• 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.
    • Using our voices -- and using our science

      Hinman, Johhanna (Georgia Public Health Association, 2015)
      At the close of the 2015 Annual Meeting and Conference of the Georgia Public Health Association (GPHA), President Deborah Riner encouraged the assembly to “use your voice[s],” to be advocates for public health. Indeed, the history of our successes in public health reflects a history of advocacy, of speaking up to make change. Our charge is to use our voices to express our passion for public health or specific public health causes, and to use our voices to promote the best available science.
    • 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.
    • Association between air temperature and heart disease death rates in Georgia counties

      Hart, John (Georgia Public Health Association, 2016-07-19)
      Background: In this ecological study, global warming theory was tested on a local level, in Georgia. The hypothesis was that warmer counties would be associated with higher death rates. Methods: Heart disease death rates (HDDR) for 2008-2010 by Georgia county were compared to air temperature, also by county for the same years. Three race categories for HDDR were studied: black, white, and all races. Since there is evidence that living at higher land elevations provides a protective effect against heart disease, land elevation by county was included as a second predictor. Results: Correlation analyses revealed low strength, statistically significant correlations with white and all races HDDR as follows: direct for air temperature and indirect for land elevation. Correlations for blacks were negligible strength and statistically non-significant. Thus, multiple linear regressions (MLRs) were considered appropriate for whites and all race HDDR. In MLRs, temperature and elevation essentially cancelled each other relative to HDDR, resulting in statistically non-significant regression coefficients for each in both race categories (p > 0.15). This may have in part been due to the slight collinearity that was observed between the two predictors (variance inflation factor = 10.6 for both predictors in both race categories). The study is limited by: a) its (ecological) design, where individual exposures are unknown; and b) the-less-than ideal regression model that revealed slight collinearity between the predictors. Further research is required to verify these findings. Conclusions:
    • Tapping the “town and gown” potential for correctional health research collaborations

      Gates, Madison L.; Staples-Horne, Michelle; Webb, Nancy C.; Braithwaite, Ronald; Hastings, Beverly (Georgia Public Health Association, 2015)
      Background: Collaborations between juvenile justice systems (town) and academia (gown) promise to significantly enhance what we understand about high rates of sexually transmitted infections (STIs) found among detained populations, particularly African American young women. However, research related to the sexual health of adolescent detainees has not occurred in proportion to the magnitude of issues found in the population. While there are many challenges to conducting research with this population, there are also lessons learned and best practices from other studies that may provide guidance. Methods: In 2015, we implemented a pilot project with young women in a detention center to understand the association between STIs and relationship dynamics. Using a formative assessment-based approach, the team periodically compared expectations to actual milestones and outcomes. This approach has provided feedback, guidance and lessons learned that we will use to adjust our pilot project. Results: Three challenges emerged from our review: concerns related to different agendas, bureaucratic difficulties and human protection. In addressing these challenges, we identified study procedures to revise and to incorporate into future works. Conclusions: Juvenile justice and academic partnerships require extensive pre-research work to account for the many challenges to implementing and conducting projects with this population. However, “town and gown” approaches to understanding and improving the sexual health of detainees can result in a more complete assessment of these issues compared to either a solely academic or juvenile justice investigation.
    • Ebola: Working through fear

      Fitzgerald, Brenda; Georgia Department of Public Health (Georgia Public Health Association, 2015)
    • 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.
    • Unveiling the mysteries of palliative care

      Currin-McCulloch, Jennifer; Terry, Karen; Memorial Health University Medical Center (Georgia Public Health Association, 2015)
    • 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.
    • 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.
    • 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.
    • 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