• Medicaid savings continue in the year after end of participation in the program, Money Follows the Person

      Landers, Glenn; Fuller, Kristi; Zhou, Mei; Georgia State University (Georgia Public Health Association, 2017)
      Background: The aim of this analysis was to compare Georgia’s Medicaid expenditures for participants in the Money Follows the Person (MFP) six months before, 12 months during, and 12 months after MFP participation. Methods: Differences in Medicaid expenditures for three populations of MFP participants (individuals with developmental disabilities, individuals with physical disabilities, and older adults) were compared by use of repeated measures t-tests. Results: Per-member per-month Medicaid expenditures were lower across the three populations when comparing six months prior to transition from an institution to 12 months after leaving the MFP program. Conclusions: The incorporation of features from programs such as MFP into existing state Medicaid long-term services and supports may assist in reducing the growth of future expenditures.
    • Meeting Public Health Challenges

      McKinley, Thomas; Augusta State University; Mercer University (Georgia Public Health Association, 2006)
      From the Editor
    • Meeting the public health workforce’s training priorities in Georgia and the southeast

      Lloyd, Laura; Alperin, Melissa; Carvalho, Michelle; Miner, Kathleen; Emory University (Georgia Public Health Association, 2016)
      Background: The mission of the Region IV Public Health Training Center (R-IV PHTC) is to build knowledge and skills in the public health workforce in the eight states of HHS Region IV by providing competency-based training. Workforce training needs are changing quickly and dramatically in light of new developments in public health practice and science, emerging diseases, changes in the health care environment, and the growing emphasis on inter-professional practice. Additionally, a 2014 survey conducted by the Association of State and Territorial Health Officials (ASTHO) found that at least 38% of the current public health workforce plans to retire by 2020. Therefore, it is increasingly crucial to prepare upcoming managers for leadership positions and to train entry-level workers to assume more advanced roles. Methods: To address current and emerging training needs in Georgia and the southeast, the R-IV PHTC continually identifies emerging priorities and effective training approaches. It explores training needs through a review of formal needs assessments, key stakeholder interviews, surveys of targeted audiences, informal partner communications, and training evaluation data. An interactive component of the GPHA session allowed participants to identify and discuss their own professional training needs. Results: Workforce development needs assessments data across several southeastern states identified recurring training needs for professionals in Tiers 1, 2 and 3 of the Council on Linkages Core Competency domains for Analytical/Assessment Skills and Financial Planning/Management. In Georgia, top competency training needs gathered from a variety of assessment methods included Cultural Competency, Communication, Financial Planning/Management, Public Health Science, and Leadership/Systems Thinking. Participants in the workshop’s interactive component expressed highest personal need for training in Financial Planning/Management, Analytical/Assessment Skills, and Policy Development/Program Planning. However, for others in their organizations, they identified a priority need for leadership training. Conclusions: The R-IV PHTC assesses training needs and provides training resources to respond to current and emerging public health workforce development needs in Georgia and the southeast.
    • The mentoring cycle: A two-way exchange

      Plaspohl, Sara; Armstrong State University (Georgia Public Health Association, 2016)
    • Mindfulness Meditation through a Mobile App

      Huff, Sabrina; Murray, Cleston-Lee; Restrepo, Leigha; Jones, Shelby; Psychological 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.
    • Minimum Flow Rate in Electro-Coflow

      Overlie, Benjamin; Chemistry and Physics (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.
    • Missed opportunities for diagnosing HIV via routine screening in an inner-city primary care clinic

      Hankin, Abigail; Turbow, Sara; Spicer, Jennifer; Freiman, Heather; Shah, Bijal; Travis, Natasha; Emory University (Journal of the Georgia Public Health Association, 2015)
      Background: Although routine, opt-out HIV screening has been recommended for nearly a decade, clinical practice has not kept pace. Here, we examine missed opportunities for HIV screening among patients newly diagnosed with HIV via a routine non-targeted opt-out HIV screening program in a primary care clinic at an inner-city safety-net hospital. Methods: Select demographic and clinical data were analyzed for all persons with a new HIV diagnosis between July 9, 2013 and August 31, 2015. Retrospective reviews of medical records were performed to identify missed opportunities for HIV screening in the year prior to HIV diagnosis. Results: Among 6,582 patients tested for HIV as part of the screening program, 27 patients had a new HIV diagnosis (0.41%). In the year prior to diagnosis, 19 (70%) of these had contact with the healthcare system but were not tested for HIV. At the visit associated with the new HIV diagnosis, 70% of patients did not present with an indication for risk-based HIV screening or symptoms potentially associated with HIV-related infections. Conclusions: Despite CDC recommendations for routine, non-targeted, opt-out HIV screening in all healthcare settings, 70% of patients newly diagnosed with HIV via routine screening in a primary care clinic had contact with the healthcare system in the year prior to the new HIV diagnosis but were not tested for HIV. These findings highlight the importance of routine, non-targeted screening to identify patients with HIV as well as continued provider and patient education about the value of routine HIV screening.
    • Mock Me! A guide to developing a first rate training tool on a second rate budget

      Baxter, Galen; Georgia Department of Health (Georgia Public Health Association, 2017)
      Background: Working closely with county Environmental Health Specialists through the Standardization Process, a critical need was identified. Assistance was needed in prioritizing inspections based on risk levels identified in restaurant kitchens during inspections. Additionally, more training was needed to help them identify other areas in food service establishments that require further assessment. Methods: Tight budget constraints prevented the purchase of expensive training equipment; however, with a little creativity and team work, a mock kitchen made entirely out of cardboard, tape and a couple of aluminum pans was created as a portable, hands-on training tool that could be easily transported around the state. Results: Overwhelming positive feedback was received from the districts that experienced training using the tool. Environmental Health Specialists suddenly had an opportunity to practice and apply what they had learned within a controlled environment and increase their confidence in assessing and prioritizing during inspections. Conclusions: Solutions to problems can sometimes be found using a very simple approach. A little bit of creativity and a willingness to literally “think outside the box” can go a long way in providing viable, alternative solutions to common roadblocks in government. The key to creating an effective training tool is to accurately identify training gaps in the intended audience.
    • Modifying And Validating A Quality Of Life Measure to Fit Your Patient Population

      Johnson, Michelle R.; Maclean, J. Ross; Rogers, Rebecca L.; Fick, Donna M.; Kallab, Andre; Augusta State University; Medical College of Georgia; Augusta State University; Medical College of Georgia; Medical College of Georgia (Georgia Public Health Association, 2007)
      Introduction: A well-developed quality of life (QoL) instrument is valuable in identifying the burden of illness. We were interested in exploring whether existing QoL instruments were suitable for patients in our medical setting and, if not, whether this could be rectified by adapting an existing valid and reliable instrument to meet the specific needs of our patient population. For the purposes of this study, we chose to evaluate the quality of life of patients with breast cancer. Specifically, we were interested in two aspects of QoL in women with breast cancer. The first was whether existing instruments were pertinent to the women in our venue. The second research interest was dependent upon the first. If current instruments were found wanting, could this be rectified through the creation and validation of new domains of relevance to these patients? Method: First, five patients were interviewed to ascertain QoL issues pertinent to women in our medical setting. Second, to determine regional appropriateness of existing breast cancer QoL instruments, a search was conducted to identify and review existing breast cancer specific QoL instruments. Third, an addendum was created (to be used in conjunction with an existing instrument identified through the search) that contained three QoL domains not typically found: Financial, Spirituality and Satisfaction with Medical Care. The addendum was then tested along with an existing instrument (FACT-B). Results: Internal consistency for the new scales, Satisfaction with Medical Care, Spirituality, and Financial had alpha coefficients of 0.81, 0.80, and 0.63 respectively. The total score for FACT-B plus addendum was 0.69. Pearson’s correlation coefficients were 0.49 for Financial, 0.64 for Satisfaction with Medical Care, and 0.70 for Spirituality. Total test/retest was 0.71.
    • Molecular Self-Organization of Three-Component Lipid Membranes

      Osby, Austin; Department of Chemistry and Physics (Augusta University Libraries, 2020-03)
      By constructing a Landau-like energy functional, we investigate the molecular organization of a three-component mixture in cell membranes. In the strongly interacting limit, we model the interaction between molecules using pseudospin variables and convert them into non-interacting variables using a mean-field theory. Next, we construct the two-order parameter Landau-type energy functional through the Helmholtz free energy. By analyzing the Landau free energy, we map out the phase diagram focusing on homogeneous and various phase separated states on the cell membrane.
    • A multi-county health district’s journey to accreditation: The challenges and benefits

      Echols, Tara; Gwinnett, Newton and Rockdale County Health Departments (Georgia Public Health Association, 2017)
      Background: In September 2011, the Gwinnett, Newton, and Rockdale Health Departments began to discuss accreditation. We regarded accreditation as a way to highlight our strengths and identify areas for quality and performance improvement as well as an opportunity to improve our capacity for greater accountability, increased efficiency and improved process flow. We further viewed it as a means to successfully carry out our mission, and effectively deliver the core functions and ten essential public health services. Methods:With financial backing from Healthcare Georgia Foundation and technical assistance from Georgia Southern University, the Gwinnett, Newton and Rockdale County Health Departments began its pursuit of accreditation by assessing department processes, policies, and procedures for alignment to the Public Health Accreditation Board (PHAB) standards. This resulted in identified areas for improvement and needed policy and procedure development. The Model for Improvement was actively used throughout our pursuit of accreditation, and we viewed the process as several inter- related plan, do, check, act (PDCA) cycles. After being advised on several options, we changed our application from multi-jurisdictional to a local health district based on guidance from PHAB for all the health districts in Georgia. Domain leads were assigned; these later developed into domain teams comprised of individuals with expertise in various relevant areas. The teams met on a regular basis to review domain documentation and to discuss the ‘story’ it tells about our department. We prepared for the site visit by conducting a mock site visit using local PHAB site visitors. This experience was extremely helpful in calming the participant staff and identifying areas that we could improve. Results: After several iterations of guidance from PHAB on how we should apply we applied as a local public health district. With feedback from our mock site visit we were able to prepare for and successfully complete our site visit with no request to reopen any measures. We received a stellar site visit report with 93% of the measures scored ‘fully demonstrated’ and 7% scored ‘largely demonstrated’. Our department was accredited on August 17, 2016 as the 3rd accredited health district in the State of Georgia. Conclusions: The process of pursuing accreditation has been a challenge on various fronts; from indecision about how we should apply, to uncertainty about interpretation of the standards, to hesitance about choosing county-specific or departmental documentation. However, the culture of quality and solidified community partnerships that resulted from this process are invaluable.
    • Multi-Level Evaluation of a Perinatal Health Program in Rural Southeast Georgia

      Raychowdhury, Swati; Tedders, Stuart H.; O'Steen, Greta; Jones, Sarah K.; Georgia Southern University; Southeast Health District (Georgia Public Health Association, 2007)
      Problem: Infant mortality has declined steadily in the past decade, however, significant disparities associate with lack of adequate perinatal health services and barriers to access disproportionately impact women residing in rural areas. In Georgia, data suggest significant challenges with respect to birth outcomes, and this problem seems to be exacerbated in rural regions of state. The objective of this presentation is to report on the impact of a regional perinatal health care collaborative implemented in rural southeast Georgia. Method: Analysis of pre-intervention and post-intervention birth outcomes (gestational age, birth weight and infant mortality) served as the focal point programmatic evaluation. Differences in mean gestational age and mean birth weight were analyzed using a t-test (α = 0.05). Proportional differences in low birth weight and infant mortality were assessed using the chi-square test (α = 0.05). Differences were investigated relative to race (white and nonwhite). Results: Analysis of white participants showed no significant difference in any birth outcomes investigated. Furthermore, analysis of non-white PHP participants suggested significant improvements in all birth weight (p < 0.001), gestational age (p = 0.007), low birth weight (p = 0.002), and infant mortality (p = 0.007). Conclusion: The perinatal health program in southeast Georgia demonstrated considerable effectiveness as measured through pre-intervention and post-intervention birth outcomes. The potential for improved health outcomes of high risk pregnant women and infants as a result of adequate perinatal care may also lead to the achievement of Healthy People 2010 within this region.
    • A multisite evaluation of pediatric asthma-related treatment in accordance to the 2007 National Heart, Lung, and Blood Institute Expert Panel Report – 3 guidelines

      Oraka, Emeka; Robinson, Brittani; Ousley, Trevor; Lopez, Francesca; Graham, LeRoy (Georgia Public Health Association, 2016-08-18)
      Background: To determine if Georgia-based healthcare providers who received continuing education on pediatric asthma as described by 2007 National Heart, Lung, and Blood Institute Expert Panel Report – 3 guidelines demonstrated improvements in asthma-related treatment. Methods: We used a multi-site, cross-sectional design. Data were collected via surveys administered to healthcare providers and via randomized medical chart abstractions. Chart abstraction occurred at 12 months prior to intervention (n = 149); one-month post-intervention (n = 208); and three months post-intervention (n = 123). Results: Substantial improvements were observed among the providers who used pre/post bronchodilator spirometry (5% at baseline, 12% at one month, and 19% at three months), and there was a significant increase in the number of patients being advised to improve conditions at home or school to avoid asthma triggers (9% at baseline, 43% at one month, and 37% at three months). However, prescription of preventive medications and patients being taught proper medication/spacer technique by providers decreased from baseline to three-months (69% vs 55% and 41% vs 27%, respectively). Providers’ self-reported barriers and patient load were consistently associated with poorer treatment outcomes. Healthcare providers who received continuing education on NHLBI - EPR 3 guidelines demonstrated an increase in spirometry use and in advising patients on improving home and school conditions. While these findings are useful, provider-reported barriers such as time, organizational, and insurance barriers prevent providers from effectively systematically incorporating all of the EPR 3 guidelines. Conclusions: Internal efforts to address clinical barriers combined with continued education may result in improvements in pediatric asthma-related treatment outcomes.
    • The need for culturally-tailored smartphone applications for weight control.

      Coughlin, Steven S.; Hardy, Dale; Caplan, Lee S.; Coughlin, S. S., Hardy, D. Caplan, L. S. (2016). Department of Community Health and Sustainability, Division of Public Health, University of Massachusetts, Department of Epidemiology, Rollins School of Public Health, Emory University, College of Allied Health Sciences, Augusta University, Department of Community Health and Preventive Medicine, Morehouse School of Medicine (Georgia Public Health Association, 2016)
      Approximately 35% of U.S. adults are obese, and this rate is expected to increase by almost 50% by 2030. New media such as smartphone applications (apps) provide a useful and low-cost way to disseminate weight control information. For many culturally distinctive population subgroups, however, there is currently an absence of research-tested smartphone apps for weight control.
    • A Needs Assessment of Hypertension in Georgia

      Lopez, Faye; Rimando, Marylen; Khapekar, Harshali; Mercer University (Georgia Public Health Association, 2006)
      Hypertension is a leading cause of stroke, coronary artery disease, heart attack, and heart and kidney failure in the United States. In Georgia, the percentage of those with hypertension and related diseases remain above the national average. The aim of this paper is to offer a basic review of hypertension including physical complications of the disease and to provide statistics regarding the scope of hypertension in the state of Georgia. Additionally, the paper provides insights on current hypertension programs such as the National High Blood Pressure Education Program (NHBPEP) and Dietary Approaches to Stop Hypertension (DASH). In conclusion, a statewide or local hypertension education program should be implemented to improve awareness, treatment, opportunities, and control of hypertension in an effort to reduce cardiovascular disease rates in Georgia.
    • 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.
    • Nicotine poisoning trends in Georgia

      Fabayo, Oluwayomi; Chung, Alina; Kenneth, Ray; O'Connor, Jean; Georgia Department of Public Health (Georgia Public Health Association, 2016)
      Background: Nicotine is a toxic chemical that can cause adverse health effects. Nicotine poisoning can result from exposure to tobacco and other nicotine containing products. It can cause nausea, vomiting, abdominal pain, fever, dizziness, seizures, tachycardia, hypertension and edema. Nicotine poisoning can affect both adults and children. Methods: The Georgia Department of Public Health secured data from the Georgia Poison Center in order to analyze nicotinespecific poisoning calls, including e-cigarette poisoning calls. The data on tobacco/nicotine poisoning or exposure calls were collected from April 2009 to April 2015. The data on calls related to nicotine poisoning from e-cigarettes were collected from January 2011 to April 2015. Results: Approximately 1,513 tobacco/nicotine poisoning calls were received over 6 years. Of these, 1, 212 were related to exposures in children ages 0 to 5 years, including 853 from cigarette use, 474 from cigars and chewing tobacco, and 23 from Nicoderm, Nicorette and hookahs. Approximately, 164 calls on nicotine poisoning from e-cigarettes were received over 4 years. Of these, 93 were related to exposure in children ages 0 to 5 years. Ingestion accounted for 107 of the calls, while 22 had nicotine poisoning through dermal routes, 21 through inhalation/nasal routes and 12 through ocular routes. Conclusions: Nicotine poisoning is a major public health problem in Georgia; it is caused by tobacco products and electronic nicotine delivery systems. Adopting tobacco-free/smoke-free policies that include e-cigarettes in homes, workplaces and vehicles will prevent nicotine poisoning.
    • Nonprofit hospitals and community health needs assessments

      Stephens, Beth (Georgia Public Health Association, 2015)
      Background: The Patient Protection and Affordable Care Act of 2010 requires all hospitals filing as 501(c)(3) nonprofit organizations to conduct a Community Health Needs Assessment (CHNA) every three years. Many Georgia hospitals published their first CHNAs in 2012 and 2013. The goals of this research and policy project were to assess compliance with the new CHNA requirements for nonprofit hospitals, provide recommendations to hospital administrators and policymakers, and encourage hospitals to engage in meaningful ways with community-based organizations and local public health departments in the next round of CHNAs. Methods: With funding from the Healthcare Georgia Foundation, Georgia Watch reviewed the initial CHNAs of 38 nonprofit hospital facilities in Georgia. Georgia Watch developed an evaluation tool to assess hospital compliance with five major components of the new CHNA requirements: 1) defining community; 2) collecting secondary data on community health; 3) gathering community input and primary data; 4) prioritizing community health needs; and 5) implementing strategies to address identified community health needs. To gain a deeper understanding of hospital processes, Georgia Watch supplemented document review with hospital leadership interviews and a survey of community input providers. This research was intended to inform, assist, and encourage citizens, community health stakeholders, public health departments, and hospital administrators. At the end of the session, audience members were better equipped to evaluate the adequacy of nonprofit hospital CHNAs within their own communities and encourage local hospitals to develop effective community benefit programs. Results: Georgia Watch found that hospitals are still learning how to navigate the CHNA process and that improvements can be made during the next round of CHNAs. Conclusions: Georgia Watch’s research provides insight on how hospitals can best engage their communities, prioritize local health concerns, initiate valuable partnerships, and develop meaningful, evidence-based strategies to address community health needs.Methods: With funding from the Healthcare Georgia Foundation, Georgia Watch reviewed the initial CHNAs of 38 nonprofit hospital facilities in Georgia. Georgia Watch developed an evaluation tool to assess hospital compliance with five major components of the new CHNA requirements: 1) defining community; 2) collecting secondary data on community health; 3) gathering community input and primary data; 4) prioritizing community health needs; and 5) implementing strategies to address identified community health needs. To gain a deeper understanding of hospital processes, Georgia Watch supplemented document review with hospital leadership interviews and a survey of community input providers. This research was intended to inform, assist, and encourage citizens, community health stakeholders, public health departments, and hospital administrators. At the end of the session, audience members were better equipped to evaluate the adequacy of nonprofit hospital CHNAs within their own communities and encourage local hospitals to develop effective community benefit programs. Results: Georgia Watch found that hospitals are still learning how to navigate the CHNA process and that improvements can be made during the next round of CHNAs.
    • Operational and financial performance of Georgia’s Critical Access Hospitals

      Kimsey, Linda; Apentenge, Bettya; Mase, William; Opoku, Samuel; Hanna, Mark; Boakye, Kwabena; Carhuff, Lisa; Owens, Charles; Peden, Angela; Tedders, Stuart; et al. (Georgia Public Health Association, 2017)
      Background: Georgia’s Critical Access Hospitals (CAHs) face increasingly complex threats to financial sustainability, as demonstrated by the disproportionally high number of closures in comparison to other states in the nation. Methods: Financial performance measures (including profitability, revenue, liquidity, debt, utilization, and productivity), site visits, key personnel interviews, and a revenue cycle management assessment were used to assess the strategic landscape of CAHs in Georgia, analyze financial and operational performance, and provide recommendations. Results: For CAHs in Georgia, financial and operating performance indicators, interviews, and assessments depict a challenging operating environment, but opportunities for improvement exist through implementation of a Lean Six Sigma program and improved benchmarking processes. Conclusions: Georgia’s CAHs operate in a challenging environment, but operational improvement strategies (such as a Lean Six Sigma program) and benchmarking directed towards business processes, including revenue cycle management, provide opportunities for sustainability in the future.
    • Partnership approach to establishing tobacco-free colleges and universities in Georgia

      Coleman, Anne-Marie; Ray, Kenneth; Toodle, Kia; Chung, Alina; O'Connor, Jean; Georgia Department of Public Health (Georgia Public Health Association, 2016)
      Background: Smoking rates in young adults ages 18-24 have been steadily declining since 2011 (2011:25.0%, 2012:22.3%, 2013:16.5% (BRFSS). The Georgia Department of Public Health (GDPH) partnered with the Georgia Board of Regents to adopt the 100% Tobacco Free Colleges/Universities policy. Methods: The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based surveillance system, administered by the GDPH in collaboration with the CDC. The survey began in 1984 with 15 states participating, including Georgia. The data from this survey were used to inform key shareholders of smoking prevalence to encourage policy adoption as a method of decreasing tobacco use. The GDPH used the CDC’s Partnership Toolkit to recruit and retain partnerships with various multi-sector organizations in working towards systems change. Results: The Georgia Board of Regents—the governing body for the state’s system of colleges and universities –adopted the model 100% tobacco free colleges/universities policy resulting in a systems change of 31 campuses now having the model policy in place. The policy not only impacted the students who fall in the 18-24 age group, but the staff and visitors as well. Conclusions: Partnerships play a key role in creating systems changes. The partnership between the Georgia Board of Regents and the Georgia Department of Public Health contributed to the growing number of colleges and universities who are now 100% Tobacco Free. Using the CDC’s Partnership Toolkit allowed for sustainable partnerships leading to positive social change.