Fine Arts Conference.
    • Evaluating public and private partnership to improve food and language nutrition among children 0-5 years

      Ejikeme, Chinwe; Threets-Powell, Kia; Vall, Emily Anne; Wagner, Laura; Fiedorowicz, Luke; Idaikkadar, Audrey; O'connor, Jean (Georgia Public Health Association, 2016)
      Background: Racial and ethnic minority populations in Georgia experience increased rates of chronic disease and poor health and education outcomes, which can be prevented through enhanced public- private partnerships. Using the Centers for Disease Control and Prevention (CDC) evaluation framework, the Evaluation Subcommittee for the Georgia Partnership for Food and Language Nutrition Project comprised of representatives from various stakeholders affiliated with state agencies, academia, and community-based organizations developed an evaluation plan to improve the collaborative effort designed to improve food and language nutrition among children 0-5 years. The purpose of this mixed-methods study was to assess influential collaborative factors. Methods: An online assessment survey that included open-ended qualitative questions was administered to all stakeholders (n=15; response rate=67%) to assess the strengths and weaknesses of the partnership, its leadership effectiveness and partners’ perceptions about the partnership. Baseline descriptive statistics were calculated and content analysis was performed with the qualitative data to understand partners’ perceptions. Results: The partnership scored variably across four categories that determine partnership strengths. Five factors were identified as the strengths of the partnership: favorable political and social climate; members see collaboration as in their self interest; unique purpose of partnership mission and goals; skilled leadership; and sufficient resources to support its operation.However, other areas were found to need urgent intervention, including improving on the leadership of the Georgia Department of Public Health (GA-DPH). In addition, communication as well as process and structure factors were identified as weaknesses including: a need to establish informal relationships and develop communication skills; a lack of flexibility; and an absence of clear roles and policy guides. Conclusions: Developing an action plan to address identified weaknesses will help ensure the accomplishment of the expected health and education outcomes among targeted, minority Georgia communities.
    • Evaluation of food access and food security concerns among public housing residents

      Gaddis,Cheryl L. R.; Lian, Brad; Watts, Nicole; Thompson, Leontyne; Mercer University, Department of Public Health (Journal of the Georgia Public Health Association, 2015)
      Background: In 2012, food insecurity affected 14.5% of the households in the U.S and 20% in the state of Georgia. Individuals who are food-insecure can experience malnutrition, and social and physical problems. The purpose of this study was to assess food access and security concerns in two counties of the North Central Health District 5-2 (NCHD 5-2) in Georgia and to aid in devising interventions to increase food access and reduce food insecurity. Methods: Data collection involved surveying 399 public housing residents within two NCHD 5-2 counties using the Household Food Security Survey developed by the US Department of Agriculture. The survey contained 24 questions focusing on demographics and household food status and on the severity and prevalence of food access and security. Results: Of the 399 participants, 91.9% reported annual household incomes less than $30,000; 61% (n = 244) reported receiving Supplemental Nutrition Assistance Program (SNAP/food stamps) benefits, 11% (n = 46) received Women, Infants, and Children (WIC) benefits, and 3.3% (n = 13) received Temporary Assistance for Needy Families (TANF). Results for food security status (whether or not families have access to food at all times) showed that 7.3% (n = 29) were classified as high food secure, 22.8% (n = 91) as marginally food secure, 30.6% (n = 122) as low food secure, and 39.3% (n = 157) as very low food secure. Conclusions: Most of the residents with some form of food insecurity received government food assistance, yet still identified as being unable to feed themselves or their families for the month. Recommendations to evaluate this problem include additional research and implementation of public health efforts to address food access and insecurity through policy changes and implementation of programs.
    • Evaluation of Mammal Hair as a Potential Wild Pig Repellent on Cowden Plantation in Jackson, South Carolina

      Hitchens, Samantha; Biological Sciences (Augusta University Libraries, 2020-05-05)
      This item presents the abstract for a poster presentation at the 21st Annual Phi Kappa Phi Student Research and Fine Arts Conference.
    • 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.