Volume 1, Number 1, 2006

Table to Contents

From the Editor

Meeting Public Health Challenges, M. Thomas

Practice in Action

A Worldwide Crisis: Inappropriate Antibiotic Use and Resistant Bacterial Infections, A. Vickery, J. Wilde

Original Research

Sexually Transmitted Infections: Perceived Knowledge versus Actual Knowledge, H. Ferguson, R. Topolski, & M. Miller

An Examination of Adolescents’ Knowledge and Attitudes Related to Heart Disease, Nutrition, Physical Activity, and Media Influences and the Adoption of a Healthy Lifestyle, M. Schenkman, R. Martin, & S. Butler

Emerging Professionals

Knowledge and Attitudes of Restaurant Operators Concerning the Requirements of the Georgia Smoke-Free Air Act, J. B. Fountain

Editor

McKinley Thomas, Augusta State University, Mercer University School of Medicine

Editorial Board

Kathi J. Bivens, Augusta State University
Georgia L. Gerard-Reed, Augusta State University
Paula Dohoney, Augusta State University
Curtis Gobely, Georgia Division of Public Health
Anthony Parrillo, Georgia Southern University
Jane M. Perry, Georgia Division of Public Health
Rebecca Rogers, Augusta State University
Lee Tanenbaum, Georgia Division of Public Health
Anna Vickery, Medical College of Georgia
Naomi Williams, Medical College of Georgia 


Volume 2, Number 2 2006

Table to Contents

From the Editor

Historical Critique of the Leading Causes of Death in the United, States, M. Thomas

Practice in Action

A Needs Assessment of Hypertension in Georgia, F. Lopez, M., Rimando, & H. Khapekar

Original Research

Racial Differences in Perception of Breast Cancer Risk in Rural Southeast Georgia, S. Tedders, A. Parrillo, K. Peace, & J. Knight

Care Quality for Adult Medicaid Beneficiaries with Type 2 Diabetes Varies by Primary Care Provider Subspecialty, R. Mayberry, R., Finley, E. Alema-Mensah, & T. Davis

Pregnancy and Delivery Costs in Georgia Medicaid: PCCM versus Fee-for-Service Enrollees, C. Raskind-Hood, E. Kathleen Adams, E., Alema-Mensah, &, R. Mayberry

Editor

McKinley Thomas, Augusta State University, Mercer University School of Medicine

Editorial Board

Grace Baugh, Medical College of Georgia
Kathi J. Bivens, Augusta State University
Georgia L. Gerard-Reed, Augusta State University
Paula Dohoney, Augusta State University
Curtis Gobely, Georgia Division of Public Health
Mary Mathis, Mercer University
Anthony Parrillo, Georgia Southern University
Jane M. Perry, Georgia Division of Public Health
Rebecca Rogers, Augusta State University
Lee Tanenbaum, Georgia Division of Public Health
Anna Vickery, Medical College of Georgia
Naomi Williams, Medical College of Georgia

Collections in this community

Recent Submissions

  • Pregnancy and Delivery Costs in Georgia Medicaid: PCCM versus Feefor- Service Enrollees4

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

    Mayberry, Robert M.; Finley, Rita; Alema-Mensah, Ernest; Davis, Trobiand A.; Baylor Health Care System; Morehouse College (Georgia Public Health Association, 2006)
    The Georgia Medicaid primary care case management (PCCM) program, phased in over the 1994- 1997 period, has now given way to a capitated managed care model of regional care management organizations (CMOs). Using Georgia Medicaid eligibility and provider claim data for 1996-1998, this study investigated diabetes care quality and whether it varied by primary care provider subspecialty in a longitudinal follow-up of newly diagnosed adults with type 2 diabetes during the early phase of the PCCM program. Results indicated that the quality of diabetes care was suboptimal and varied significantly by PCP subspecialty, with patients seen by generalists least likely to have their HbA1c monitored as recommended during office visits (odds ratio = 0.34, (95% confidence interval 0.16- 0.73). No PCP subspecialty consistently performed better or worse on all diabetes care quality indicators investigated. The lessons learned from this investigation are that variations in Medicaid care quality by PCP subspecialty is likely to remain and the new CMO model of care will unlikely demonstrate immediate improvement in diabetes care quality.
  • 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.
  • A Needs Assessment of Hypertension in Georgia

    Lopez, Faye; Rimando, Marylen; Khapekar, Harshali; Mercer University (Georgia Public Health Association, 2006)
    Hypertension is a leading cause of stroke, coronary artery disease, heart attack, and heart and kidney failure in the United States. In Georgia, the percentage of those with hypertension and related diseases remain above the national average. The aim of this paper is to offer a basic review of hypertension including physical complications of the disease and to provide statistics regarding the scope of hypertension in the state of Georgia. Additionally, the paper provides insights on current hypertension programs such as the National High Blood Pressure Education Program (NHBPEP) and Dietary Approaches to Stop Hypertension (DASH). In conclusion, a statewide or local hypertension education program should be implemented to improve awareness, treatment, opportunities, and control of hypertension in an effort to reduce cardiovascular disease rates in Georgia.
  • From the Editor Historical Critique of the Leading Causes of Death in the United States

    Thomas, McKinley; Mercer University (Georgia Public Health Association, 2006)
    From the Editor
  • Knowledge and Attitudes of Restaurant Operators Concerning the Requirements of the Georgia Smoke-Free Air Act

    Fountain, Jeffery B.; Coffee County Health Department; Columbia Southern University (Georgia Public Health Association, 2006)
    The State of Georgia enacted the Georgia Smoke-Free Air Act (GSAA) in 2005 to limit smoking in public places including restaurants. The purpose of this study was to determine if a correlation exists between restaurant operators’ attitude toward smoking regulation and prevention and their knowledge of requirements of the GSAA. Participants from Atkinson, Bacon, and Jeff Davis counties, three of the smaller populated rural counties of the Southeast Health District, completed questionnaires for this study (n = 41). The correlation was weak and not determined to be statistically significant (r = - .251) but did indicate restaurant operators agree they have not lost more customers than have been gained as a result of the enactment of the GSAA. The study also indicates that these restaurants do not have access to computers, printers, and the Internet for GSAA information, education, or requirements.
  • An Examination of Adolescents’ Knowledge and Attitudes Related to Heart Disease, Nutrition, Physical Activity, and Media Influences and the Adoption of a Healthy Lifestyle

    Schenkman, Melissa; Martin, Randolph; Butler, Susan; Emory University (Georgia Public Health Association, 2006)
    The present pilot study aimed to determine the attitudes, beliefs, behaviors, and degree of knowledge among adolescents related to healthy eating, exercise, heart disease, the influence of television, and possible factors in modifying their attitudes toward adopting a healthy lifestyle. Juniors and seniors from two private high schools (N=62) in metro Atlanta were surveyed. The study was based on the Social Cognitive Theory and the Health Belief Model. The research questions examined the impact of nutrition and heart disease knowledge on physical activity behavior, and the impact of television media exposure on eating habits. A 36-question cross-sectional survey compiled from various sources in the literature and health-related organizations was used to assess the outcomes of interest. Data analysis was conducted using frequencies, descriptive statistics, simple hypothesis tests, and chisquare analysis. Those who reported physical activity participation and those who did not, were not found to differ significantly on their composite nutrition and heart disease knowledge score, F (6,55)=.763, p=. 602. In addition, the three groups, reporting different amounts of physical activity participation in hours/week, were not found to differ significantly on their composite nutrition and heart disease knowledge score F (6, 50)=1.628, p=. 159. In terms of television viewing’s effect on eating habits, television viewing was not found to play a significant role in the frequency of breakfast food consumption F (3, 57)=2.269, p=. 090; or on how often adolescents ate fast food, F (1, 59)=. 025, p=. 875. Yet, the amount of television hours viewed on a typical weekday were significantly related to how often an adolescent thinks about their health when deciding what to eat (X= .008). The 5 groups of amounts of television viewing hours, differed significantly on how often adolescents’ thought about their health when deciding what to eat, specifically those who thought about their health always and sometimes F (3, 57)=3.241, p=. 029). The Post Hoc test showed a significant difference of .998 hours in the amount of TV watched by those who always think about their health when deciding what to eat (M=2.11 hours/weekday) and those who sometimes think about it (M=3.10 hours/weekday). Suggested primary implications for public health practice include access to school-sponsored or recreational sports teams for all adolescents, nutrition and heart disease education via sports teams, and parental involvement in their adolescent’s food choices and health behavior.
  • Sexually Transmitted Infections: Perceived Knowledge versus Actual Knowledge

    Ferguson, Heather; Topolski, Richard; Miller, Marc; Augusta State University (Georgia Public Health Association, 2016-05-26)
    Sexually transmitted infections (STIs) continue to be a serious problem, with potentially severe consequences. Past research has found that people may not seek out treatment for STIs because they do not know what symptoms to look for (Greenberg et al., 2002). The present study investigated many aspects of STI knowledge, including perceived knowledge and actually knowledge. Moreover, this study added a novel and applied aspect to the assessment of STI knowledge: visual knowledge. Overall, participants performed poorly on the actual STI knowledge, however, those who rated their knowledge as high performed significantly better than those who rated their knowledge as low. The data revealed two significant predictors of actual STI knowledge, level of STI education and number of previously contracted STIs. In addition, it was found that participants performed better on the written portion of the test than the visual portion of the test. The authors content that increased education may assist in reducing the transmission of sexually transmitted diseases.
  • A Worldwide Crisis: Inappropriate Antibiotic Use and Resistant Bacterial Infections

    Vickery, A.; Wilde, James (Georgia Public Health Association, 2006)
    The GUARD (Georgia United against Antibiotic Resistant Disease) Coalition seeks to reduce the spread of antibiotic-resistant disease and save antibiotic efficacy by decreasing inappropriate antibiotic use throughout the state of Georgia. The GUARD Coalition functions through the collaborative efforts of approximately 148 professional, academic, and community partners.
  • Meeting Public Health Challenges

    McKinley, Thomas; Augusta State University; Mercer University (Georgia Public Health Association, 2006)
    From the Editor