• Tailoring a hybrid program for reducing health and education disparities in Georgia communities: Outcomes of listening sessions

      Ejikeme, Chinwe; Georgia Department of Public Health (Georgia Public Health Association, 2017)
      Background: Minorities in Georgia experience increased rates of chronic disease and poor health and education outcomes. In the general population in 2013, about 35% of adolescents were either overweight or obese and approximately 13% of children 2-4 years old were obese, with minorities accounting for higher rates. In 2010, 23% of students from low-income families, comprising a higher proportion of minorities, scored at or above proficient level for reading at the end of third grade. Targeting children 0-5 years, Georgia Department of Public Health developed an integrated curriculum to train Early Childcare Educators (ECEs) to increase their knowledge and skills to model food, activity and language nutrition in their classrooms and to coach families. We conducted listening sessions to understand attitudes and knowledge around nutrition in 3 communities with significant racial and ethnic populations. Methods: Listening sessions with ECEs and families were conducted separately in each community. Participants engaged in guided one-hour discussions around food, activity and language nutrition and completed a post-listening session survey to assess their nutrition practices with the children in their care or homes. Results: 70 ECEs and families participated in the sessions and post session surveys. With an over 80% satisfaction rate with sessions, results showed that although baseline understanding of and challenges to modelling nutrition differed in different communities, many strategies used to support nutrition were common across communities. Participants also demonstrated a need for support in increasing access to resources to improve nutrition. Conclusions: This study suggested that multiple issues hinder optimal engagement of children 0-5 years in improved nutrition. Addressing the factors specific to targeted communities is essential to reducing disparities. Thus, integrating these findings in the development of the curriculum and training strategy has the potential to produce more knowledgeable and skilled ECEs as coaches for improving nutrition.
    • Tapping the “town and gown” potential for correctional health research collaborations

      Gates, Madison L.; Staples-Horne, Michelle; Webb, Nancy C.; Braithwaite, Ronald; Hastings, Beverly (Georgia Public Health Association, 2015)
      Background: Collaborations between juvenile justice systems (town) and academia (gown) promise to significantly enhance what we understand about high rates of sexually transmitted infections (STIs) found among detained populations, particularly African American young women. However, research related to the sexual health of adolescent detainees has not occurred in proportion to the magnitude of issues found in the population. While there are many challenges to conducting research with this population, there are also lessons learned and best practices from other studies that may provide guidance. Methods: In 2015, we implemented a pilot project with young women in a detention center to understand the association between STIs and relationship dynamics. Using a formative assessment-based approach, the team periodically compared expectations to actual milestones and outcomes. This approach has provided feedback, guidance and lessons learned that we will use to adjust our pilot project. Results: Three challenges emerged from our review: concerns related to different agendas, bureaucratic difficulties and human protection. In addressing these challenges, we identified study procedures to revise and to incorporate into future works. Conclusions: Juvenile justice and academic partnerships require extensive pre-research work to account for the many challenges to implementing and conducting projects with this population. However, “town and gown” approaches to understanding and improving the sexual health of detainees can result in a more complete assessment of these issues compared to either a solely academic or juvenile justice investigation.
    • TEACH Kitchen: A Chronological Review of Accomplishments

      Chea, Jung Hee; Ansa, Benjamin E.; Smith, Selina A.; Augusta University (Georgia Public Health Association, 2017)
      Background: The Eating and Cooking Healthy (TEACH) Kitchen was founded at the Medical College of Georgia in 2015 as a nutrition-based intervention to combat the high prevalence of obesity and obesity-related chronic diseases in the area of Augusta, Georgia. Despite the importance of diet in the management of chronic diseases, inadequate nutrition education among patients and healthcare providers presents a barrier. The purpose of TEACH Kitchen is to address this gap. Methods: TEACH Kitchen is as a student-led initiative that promotes healthy cooking among medical students and patients with chronic diseases. Healthy nutrition and cooking classes are held during the academic year. Participants spend four weeks on each of four modules: obesity, hypertension, hyperlipidemia, and diabetes mellitus. Data collection, which began in January 2017, is currently on going. TEACH Kitchen has collaborated with Augusta University, Sodexo, and Kohl’s. Results: Currently, TEACH Kitchen has enrolled 14 patients and 6 children. Anticipated results include measurements of preand post-intervention changes in knowledge, attitudes, beliefs, and competence in nutrition, as well as differences in clinical indicators, including body mass index, blood pressure, lipid profile, and HbA1c. Conclusions: TEACH Kitchen is the first medical school-based nutrition/cooking education initiative in Augusta, Georgia. It provides patients and medical students with hands-on healthy nutrition/cooking experience with the goal of decreasing the prevalence and improving the outcome of obesity-related diseases.
    • Techniques Used to Establish the First Person Narrator and Perspective in Double Indemnity and Murder, My Sweet

      Walton, Breana; Department of English and Foreign Languages (Augusta University Libraries, 2017-05-11)
      Directed by Billy Wilder and Edward Dmytryk respectively, the films noir Double Indemnity (1944) and Murder, My Sweet (1944) each have a storyline that unfolds from a first person perspective as told by a narrator. The techniques used in the films establish this first person perspective through which the films are understood. Both films include voice over as a technique, which determines who the narrator is and the amount of information withheld or disclosed to the audience. Establishing the visual perspective of the narrator is portrayed through differently for each film. While, Double Indemnity utilizes camera angle, Murder, My Sweet uses camera filters and special effects. Lastly, to achieve the first person narration, the character narrating in each film must be present in every scene or give explanation of events that occur in his absence. The various techniques used in each film function cohesively to establish the narrator and achieve his perspective through which the plot is understood by the audience.
    • Trends in cancer incidence rates in Georgia, 1982-2011

      Yoo, Wonsuk; Coughlin, Steven S.; Lillard, James; Georgia Regents University; Emory University; Morehouse College (Georgia Public Health Association, 2015)
      Background: Although data from the Surveillance, Epidemiology, and End results (SEER)-affiliated cancer registry are accessible to the public, there is a shortage of published research describing cancer incidences for White, Black, and other residents in Georgia. The objective of this research is to provide an overview of the trends in incidence of cancer in Georgia. Methods: Incidence data were obtained from the Surveillance, Epidemiology, and End Results (SEER) 9 program, supported by the National Cancer Institute, spanning the years 1982 to 2011. To assess trends over time, age-adjusted cancer incidence rates relative to the 2000 Standard US population and annual percent changes (APCs) were calculated using SEER*Stat software. Results: In Georgia, cancer incidence rates for women increased from 365.1 per 100,000 in 1982 to 404.2 per 100,000 in 2011, with an overall APC of 0.3% (95% confidence interval: 0.2 to 0.4), but, for men, cancer incidence rates showed a slight decline from 528.0 per 100,000 in 1982 to 513.7 per 100,000 in 2011 (APC of 0.2%, 95% CI: -0.6 to 0.1). For Black, White, and Other (Asian/Pacific Islanders/American Indians) females, there were increases in incidence in this period, with APC values of 0.6, 0.4, and 0.3, respectively. For all males and for Black and White males, there were overall decreases in incidence, with APC values of -0.2. For Other males, however, the APC value was -0.9. Conclusions: In Georgia, increases in cancer incidence rates occurred during 1982-2011 among the female population and within various racial groups in this population, but there was relative stability in incidence rates among the male population, except for Other males.
    • Trends in HIV testing among adults in Georgia: Analysis of the 2011-2015 BRFSS data

      Ansa, Benjamin; Augusta University (Georgia Public Health Association, 2017)
      Background: Georgia is ranked fifth highest among states for rates of HIV diagnosis. About 4% of persons living with HIV infection in the United States reside in Georgia, and almost 19% of these people do not know their HIV status. The present study examined the trends and associated factors of HIV testing among adults in Georgia between 2011 and 2015. Methods: The 2011-2015 Behavioral Risk Factor Surveillance System (BRFSS) data were analyzed. Results: A total of 31,094 persons aged ≥18 years were identified who responded to the question “Have you ever been tested for HIV?” Overall, there were 11,286 (44.2%) respondents who had been tested for HIV, with a slight decrease in percentage from 45.6% in 2011 to 43.7% in 2015 (APC= -0.98, not significant). Factors associated with HIV testing were being female (p=0.004), black (p<0.001), younger than 55 years (p<0.001), single (p<0.001), attaining education level above high school (p<0.001), and earning annual income of $50,000 or less (p=0.028). Conclusions: Overall in Georgia, there has been a slight decline in the temporal trend of HIV testing, and more than half of adults have never been tested for HIV.
    • Triple-negative breast cancer in Georgia: Burden, disparities, and connections to Georgia’s Breast Cancer Genomics Project

      Berzen, Alissa; Bayakly, Rana (Georgia Public Health Association, 2017)
      Background: Triple negative breast cancer (TNBC) is typically aggressive and unresponsive to traditional cancer treatment, and disproportionately affects young and Black women. Approximately 60%-80% of breast cancers in women with the breast cancer gene (BRCA) mutation are TNBC, and children of a parent with a BRCA mutation have a 50% chance of inheriting it. Current guidelines recommend women diagnosed with TNBC receive genetic testing and counseling. Georgia’s Breast and Cervical Cancer Program (BCCP) routinely screens clients for increased risk of genetic mutation via an online screening tool. Methods: Using data from the Georgia Comprehensive Cancer Registry (GCCR) for 2010-2013, we calculated TNBC percentages/rates, diagnosis stage, and case fatality rate based on vital status. By using TNBC data as a proxy for BRCA gene mutation prevalence, we assessed the burden of TNBC and racial/age disparities to inform Georgia’s genomics efforts. Results: The percentage of invasive breast cancers, versus in-situ, was the same for Georgia Black and White women; however, Black women had almost double the percentage of TNBC as compared to White women. Black women under 40 had a 20% higher breast cancer incidence rate than similarly aged White women, but had almost double the TNBC rate. Georgia TNBC cases were about twice as likely as non-TNBC cases to be deceased, and Black TNBC cases had higher fatality rates than White cases (almost twice as high in women under 40). Conclusions: Georgia’s genomics program began screening in 2012, and participating counties offer screening to all women’s health clients. Awareness of hormone receptor status (and furthermore, possible presence of genetic mutation) for women diagnosed with breast cancer can guide the proper course of treatment. Additionally, family members of women diagnosed with TNBC in Georgia may take advantage of the screening for risk of genetic mutation through the genomics program prior to a cancer diagnosis, and receive counseling where appropriate.
    • The two Georgias: Disparities in rural health and healthcare

      Nelson, D Gary; Healthcare Georgia Foundation (Georgia Public Health Association, 2016)
    • Unconsciously in the Closet: Repressed Queerness in Another Country

      O’Keefe, Alison; English and Foreign Languages (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.
    • Understanding public health: Research, evidence, and practice

      Hinman, Johanna M (Georgia Public Health Association, 2016)
    • Understanding the role of social norms in organ donation decision making among African American adults

      Lucido, Briana; Center for Disease Control and Prevention (Georgia Public Health Association, 2016-08-18)
      Background: African Americans (AAs) comprise a disproportionate number of those waiting on the national transplant list and are underrepresented among registered organ donors. While barriers to organ donation are well understood, little research has explored factors that facilitate interest in donation. Because AAs are often characterized by strong extended relationships and shared decision-making, social norms may be an influential factor in donation behavior. Utilizing the Theory of Reasoned Action, this study demonstrated the application of theory to understand the role social norms play in donation decisionmaking, among AAs. Methods: Self-administered questionnaires were completed by 425 AA adults residing in the metropolitan Atlanta area. Social norms were measured using a Likert scale consisting of two items that addressed perceptions of favorability of donation and levels of influence a loved one has over the participant’s donation decision making. Main outcomes assessed were donation intentions and expression of donation intentions via designation on one’s driver’s license. Results: Logistic regression results indicate that a loved one’s level of favorability of donation is associated with both intention (OR=2.14, p≤0.01) and expression (OR=1.71, p≤0.01); however, findings approached significance with the level of influence a loved one has on intentions (OR=1.47, p=0.07) but was not associated with expression (p>0.05). Conclusions: The results suggest that a loved one’s level of favorability has an effect on donation decision making, but, conversely, a loved one’s level of influence does not impact donation decision making. Focusing on social norms and encouraging communication may prove useful for future interventions to improve engagement in donation among AAs.
    • A unified integrated public health approach: Zika response

      Kagey, Betsy; Burkholder, Jennifer; Georgia Department of Health (Georgia Public Health Association, 2017)
      Background: Zika virus planning in Georgia has involved many units within the Georgia Department of Public Health (GDPH). Their roles and responsibilities include identifying potential vectors, alerting and educating the public on how to ‘tip n toss’, preparing and testing for Zika virus infection at the Georgia Public Health Laboratory (GPHL), monitoring travelers, including pregnant women, infected with Zika virus, direct messaging for pregnant women, mothers of newborns and women who are considering pregnancy, and education on sexual transmission for men and women. Methods: With no locally transmitted case of Zika virus infection within Georgia, the focus has been on public messaging and answering the myriad calls about Zika virus from health care providers and the public. This unified response involves numerous GDPH units: Epidemiology, Maternal and Child Health, GPHL, Emergency Preparedness and Response (EPR), Environmental Health, Risk Communication, WIC, and others. Conclusions: The Office of Public Health Emergency Preparedness and Response is one member of this multi-unit team. This session will identify the roles and responsibilities of each of these units in the unified response to Zika virus within Georgia both at the state and district level. Lessons learned from this approach build upon GDPH’s overall capacity to provide an integrated respond to public health threats and emergencies within the state.
    • Unveiling the mysteries of palliative care

      Currin-McCulloch, Jennifer; Terry, Karen; Memorial Health University Medical Center (Georgia Public Health Association, 2015)
    • Use of a teledentistry partnership program to reach a rural pediatric population

      Scaher, Tara E; Riggs, Bruce; Augusta University (Georgia Public Health Association, 2017)
      Background: Teledentistry is “the practice of using video-conferencing technologies to diagnose and provide advice about treatment over a distance.” Teledentistry has been defined as “the practice of using video-conferencing technologies to diagnose and provide advice about treatment over a distance.” This report describes the partnership of two rural Georgia public health districts. Augusta University Dental College of Georgia’s Department of Pediatric Dentistry partnered with a private practice dentist in Georgia with the goal of increasing access to care. Methods: A partnership was created that allowed dentists in a remote location to triage dental patients seen in a school-based clinic. Results: Over 3500 children were treated in a school-based dental clinic over a five year period and triaged for referral for further treatment via a teledentisty link. Conclusions: Teledentistry provides an option to reach rural populations for whom access to dental care is an issue.
    • Use of geographical information systems to identify counties in Georgia with high risk for childhood lead poisoning

      Rustin, R Christopher; Kuriantnyk, Christy; Lobsinger, Byron; Charles, Simone; Georgia Department of Public Health; Michigan University (Journal of the Georgia Public Health Association, 2015)
      Background: For children in Georgia, lead poisoning is a substantial public health problem. Primary risk factors include low socioeconomic status and poor-quality housing built prior to 1978. The Environmental Health Team of the Georgia Department of Public Health (DPH) utilized geographical information system (GIS) technology and census housing data to identify counties in which children have high risk for lead poisoning. The purpose of this research was to update and refine previous maps developed with older technology and on a different geographic scale so that targeted public health interventions can be developed. Methods: Data related to stratified and median housing age data were derived from the 2013 5-year American Community Survey. With ESRI ArcMap 10.2 geographic information software, the data were geospatially linked to the state’s county shapefile for development of spatial maps. Results: A series of spatial maps were developed utilizing housing risk factors of age and occupancy status. Refined spatial maps were developed for: 1) the percentage of homes built prior to 1978 and prior to 1950 per county; 2) owner- and renter-occupied housing stratified by age and color-coded per county; and 3) counties in which children were at high risk for lead poisoning. Conclusions: The data from this research provides information for the DPH Lead and Healthy Homes program of areas in the state where targeted interventions are needed. The updated maps can be used to educate policy makers, healthcare providers, and community leaders in regard to prevention of lead poisoning.
    • Using Machine Learning to Predict the Critical Reynolds Number of a Tandem Cylinder System

      Florentino, Ivan A.; 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.
    • Using our voices -- and using our science

      Hinman, Johhanna (Georgia Public Health Association, 2015)
      At the close of the 2015 Annual Meeting and Conference of the Georgia Public Health Association (GPHA), President Deborah Riner encouraged the assembly to “use your voice[s],” to be advocates for public health. Indeed, the history of our successes in public health reflects a history of advocacy, of speaking up to make change. Our charge is to use our voices to express our passion for public health or specific public health causes, and to use our voices to promote the best available science.
    • Using the Exercise is Medicine® on Campus platform to assess college students’ practice of physical activity in a rural setting

      Melton, Bridget; Williamson, A Jazmin; Bland, Helen; Zhang, Jian; Georgia Southern University (Georgia Public Health Association, 2016)
      Background: The college setting offers public health educators and exercise scientists a favorable environment to implement wide-spread change in levels of physical activities. With over two-thirds of all adults in the U.S. now categorized as obese or overweight (CDC, 2015), it has become necessary to increase physical activity levels on college campuses. Exercise is Medicine® on Campus (EIM®-OC) is a national initiative to increase physical activity on college campuses by creating an environment to change the subjective norm of diminished exercise movement and fitness among adults. The purpose of the present study was to use the EIM®-OC platform to assess college students’ beliefs and practices of physical activity by implementing this program in a rural setting. Methods: Implementation of EIM®-OC was conducted over a one-week period. More than 1,000 participants joined in the events led by a multi-disciplinary team. Data collected included self-reported daily physical activities, campus commuting, and level of exercise intensity. Descriptive statistics and chi-square reported frequencies and statistical differences. Results: Overall, the campus turnout for EIM®-OC events was 7.6% higher than national norms. Physical inactivity was statistically different between racial groups (P=0.04). Males reported engagement in physical activity primarily for enjoyment and social interactions. Active transport was lower in the rural community than in urban counterparts. Conclusions: Findings from this study described the successful engagement of a midsized rural campus population in an EIM®-OC campaign. The study revealed self-reported physical activity patterns of students comparable to national averages; however there was a disproportionate number of African Americans who did not participate in any vigorous physical activity.
    • Utilization of the “Connecting the Dots” worksheet to engage undergraduate students in health promotion program planning

      Lawrence, Raymona; Walker, Ashley; Georgia Southern (Georgia Public Health Association, 2017)
      Background: Developing a health promotion program plan requires attention to the links between objectives, activities, and overall program goals. Instructors developed the “Connecting the Dots” worksheet to help students establish these linkages. Methods: The “Connecting the Dots” worksheet included six questions pertinent to the students’ health promotion program plans. The worksheet was given to the students in a flipped classroom setting. Evaluation of the effectiveness of the tool was based upon group presentations at the end of the semester. Results: Students developed more viable program plans that included stronger links between objectives and corresponding program activities. Conclusions: The “Connecting the Dots” worksheet is a promising tool for engaging public health students in the process of developing health promotion program plans.
    • Variations in public health governance

      Jones, Jeffery; Bangar, Ankit; Chang, Patrick; Tarasenko, Yelena; Georgia Southern University (Georgia Public Health Association, 2015)
      Background: Studies of public health departments have found mixed results regarding the relevance of governance through local boards of health (LBOHs). Some studies find that LBOHs can be an important component in higher performance by local health departments. Other analyses, however, find no advantage for local health departments having or not having a LBOH. The hypothesis was that a typology of LBOHs nationwide can define different types of LBOHs based on their powers and responsibilities. Methods: Using national profile sample data from the National Association of Local Boards of Health, LBOHs were categorized using 34 variables based on four domains of responsibilities and duties: enforcement powers, regulatory powers, human resource powers, and budgetary powers. Correlations between types of LBOHs defined by this typology were then computed, and whether they shared significant characteristics in terms of the race, ethnicity, sex, and educational demographics of their board members was determined. ArcGIS was used to analyze the data spatially for regional and national patterns. Results: LBOHs vary considerably across the country - from LBOHs with no budgetary, enforcement, regulatory, or human resources authorities to those that have all four. Conclusions: Different types of LBOHs may have different influences on their associated local boards of health. This study provides a typology for future research to allow analysts to distinguish different types of LBOHs nationally.