• The care continuum for people living with HIV in Georgia: How can we raise the bar?

      Kelly, Jane; Rane, Deppali; Wortley, Pascale; Drenzek, Cherie; Georgia Department of Public Health (Georgia Public Health Association, 2015)
      Background: Viral suppression (VS) improves quality of life and longevity for people living with HIV (PLWH) and reduces viral transmission, but is achieved by only a minority of PLWH in Georgia Methods: By use of the Georgia HIV/AIDS surveillance database, the HIV Care Continuum was stratified by age. Results: Retention in care and VS generally increased with increasing age, with the exception of adolescents (aged 13-18 years), who had the highest retention and VS. Differences by sex, race and transmission category persisted across age groups. Among persons retained in care, the proportion achieving VS also generally increased with age. Linkage to care within 3 months of HIV diagnosis was lower among young adults (aged 19-24 years) (54%); young Black, non-Hispanic (NH) males (49%); and young Black NH men who have sex with men (MSM) (49%) as compared to those among adolescents (66%, 58%, and 57%). Conclusions: Retention in care and VS decreases with the transition from adolescence to young adulthood, possibly reflecting loss of support systems and competing priorities. At the other end of the age spectrum, health care and social support systems will be confronted with increasing numbers of older PLWH in Georgia. Challenges in HIV treatment and prevention include (a) the need for integrated medical care for aging PLWH with co-morbid conditions, and (b) the changing social environment of young PLWH.
    • 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.
    • 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.
    • E-cigarette use among undergraduate liberal arts and health sciences students: A study protocol

      Dicks, Vivian; Stone, Rebecca; Georgia Regents University (Georgia Public Health Association, 2015)
      Background: Electronic cigarettes (e-cigarettes) are battery operated devices that deliver nicotine as an inhaled vapor. Use of E-cigarettes has gained in popularity since 2007, and their use is often promoted as a safer alternative to tobacco smoking. A concern among public health experts is whether e-cigarettes can be used as an alternative method for tobacco cessation or whether they lead to nicotine dependence and use of other tobacco products. Several studies have shown a higher prevalence of use of e-cigarettes among young adults between the ages of 18 and 25, but varying results on the association between their use and perceptions of harm. For the present survey, this age group was selected because, in this group, addiction to tobacco and the likelihood for adverse effects would be lower. Thus, for this group, the chances of not starting or consideration for quitting would be higher. The purpose of this study is to investigate the knowledge, attitudes, and beliefs about using tobacco products, smoking, and e-cigarettes among undergraduate students on liberal arts and health sciences campuses of a university. Methods: Participants will be invited via email and directed to a secure website where the survey can be completed anonymously. To assess knowledge, attitudes, and beliefs, the survey will include validated questions based on recommendations by the World Health Organization ((2000) appendix A)). Anticipated Results: We anticipate that the results will show an improvement in the behavioral aspect among undergraduates at the liberal arts and health sciences campuses. We also expect that results will show an improvement in knowledge among liberal arts students but less improvement in knowledge for health sciences students. Finally, we predict an overall improvement in attitudes about tobacco use and e-cigarette use.
    • Ebola: Working through fear

      Fitzgerald, Brenda; Georgia Department of Public Health (Georgia Public Health Association, 2015)
    • Evaluation results of an innovative pilot program to increase access to fresh fruits and vegetables in Cobb County, GA

      Woodruff, C Rebecca; Shipley, Rebecca; Brown, Agnes F.; Coleman, Anne-Marie; Munoz, Jennifer; Honeycutt, Sally; Hermstad, April K; Loh, Lorna; Kegler, Michelle C.; Emory University (Georgia Public Health Association, 2015)
      Background: This abstract describes a public health practice initiative called the Farm Fresh Market (FFM) and presented pilot evaluation results. Methods: The FFM, developed by Cobb and Douglas Public Health, the McCleskey-East Cobb Family YMCA, and Cobb2020, sold low-cost fruits and vegetables to families living in the 30168 zip code of Austell, Georgia. The evaluation focused on documenting to what extent the FFM reached its intended population and increased perceived access to fresh fruits and vegetables among customers. A convenience sample of 100 returning FFM customers completed self-administered, written intercept surveys at the end of the 2014 market season. Results: The market served customers from a range of socioeconomic backgrounds. Most customers strongly agreed that the FFM made it easier (69%) and less expensive (79%) for them to buy fresh fruits and vegetables and easier for them (63%) and their families (64%) to eat a healthy diet. Most customers reported that they ate more vegetables (65%) and fruit (55%) as a result of shopping at the FFM and reported high levels of satisfaction with all aspects of the FFM. Conclusions: The results suggest that the FFM served customers from the local area and that the FFM may have increased perceived access to healthy food options among customers. Community-level interventions to increase access to healthy foods may play an important role in chronic disease prevention.
    • Immunization policies for employees of childcare facilities within the North Central Health District of Georgia

      Kamara, Paula; Lian, Brad; Smith, Jimmie; McChargue, Judy; Mercer University, North Central Health District (Georgia Public Health Association, 2015)
      ABSTRACT Background: Since the early 1980s, vaccinations have generally been required for children in licensed daycare and school settings. In these settings, vaccinations have reduced disease rates. Adults occupy these settings as well, and ensuring they are vaccinated should also reduce the potential for disease and disease transmission. Yet, there are few vaccination requirements for adults employed at daycare facilities, although such requirements have been recommended (CDC Adult immunization schedule, 2015; ACIP General Recommendations, 2011). The objective of this study was to examine current vaccination policies among childcare facilities within Georgia’s North Central Health District (District 5-2) and the climate for possible policy directives in the future. Methods: A 10-item questionnaire regarding vaccination requirements and policies and the importance of vaccination education was mailed to administrators of all 271 licensed childcare facilities within the North Central Health District in Georgia. A total of 76 questionnaires were returned, representing a 28% response rate. The district has approximately 530,000 residents and is comprised of 13 counties. Results: Of the childcare facilities, 79% have no vaccination policies in place. However, most facility directors (75%) indicated that such policies should be required, and 93 % stated that vaccination education is important for their staff members. Conclusions: Vaccination requirements can help protect children and their caregivers from communicable diseases. From a policy perspective, the climate may be favorable for the implementation of such requirements, in that most childcare directors recognize the importance of such policies and state that they should be required.
    • Impact of 1918 Spanish influenza pandemic on mortality rates in Savannah, GA, and implications for future epidemic prevention

      Plasphol, Sara; Dixon, Betty; Armstrong State University (Georgia Public Health Association, 2015)
      Background: The Spanish Influenza pandemic struck the United States in waves from September 1918 through March 1919. This study investigates the impact of the Spanish Influenza on Savannah and Chatham County, Georgia. Methods: Primary death records from the Chatham County Health Department were examined and analyzed for the years of 1917, 1918, and 1919. Historical mortality rates in the Savannah area were compared to those for other parts of the United States and world. Results: Mortality rates attributed to the Spanish Influenza within Savannah closely paralleled similar flu-related mortality rates for comparison populations in New York, London, and Madrid. Conclusions: These local primary data enable Savannah public health officials to understand the historical trends of communicable disease mortality in relation to other parts of the world, and have the potential to serve as a reference when channeling future resources into epidemic prevention in Chatham County.
    • Increased perception of mosquito problems during a stormwater restoration project

      Kelly, Rosmarie; Georgia Department of Public Health (Georgia Public Health Association, 2015)
      In 2008, a plan for improvement of the McDaniel Branch Watershed was prepared for the city of Atlanta, Department of Watershed Management. This included the construction of ponds in a kudzu-covered area at Bowen Circle. There is a perception that wetlands create mosquito problems. In point of fact, most of the vector and nuisance species in Atlanta are either container breeders or floodwater species, and do not breed in ponds. Because there is an average of 5 cases of West Nile virus (WNV) reported in Fulton County per year, most of these near Combined Sewer Overflow streams, county residents are aware of the connection between mosquitoes and WNV. As the McDaniel Branch Watershed Improvement Plan progressed, neighborhood residents became convinced that the changes being implemented in the area were increasing mosquito problems and increasing their risk of WNV infections. In Oct 2013, the Environmental Health Section of the Georgia Department of Public Health was contacted by the City of Atlanta Department of Watershed Management concerning control of mosquitoes in the ponds being created at the Bowen Circle site. It was determined that mosquito surveillance should be implemented in the area to determine if the changes to the watershed area were creating a mosquito problem. At the end of the 2014 mosquito surveillance season, it was established that there was little association between the watershed improvement project, the reported mosquito exposure, and measures of mosquito production within this neighborhood.
    • Legislative smoking bans for reducing exposure to secondhand smoke and smoking prevalence: Opportunities for Georgians

      Coughlin, Steven S.; Anderson, Jennifer; Smith, Selina A.; Emory University; Georgia Regents University (Georgia Public Health Association, 2015)
      ABSTRACT Background: Secondhand smoke, which is also referred to as environmental tobacco smoke and passive smoke, is a known human carcinogen. Secondhand smoke also causes disease and premature death in nonsmoking adults and children. Methods: We summarize studies of secondhand smoke in public places before and after smoking bans, as well as studies of cardiovascular and respiratory disease before and after such bans. Results: To protect the public from the harmful effects of secondhand smoke, smoke-free legislation is an effective public health measure. Smoking bans in public places, which have been implemented in many jurisdictions across the U.S. and in other countries, have the potential to influence social norms and reduce smoking behavior. Conclusions: Through legislative smoking bans for reducing secondhand smoke exposure and smoking prevalence, opportunities exist to protect the health of Georgians and other Americans and to reduce health care costs. These opportunities include increasing the comprehensiveness of smoking bans in public places and ensuring adequate funding to quit line services.
    • A multisite evaluation of pediatric asthma-related treatment in accordance to the 2007 National Heart, Lung, and Blood Institute Expert Panel Report – 3 guidelines

      Oraka, Emeka; Robinson, Brittani; Ousley, Trevor; Lopez, Francesca; Graham, LeRoy (Georgia Public Health Association, 2016-08-18)
      Background: To determine if Georgia-based healthcare providers who received continuing education on pediatric asthma as described by 2007 National Heart, Lung, and Blood Institute Expert Panel Report – 3 guidelines demonstrated improvements in asthma-related treatment. Methods: We used a multi-site, cross-sectional design. Data were collected via surveys administered to healthcare providers and via randomized medical chart abstractions. Chart abstraction occurred at 12 months prior to intervention (n = 149); one-month post-intervention (n = 208); and three months post-intervention (n = 123). Results: Substantial improvements were observed among the providers who used pre/post bronchodilator spirometry (5% at baseline, 12% at one month, and 19% at three months), and there was a significant increase in the number of patients being advised to improve conditions at home or school to avoid asthma triggers (9% at baseline, 43% at one month, and 37% at three months). However, prescription of preventive medications and patients being taught proper medication/spacer technique by providers decreased from baseline to three-months (69% vs 55% and 41% vs 27%, respectively). Providers’ self-reported barriers and patient load were consistently associated with poorer treatment outcomes. Healthcare providers who received continuing education on NHLBI - EPR 3 guidelines demonstrated an increase in spirometry use and in advising patients on improving home and school conditions. While these findings are useful, provider-reported barriers such as time, organizational, and insurance barriers prevent providers from effectively systematically incorporating all of the EPR 3 guidelines. Conclusions: Internal efforts to address clinical barriers combined with continued education may result in improvements in pediatric asthma-related treatment outcomes.
    • Nonprofit hospitals and community health needs assessments

      Stephens, Beth (Georgia Public Health Association, 2015)
      Background: The Patient Protection and Affordable Care Act of 2010 requires all hospitals filing as 501(c)(3) nonprofit organizations to conduct a Community Health Needs Assessment (CHNA) every three years. Many Georgia hospitals published their first CHNAs in 2012 and 2013. The goals of this research and policy project were to assess compliance with the new CHNA requirements for nonprofit hospitals, provide recommendations to hospital administrators and policymakers, and encourage hospitals to engage in meaningful ways with community-based organizations and local public health departments in the next round of CHNAs. Methods: With funding from the Healthcare Georgia Foundation, Georgia Watch reviewed the initial CHNAs of 38 nonprofit hospital facilities in Georgia. Georgia Watch developed an evaluation tool to assess hospital compliance with five major components of the new CHNA requirements: 1) defining community; 2) collecting secondary data on community health; 3) gathering community input and primary data; 4) prioritizing community health needs; and 5) implementing strategies to address identified community health needs. To gain a deeper understanding of hospital processes, Georgia Watch supplemented document review with hospital leadership interviews and a survey of community input providers. This research was intended to inform, assist, and encourage citizens, community health stakeholders, public health departments, and hospital administrators. At the end of the session, audience members were better equipped to evaluate the adequacy of nonprofit hospital CHNAs within their own communities and encourage local hospitals to develop effective community benefit programs. Results: Georgia Watch found that hospitals are still learning how to navigate the CHNA process and that improvements can be made during the next round of CHNAs. Conclusions: Georgia Watch’s research provides insight on how hospitals can best engage their communities, prioritize local health concerns, initiate valuable partnerships, and develop meaningful, evidence-based strategies to address community health needs.Methods: With funding from the Healthcare Georgia Foundation, Georgia Watch reviewed the initial CHNAs of 38 nonprofit hospital facilities in Georgia. Georgia Watch developed an evaluation tool to assess hospital compliance with five major components of the new CHNA requirements: 1) defining community; 2) collecting secondary data on community health; 3) gathering community input and primary data; 4) prioritizing community health needs; and 5) implementing strategies to address identified community health needs. To gain a deeper understanding of hospital processes, Georgia Watch supplemented document review with hospital leadership interviews and a survey of community input providers. This research was intended to inform, assist, and encourage citizens, community health stakeholders, public health departments, and hospital administrators. At the end of the session, audience members were better equipped to evaluate the adequacy of nonprofit hospital CHNAs within their own communities and encourage local hospitals to develop effective community benefit programs. Results: Georgia Watch found that hospitals are still learning how to navigate the CHNA process and that improvements can be made during the next round of CHNAs.
    • Patient-centered outcomes for GoStrong: A self-management diabetes program in Savannah, GA

      Yang, Frances; Roberts, Lizzann; Davis, Bionca; Christianson, Angela (Georgia Public Health Association, 2015)
      Background: To advance the goal of health improvement for diverse populations with diabetes, a patient-centered approach is foundational. Methods: Innovative methods were used to initiate and advance an approach to diabetes engagement and self-management. We began with a strategy to understand how patients with diabetes view and interact with the disease via the medical community and moved to program development through patient-centered design and to the development of strategic partnerships and continuous learning from patients, stakeholders, and academic research partners. Results: The mean age of the participants in the GoStrong™ program (n=106) was 51 ±9.2 (SD) years. There were significant differences in the HbA1c levels over time compared to the Control group (n=100). The mean HbA1c level from baseline to 36 months decreased from 7.49% to 6.89%, with the largest decline (to 6.28%, p<0.01) at 12 months. The mean HbA1c level for the control group increased from 8.38% to 8.49% from baseline to 36 months, with the largest increase (to 8.89%, p<0.01) at 18 months. There were significant differences for total medical costs at 12 months prior to and 12 months after starting the GoStrong program, a difference in total prescription drug costs at 12 months, and differences within the total group in number of emergency room (ER) visits. Claims information showed that GoStrong produced significantly lower total medical costs and ER visits. There was also an increase in total prescription drug costs that may be due to better medication adherence. Conclusions: For diabetics, the GoStrong program results in reduced HbA1c levels, reduced costs, and reduced ER visits.
    • Perceptions of HIV/AIDS testing among urban and rural African American church members

      Walker, Roblena E; Walden University (Georgia Public Health Association, 2015)
      Background: The prevalence of the human immunodeficiency virus (HIV) continues to affect African Americans (AA) disproportionately. The purpose of this mixed methods study, guided by the health belief model, was to examine associations linking church and ambient social environment with knowledge and perceptions of HIV/AIDS testing amongst urban and rural AA church members. Methods: Multiple regressions and t tests were used to compare perceptions of HIV/AIDS testing and knowledge of HIV/AIDS among 236 participants selected from two AA churches located in a large city (n = 122) and in a rural town (n = 114) in the Southern U.S. Results: The quantitative findings indicated that the urban participants reported significantly higher rates of testing than the rural participants, but the groups had equally high HIV knowledge and positive perceptions of HIV/AIDS testing. In-depth, individual interviews (24 urban; 24 rural) were conducted to gain a better understanding of the factors that contribute to perceptions of HIV/AIDS testing and knowledge of HIV/AIDS. Transcripts were axially coded for a priori themes and then analyzed for emergent categories of responses. These interviews indicated that the participant’s perceptions of HIV/AIDS testing were in general, not influenced by the church and that there were no noticeable distinctions regarding why HIV/AIDS testing was sought. The combined results of this study suggested that the churches surveyed were not promoting HIV/AIDS awareness and that the participants felt that the church should do more as it relates to HIV/AIDS. Conclusions: Since the AA church plays an important role in the lives of many AAs, it potentially can, particularly in rural areas, bring forth social change by advocating HIV/AIDS testing and prevention efforts in order to reduce the rate of HIV infections.
    • 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.
    • Reflections on mental health advocacy across differing ecological levels

      Thompson, J Nancy; McGee, E Robin; Munoz, C Leslie; Walker, R Elizabeth (Georgia Public Health Association, 2015)
      ABSTRACT Background: According to the World Health Organization, mental health advocacy is comprised of a range of actions designed to change aspects of attitudes and structures that impede the achievement of positive mental health in populations. Methods: According to the World Health Organization, mental health advocacy is comprised of a range of actions designed to change aspects of attitudes and structures that impede the achievement of positive mental health in populations. Results: We have proposed interventions and advocacy effort for each ecological level. Project UPLIFT, a distance-delivered intervention for mental health is presented as an example of an effort that can affect several levels of the social ecology. Conclusions: Advocacy and interventions that make an effort to encompass the levels of the social-ecological model may contribute to greater progress in improving mental health outcomes.
    • The role of perception in developing healthy lifestyles and community engagement

      Coleman, Anne-Marie; Hicks-Coolick, Anne; Brown, Agnes F.; Georgia Department of Public Health; Cobb and Doglas Public Health Department; Kennesaw State University (Georgia Public Health Association, 2015)
      Background: The Cobb and Douglas Public Health Department and the Cobb2020 partnership, sponsored by the Mobilizing for Action through Planning and Partnering program, facilitated six focus groups in Cobb County to ascertain residents’ perceptions of healthy behaviors. The purpose of the research was to assist in the development of programs to increase healthy behaviors. Methods: Purposive sampling was used to choose fifty-eight participants, who were divided into six groups in different geographic locations. The focus group questions concerned healthy living, health communications, and community health. Qualitative data analysis techniques were used to generate themes and categories across and within groups. Results: Six themes emerged: 1) need for education; 2) healthy food choices; 3) access to healthcare; 4) trust in health care providers; 5) affordable healthcare; and 6) need for local resources. The results show how community members’ perceptions regarding: a) policies that affect health, b) environments that promote healthier choices, and c) systems that allow individuals to be health consumers influence healthy living and community engagement. Other findings note different perceptions between those with and without health insurance. In addition, socio-economic status and ethnicity were seen as factors related to the perceptions of participants. Conclusions: The findings of this study informed a comprehensive, county-wide Community Health Improvement Plan. As a result of these studies, Cobb & Douglas Public Health established, as two chronic disease prevention interventions, the Cobb2020 Farm Fresh Market and, in the City of Kennesaw, the 100% Tobacco Free Parks and Cemeteries policy. Keywords: focus group, healthy living, individual perceptions, health belief model
    • 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.