• Quality Rated childcare programs and social determinants of health in rural and nonrural Georgia

      Webb, Nancy C.; Gates, Madison L.; Augusta University (Georgia Public Health Association, 2016)
      Background: Early childhood is linked to school readiness and early school achievement. Through its Quality Rated (QR) program, which was designed to improve the quality of care in early childhood programs, the state of Georgia has been a trailblazer in funding universal preschool and in improving the quality of childcare programs. We have assessed differences in the availability of QR childcare programs in Georgia to learn if, in rural versus non-rural counties, there is a relationship between QR childcare programs and health-related outcomes. Methods: This cross-sectional study evaluated county-level data to evaluate the relationship between QR childcare programs and social determinants of health. County-level data for Georgia were extracted from the Georgia Department of Early Care and Learning, County Health Rankings and Roadmaps, and the Georgia Juvenile Justice Data Clearinghouse. Results: Counties without QR childcare programs had child mortality rates 3.5 times higher than those for the state overall. Other differences in health-related outcomes included, but were not limited to, teen birth rates, low birth-weight babies, children in poverty, housing problems, and food insecurity. Conclusions: It is now appropriate to address the prevalence of health disparities in rural areas of Georgia and focus on some of the disparities through the QR early childhood programs and other state agencies. Empowering rural communities to address health disparities may be the most favorable path toward diminishing these inequalities.
    • Quantitative Data Analysis of Multiple Factors Associated with Low Birth Weight in Bibb County, Georgia

      Jackson, Haley D.; Wei, Yudan; Chen, Fan; Mercer University (Georgia Public Health Association, 2008)
      Objective This study aims to identify and evaluate significant risk factors associated with low birth weight in Bibb County, Georgia. Methods Data used in this study was obtained from the Georgia Department of Human Resources’ Vital Records Offices. The sample consists of 2,346 white and black or African American women giving birth in Bibb County, Georgia in 2005. Logistic regression was used to analyze the risk factors associated with low birthweight in Bibb County, Georgia. The multiple factors analyzed as independent variables included maternal race, maternal education, maternal age group, socioeconomic status, marital status, maternal tobacco use during pregnancy, maternal alcohol use during pregnancy, trimester mother began prenatal care and number of prenatal care visits mother received. The dependent variable analyzed was whether the infant was born low birth weight. Results Logistic regression analysis showed that the most significant risk factor associated with low birth weight in 2005 was receiving less than six prenatal care visits (odds ratio [OR] = 3.6; 95% CI = 2.5, 5.3). Maternal education of 12th grade of less (OR = 1.7; 95% CI = 1.2, 2.3), maternal race of black or African American (OR = 2.0; 95% CI = 1.5, 2.6), and use of tobacco during pregnancy (OR = 1.7; 95% CI = 1.2, 2.4) were also significant factors for low birth weight. Conclusions Based on the observations of the present study, it is recommended that intervention programs and communication tools should focus on those significant risk factors associated with low birth weight and target at-risk pregnant women; hence, reducing the incidence of infants born low birth weight in Bibb County, Georgia.
    • Racial Differences in Perception of Breast Cancer Risk in Rural Southeast Georgia

      Tedders, Stuart H.; Parrillo, Anthony V.; Peace, Karl E.; Knight, Jannell R.; Georgia Southern University; South Central Health District (Georgia Public Health Association, 2006)
      A university-public health collaborative was formed to more fully understand cancer risk among rural women in Georgia. Objectives: This study sought to gain an understanding of racial differences with regard to behavioral risk, perception of breast cancer risk, and perception of barriers to screening. Design: Differences in subjects’ risk and risk perception were assessed by creating, piloting, and administering a written survey at local health departments. Sample: A purposive sample of females enrolled in breast and cervical cancer screening programs in four rural counties in southeast Georgia (n = 147) were surveyed. Subjects were randomly invited to participate. Incentives were provided to enhance participation. Results: White females were significantly more likely than were black females to perceive pollution (OR: 4.63; p = 0.038), smoking (OR: 2.39; p = 0.018), age (OR: 3.01; p = 0.013), and hormone replacement therapy (OR: 3.17; p = 0.005) as factors influencing their breast cancer risk, and to perceive cost as a barrier to screening (OR: 2.89; p = 0.032). From a risk perspective, black females were more likely than white females to have had five-or-more pregnancies (p = 0.005), and to have given birth before age fifteen (p = 0.011). Conclusions: This study provided important baseline data about breast cancer risk necessary in developing effective health promotion programs.
    • Randomness and inference in medical and public health research

      Hayat, Matthew J; Knapp, Thomas; Georgia State University, Ohio State University (Georgia Public Health Association, 2017)
      Background: The purpose of this study was to provide a basis for describing the types of randomness used and statistical inferences reported in the medical and public health research literature. Methods: A study was conducted to quantify the types of research designs and analyses used and reported in medical and public health research studies. A stratified random sample of 198 articles from three top-tier medical and public health journals was reviewed, and the presence or absence of random assignment, random sampling, p-values, and confidence intervals, as well as type of research design, were quantified. Results: Random sampling was used in 58 (29.3%) and random assignment in 21 (10.6%) articles. Most (n=125; 63.1%) research studies did not report random assignment or random sampling; however, statistical inference was applied in more than 90%. Conclusions: Results revealed a concerning overuse of statistical inference. Incorrectly applying statistical inference when not warranted has potentially damaging medical and public health consequences. Researchers should carefully consider the appropriateness of using statistical inference in medical and public health research.
    • The Real "Monster" in Frankenstein

      Urizar, David O.; Department of Biological Sciences (Augusta University Libraries, 2016-10)
      The story of Frankenstein is typically seen as a battle between Victor Frankenstein and the “monster” of the story. However I argue that that the real “monster” of the story is in fact Victor Frankenstein who is suffering from paranoid schizophrenia and that the “monster” is really just a delusions that Victor uses to cope with the idea that he in fact is the killer of the story. This concept is evident in the fact that no one in the story has ever seen both Victor Frankenstein and the “monster” alive in the same place. The characteristics of the “monster’ also point towards the idea that the “monster” could not possibly exist. Even the way that Victor acts throughout the book point to the idea that he does not really care for the safety of his loved ones. Overall the actions that play out in the story point towards the idea that Victor Frankenstein is the real “monster” of the story.
    • Recruitment, retention, and succession planning for district health directors

      Rudd, Lee; Georgia Department of Health (Georgia Public Health Association, 2017)
      Background: Since the District Health Director (DHD) leads the district health organization, plans must be put in place to ensure that we retain current directors and anticipate the future when the DHD retires from the position. Methods: Best practices in the areas of recruiting, retention, and succession planning are used to present resolutions to the problems. Results: By following the steps identified in the best practices, there is a reasonable chance that the district will be prepared for any change in leadership. Conclusions: Using the best practices identified by human resources professionals combined with the unique characteristics of public health districts will ensure success.
    • Reducing and eliminating health disparities through prevention and public health

      Blumenthal, Daniel S.; Morehouse School of Medicine (Georgia Public Health Association, 2016)
      African Americans suffer more from health disparities than any other racial or ethnic group. In fact, African Americans have the highest mortality rate from every major cause of death. If public health is (as it fancies itself) social justice in health and health care, then it must address this injustice. The underlying cause of disparities is social determinants: income, education, discrimination, powerlessness, and other social factors. In the long run, a “level playing field” must be developed for these factors. But considerable progress in reducing disparities can be achieved through health promotion and disease prevention initiatives that focus on lifestyle determinants of health: tobacco control, improvements in diet, increases in physical activity, firearm control, and other wellknown measures
    • Reducing sexual risk behaviors and intentions among rural African American youth

      Brown, Natasha; Georgia State University (Georgia Public Health Association, 2017)
      Background: In spite of dramatic declines in teen pregnancy and childbearing in every state and amongst all racial groups, progress to-date remains unbalanced and disparities persist. Blacks, Hispanics, and youth residing in southern states or rural areas continue to experience the highest teen pregnancy rates in the nation. In an effort to enhance protective factors that help youth avoid behaviors placing them at risk for pregnancy, between September 2011 and May 2013, a public school district in rural southeast U.S. implemented an evidence-based youth development program designed to address these issues. Methods: A single-group, repeated measures design was employed to assess changes over time in past sexual risk behaviors, intentions regarding future behaviors, use of contraceptives, and pregnancy. The main questions answered were: does the program make a difference in the lives of youth involved, and to what extent? To answer these questions, participants completed brief self-administered surveys during the first and last sessions of the intervention (pre-/post-intervention surveys). Results: 447 predominantly African American (98%) students in grades 8-12 were enrolled; 94% completed the program. There were significant improvements in participants’ self-reported behaviors and intentions. For instance, when asked about their sexual activity during the three months before the pre-test, 69.0% of the students surveyed had sex at least once, but only 47.6% at post. Of those, 48.8% at pre and 58.2% at post reported having used a condom; 52.9% (pre) versus 69.6% (post) used some form of birth control. Conclusions: Students participating in this youth development program reported reductions in sexual risk behaviors and greater intentions to engage in safer sex practices in the future. Among the many lessons learned was the importance of offering incentives throughout the program’s duration to retain participants for the 9-month, 25-session intervention period.
    • Reflections on mental health advocacy across differing ecological levels

      Thompson, J Nancy; McGee, E Robin; Munoz, C Leslie; Walker, R Elizabeth (Georgia Public Health Association, 2015)
      ABSTRACT Background: According to the World Health Organization, mental health advocacy is comprised of a range of actions designed to change aspects of attitudes and structures that impede the achievement of positive mental health in populations. Methods: According to the World Health Organization, mental health advocacy is comprised of a range of actions designed to change aspects of attitudes and structures that impede the achievement of positive mental health in populations. Results: We have proposed interventions and advocacy effort for each ecological level. Project UPLIFT, a distance-delivered intervention for mental health is presented as an example of an effort that can affect several levels of the social ecology. Conclusions: Advocacy and interventions that make an effort to encompass the levels of the social-ecological model may contribute to greater progress in improving mental health outcomes.
    • A region-wide field placement program built on the foundation of mentorship and professionalism

      Carvallo, Michelle; Lloyd, Laura; Alperin, Melissa; Miner, Kathleen (Georgia Public Health Association, 2016)
      Background: The Region IV Public Health Training Center (R-IV PHTC) provides public health students from the eight states of HHS Region IV with essential practice experiences that demonstrate the value of working with underserved populations. The Pathways to Practice Scholars field placement program is built on a foundation of mentorship, professionalism, and community. Methods: Sixteen student scholars (13 graduate; 3 undergraduate) were selected to work during May-August 2015 in practice-oriented agencies serving underserved populations. Each scholar received a $1500 living allowance. Seven of 16 accepted an internship outside the state of their university. In conjunction with mentors, Scholars developed work plans based on Council on Linkages Core Competency domains. Requirements included a pre-, mid- and post-assessment, an executive summary/reflection, and a virtual webinar presentation. Results: Student Scholars worked at sites across eight states in state or local health departments, Area Health Education Centers (AHECs), and healthcare settings. Students identified Core Competency domains they developed most during the field placement: Communication, Analytical/Assessment, Leadership/Systems Thinking, and Community Engagement. The R-IV PHTC asked mentors to treat interns as valued employees and include them in activities beyond their specific project. Indicators of successful mentorship included expressed appreciation for student assistance and the desire to enrich the student experience while benefiting the agency mission. Mentors provided clearly defined projects for a short timeframe (10-12 weeks), adjusted to the students’ capacity and readiness, and offered opportunities to apply classroom skills to practice. They helped students develop immediately useful products in collaboration with community stakeholders. Conclusions: Mentors play a crucial role in the development and success of field placement students, but students and mentors share equal responsibility in fostering the relationship. Past case studies from this program demonstrate that some students find employment in these same agencies after graduation, and become mentors for future students, thus, creating a self-perpetuating learning communit
    • Relationship of Fruit and Vegetable Servings and Self-Reported Diabetics in the Southeast and Northeast

      Rimando, Marylen; Lopez, Faye; Battula, Haritha; Mercer University (Georgia Public Health Association, 2007)
      According to the American Diabetes Association, most diabetic patients are not consuming the recommended 3-5 servings of vegetables and 2-4 servings of fruits a day. This study examined fruit and vegetable servings of self-reported diabetics (N=35,407) in select southeastern and northeastern states using Behavioral Risk Factor Surveillance System (BRFSS) 2005 data. The estimate for both fruit and vegetable servings and self-reported diabetes was determined using multivariate logistic regression, adjusting for sociodemographics and geographic region. The results indicated a significant difference between fruit and vegetable servings for diabetics and non-diabetics (p<0.0001). A higher percentage of diabetics in the northeast consumed more than three servings of fruit and vegetables when compared to diabetics in the southeast. Respondents in the northeast were 21% more likely to consume five or more servings of fruit and vegetables and 16% less likely to be diabetic than those in the southeast after adjusting for age, race, sex, and geographic region. In conclusion, diabetics in the northeast consumed more servings of fruit and vegetables than did those in the southeast. Multiple factors influence fruit and vegetable consumption and diabetes and should be considered when developing targeted nutritional interventions. Diabetes educators, nurses, and physicians can encourage diabetic patients to consume more fruit and vegetables and motivate them to continue eating fruit and vegetables.
    • A review of community-based participatory research studies to promote physical activity among African Americans.

      Coughlin, Steven S; Smith, Selina A; Department of Community Health and Sustainability, Division of Public Health, University of Massachusetts, Department of Epidemiology, Rollins School of Public Health, Emory University, Institute of Public and Preventive Health, Augusta University (Georgia Public Health Association, 2016)
      As part of the planning process for new research, the literature on community-based participatory research (CBPR) approaches for promoting physical activity in African American communities was systematically reviewed.
    • A review of strategies to increase access to oral health services

      Davis, Breyana; Plasphol, Sara; Armstrong State University (Georgia Public Health Association, 2017)
      Background: Leading Health Indicators (LHIs), a subset of objectives for Healthy People 2020, were selected to communicate at-risk health issues and actions that can be taken to address them. Nationally, the number of children, adolescents, and adults who visited the dentist in the past year has decreased, suggesting that oral health continues to be a problem caused by barriers preventing access to oral health services. This review aimed to identify strategies to increase access to oral health services that will be useful in moving toward the LHI objectives. Methods: Preliminary research was conducted on the LHI via the Healthy People 2020 website. Health-related, peer-reviewed articles were selected and evaluated to determine current strategies used to increase access to oral health services that would lead to achievement of the LHI objectives. Results: Evidenced-based literature shows that economic, educational, and personal barriers prevent access to oral health services. Through health promotion and educational interventions, however, good oral health can be established. Such improvements will lead to attaining the LHI objectives in moving towards the target goals of Healthy People 2020. Conclusions: Since primary prevention and early intervention procedures lead to improved oral health, such methods can be useful in reaching the LHI objectives and the target goal of Healthy People 2020.
    • Risk Factors for HIV Transmission among Hispanic Men Who Have Sex with Men in Atlanta

      Nanan, Denyse N. C.; Hepburn, Valerie A.; Georgia State University (Georgia Public Health Association, 2007)
      This study assessed and compared demographic factors, psychosocial factors, health seeking behavior, and sexual practices of two convenience samples of Hispanic/Latino gay men and men who have sex with men (MSM) in the metropolitan Atlanta region. The aim was to obtain data on emerging HIV/AIDS patterns in this group. Bilingual surveys were conducted in 2000 and 2006 at local gay bars. Discrepancies observed between HIV/AIDS knowledge and sexual behaviors in 2000 were replicated in 2006. Contrary to expected improvements due to enhanced HIV/AIDS education and awareness, risk behavior for HIV/STDs increased significantly between 2000 and 2006. These findings should inform the design and delivery of programs aimed at meeting the HIV/AIDS prevention, education and treatment needs of this growing population.
    • The role of perception in developing healthy lifestyles and community engagement

      Coleman, Anne-Marie; Hicks-Coolick, Anne; Brown, Agnes F.; Georgia Department of Public Health; Cobb and Doglas Public Health Department; Kennesaw State University (Georgia Public Health Association, 2015)
      Background: The Cobb and Douglas Public Health Department and the Cobb2020 partnership, sponsored by the Mobilizing for Action through Planning and Partnering program, facilitated six focus groups in Cobb County to ascertain residents’ perceptions of healthy behaviors. The purpose of the research was to assist in the development of programs to increase healthy behaviors. Methods: Purposive sampling was used to choose fifty-eight participants, who were divided into six groups in different geographic locations. The focus group questions concerned healthy living, health communications, and community health. Qualitative data analysis techniques were used to generate themes and categories across and within groups. Results: Six themes emerged: 1) need for education; 2) healthy food choices; 3) access to healthcare; 4) trust in health care providers; 5) affordable healthcare; and 6) need for local resources. The results show how community members’ perceptions regarding: a) policies that affect health, b) environments that promote healthier choices, and c) systems that allow individuals to be health consumers influence healthy living and community engagement. Other findings note different perceptions between those with and without health insurance. In addition, socio-economic status and ethnicity were seen as factors related to the perceptions of participants. Conclusions: The findings of this study informed a comprehensive, county-wide Community Health Improvement Plan. As a result of these studies, Cobb & Douglas Public Health established, as two chronic disease prevention interventions, the Cobb2020 Farm Fresh Market and, in the City of Kennesaw, the 100% Tobacco Free Parks and Cemeteries policy. Keywords: focus group, healthy living, individual perceptions, health belief model
    • The role of The Dental College of Georgia in meeting the oral health needs of Georgians

      Lefebvre, Carol; Augusta University (Georgia Public Health Association, 2017)
      As the state’s only dental school, The Dental College of Georgia (DCG) takes seriously its role in meeting the oral health needs of Georgia. Georgia is the largest state in physical size east of the Mississippi River, and it continues to be one of the fastest growing states in population. In 2016, the estimated population of Georgia was 10,310,371.1 Over the past 3 years, the number of single-county or low-income Dental Health Professional Shortage Areas (DHPSAs) in Georgia has increased to 131, an increase of 50 areas in 3 years.2
    • Salty or Slightly Salty: Is Fish Species Richness Affected by an Obsolete Navigational Cut?

      Patterson, Rebecca; Mathews, Loren; Saul, Bruce; Biological Sciences, Georgia Southern University (Biology) (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.
    • Schizoaffective Disorder Depressive Type in “The Yellow Wallpaper” by Charlotte Perkins Gilman

      German, Lindsey; English and Foreign Languages (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.
    • Screening for developmental delay in Georgia's family shelters: Formative evaluation of a quality improvement initiative

      So, Marvin; Agbayani, Luistita; Gutierrez, Mariel; Griffins, Josef; Emory University; Atlanta Children's Shelter; Greenbriar Children's Shelter; Interfaith Hospitality Network (Georgia Public Health Association, 2016)
      Background: Children in families experiencing homelessness are at elevated risk for cognitive, motor, speech, and other developmental delays. Given the prevalence of family homelessness in Georgia and across the U.S., investigating the feasibility of implementing developmental screeners while families are in shelters is warranted. Methods: Three pilot shelters were selected for the development and implementation of Quality Improvement (QI) Teams, who used Plan-Do-Study-Act (PDSA) Cycles to make progress towards universally screening children for delay. We employed a formative evaluation to (1) characterize screening rates and shifts in shelter as a result of QI initiatives, and (2) identify barriers and facilitators to implementing QI interventions in family shelters. Results: Screening rates in all three shelters increased over the study period between 13-50%. Primary implementation facilitators included team members with experience in QI principles; having a medical provider on the team; possessing an “improvement culture;” and having diverse perspectives represented. Primary barriers included a lack of time or commitment in QI team leaders; medical providers with limited time in shelter; lack of training on how to represent and discuss QI data; and restrictive organizational policies. Conclusions: Family shelters demonstrate promise for implementing developmental screeners for at-risk children. Although challenges have been identified, facilitating factors are prevalent and underscore the importance of QI team preparation, composition, and cohesion. The relative availability, low-cost, and potential for impact of developmental screeners offer credence to their uptake and implementation within shelter clinical contexts.
    • A screening tool for identification of victims of commercial sexual exploitation of children

      Livings, Michelle; Greenbaum, Jordan; Lewis, Rayleen; Williams, Jeremiah; Self-Brown, Shannon; Lai, Betty; Georgia State University, Stephanie Blank Center for Safe and Healthy Children, Children's Healthcare of Atlanta, National Center for Immunization and Respiratory Disease at the Centers for Disease Control and Prevention (Georgia Public Health Association, 2017)
      Background: Commercial sexual exploitation of children (CSEC) and sex trafficking have only recently been recognized as problems by healthcare providers. Both UNICEF (2014) and the Institute of Medicine (2013) have stressed the need for systematic research to assist healthcare providers in the identification of victims. The aim of this poster is to describe initial findings relating to the development of a screening tool to identify CSEC victims. Methods: Twenty-seven sites nationwide (e.g., emergency departments and specialized clinics) participated in a study to validate a screening tool for identifying CSEC victims in an outpatient setting. The study was conducted under approval from the Institutional Review Board at Children’s Healthcare of Atlanta. Inclusion criteria for the study generally involved being an English-speaking adolescent aged 11-18 years. Results: Study enrollment is ongoing. Preliminary data for 210 youth were analyzed for this abstract. The sample was diverse with respect to age (M=14.59 years, SD=1.490 years) and ethnicity (56.4% Caucasian, 31.8% African American, 3.9% mixed race, and 7.8% Hispanic); the sample was predominantly female (92.8%). Of the 210 youth in the sample, 115(54.8%) have had sex. Of these 115 youth, 13(11.3%) have traded sex for money, drugs, or housing; 7(58.3%) of 12(10.4%) complied when asked by someone to have sex with another person; 8(61.5%) of 13(11.3%) performed sexual acts in public when propositioned; and 19(45.2%) of 42(36.5%) shared provocative photos when prompted. Medical providers flagged 14 youth (6.7% of total 210) as potential CSEC victims. Conclusions: The screening tool shows promise for effective identification of CSEC victims. This poster will present additional data and further quantitative analyses exploring the influences of sexual behavior, drug and alcohol use, and other factors on the risk of becoming a CSEC victim. Implications for researchers and clinicians will also be discussed.