• Characteristics of rural users of emergency medical services in Georgia: A populationbased study

      Turner, Nannette; Chen, Huey; Morosanu, Liliana; Mercer University (Georgia Public Health Association, 2016)
      Background: Emergency medical services (EMS) are an essential part of health care. Appropriate information about EMS usage in rural areas will allow effective utilization of EMS resources for their intended purpose, and at the state level, drive the adoption of better EMS policies to ensure and maintain equitable access to these health services in rural areas. Methods: The present study, performed by analyzing data from the Georgia Emergency Medical Services Information System (GEMSIS), describes the population using EMS in rural Georgia. Distributions of rural EMS transports are reported, along with usage for selected population groups based on race, gender, age groups, and primary impressions recorded by emergency medical personnel (EMP). Results: The groups with the highest rates of EMS use were African Americans, females, and the elderly. In 2014, about twice as many African Americans used EMS as compared to Whites. Rural use of EMS increased with age, with the elderly having the highest percentage of users. About 31% of all transports were for emergency conditions; the remaining 69% were for non-emergencies. The most frequent health complaints were those for altered physical conditions and traumatic injuries. Conclusions: The findings of this study can guide decision in planning future services and ensuring appropriate access to EMS in rural Georgia.
    • Characterization of Protein Sensitive G-Protein Coupled Receptors

      Nam, Alisha; Okashah, Najeah; Biological Sciences, Pharmacology & Toxicology, Chemistry & Physics (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.
    • Characterizing discrepancies in school recovery after disasters

      Shah, Hazel; Georgia State University (Georgia Public Health Association, 2019-01-30)
      Background: Academic institutions provide consistency and routine to children. When disasters damage schools, students often suffer in a variety of ways, and racial minority students are often impacted disproportionately. However, minimal research exists exploring these discrepancies. This presentation examines racial disparities in school systems affected by Hurricane Ike (2008). Methods: This study, funded by the National Science Foundation, uses publicly available Texas Education Agency data from approximately 600 schools affected by Hurricane Ike. Schools were included in the study based on two criteria: if they were declared “disaster areas” by FEMA and if they were closed for at least 10 school days after Hurricane Ike. Results: Descriptive analyses were conducted comparing school characteristics and pass rates for all students in grades 3-11 on the Texas Assessment of Knowledge and Skills (TAKS) standardized test during pre- and post-hurricane school years (i.e., 2003 – 2011). Mean pass rates on the TAKS varied greatly by race/ethnicity and other factors. Of African American students, 60.7% (SD=17.4) passed the TAKS in 2004 compared to 69.9% in 2011 (SD=15.0); 68.0% (SD=15.7) of Hispanic students passed in 2004 as opposed to 76.23% (SD=12.2) in 2011; 78.8% (SD=14.8) of White students passed in 2004 versus 83.1% in 2011. Further analyses will explore various other determinants influencing academic performance. Conclusions: Preliminary findings show discrepancies at baseline in academic outcomes between racial/ethnic groups. These discrepancies persisted post-hurricane, though all groups saw an increase in pass-rates. Further research utilizing advanced statistical approaches and geographic information system (GIS) analysis could yield insights on variation of academic performance between schools and school districts, as well as physical exposure and risk factors. These insights can inform strategies for improving schools’ academic trajectories after disasters and optimizing community recovery as a whole.
    • Characterizing the NADPH Oxidase 1-Evoked Pancreatic Stellate Cell Secretome

      Chakraborty, Ananya; Mondal, Souravi; Zhi, Wenbo; Csanyi, Gabor; Sabbatini, Maria; Department of Biological Sciences; Center for Biotechnology and Genomic Medicine; Department of Pharmacology and Toxicology (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.
    • Childhood cancer incidence in Georgia: Descriptive epidemiology, geographic trends, and disparities in insurance coverage and health care access

      Kanu, Florence; Robb, Wagner Sara; Corriero, Rosemary; University of Georgia (Georgia Public Health Association, 2015)
      Background: Limited research has been conducted concerning childhood cancer (CC) incidence in Georgia, which is a leading cause of death for children in the US. The purpose of this study was to determine if county-level CC incidence rates differed by geography or race and if health care access disparities exist. Methods: Incidence data were obtained from the Georgia Comprehensive Cancer Registry for 2000-2011. Age-adjusted incidence rates per 100,000 were analyzed by sex, race, and county. Hotspots and coldspots of CC incidence were analyzed using the Getis-Ord GI* statistic. Health care access data for children under 19 were obtained using US Census Bureau’s Small Area Health Insurance Estimates for 2011. Georgia’s three children’s oncology group (COG) treatment facilities with 40-mile buffer zones were geographically overlaid with CC incidence rate maps and health insurance maps using Geographic Information Systems (GIS). Results: For leukemia and central nervous system cancers, incidence rates were significantly different between Whites [7.8, 95% confidence interval (CI) (7.4, 8.2)] and Blacks [5.2, 95% CI (4.8, 5.6)]. Statistical hotspots of CC were observed in north Georgia. A lower percentage of insurance coverage among children was observed in southeast GA. Approximately 25% of Georgia counties that were not within a COG buffer had a higher percentage of children who were uninsured (mean ± SD: 10.28% ± 1.86%). Conclusion: Higher CC incidence rates and disparities in access to care were evident in north Georgia. Future research is needed in these geographies to investigate potential risk factors associated with CC incidence patterns and racial differences in Georgia.
    • Children, Philosophy, and Early Education

      Garrett, Elyse M.; Maynard, Lee; Department of English and World Languages (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.
    • Chronic disease prevention as an adaptive leadership problem

      O'Connor, Jean; Georgia Department of Public Health (Georgia Public Health Association, 2017)
    • Civilizing with a Krag: U.S. Counter-Insurgency in Vietnam and Iraq

      Ritchie, George (Augusta University Libraries, 2018-04)
    • A clinical trial to increase the identification, genetic counseling referral and genetic testing of women at risk for hereditary breast and/or ovarian cancer

      Bellcross, Cecelia; Stanislaw, Christine; Hermstad, April (Georgia Public Health Association, 2017)
      Background: Approximately 1/300 individuals in the general population are at risk for hereditary breast and ovarian cancer due to an inherited mutation in the BRCA1/BRCA2 genes. BRCA mutations are associated with dramatically increased risks for breast cancer, especially at younger ages, in addition to ovarian cancer. Enhanced screening and risk reduction strategies can significantly reduce associated morbidity and mortality. The United States Preventive Services Task Force (USPSTF) recommends identifying women at-risk for BRCA mutations for receipt of genetic counseling and if appropriate, testing. The Breast Cancer Genetics Referral Screening Tool (B-RST) is a validated screen endorsed by USPSTF to facilitate this process. This implementation study seeks to evaluate the most effective means of follow-up for screen-positive women to maximize the number who are referred to, and receive, cancer genetic counseling (CGC) services. Methods: B-RST (v3.0) was used in three Emory Healthcare breast-imaging centers. Screen-positive women were randomized into three methods of follow-up (patient initiated, physician notification, or staff phone call). Primary outcomes were to compare the number of screen positive individuals who were referred for, scheduled, and completed a CGC appointment among the three groups. Results: Of 3,419 women approached, 63% participated and 579 (27%) screened positive. Appointments were scheduled by 7% of Group 1 participants, 17% of Group 2 individuals, and 11% of Group 3 (p<0.001). Scheduling challenges included physician non-response to notification and unsuccessful direct contact. Of those scheduled, 73% completed the CGC appointment. Conclusions: Genomic medicine is receiving increased attention in the public health arena. Screening with B-RST 3.0 in mammography settings can improve identification of individuals at-risk for BRCA mutations and facilitate referral to CGC services. Despite B-RST’s ability to easily and accurately identify individuals appropriate for CGC, additional strategies are needed to facilitate completion of CGC in routine clinical practice.
    • Clinicians’ Perception of Inmates’ Satisfaction with Mental Health Services

      Daniel, Jerry B.; Korr, Wynne S.; Mercer University; University of Illinois at Urbana-Champaign (Georgia Public Health Association, 2007)
      A growing body of literature addresses the mental health needs of prison inmates; however, very little research has examined mental health services among this population. Based on the Behavioral Model of Health Services Use (Andersen Model), the current study examined clinicians’ perception of inmates’ satisfaction with mental health services. The study’s main objective was to identify the effect of three major groups of predictor variables (predisposing, enabling, and need) on clinicians’ perception with inmates’ satisfaction with mental health services. The study utilized an exploratory, survey methodology. Although only a few variables were found to be statistically significant in the multivariate analyses, the findings of the study are a significant step in beginning to understand satisfaction of mental health services by inmates. The link between satisfaction and treatment outcome has great significance in the correctional environment, where staff and inmates may tend to see each other as adversaries.
    • Coastal septic tank inventory: data resources for future wastewater management planning

      Alcorn, Jessica; University of Georiga (Georgia Public Health Association, 2017)
      Background: The US Environmental Protection Agency estimates that more than one in five homes are served by decentralized wastewater treatment systems—commonly known as septic tanks. In coastal areas where it is impossible to extend sewer service due to either financial or hydrogeological constraints, septic tanks are an integral part of wastewater treatment. When maintained adequately and installed under appropriate conditions, septic tanks remove excess nutrients and dangerous pathogens from wastewater. As coastal infrastructure is increasingly threatened by recurrent flooding, extreme weather events, and future sea level rise, coastal communities will need to assess the adequacy of their wastewater management systems and plan for future changes. Methods: Through funding from the Coastal Resource Division of the Department of Natural Resources, UGA’s Marine Extension has completed digitization of historic septic tank records into the Digital Health Department database in five coastal counties. This presentation will discuss how septic tank records have been linked to unique parcel identification numbers; the methodology for identification of potential undocumented septic tanks; and online, interactive GIS mapping features to allow expanded access and applications of the data. The septic tank inventory offers two primary benefits. First, digitization of septic tank records increases the efficiency of local public health departments in fulfilling information requests. Second, mapping the septic tank data allows for identification of areas in the county where septic tanks might be at the highest risk of failure or where targeted water sampling might be beneficial. Results and Conclusions: This presentation will focus on enhancing awareness of the data resource that has been created and potential uses in local wastewater management planning that incorporates climate considerations. This presentation will also demonstrate how other relevant GIS datasets can be integrated with the septic tank inventory.
    • Coliphage as an indicator of the quality of beach water to protect the health of swimmers in coastal Georgia

      Gallard-Gongora, Javier; McGowan Mark, Kathryn; Jones, Jeff; Aslan, Asli; Georgia Southern Universit (Georgia Public Health Association, 2017)
      Background: Gastrointestinal disease affects millions of people in the United States and places a substantial economic burden upon healthcare systems. Recreational waters polluted with fecal material are a main source for transmission of gastrointestinal disease. Georgia beaches are monitored for the presence of fecal indicator bacteria, but these bacteria are not well associated with enteric viruses. The United States Environmental Protection Agency (US EPA) has recently proposed coliphage (a virus of Escherichia coli) as an alternative indicator of fecal contamination in recreational waters. The present study compares fecal indicator bacteria and coliphage concentrations at two Georgia beaches with adjacent creeks that have a history of pollution. Methods: For one year, samples and environmental data were collected from four sites on Jekyll Island, GA, during the peak swimming season and the off-season. Samples were processed using US EPA-approved methods for membrane filtration and plaque formation. Statistical analyses were performed using t-tests and Spearman correlations. Results: The highest numbers of enterococci and significant differences with coliphage were found at Saint Andrews Creek during the swimming season and the off-season. The enterococci concentrations at Clam Creek sites did not exceed recommended recreational water criteria. During the off-season, concentrations of enterococci and coliphages were different at Clam Creek sites, indicating a potential risk for presence of enteric virus when enterococci could not be detected. Conclusions: The US EPA has proposed to adapt coliphage concentrations as an alternative indicator of water pollution for routine beach monitoring nationally. The present study provides a background for adoption of this method in Georgia. Measures of enterococci do not provide sufficient information about the associated human health risk. Inclusion of these viral indicators will improve decision making for beach closures and for protection of the health of swimmers.
    • Collecting physiological stress measures in research among high-risk parents for child maltreatment: A qualitative investigation

      Tiwari, Ashwini; Self-Brown, Shannon; Robinson, Charles; McCarty, Colleen; Carruth, Laura; Georgia State University (Georgia Public Health Association, 2016)
      among parents at high risk of child maltreatment (CM). However, no known studies on these programs have examined physiological biomarkers for stress, such as impaired levels of cortisol and dehydroepiandrosterone (DHEA), and telomere length. Further, no details are known regarding the feasibility of collecting biological markers from parents. This research examined qualitative findings from a multidisciplinary neurobiology and public health study that examined physiological responses to a six-week, evidence-based, behavioral parenting program, among a maternal population at risk of CM perpetration in Atlanta, Georgia. Methods: Eighteen high-risk mothers were assessed at pre-intervention and post-intervention for parental stress and behavior (i.e., self-report, observational), and non-invasive physiological markers for cortisol, DHEA, and telomere length, Hormones were measured using two salivary methods, passive drool and Salivette swabs, as well as hair samples. Telomere length was assessed using cheek swabs. Semi-structured interviews were conducted at baseline to examine the feasibility of collecting biological samples for parental stress research among a sub-sample of participants (n=13). Results: Early qualitative themes suggest interest in providing hair and cheek swab samples. Notable suggestions were made to improve saliva collection. Particularly, participants showed clear preference for swabbing methods over passive drool collection. Conclusions: These study findings add novel results to the parenting literature on parental stress and provide emerging evidence on parental willingness to engage in physiological research. Acceptance of collection methods encourages further examination of biomarker correlates using non-invasive and inexpensive methods in biobehavioral research.
    • Colon cancer knowledge, screening barriers, and information-seeking in Northeastern Georgia

      Springstion, Jeffrey; Hou, Su-I; University of Georgia; University of Central Florida (Georgia Public Health Association, 2016)
      Background: The present study assessed utilization of colorectal cancer (CRC) screening and knowledge, barriers, and information-seeking among adults in northeastern Georgia. Methods: A total of 245 people aged 40 years and older from selected rural, suburban, and small towns in northeastern Georgia participated in this cross-sectional survey. Results: Respondents aged 50 years and older were more likely to think that they “don’t need screening at their current age” as compared with those in their 40s. Higher information-seeking correlated with lower screening barriers (p<0.001), and colonoscopy history correlated with higher levels of information-seeking (p=0.001). Discussion: Respondents generally had a low level of knowledge about CRC. Individuals with lower perceived screening barriers indicated a higher likelihood to seek more information about CRC and therefore might be more likely to be screened by colonoscopy.
    • Community engagement to address socio-ecological barriers to physical activity among African American breast cancer survivors

      Smith, Selina A.; Whitehead, Mary S.; Sheats, Joyce Q.; Chubb, Brittney; Alema-Mensah, Ernest; Ansa, Benjamin E.; Augusta University, SISTAAH, Institute of Public and Preventative Health, Department of Community Health and Preventative Medicine (Georgia Public Health Association, 2017)
      Background: With high rates of obesity, low levels of physical activity (PA), and lack of adherence to physical activity guidelines (PAGs) among African American (AA) breast cancer survivors (BCSs), culturally appropriate interventions that address barriers to participation in PA are needed. Methods: To develop intervention content, members of an AA breast cancer support group participated in four 1-hour focus group discussions (related to the barriers to PA, strategies for overcoming them, and intervention content), which were audiotaped, transcribed, and analyzed. Results: The support group collaborated with researchers to construct the Physical Activity Intervention Developed (PAID) to Prevent Breast Cancer, a multi-component (educational sessions; support group discussions; and structured, moderately intensive walking, strength training, and yoga), facilitated, 24-week program focused on reducing multi-level barriers to PA that promote benefits (‘pay off’) of meeting PAGs. Conclusions: Community engagement fostered trust, promoted mutuality, built collaboration, and expanded capacity of AA BCSs to participate in developing an intervention addressing individual, interpersonal, organizational, and community barriers to PA.
    • Community preparedness: Expanding existing partnerships with academia to build resilience through experiential learning

      Cleveland, Nina; Palen, Mark; University of Georgia (Georgia Public Health Association, 2016)
      Background: Sustainability and mitigation in preparedness after grant money is gone has suddenly become a hot topic in the public health emergency preparedness world. By the same token, funding provided by the Federal Emergency Management Agency (FEMA) for individual preparedness initiatives has not had the desired mitigation impacts. The question becomes, are there alternative approaches that reach more individuals to build a culture of preparedness in communities? One solution involves the leveraging of academic and regional public health partnerships with their Medical Reserve Corps Units (MRC), to train college students in individual preparedness. The purpose of this study is to describe best practices and discuss the incorporation of experiential learning and training activities into an Introduction to Public Health course at the University of Georgia. It also describes the development of a strong academic and practice partnership though the use the agencies’ MRC units. Methods: Three experiential learning activities, rooted in the constructs of perceived susceptibility, perceived benefits and self-efficacy were introduced into the course. First, didactic elements addressing the purpose and structure of public health response, individual preparedness and the role of Medical Reserve Corps volunteers in response were incorporated. Second, the public health partner developed a lecture covering public health emergency preparedness and response using a real world-sheltering example and coupled it with a tabletop exercise. Finally, students were given a final exam option where they built a home emergency kit. Results: Over the course of 3 years, approximately 500 students have been trained in individual preparedness. Students have demonstrated an increased foundational knowledge about the Medical Reserve Corps and public health preparedness in general. Furthermore, this collaboration increased the numbers of new MRC Volunteers and provided for a strong academic practice partnership. Conclusions: Through this collaboration, more students know how to take care of themselves and their families, decreasing the number of potential well worried. This collaboration has also strengthened the ties between the two institutions, leading to more opportunities for partnership.
    • Community-based approaches to reduce chronic disease disparities in Georgia

      Rollins, Latrice; Akintobi, Tabia Henry; Hermstad, April; Cooper, Dexter; Goodin, Lisa; Beane, Jennifer; Spivey, Sedessie; Riedesel, Amy; Taylor, Olayiwola; Lyn, Rodney; et al. (Georgia Public Health Association, 2017)
      Background: Among underserved and racial/ethnic minority populations in Georgia, there are profound health disparities and a burden of chronic diseases. Such diseases, which are preventable, are influenced by risk factors, including poor nutrition, physical inactivity, lack of quality health care, and tobacco use and exposure. Awardees of the Racial and Ethnic Approaches to Community Health (REACH) and Partnerships to Improve Community Health (PICH) are implementing community-based initiatives using evidence-based, policy, systems, and environmental approaches to reduce racial and ethnic health disparities and the chronic disease burden in underserved urban and rural Georgia communities. Methods: Within the context of a social ecological framework, the REACH and PICH awardees selected interventions. Their impact in the areas of tobacco use and exposure, chronic disease prevention and management, and nutrition are described. Results: To date, the interventions of Georgia’s PICH and REACH awardees have reached approximately 805,000 Georgia residents. Conclusions: By implementing strategies for community-based policy, systems, and environmental improvement, Georgia’s PICH and REACH awardees are reducing tobacco use and exposure; increasing access to healthy foods; and providing chronic disease prevention, risk reduction, and management opportunities for underserved communities in urban and rural Georgia communities. Their efforts to address chronic disease risk factors at various social and ecological levels are contributing to a reduction in racial/ethnic health disparities and the chronic disease burden in Georgia.
    • Community-based participatory research principles for the African American community

      Smith, Selina A.; Whitehead, Mary S.; Sheats, Joyce Q.; Ansa, Benjamin E.; Coughlin, Steven S.; Blumenthal, Daniel S.; School of Medicine; Georgia Regents University; University of Massachusetts; Morehouse College (Georgia Public Health Association, 2015)
      Background: Numerous sets of principles have been developed to guide the conduct of community-based participatory research (CBPR). However, they tend to be written in language that is most appropriate for academics and other research professionals; they may not help lay people from the community understand CBPR. Methods: Many community members of the National Black Leadership Initiative on Cancer assisting with the Educational Program to Increase Colorectal Cancer Screening (EPICS) had little understanding of CBPR. We engaged community members in developing culturally-specific principles for conducting academic-community collaborative research. Results: We developed a set of CBPR principles intended to resonate with African-American community members. Conclusions: Applying NBLIC-developed CBPR principles contributed to developing and implementing an intervention to increase colorectal cancer screening among African Americans.
    • Community-based participatory research principles for the African American community

      Smith, Selina A.; Whitehead, Mary S.; Sheats, Joyce Q.; Ansa, Benjamin E.; Coughlin, Steven S.; Blumenthal, Daniel S. (Georgia Public Health Association, 2015)
      Background: Numerous sets of principles have been developed to guide the conduct of community-based participatory research (CBPR). However, they tend to be written in language that is most appropriate for academics and other research professionals; they may not help lay people from the community understand CBPR. Methods: Many community members of the National Black Leadership Initiative on Cancer assisting with the Educational Program to Increase Colorectal Cancer Screening (EPICS) had little understanding of CBPR. We engaged community members in developing culturally-specific principles for conducting academic-community collaborative research. Results: We developed a set of CBPR principles intended to resonate with African-American community members. Conclusions: Applying NBLIC-developed CBPR principles contributed to developing and implementing an intervention to increase colorectal cancer screening among African Americans.
    • A comparison of hospital utilization in urban and rural areas of South Carolina

      Dicks, Vivian; Augusta University (Georgia Public Health Association, 2016)
      Background: Previous studies have described health care utilization based on insurance status and ethnicity. Few investigations, however, have looked at rural populations in relation to distance in securing health care. Methods: The 2008 to 2009 Healthcare Cost and Utilization Project (HCUP) State Inpatient Database (SID) for South Carolina was used to assess the relationship of living in rural versus urban communities and the demographic variables related to insurance coverage. By use of bivariate and multivariate analyses, patient socio-demographic characteristics were explored for working-aged groups in relation to their income and for payer status (Medicaid or uninsured) relative to those privately insured. Results: Of hospitalizations, 68.89% were for those living in urban areas, 20.52% in large rural areas, 6.57% small rural areas, and 4.02% in isolated rural areas. Blacks lived predominantly in small rural (53.65%) and isolated rural communities (51.55%). As income decreased, the percentage of hospital admissions increased, from 5.83% for those earning $66,000 to 43.29% for those earning between $1 and $39,999. Conclusions: Hospital admissions may not be entirely dependent on race, income or insurance, but could also be influenced by geographic access. Further, having private insurance, higher incomes, and living in urban areas are positive predictors for better health outcomes.