• Venomous spiders of the southeastern US: An unexpected threat

      Collins, Alex; Samples, Oreta; Fort Valley State University (Georgia Public Health Association, 2015)
      Background: Environmental health specialists recommend that residents of the Southeastern US, including Georgia, have the ability to identify the three venomous spiders indigenous to this area. It is necessary to recognize the black widow, brown widow, and brown recluse spiders and to be familiar with the likely habitats of these insects and with the symptoms of bites. The primary author, who serves as an Environmental Health Specialist and is a hobbyist who works with distressed wood, frequently encounters all three of these spiders. Methods: A literature review supports the fact that these three venomous spiders are indigenous to Georgia. Results: Spiders, a common sight in rural and urban areas of Georgia, are often not considered as being especially dangerous. Three common species of spiders found in Georgia are, however, venomous. Conclusions: Recognition of spiders is particularly appropriate for the protection of food service workers, employees working in tourist accommodations, and hobbyists who routinely invade spider habitats. The evaluation of educational efforts may be assessed by the numbers of reported cases of spider bites among these populations.
    • 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.
    • Advocating for pregnant women in prison: Georgia can do better

      Webb, Nancy C.; Gates, Madison L. (Georgia Public Health Association, 2015)
      Background: Women are the fastest growing segment of the U.S. prison populace and approximately 1 in 25 were pregnant when they were incarcerated. However, women, including pregnant women, are receiving unacceptable health care in correctional systems. Further, many correctional systems lack policies to protect the best interest of incarcerated women, mothers and their children. Methods: We reviewed the literature on pregnant women in prison and found that corrections has been slow in making changes and adapting facilities for women, especially related to pregnancy, parenting skills and nurseries. It has been suggested the parent-infant attachment and the involvement incarcerated parents have with their children can help in preventing intergenerational crime. Results: The prison system in the U.S. is not set up to meet the needs of pregnant women prisoners. Many states, including Georgia, do not have policies regarding prenatal care or the use of restraints during labor and delivery. Conclusions: Georgia should rethink its prison-spending model. It would behoove Georgia’s leaders to take a look at what programs exist for pregnant women and mothers and consider adopting a model that would be a good fit for our state. We propose a collaborative approach for stakeholders to improve the care of pregnant offenders and the health of their children.
    • 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.
    • 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.
    • 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.
    • 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.
    • 86th Annual Georgia Public Health Association Meeting & Conference Report

      Smith, Selina A.; Abbott, Regina; Sims, Christy; Medical College of Georgia, Georgia Public Health Association (Georgia Public Health Association, 2015)
      The 86th annual meeting of the Georgia Public Health Association (GPHA) and joint conference with the Southern Health Association was held in Atlanta, Georgia, on April 13-14, 2015, with pre-conference (April 12th) and post-conference (April 14th) Executive Board meetings. As Georgia’s leading forum for public health researchers, practitioners, and students, the annual meeting of the GPHA brings together participants from across the state to explore recent developments in the field and to exchange techniques, tools, and experiences. Historically, the GPHA conference has been held in Savannah (n=24); Jekyll Island (n=20); Atlanta (n=16); Augusta (n=4); and Gainesville (n=1). There was no annual meeting during the early years (1929-1936); during World War II (1941-1943 and 1945); and for four years during the 1980s. Between 2006 and 2010, GPHA held one-day annual meetings and business sessions with educational workshops. Several new initiatives were highlighted as part of this year’s conference. These included a “move and groove” physical activity lounge, registration scholarships for students with a dedicated meet-and-greet reception, an expanded exhibit hall, presentation and approval of three resolutions (related to healthy foods at official activities and events; weapons at official activities and events; and memorials), and approval of the 2015 legislative policy positions and amended association bylaws. The theme for the conference was Advocacy in Action for Public Health. Specifically, the program addressed ensuring access to care; protecting funding for core programs, services, and infrastructure; eliminating health disparities; and addressing key public health issues important to the state of Georgia. One hundred and nine (109) abstracts were submitted for peer review; 36 were accepted for poster and 40 for workshop presentations. Four plenary sessions with keynote speakers covered the intersection between advocacy and policy, Georgia’s response to the Ebola crisis, palliative care, and essentials of advocacy in action for public health. Concurrent workshops focused on Board of Health training, public health accreditation, capacity building, collaboration, patient-centered outcomes, synthetic cannabinoid use, the HIV care continuum, use of data for informed decision making, environmental threats, organizational development, epidemiology, policy, and regulation. Thirty-two (32) awards were presented, including Lawmaker of the Year Award to Governor Nathan and First Lady Sandra Deal for their active and engaged role in promoting public health in Georgia; and the Sellers-McCroan Award to Commissioner Brenda Fitzgerald, Georgia Department of Public Health (DPH) State Health Officer, for her leadership of the Georgia Ebola Response Team and leadership of the newly formed department. The conference attracted 569 registrants primarily through pre-registration (n=561) with limited onsite registration (n=8). For this year’s conference, there was a significant increase in attendance (36%) and exhibitors (33%) relative to 2014. Of registrants reporting GPHA section participation, representation included: academic (5%); administration (10%); boards of health (13%); career development (15%); emergency preparedness (2%); epidemiology (5%); health education and promotion (2%); information technology (2%); maternal and child health (3%); medical/dental (3%); nursing (10%); nutrition (<1%); and other/no record (15%). There was 100% participation in the conference from the state’s 18 public health districts. The conference evaluation completed by a representative sample of registrants indicated areas of potential improvement as: starting sessions on time, using electronic and social media for the conference agenda/syllabus, and decreasing workshop sessions to 45 minutes. Most rated the conference as “good” or “excellent.”
    • 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.
    • 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.
    • 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.
    • 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.