• 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.
    • Partnership between academic and public health to train public health nurses new chronic diseases protocols

      Martin, Kathryn; Wood, Elena; Goggans, Stephen; Mulloy, Anthony; Brown, Shilpa; Wallach, Paul; Augusta University, East Central Health District (Georgia Public Health Association, 2017)
      Background: According to the Georgia Department of Public Health (DPH), cardiovascular disease is the leading cause of death in Georgia (29% in 2013). Diabetes (DM) and hypertension (HTN) are known risk factors for cardiovascular disease. In 2013, the prevalence of diabetes was 11% and of hypertension was 35% of the state’s adult population. There are not sufficient healthcare providers to manage these patients. To address this concern, the DPH Chronic Disease Prevention Section contracted with the Medical College of Georgia (MCG) at Augusta University to design and implement an innovative training program for Georgia public health nurses on diabetes and hypertension protocols. Methods: The two days’ training consisted of lectures, workshops, case discussions, simulation, physical examination practice, and both written and clinical skills testing developed and presented by MCG faculty members in accordance with DPH DM and HTN protocols. The epidemiology, risk factors, disease process, and appropriate pharmacologic and non-pharmacologic management protocols were covered during the training sessions. Results: A post-training evaluation survey was conducted to evaluate accomplishment of the 10 learning objectives, the effectiveness of teaching approaches, appropriateness of training facilities, and whether personal learning goals were met. Participants rated “meeting program objectives” highly with 96% of responses “met”, 3.5% “somewhat met”, and 0.5% “not met”. Participants were asked to rate personal knowledge of HTN and DM before and after the training (5-1 Likert scale with 5 = most knowledgeable and 1 = least knowledgeable). Average for pre-training was 3.0, and after the training 4.2. Conclusions: A partnership between the DPH and a public medical school resulted in a successful training of public health nurses. Participants agreed that the training effectively improved knowledge and ability to provide care with diabetic and hypertensive patients. Evaluation of the training on public health nurses’ actual practice is desired, with the hope of disseminating better services to and improved healthcare for the population of Georgia.
    • The Past is a Foreign Country They View Things Differently There: The Perception of “The Invisible Empire of the Ku Klux Klan” as a Benevolent Secret Society from 1915 to 1965

      Typhair, Dillon; History, Anthropology, & Philosophy (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.
    • Patient-centered outcomes for GoStrong: A self-management diabetes program in Savannah, GA

      Yang, Frances; Roberts, Lizzann; Davis, Bionca; Christianson, Angela (Georgia Public Health Association, 2015)
      Background: To advance the goal of health improvement for diverse populations with diabetes, a patient-centered approach is foundational. Methods: Innovative methods were used to initiate and advance an approach to diabetes engagement and self-management. We began with a strategy to understand how patients with diabetes view and interact with the disease via the medical community and moved to program development through patient-centered design and to the development of strategic partnerships and continuous learning from patients, stakeholders, and academic research partners. Results: The mean age of the participants in the GoStrong™ program (n=106) was 51 ±9.2 (SD) years. There were significant differences in the HbA1c levels over time compared to the Control group (n=100). The mean HbA1c level from baseline to 36 months decreased from 7.49% to 6.89%, with the largest decline (to 6.28%, p<0.01) at 12 months. The mean HbA1c level for the control group increased from 8.38% to 8.49% from baseline to 36 months, with the largest increase (to 8.89%, p<0.01) at 18 months. There were significant differences for total medical costs at 12 months prior to and 12 months after starting the GoStrong program, a difference in total prescription drug costs at 12 months, and differences within the total group in number of emergency room (ER) visits. Claims information showed that GoStrong produced significantly lower total medical costs and ER visits. There was also an increase in total prescription drug costs that may be due to better medication adherence. Conclusions: For diabetics, the GoStrong program results in reduced HbA1c levels, reduced costs, and reduced ER visits.
    • Perceptions of HIV/AIDS testing among urban and rural African American church members

      Walker, Roblena E; Walden University (Georgia Public Health Association, 2015)
      Background: The prevalence of the human immunodeficiency virus (HIV) continues to affect African Americans (AA) disproportionately. The purpose of this mixed methods study, guided by the health belief model, was to examine associations linking church and ambient social environment with knowledge and perceptions of HIV/AIDS testing amongst urban and rural AA church members. Methods: Multiple regressions and t tests were used to compare perceptions of HIV/AIDS testing and knowledge of HIV/AIDS among 236 participants selected from two AA churches located in a large city (n = 122) and in a rural town (n = 114) in the Southern U.S. Results: The quantitative findings indicated that the urban participants reported significantly higher rates of testing than the rural participants, but the groups had equally high HIV knowledge and positive perceptions of HIV/AIDS testing. In-depth, individual interviews (24 urban; 24 rural) were conducted to gain a better understanding of the factors that contribute to perceptions of HIV/AIDS testing and knowledge of HIV/AIDS. Transcripts were axially coded for a priori themes and then analyzed for emergent categories of responses. These interviews indicated that the participant’s perceptions of HIV/AIDS testing were in general, not influenced by the church and that there were no noticeable distinctions regarding why HIV/AIDS testing was sought. The combined results of this study suggested that the churches surveyed were not promoting HIV/AIDS awareness and that the participants felt that the church should do more as it relates to HIV/AIDS. Conclusions: Since the AA church plays an important role in the lives of many AAs, it potentially can, particularly in rural areas, bring forth social change by advocating HIV/AIDS testing and prevention efforts in order to reduce the rate of HIV infections.
    • Perfluorooctanoic Acid (in the Presence of Fetal Bovine Seruym) Induces Proliferation in ERα Positive and ERα Negative Breast Cancer Cell Lines

      Gaw, Victoria; Glenn, Manderrious; 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.
    • Perinatal health and school trajectories

      Williams, Bryan; Weldon, Arianne; Fitzgerald, Brenda; Gary, Fran; Emory University (Georgia Public Health Association, 2016)
    • Physician attitudes toward the ethics of pre-exposure prophylaxis (PrEP): Cost, safety, and resource allocation

      Grippo, Jessica; Smallwood, Stacy; Pincura, Katherine; Wright, Tamara; Masa, WIlliam (Georgia Public Health Association, 2017)
      Background: In the United States, human immunodeficiency virus (HIV) remains a substantial public health issue. There is evidence that the use of antiretroviral medications such as pre-exposure prophylaxis (PrEP) can be a safe and effective primary prevention strategy to reduce new cases of HIV infection. Provider practice behavior as it relates to prescribing PrEP and the potential impact on specific vulnerable populations needs increased attention. Few studies have evaluated the attitudes of physicians towards ethical issues related to prescribing PrEP. Methods: The purpose of the present literature review was to evaluate provider attitudes toward the ethics of prescribing PrEP for individuals at risk of acquiring HIV infection. Searches of the PubMed and Cochrane databases were conducted. Three reviewers independently assessed the relevance of articles and discarded those not directly related to the attitudes of physicians toward ethics of the cost, safety, and resource allocation of PrEP. A total of twenty-one articles were included in the review. Results: Provider attitudes and perceptions focused on three areas: resource allocation, cost, and safety or effectiveness of PrEP. Providers who were hesitant in prescribing PrEP were concerned with the availability of resources, patient adherence, risk of drug resistance, and toxicity. In the studies reviewed, few providers had prescribed PrEP; however, prescribing practices trended upward with time and awareness. Conclusions: Realization of the benefits of PrEP will require a utilitarian ethical approach to identifying the populations that will benefit most, monitoring for adverse effects, addressing costs, and educating and training providers to prescribe PrEP responsibly. Ensuring that PrEP fulfills its potential as part of a combination regimen for HIV prevention requires identification of additional evidence, education, support services, and resources that are needed, as well as the regulatory framework and cost scenarios for access to PrEP.
    • Planning a national-level data collection protocol to measure outcomes for the Colorectal Cancer Control Program

      Satsangi, Anamika; DeGroff, Amy; Centers for Disease Control and Prevention (Georgia Public Health Association, 2016)
      Background: The Colorectal Cancer Control Program (CRCCP) of the Centers for Disease Control and Prevention (CDC) funded 30 grantees to partner with health systems with the goal of increasing screening for colorectal cancer (CRC). Methods: Evaluators applied CDC’s Framework for Program Evaluation to design a national level outcome evaluation for measuring changes in CRC screening rates in partner health systems. Results: The resulting evaluation design involves the collection and reporting of clinic-level CRC screening rates supplemented by various tools to support the reporting of high quality, reliable data. Conclusions: The CRCCP evaluation represents a strong design to measure the primary outcome of interest, CRC screening rates, and public health practitioners can benefit from lessons learned about stakeholder involvement, data quality, and the role of evaluators in data dissemination.
    • Portrayal of Mental Illness in Edgar Allan Poe’s “The Tell-Tale Heart”

      Shaikh, Arika; English and Foreign Languages (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.
    • Predictors of mammogram and Pap screenings among US women

      Akuse, Sewuese; Tate, Koren; Addision, Tiffany; Drayton, Tierra; Kanda, Deborah; Sullivan, Kelly; Jiann-Ping Hsu College of Public Health; Georgia Southern University (Georgia Public Health Association, 2016)
      Background: The most common cancers among women are breast and cervical cancer. Although early detection of cancer has been shown to increase the likelihood of survival, many women are not screened for these cancers as often as practice guidelines recommend. The objective of this study was to examine the mammography and Papanicolaou (Pap) smear screening practices among women within the United States, and to determine predictors of screening. Methods: Data from the 2012 and 2014 Behavioral Risk Factor Surveillance System were used. The association between demographic predictors (age, marital status, education level, employment status, income, health insurance, and medical cost concerns) and having Pap or mammogram screening consistent with guideline recommendations was assessed using logistic regression analysis. Results: Pap and mammography screenings were positively associated with younger age, minority race, being married, having a higher level of education, being employed, having higher household income, having health insurance and not having financial concerns regarding affording doctor visits. Blacks and Hispanic women were more than twice as likely to have Pap screenings (Black: OR=2.16, 95% CI 1.97-2.36; Hispanic: OR=2.33, 95% CI = 2.11-2.58) and mammograms (Blacks: OR=2.11, 95% CI 1.88-2.36; Hispanics OR=1.82, 95% CI 1.60-2.07) compared to White women. Women earning less than $10,000 per annum were much less likely to have cervical cancer screenings (OR=0.57, 95% CI 0.51-0.65) compared to women with higher incomes while mammography screening was less likely among women who reported financial barriers to health care (OR=0.59, 95% CI 0.53-0.64). Conclusions: Women from minority ethnic groups were more likely to be screened for cervical cancer compared to White, non-Hispanic women. Women from low-income households and women who could not visit a doctor due to costs had the strongest association with lacking screenings.
    • Pregnancy and Delivery Costs in Georgia Medicaid: PCCM versus Feefor- Service Enrollees4

      Raskind-Hood, Cheryl; Adams, E. Kathleen; Alema-Mensah, Ernest; Mayberry, Robert M.; Morehouse College; Emory University; Baylor Health Care System (Georgia Public Health Association, 2006)
      This study examines the enrollment, resource utilization, and prenatal care cost patterns among pregnant black and white women in Georgia’s PCCM program, Georgia Better Health Care (GBHC), compared with those acquiring pregnancy and delivery services through Georgia’s Fee for Service (FFS) sector. Birth certificate data from 1998 were linked with Medicaid enrollment and claims data from 1997 and 1998 to construct a retrospective pregnancy history for each Medicaid woman giving birth in Georgia hospitals in 1998. Total payments for pregnancy and delivery services and on the total number of prenatal care visits were derived for each woman in the sample. Multivariate logistic analyses were employed to assess the role of PCCM versus FFS in determining total payments and the likelihood of a prenatal hospitalization, length of hospital stay longer than 2 days following delivery, and cesarean section delivery. While prenatal pregnancy services and delivery costs were higher for those in PCCM than FFS, PCCM women had fewer prenatal care visits and were less likely to have delivery stays longer than 2 days postpartum compared with FFS women. The higher costs under PCCM are apparently related to the finding that this delivery system was highly associated with having more prenatal hospitalizations compared with FFS. In similar analyses conducted separately for white and black pregnant women, black women served by PCCM followed these overall results across delivery systems while there were no differences in the likelihood of a prenatal hospitalization or total prenatal care visits for whites served by PCCM versus FFS. In light of Georgia’s turn toward full capitation under its new managed care initiative, many issues regarding pregnancy services and delivery such as earlier program enrollment, coordination of care, payment policies and capitation rates will need to be addressed.
    • Prehistoric Dinosaurs: An Exploration of Fact vs. Fiction Through the Creation of Comparative Sculptural Forms

      Havens, Krista; Art and Design (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.
    • A preliminary examination of elevated blood lead levels in a rural Georgia county

      Rustin Chrstopher; Sun, Yu; Calhoun, Chris; Kuriatnyk, Christy; Georgia Southern University, Georgia Department of Health (Georgia Public Health Association, 2016)
      Background: Rural areas are often viewed as lower risk for lead poisoning and toxic exposures seriously impacting development of the brain and central nervous system; this report examines the prevalence of elevated blood lead levels for children <6 years of age in rural Ben Hill County, GA. Methods: Lead surveillance data from the Georgia Department of Public Health (DPH) were analyzed using SAS®v-9.3 to calculate the prevalence of elevated blood lead levels (≥5ug/dL) among those children in Ben Hill County who had been tested for lead; the results were compared to Georgia and national data. Results: A preliminary analysis of 2010-2015 screening data for Ben Hill County indicates that 8.73% (95%- CI: 7.4%-10.1%) of children that were tested for lead exceeded the Centers for Disease Control reference level (≥5ug/dL) and is approximately 3.5 and 2.4 times higher, respectively, when compared to the National (2.5%) and State (3.64%) percentages of children exposed to lead at or above the reference level. Conclusions: While these data are preliminary and more analysis is planned to ascertain the full breadth, source, and scope of the problem, it highlights lead poisoning risks rural communities face that are often overlooked in population-based risk analysis and research on lead exposure in children.