• 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.
    • Promoting policy and environmental change in faith-based organizations: Organizational level findings from a mini-grants program

      Hermstad, April K; Arriola, Kimberly; Clair, Shauna; Honeycutt, Sally; Carvalho, Michelle; Cherry, Sabrina; Davis, Tamara; Fraizer, Sheritta; Escoffery, Cam; Kegler, Michelle C.; et al. (Georgia Public Health Association, 2015)
      Background: High rates of heart disease, cancer, and stroke exist in rural South Georgia, where Emory’s Cancer Prevention and Control Research Network provided mini-grants and technical assistance to six faith-based organizations to implement policy and environmental changes to promote healthy eating (HE), physical activity (PA), and tobacco use prevention (TUP). Drawing from a Social Ecological Framework, we hypothesized that church members would perceive an increase in messages, programs, and the availability of facilities to support HE, PA, and TUP over a 1-year period. Methods: Members (N=258) completed self-administered questionnaires that assessed perceptions of the existing church health promotion environment relative to HE, PA, and TUP policies, as well as their eating behavior and intention to use PA facilities at church at baseline and 1-year follow-up. Results: Members at three of the six churches perceived increases in delivery of HE messages via sermons, church bulletins, and food labels, and increased availability of programs that support HE (p<0.05). Members at four churches reported increases in healthy foods served and decreased unhealthy foods served at three churches over the 1-year period (p<0.05). Of the five churches that implemented changes to promote PA, members at two churches perceived increases in healthy PA messages (p<0.05) and those at three churches perceived increased PA facilities (p<.05). One of two churches that implemented TUP policies, according to responses of members, had an increase in messages on smoking, (p<0.05). Conclusions: Community mini-grants may be a viable mechanism for promoting environmental change supporting HE, PA, and TUP policies in church environments.
    • 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.