• Social and behavioral implications of National Collegiate Athletic Association sickle cell trait screening: The athletes’ perspective

      Lawrence, H Raymona; Scott, Alison; Haywood, Carlton; Robinson, Kayin; Mason, Mondi; Georgia Southern University, The College of William and Mary, Johns Hopkins University, University of Georgia, City and County of Denver Department of Environmental Health (Journal of the Georgia Public Health Association, 2015)
      Background: In August 2010, the National Collegiate Athletic Association (NCAA) implemented a policy mandating sickle cell trait (SCT) testing for all Division I collegiate athletes. Subsequently, all Division II-III athletes were also compelled to undergo SCT testing. This decision has met with controversy among healthcare providers, researchers, and sickle cell advocates. However, there is little information concerning the athletes’ perspective of this policy. The purpose of this paper is to report the findings of a qualitative study that explored college athletes’ perceptions of sickle cell trait SCT, NCAA policies on SCT testing, and potential implications of SCT screening. Methods: The participants were eighteen male and female athletes (ages 18-24), members of NCAA-governed teams who were on the study campus from April-August 2010. Athletes participated in focus groups that gathered their perceptions of the SCT, the NCAA SCT policy, and social and behavioral implications of a SCT diagnosis. Results: Athletes lacked knowledge of the SCT and the implications of a positive screening test result, desired health education about SCT, were conflicted about sharing health information, and feared loss of playing time if found to carry the SCT. Conclusions: The study revealed athletes’ perceptions of the SCT and mandated NCAA SCT testing that should be addressed by college health professionals.
    • Social and Economic Determinants of Infant Ill Health in 159 Georgia Counties: A Comparison Study

      Peden, Angela; Scott, Alison; Peden, John G.; Georgia Southern University (Georgia Public Health Association, 2009)
      Prematurity and low birth weight (LBW) are important causes of infant morbidity in Georgia and the United States. Georgia county-level data were used to explore the relationships between prematurity and LBW and two social and economic determinants of health: race and poverty status. Spearman rank correlations and Friedman and Wilcoxon signed rank tests were used. Prematurity and LBW were positively associated with poverty status and the presence of large African American populations. While causation cannot be inferred from correlative data, this analysis highlights the need to consider the role of social and economic factors in infant morbidity. It also highlights the need to target interventions and services to geographic areas most in need.
    • Social networks as predictors of colorectal cancer screening in African Americans

      Alema-Mensah, Ernest; Smith, Selina; Claridy, Mechelle D; Ede, Victor; Ansa, Benjamin E.; Blumenthal, Daniel S.; Morehouse School of Medicine, Augusta University (Georgia Public Health Association, 2017)
      Background: Early detection can reduce colorectal cancer (CRC) mortality by 15%–33%, and screening is widely recommended for average-risk adults beginning at age 50 years. Colorectal cancer mortality rates are higher in African Americans than in whites, while screening rates are somewhat lower. Individual social networks can reduce emotional and/or logistical barriers to health-promoting but distasteful procedures such as CRC screening. The aim of this study was to examine social network interactions, and their impact on CRC screening among African Americans. We hypothesized a positive association between social network index (SNI) scores and CRC screening. Methods: In a community intervention trial with four arms, we previously demonstrated the efficacy of a small group educational intervention to promote CRC screening among African Americans. This intervention outperformed a one-on-one educational intervention, a reduced out-of-pocket expense intervention, and a control condition. In the present analysis, we compared the SNI scores for participants in the small group intervention cohort with a comparison group comprised of the other three cohorts. Social networks were assessed using the Social Network Index developed by Cohen. Results: Small group participants had a significantly higher network diversity score (Mean difference 0.71; 95% CI, 0.12-1.31; p=0.0017) than the comparison group. In the second component of the SNI score - -the number of people talked to over a two week period -- the small group intervention cohort also scored significantly higher than the comparison group. (Mean difference, 9.29; 95% CI, 3.963-14.6266; p=0.0004). Conclusions: The findings suggest that social interaction and support was at least partially responsible for the relatively high post-intervention screening rate in the small group intervention participants. Education in small groups could foster strong social networks. Strong and positive network diversity and a large number of people in social networks may enhance CRC screening rates among African Americans.
    • Social, Economic and Health Costs of Unintended Teen Pregnancy: The Circle of Care Intervention Program in Troup County, Georgia

      Brace, Andrea M.; Hall, Michael; Hunt, Barry P.; Center for Community Studies; Mississippi State University (Georgia Public Health Association, 2008)
      Unintended teenage pregnancy in the United States is a public health concern with ramifications that include a variety of social, economic and health costs. It has been estimated that adolescents giving birth before the age of 18 cost the United States at least $9.1 billion dollars annually (NCPTUP, 2008). Latest available national data indicate a slight increase in rates of unintended teen pregnancy after a 15 year period of steady decline. The unintended teen pregnancy rate in Troup County, Georgia in 2006 was 51.9/1,000 which was higher than the national average of 41.9/1,000(Kids Count, 2008). The purpose of this study was to review the Circle of Care intervention program, a collaborative multi-agency teen pregnancy prevention program. The Circle of Care program was developed in 1997 through the efforts of multiple community partner organizations. These organizations included the local school system, the Division of Family and Children Services, Public Health, Troup County Family Connection, the local teen clinic, the local hospital and other organizations. Participants in the Circle of Care program receive multiple services, including case management, a family assessment, parenting classes, home visits from the case manager, family planning assistance, services from the teen health clinic and the Division of Family and Children Services. Preliminary data indicate that Circle of Care participants gained social, economic and health benefits from participation in the program including: higher rates of high school enrollment, no repeat pregnancies, and no reported incidences of child abuse or child neglect. Projected cost savings from these outcomes are also reported. Preliminary examination of the Circle of Care program supports the efficacy of multi-level, collaborative efforts to reduce unintended teen pregnancy and subsequent social, economic and health risks. Future research should examine longer term outcomes of this program.
    • Solo practice physicians in Georgia

      Mutiso, Fedelis; Akowuah, Emmanuel; Opoku, Samuel; Apenteng, Bettye; Georgia Southern University (Georgia Public Health Association, 2017)
      Background: Office-based physicians can practice in a solo or group setting. Solo physician practices are staffed by a single physician who is responsible for all the care of the patients. Physicians in solo practices are also responsible for the infrastructure, personnel and investment cost of their practices. Further, evidence suggests that physicians in solo practices are more likely to be dissatisfied with their medical career compared to those in group practices. Given these challenges, current trend suggests a shift away from solo physician practices. However, there are still physicians in solo practices in Georgia but little is known about them. This study attempts to characterize the physicians working in solo practices and in so doing, add to the growing knowledge of the healthcare workforce in Georgia. Methods: The 2014 Physician Compare data were used for this study. This database contains information on individual physician level characteristics including gender, credential, primary specialty and practice type. The data were linked to the 2014 Area Resource File to provide information on the rural/urban location of physician practices. Physician practices were classified as rural or urban based on the Economic Research Service classification. Chi square and t-tests were carried out to examine the characteristics of physicians practicing in solo practices. Statistical analyses were conducted in StataMP 14. Results: Of the 13,499 Georgia physicians studied, 1448 physicians were in solo practices. The majority of these physicians were in urban areas (78.30%; p<0.001), male (72.18% p<0.001), had primary care specialties (46.31% p<0.001) and more experience in practice (27.6 years; p<0.001). In addition, almost three quarters did not use electronic health records (71.97% p<0.001) and the majority did not report on quality measures to the Centers for Medicare and Medicaid Services (66.7%; p<0.001). Conclusions: There are a large number of physicians in solo practices in Georgia. Given the challenges facing these physicians, it is important for Georgia to consider approaches to decrease the burden on physicians working in solo practices.
    • The Spaces They Occupied: Women as the Determiners of Success in the French Revolution

      Stewart, Keturah; History, Anthropology, & Philosophy (Augusta University Libraries, 2020-05-04)
      This item presents the abstract for an oral presentation at the 21st Annual Phi Kappa Phi Student Research and Fine Arts Conference.
    • Spiritual health: The often-overlooked dimension of health

      Riley, Clarence; Imoyera, Peter; Samples, Oreta; Green, Gregory; Fort Valley State University (Georgia Public Health Association, 2015)
      Background: Spiritual health, one of the six dimensions of health (physical, social, intellectual, emotional, environmental, and spiritual), is often overlooked and has become less prominent in the literature and in public forums. This once-touted dimension of health is now seldom considered. Methods: A review revealed that literature on spiritual health is sparse and, when found, is dated. Results: The existing literature indicates that spiritual health relates to various aspects of well-being, including medical/physical health, mental/psychological health, and educational/intellectual health. It is likely that the decline of consideration of spiritual health is due to the decrease in public discussion of spiritual matters and to the tendency of our society to focus on “political correctness.” Conclusions: Although the fear of alienating others by political incorrectness is foremost in the minds of many, this does not negate the fact that spiritual health is of benefit and can lead many to experiencing a better standard of health. It is our contention that spiritual health is often overlooked but has benefits that need not be concealed by political correctness. Spiritual health should be returned to the mainstream of public health, where its benefits can be enjoyed by those who choose to use them.
    • The state of accreditation readiness in Georgia: A case study

      Peden, Angela; Shah, H Gulzar; Toal, Russell; Alexander, Dayna S.; Wright, Alesha; Anderson, Ashton; Marshall, A Nandi; Uhlich, Scott; Jones, Jeffery; Georgia Department of Public Health; et al. (Georgia Public Health Association, 2015)
      Background: Georgia’s public health districts first began exploring the idea of national public health accreditation in 2008 when Cobb & Douglas Public Health included accreditation in their strategic plan. In May 2015, Cobb & Douglas Public Health was the first Georgia public health district to achieve national accreditation status. This article discusses the current state of accreditation readiness in Georgia and explores strengths and barriers to accreditation. Methods: This study utilized a case study approach in order to examine PHAB accreditation efforts in Georgia within a real-life context. Data came from three sources: nine Accreditation Readiness Assessments, a PHAB Pre-Application Technical Assistance Survey, and state-wide Accreditation Readiness Survey. Results: The Accreditation Readiness Assessments resulted in several lessons learned about common strengths and barriers to accreditation. Strengths included a dedicated staff and supportive Boards of Health. Barriers included accreditation fees and a lack of personnel time. The PHAB Pre-application TA Survey revealed that the majority of those surveyed would recommend TA to other agencies pursuing PHAB accreditation (91%). The Accreditation Readiness Survey revealed that 14 of 18 GA public health districts are either PHAB accredited (1 district), actively pursuing PHAB accreditation (2 districts), or planning to apply (11 districts). This includes 116 of the 159 Georgia counties (73%). Conclusions: The results of this case study show that 72% of Georgia’s public health districts are engaged in accreditation-related activities. This includes activities such as accreditation readiness assessment, community health assessment, QI council and plan development, strategic planning, and policy review.
    • STD services delivery arrangements in Georgia county health departments

      Williams, Karmen S; Shah, Gulzar H; Peden, Angie; Livingood, Bill; Willams & Williams Consulting Group, Georgia Southern University, University of Florida (Georgia Public Health Association, 2017)
      Background: Uniformity, standardization, and evidence-based public health practice are needed to improve the efficiency and quality of services in local health departments (LHDs). Among the highest priority and most common public health services delivered by LHDs are services related to sexually transmitted diseases (STDs) and sexually transmitted infections (STIs). Objective: The purpose of this study was to examine potential variations in the delivery of sexually transmitted disease (STD) services among county health departments (CHD) in Georgia, to determine if potential variations were due to varied administrative practices, and to understand delivery arrangements so that future cost studies can be supported. Methods: Web-based surveys were collected from 134 county health departments in Georgia in 2015. Results: Screening for gonorrhea, chlamydia and syphilis occurred in all the surveyed CHDs. Sixty-eight percent of the CHDs had one or more staff who performed investigations for persons already screened positive for STDs. Partner notification services provided by the CHD staff occurred in only 35 percent of the surveyed CHDs. Conclusions: Variances regarding diagnostic methodologies, work time expenditures, and staff responsibilities likely had an influence on the delivery of STD services across Georgia’s CHDs. There are opportunities for uniformity and standardization of administrative practices.
    • Stress Coping Mechanism and the Effects of Academic Stress

      Quick, Erin (Augusta University Libraries, 2020-05-04)
      This item presents the abstract for an oral presentation at the 21st Annual Phi Kappa Phi Student Research and Fine Arts Conference.
    • Student involvement in curriculum development enhances medical education

      Griffeth, Jacline; Sawyer, Alexandra; Johnson, Nolan; Hashmi, Osama; Gupta, Neha; Swartz, Sarah; Martin, Kathryn; Augusta University (Georgia Public Health Association, 2017)
      Background: During the 2014 annual review of the curriculum for first year medical students at the Medical College of Georgia, the public health module was noted as an area that needed improvement. To address this concern, a Public Health Curriculum Workgroup was formed for the purpose of identifying specific areas to improve and developing a more robust and integrative curriculum. A small cohort of medical students with public health backgrounds were invited to be members of this workgroup and participate in the development and delivery of public health content to the next cohort of first year medical students. We hypothesized that having this type of student participation results in a more clinically relevant and engaging curriculum. Methods: The curriculum workgroup met weekly to establish learning objectives, prioritize topics, and design interactive activities. The student members contributed to both curricular planning and content delivery. First year medical students completed course evaluations following the public health curriculum. These evaluations included five Likert scale questions and three narrative feedback response questions. Evaluation data before and after student involvement in the curriculum was examined. Results: Student evaluations of the overall quality of the public health curriculum increased 38% from 2014-2016. The measure of how well the content contributed to development as a future physician increased 36%. There was a 33% increase in how well the instructional materials aided understanding of topics. Theming of narrative evaluation comments showed that student involvement in the curriculum was well received. In 2016, 28.4% of narrative comments cited student presentations as the most valuable aspect of their public health experience. Conclusions: Involving medical students with public health backgrounds in curriculum development and content delivery of a public health module for first year medical students led to improvements in overall quality, clinical relevance, and instructional materials.
    • A Study of Human Skin Color, a Natural Sunscreen: Physiology, Molecular Evolution, Public Health, and Student Learning

      Ayala, Juan; 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.
    • Studying Gene Expression in Whole Embryos by in situ Hybridization: A Peer-to-Peer Laboratory Guide

      Kalra, Aarushi; Xia, Di; Department of Biological Sciences (Augusta University Libraries, 2017-05-11)
      The extracellular matrix (ECM) plays an important role in cell to cell signaling pathways. Our goal is to provide a full laboratory guide for students to study gene expression in zebrafish embryos by in situ hybridization. Prior to our study, the laboratory had observed disorganized and shortened cilia in cells that are important for cell signaling in the pronephric duct and neural tube floor plate of the zebrafish embryo. Ciliogenesis depends on a master transcriptional regulator, foxj1a, whose mRNA expression can be monitored through in situ hybridization and microscopic imaging. Knockdown morpholino-injected, control mismatched morpholino-injected, and uninjected embryos were fixed to determine if foxj1a transcription is qualitatively affected by ECM gene knockdown. Our results showed that the knockdown embryos portrayed an inconsistent foxj1a signal strength along the length of the pronephric duct, when compared to analysis of control mismatched and wild-type uninjected embryos. We created this manuscript for other students to observe how ECM gene knockdown can affect foxj1a mRNA expression, but also to give them a guide to the tools they would need to explore their own genes of interest, in zebrafish or in many other organisms and tissues.
    • Substance use-related brief interventions with emergency department patients reduce mental health co-morbidities

      Johnson, J. Aaron; Abraham, Amanda J.; Georgia Regents University; University of Georgia (Georgia Public Health Association, 2015)
      Background: Research on screening and brief interventions (SBIs) has shown that, in addition to reducing alcohol use, interventions delivered in healthcare settings can reduce trauma readmissions, hospitalization days, driving offenses, and future healthcare utilization and costs. Mental health co-morbidities often accompany unhealthy alcohol and drug use, but few studies have examined the impact of SBIs on the mental health of patients. The present study determined if SBIs focused on reducing alcohol or drug use affected the mental health status of patients at a six-month follow-up. Methods: Participants (N=1152) were randomly sampled from patients receiving SBIs for at-risk alcohol or drug use after presenting to one of two urban emergency departments (EDs) in Georgia. Telephone follow-up interviews were completed with 698 of the original participants at six months after the intervention. Mental health co-morbidities were measured at both time points using the Global Assessment of Individual Needs Short Screener (GAIN-SS) and the SF-12. Analyses were conducted using paired samples t-tests. Results: Analyses found significant reductions in the percentage of patients reporting feelings of anxiety (45% to 33%, p<0.001), depression (52% to 37%, p<0.001), and suicidal ideation (13% to 8%, p<0.001) as well as improvements in global mental health measures (SF12 mental health score and internalizing and externalizing subscales of the GAIN-SS). Conclusions: Six months after receiving SBIs for alcohol and drug use in EDs, several measures of the mental health of participants showed significant improvements. Widespread implementation of SBIs in Georgia's EDs may affect a broad array of public health concerns, including mental health.
    • Suite for Piano – Blending Styles and Discovering Creative Process

      Kenison, Aurora; Department of Music (Augusta University Libraries, 2021-05-18)
      This item presents the abstract for a presentation at the 2021 Annual Phi Kappa Phi Student Research and Fine Arts Conference at Augusta University.
    • Superconductivity and Magnetism in the A15 Phase of Alkali-Doped Fullerides

      Kieu, Khang; De Silva, Theja; Department of Chemistry and Physics (Augusta University Libraries, 2021-05-18)
      This item presents the abstract for a presentation at the 2021 Annual Phi Kappa Phi Student Research and Fine Arts Conference at Augusta University.
    • Surveillance, Epidemiology, and End Results (SEER) data for monitoring cancer trends

      Yoo, Wonsuk; Coughlin, Steven S; Augusta University (Georgia Public Health Association, 2019)
      Background: Monitoring cancer trends allows evaluation of the effectiveness of cancer screening or detection methods and determination of priorities in cancer control programs. Government officials and policy makers also use information on cancer trends to allocate resources for cancer research and prevention. 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 incidence rates for White, Black, and other residents in Georgia. The objective of this research is to provide an overview of how to use SEER data through analysis of the incidence rate for cervical cancer. Methods: Cervical cancer cases (ICD-O-3/WHO 2008 =’Cervix Uteri’, corresponding to C530-C539) were obtained from the SEER18 database. It includes the largest geographic coverage compared to SEER 9 and SEER 13 data. The incidence and incidence rates for cervical cancer were obtained, stratified by year (2000-2012), sex, race/ethnic groups, and region (Georgia and US). Age-adjusted incidence and incidence rates (to the 2000 US standard population) were calculated using SEER*Stat software, which is available, free of charge, on the SEER Web site: http://seer.cancer.gov. Results: Age-adjusted incidences and incidence rates in Georgia and the US from SEER 18 data were created by SEER*Stat. The incidence rates were stratified by age variable (5-year category), sex, race/ethnicity, and other socio-demographic variables. Annual percent changes (APC) and 95% CI were also obtained to characterize trends in cancer rates over time. The trends for age-adjusted incidence rates for regions (Georgia and the US) and race (white, black, others) were compared using APC. Furthermore, age-specific incidence and incidence rates for cervical cancer for Georgia and US for recent five years (2008-2012) were reported. Conclusions: The Surveillance, Epidemiology, and End results (SEER) program provides cancer researchers a convenient and intuitive system for viewing individual cancer records and producing statistics useful in studying the impact of cancer on a population.
    • Surviving HIV and dying for a smoke: Implications for tobacco use among people living with HIV

      Culbreth, Rachel; Kelly, Jane; Maggio, David; Wortley, Pascale; Drenzek, Cherie; Georgia Department of Public Health HIV/AIDS Epidemiology Section; Georgia State University; Georgia Department of Public Health (Georgia Public Health Association, 2015)
      Background: Since the advent of highly active antiretroviral therapy in the mid-nineties, deaths among persons living with HIV (PLWH) have declined nationally. Now a controllable condition, HIV has become a chronic disease, highlighting the importance of tobacco cessation in lowering morbidity and premature mortality. Current smoking is approximately twice as high among PLWH compared with the general population. PLWH who smoke experience higher rates of cardiovascular disease, AIDS-defining illnesses, and cancer than PLWH who do not smoke. Loss of life-years associated with smoking among PLWH is greater than life-years lost from HIV. Methods: Data on current smoking, derived from the 2009-12 Georgia Medical Monitoring Project (MMP) were analyzed. Smoking rates were calculated by demographic characteristics, and results were compared to those from the 2011 Georgia Behavioral Risk Factor Surveillance System (BRFSS), a population-based telephone survey. Results: The prevalence of current smoking among PLWH was 36.1%, compared with 21.2% among the general population in Georgia. Smoking prevalence for PLWH generally varied by demographic characteristics according to the same pattern as for the general population, but prevalence was consistently higher among PLWH. Conclusions: The prevalence of current smoking among PLWH in Georgia is high. Clinical and public health interventions must address smoking cessation as part of HIV care to prevent disease, improve quality of life, and reduce mortality. HIV-infected smokers have more barriers to quitting (alcohol, depression, drug dependence, and inaccurate risk perception) and a lower quit rate than non-HIV-infected smokers. Efficacy studies of behavioral and pharmacological interventions for smoking cessation specific to PLWH are needed.
    • Syphilis in Georgia, 2009-2014

      Moore, Kathryn; Parker, Leonardo; Wells, Joy; Georgia Department of Health (Georgia Public Health Association, 2016)
      Background: In the period of 2002-2014, Georgia has ranked among the top three states in the United States for rates of primary and secondary syphilis cases, creating a continuing need to analyze the data and to plan and implement disease prevention efforts. Methods: The present effort involved analysis of data from Georgia’s electronic disease reporting system, State Electronic Disease Surveillance System (SendSS), including demographic characteristics by year for the period of 2009-2014 and behavioral data obtained from interviews with communicable disease specialists. Results: In Georgia, from 2009-2014, primary and secondary syphilis, the infectious stages of the disease, were seen most commonly among black, non-Hispanic (77%) males (91%) between the ages of 20-29 (45%); 52% were males who have sex with other males. Conclusions: Analysis of the data provides a better understanding of the populations affected by syphilis. It can enhance discussions about disease surveillance, prevention, and strategies to decrease the burden of this disease.
    • A systematic review of lifestyle interventions for chronic diseases in rural communities

      Smith, A Selina; Ansa, Benjamin; Augusta University (Georgia Public Health Association, 2016)
      Background: Rural Americans suffer disproportionately from lifestyle-related chronic diseases (e.g., obesity, diabetes, hypertension, cardiovascular disease, and breast cancer). Interventions that consider the distinctive characteristics of rural communities (e.g., access to healthcare, income, and education) are needed. As an initial step in planning future research, we completed a systematic review of dietary intake and physical activity interventions targeting rural populations. Methods: Manuscripts focused on dietary intake and physical activity and published through March 15, 2016, were identified by use of PubMed and CINAHL databases and MeSH terms and keyword searches. Results: A total of 18 studies met the inclusion criteria. Six involved randomized controlled trials; 7 used quasi-experimental designs; 4 had a pre-/post-design; and 1 was an observational study. Eight studies were multi-site (or multi-county), and 3 focused on churches. Primary emphasis by racial/ethnic group included: African Americans (6); Whites (2); Hispanics (3); and two or more groups (7). Most studies (17) sampled adults; one included children. Two studies targeted families. Conclusions: Additional lifestyle intervention research is needed to identify effective approaches promoting healthy diet and exercise and chronic disease prevention in rural communities. Studies that include rigorous designs, adequate sample sizes, and generalizable results are needed to overcome the limitations of published studies.