• “Illegal”: Job Attainment and Socio-Economic Status Among First-Generation Mexican Americans, 1980s-2000s

      Esteban, Isabella; History, Anthropology, and Philosophy (Augusta University Libraries, 2020-05-05)
      This item presents the abstract for an oral presentation at the 21st Annual Phi Kappa Phi Student Research and Fine Arts Conference.
    • Immunization policies for employees of childcare facilities within the North Central Health District of Georgia

      Kamara, Paula; Lian, Brad; Smith, Jimmie; McChargue, Judy; Mercer University, North Central Health District (Georgia Public Health Association, 2015)
      ABSTRACT Background: Since the early 1980s, vaccinations have generally been required for children in licensed daycare and school settings. In these settings, vaccinations have reduced disease rates. Adults occupy these settings as well, and ensuring they are vaccinated should also reduce the potential for disease and disease transmission. Yet, there are few vaccination requirements for adults employed at daycare facilities, although such requirements have been recommended (CDC Adult immunization schedule, 2015; ACIP General Recommendations, 2011). The objective of this study was to examine current vaccination policies among childcare facilities within Georgia’s North Central Health District (District 5-2) and the climate for possible policy directives in the future. Methods: A 10-item questionnaire regarding vaccination requirements and policies and the importance of vaccination education was mailed to administrators of all 271 licensed childcare facilities within the North Central Health District in Georgia. A total of 76 questionnaires were returned, representing a 28% response rate. The district has approximately 530,000 residents and is comprised of 13 counties. Results: Of the childcare facilities, 79% have no vaccination policies in place. However, most facility directors (75%) indicated that such policies should be required, and 93 % stated that vaccination education is important for their staff members. Conclusions: Vaccination requirements can help protect children and their caregivers from communicable diseases. From a policy perspective, the climate may be favorable for the implementation of such requirements, in that most childcare directors recognize the importance of such policies and state that they should be required.
    • Impact of 1918 Spanish influenza pandemic on mortality rates in Savannah, GA, and implications for future epidemic prevention

      Plasphol, Sara; Dixon, Betty; Armstrong State University (Georgia Public Health Association, 2015)
      Background: The Spanish Influenza pandemic struck the United States in waves from September 1918 through March 1919. This study investigates the impact of the Spanish Influenza on Savannah and Chatham County, Georgia. Methods: Primary death records from the Chatham County Health Department were examined and analyzed for the years of 1917, 1918, and 1919. Historical mortality rates in the Savannah area were compared to those for other parts of the United States and world. Results: Mortality rates attributed to the Spanish Influenza within Savannah closely paralleled similar flu-related mortality rates for comparison populations in New York, London, and Madrid. Conclusions: These local primary data enable Savannah public health officials to understand the historical trends of communicable disease mortality in relation to other parts of the world, and have the potential to serve as a reference when channeling future resources into epidemic prevention in Chatham County.
    • The Impact of Cardiac Rehabilitation on CVD Risk Factors in Diabetic Patients

      Thomas, Eyana; Lian, Eric; Roberts, Kimberly; Nursing (Augusta University Libraries, 2020-05-04)
      This item presents the abstract for a poster presentation at the 21st Annual Phi Kappa Phi Student Research and Fine Arts Conference.
    • Impact of Chlamydia & Gonorrhea in Georgia: An Urban/Rural Comparison (2000-2004)

      Raychowdhury, Swati; Tedders, Stuart H.; Jones, Sarah K.; Georgia Southern University (Georgia Public Health Association, 2008)
      Background: In 2005, 33,562 cases of chlamydia and 15,860 cases of gonorrhea were reported in the State of Georgia, respectively corresponding to 3.4% and 4.7% of all cases reported nationally (CDC, 2005). Disparities of infection with respect to race and gender are evident for both diseases. The objective of this study was to determine the magnitude of chlamydia and gonorrhea in rural Georgia compared to urban areas of the state. Methods: County level data necessary for analysis were acquired using the Georgia Division of Public Health’s Online Analytical Statistical Information System database (GDHR, 2007). Rates of infection by gender and race (black vs. white) were aggregated over a five year period (2000 – 2004) and indirectly adjusted using Georgia as the standard. Rates for rural counties, defined as populations less than 35,000, were statistically compared to urban rates using a test of proportions (α = 0.05). Additionally, rate ratios and 95% confidence intervals were calculated to further quantify risk. Results: Although variation exists, data suggest infection of both diseases in Georgia is an urban problem, disproportionately impacting black residents. For chlamydia, adjusted rates for white males (21.0/100,000) and black males (313.9/100,000) were significantly higher in urban counties. Quantified risk as indicated by rate ratios [RR] and 95% confidence intervals [95%CI] suggest an 18% increase of risk among white males (RR = 1.18; 95%CI = 1.07, 1.30) and 33% increase of risk among black males (RR = 1.33; 95%CI = 1.27, 1.38). Among females, rates in rural areas of the state were higher for whites (121.9/100,000) and blacks (1,045.5/100,000). However, these differences were not significant. For gonorrhea, rates in urban areas were significantly higher among white males (15.5/100,000), black males (519.6/100,000), and black females (414.2/100,000) as compared to rural populations. Additionally, elevated risk of gonorrhea among these groups ranged from a 10% increase among black females (RR = 1.10; 95%CI = 1.07, 1.14) in urban areas to a 65% increase among white males (RR = 1.64; 95%CI = 1.43, 1.85) in urban areas. Conclusions: The State of Georgia continues to report two of the most common sexually transmitted infections at an alarming rate. The disproportionate impact of minorities is evident, although further assessment of the variation between urban and rural areas is warranted to more fully explain risk of infection.
    • The Impact of Vegetarians and Vegans on the Meat, Egg, and Dairy Industry

      Cantenot, Marie; Finance and Economics (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.
    • Impacts of Cultural Barriers on Healthcare

      Mahoney, Eden; Allied Health Sciences, Communication, History, Anthropology & Philosophy (Augusta University Libraries, 2020-05-05)
      This item presents the abstract for an oral presentation at the 21st Annual Phi Kappa Phi Student Research and Fine Arts Conference.
    • Implementation and evaluation of the Carrera Program for delaying teen sex in Georgia

      Tucker, Tressa; Langley, Mary; Morehouse School of Medicine (Georgia Public Health Association, 2016)
      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.
    • Implementation of the SafeCare model in Georgia for preventing child maltreatment

      Whitaker, Daniel; Glasheen, Theresa; Georgia State University (Georgia Public Health Association, 2017)
      Background: The SafeCare model is a behaviorally-based parenting model used in the prevention of child maltreatment. SafeCare targets three proximal risk factors for child neglect and abuse: parent-child interactions, home safety, and child health. SafeCare is one of only a few evidence-based practices for preventing child neglect, the dominant problem in child welfare, accounting for over 75% of child maltreatment cases. SafeCare has been broadly implemented in several states in the US, including Georgia, and is disseminated by the National SafeCare Training and Research Center (NSTRC) at Georgia State University. The presentation will (1) describe SafeCare and associated data, (2) describe the SafeCare implementation. Methods: SafeCare has been implemented in Georgia since 2008 using a rigorous implementation model, which includes on-going quality assurance of SafeCare providers and skill acquisition evaluation in families. Providers of child welfare services have been trained to deliver SafeCare and have been coached by trainers from NSTRC. Evaluation data are regularly collected which include provider fidelity via observed sessions, family outcomes relating to completion of SafeCare, and skill acquisitions (i.e., changes in parenting behaviors, reductions in home hazards, and increases in knowledge and behaviors regarding child health care). Results: Recent evaluation data (2013-2015) indicate 115 families have been referred to a SafeCare provider and 100 families completed at least one session. Thirty-eight (38%) have completed the program in its entirety. Provider fidelity data collected monthly indicate high program fidelity (mean of 91% of desired behaviors performed). Family behavior data indicate excellent skill acquisition among families completing each SafeCare model. Parenting skills increased by 104%; home hazards were reduced by 85%, and child health care skills increased by 34%. Conclusions: The SafeCare model is an effective parenting program for reducing child maltreatment, and has been implemented successfully in Georgia. Broader impact of SafeCare will require increased implementation of the model to increase reach.
    • Implementing the Healthy University Approach to Mental Health at Augusta University

      Jackson, Lauren; Psychological Sciences, Chemistry and Physics, Population Health Sciences (Augusta University Libraries, 2020-05-05)
      This item presents the abstract for an oral presentation at the 21st Annual Phi Kappa Phi Student Research and Fine Arts Conference.
    • The importance of early brain development

      Fitzgerald, Brenda; Georgia Department of Health (Georgia Public Health Association, 2016)
    • The Importance of Encompassing Medical History in Pre-Medicine

      Alapatt, Vinaya-Ann; Department of Art and Design (Augusta University Libraries, 2020-03)
      This essay presents an argument on the integration of medical humanities in pre-medical undergraduate curriculum. This project culminated from an assignment of the Drawing II course in the spring 2018 semester, which included a short paper on a research topic of interest, and a drawing.
    • Improving rural access to care: Recommendations for Georgia’s health care safety net

      Minyard, Karen; Parker, Chris; Butts, John; Georgia State University (Georgia Public Health Association, 2016)
      Background: In Georgia, the safety net provides health care services to vulnerable populations scattered across 74 urban and 85 rural counties. In rural communities, the safety net is challenged with longstanding gaps in service provision and persistent difficulty in making services accessible. The rural safety net in Georgia is vulnerable. Methods: An environmental scan was conducted of the Georgia rural safety net to assess who it serves, its providers, and how care is accessed in light of the Affordable Care Act (ACA). The scan included analysis of population-based census and health databases and a literature review to inform recommendations. Results: The population served by the rural safety net is typically older, poorer, and less healthy than the population in urban areas. The principal providers of care in the rural safety net are community hospitals, federally sponsored and free or charitable clinics, and some health departments. While the ACA provides an opportunity to increase insurance coverage and access to care, it poses a financial challenge to providers of the rural health safety net. As the health system evolves, the rural health safety net must adapt to shifting priorities and patient populations. Conclusions: To enhance the sustainability of the rural safety net, it is necessary for providers to focus on coordination of care through integration of services and broader health system partnerships. Providers of the Georgia rural safety net and stakeholders should focus on (a) ensuring a comprehensive assessment of all components of the safety net, (b) facilitating change through high-performing health departments and community-based organizations, (c) funding efforts to provide patient-centered medical homes for the rural uninsured, (d) emphasizing the value of technology in the provision of care and information/data exchange, and (e) rewarding innovations in rural and safety net workforce development and deployment.
    • 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.
    • Increasing breastfeeding duration and exclusivity in a sample of rural women: A pilot study

      Chopak-Foss, Joanne; Yeboah, Felicia; Georgia Southern University (Georgia Public Health Association, 2017)
      Background: Increasing breastfeeding exclusivity and duration is an objective of Maternal and Child Health (MICH-21.4 and 21.5) of the Healthy People 2020 initiative. Breastfeeding rates differ considerably between high-income and low-income women. Methods: This was a pilot project conducted to assess the feasibility of an intervention to increase breastfeeding practices overall and to improve exclusive breastfeeding rates among a sample of rural women enrolled in the Special, Supplemental Nutrition Program for Women, Infants and Children (WIC) in a rural Georgia county. Participants were recruited from the local regional hospital (n=27). Support group meetings were offered over a four-week period and began within five days of birth. At each meeting, data were gathered on demographic characteristics, pacifier use, initiation of cup feeding, and rates of breastfeeding duration and exclusivity. Results: More than 60% of the participants breastfed exclusively for the first week, but by the end of the fourth week, that number dropped to under 45%. Conclusions: Low-income women continue to be among the most challenging group in which to improve breastfeeding duration and exclusivity rates. Public health programs need to create innovative ways in which to improve breastfeeding rates. Lessons learned from the pilot study are described and suggestions for future study are provided.
    • Infant Mortality Trends among Georgia Residents, 1995 – 2003: Targeting Healthy People’s 2010 Goals

      Sturges, Diana; Gunn, Laura; Shankar, Padmini; Shroff, Shrikrishna; Georgia Southern University (Georgia Public Health Association, 2007)
      Population-based trends in infant mortality among Georgia Residents between 1995 and 2003 were assessed on characteristics such as race, birth weight, neonatal and post-neonatal periods, and cause of death. A statistical analysis was conducted to show that the Georgia infant mortality rate (IMR) remained constant throughout the study period and averaged 8.67 per 1,000 live births. The analysis revealed racial disparities, with an IMR ranging from 6.03 in white infants to 13.76 in black infants, with less than one percent (0.86%) change, on average, among the differences between black and white mortality rates across the nine-year period. The disparities were also evident in infants with low birth weight (LBW) and very low birth weight (VLBW). Black infants born with LBW (12.9%) and VLBW (9.98%) have more than twice the rate of infant mortality compared to white infants born with LBW (6.64%) and VLBW (1.12%). Mortality in the neonatal period accounted for more than half (67.96%) of all infant deaths and exhibited considerable ethnic differences. Among all groups, black male neonates (10.7) have the highest mortality rates. The average neonatal mortality rate across the entire study period is 5.89 (SD=0.20); the average postneonatal mortality rate across the entire study period is 2.78 (SD=0.22). The five leading causes of death among Georgian infants in descending order were: birth defects, prematurity and low birth weight, Sudden Unexplained Infant Deaths (SUID), other perinatal conditions and respiratory conditions with racial differences in the ordering.
    • The influence of Georgia’s Quality Rated System on school readiness in pre-school children

      Phillips, Dena; Webb, Nancy; Augusta University (Georgia Public Health Association, 2016)
      Background: Georgia rates the quality of early childcare learning centers using a tiered quality improvement system. Georgia’s Quality Rated system (QR) designates a star level, (one star, two stars or three stars) to each center based on a portfolio of QR standards and an onsite assessment by Georgia Department of Early Care and Learning (DECAL). Childcare centers applying for QR status first submit a portfolio documenting how their practices align with QR standards centered on staff qualifications; child health, nutrition and physical activity; family engagement; holistic curricula and teacher-to-student ratios. Subsequently, an on-site assessment of the center is performed by DECAL using the Early Childhood Environment Rating Scale– Revised (ECERS-R). Methods: The Bracken School Readiness Assessment-3rd Edition (BSRA-3) was administered to children in various one-star (N=2), two-star (N=4) and three-star (N=6) childcare learning centers in Georgia. Children’s height and weight were recorded and BMI assessments were conducted. Results: Significant differences were found in school readiness scores based on quality rating with two and three star centers scoring higher than one star centers. Children in childcare centers at the one-star level (Mean = 95.00, SD = 16.80) performed lower than children in childcare centers at the two-star level (Mean = 103.67, SD = 16.55) and three-star level (Mean = 100.42, SD = 14.35). Multiple comparison tests did not reveal differences between two-star and three-star level centers. Conclusions: Higher levels of quality in QR childcare centers displayed more school readiness than centers with lower levels of quality. Future studies should examine differences in higher quality centers to further explore the influence of QR programs on school readiness.
    • Injection drug use and hepatitis C: Interventions in behavioral health settings

      Sutton, Marie; Imagine Hope INC (Georgia Public Health Association, 2017)
      Background: Georgia is experiencing a crisis of injection drug use and hepatitis C virus (HCV) infection. From 2002 to 2014, the statewide drug overdose mortality rate increased, with nearly every county experiencing a significant increase in drug overdose mortality. Especially concerning is the rising HCV infection rate in people younger than 30, many of whom inject drugs. HCV incidence in young people increased over 200% in Georgia from 2006 to 2012. CDC officials have suggested “…Georgia is experiencing an expanding epidemic of heroin use that is driving an increase in injection drug use, putting many more at risk for the spread of HIV and HCV infection.” Methods: Now in its second year, Imagine Hope is a Georgia-wide project that includes 20 agencies (8 methadone clinics, 12 abstinence based agencies) serving substance-using populations. It offers free routine HCV testing and linkage to care. Nearly all individuals served inject drugs. The agencies have implemented a novel combination of embedding routine HCV testing into services; tandem testing for HCV and HIV; linking individuals to HCV care and treatment; and providing access to two support groups. Results: Over 18 months, 6,136 consumers received HCV antibody testing. Of those, 677 (11%) were HCV antibody positive (Ab+), with 83% of them born outside the baby-boomer cohort. To confirm HCV status, clinics conducted RNA tests, completing 464 such tests that yielded 381 (82.1%) confirmed cases of HCV. Currently, the project has linked 102 (36.8%) confirmed HCV+ clients to care and treatment services, with 12 (11.8%) clients experiencing total remission. Conclusions: Among intravenous drug users, HCV prevalence is high, while infection awareness is low. Navigators and support groups enhance linkage. Connecting a population of mostly uninsured behavioral health clients to care is feasible. Providing HCV RNA confirmatory testing in the behavioral health setting greatly enhances the linkage to care process.
    • Integrating food and language nutrition to reach Georgia’s children in early care and education environments

      O'Connor, Jean; Ejikeme, Chinwe; Fernandez, Maria; Powell-Threets, Kia; Idaikkadar, Audrey; Kay, Christi; Vall, Emily; Ross, Kimberly; Fitzgerald, Brenda (Georgia Public Health Association, 2016)
      Background: Educational attainment and health are mutually reinforcing outcomes. Good health supports children in the achievement of academic milestones, such as grade-level reading, and is associated with higher socio-economic status, longer life expectancy, and lower lifelong chronic disease. Improving health outcomes and increasing the potential for high educational attainment is necessary for reducing disparities, improving population health, and reducing morbidity. Early childhood and associated settings present opportunities to address lifelong health. Methods: To guide the development of programs to reach large numbers of children, we reviewed the literature associated with interventions during early childhood to promote healthy food consumption patterns and language development—“food and language nutrition.” Results: Identified in the systematic review were 12 articles. A recurrent theme was the social-ecological model, widely used in the studies identified through the literature review. Conclusions: The findings suggest a theoretical framework and key considerations that could guide the development of integrated interventions to improve food and language nutrition. With these findings, the authors propose a conceptual model and outline a public health program to address food and language nutrition together in early care settings in the state of Georgia, with the potential for application in other geographic areas.
    • Intersecting motivations for leaving abusive relationships, substance abuse, and transactional sex among HIV high-risk women

      David, Naomi; Hussen, Sophia; Comeau, Dawn; Kalokhe, Ameeta; Emory University (Georgia Public Health Association, 2016)
      Background: Women bear a significant burden of the HIV epidemic in the United States. Women classified as ‘HIV high-risk’ often bring co-existing histories of intimate partner violence (IPV), drug use, and transactional sex. To help inform future comprehensive HIV prevention strategies, we aimed to explore common motivating reasons and barriers to leaving and/or terminating engagement in each of these risk-promoting situations. Methods: Between August and November 2014, in-depth interviews were conducted with 14 HIV high-risk women in Atlanta, Georgia who had experienced IPV in the previous 12 months, and used drugs and/or engaged in transactional sex in the previous five years. Participants were asked about histories of IPV, drug use, and/or engagement in transactional sex, and the motivating reasons and barriers to terminating each. Results: Women reported a range of motivating reasons for leaving IPV, drug use, and transactional sex. Overlapping themes included impact on children, personal physical health/safety, and life dissatisfaction. Financial need was identified as a common barrier to leaving. Conclusions: Future HIV prevention research should further explore the perceived impact of IPV, drug use, and transactional sex on physical health/safety, life dissatisfaction, one’s children, and financial need as motivators and barriers to reducing upstream HIV risk.