• 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.
    • 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.
    • 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.
    • Trends in cancer incidence rates in Georgia, 1982-2011

      Yoo, Wonsuk; Coughlin, Steven S.; Lillard, James; Georgia Regents University; Emory University; Morehouse College (Georgia Public Health Association, 2015)
      Background: Although data from the Surveillance, Epidemiology, and End results (SEER)-affiliated cancer registry are accessible to the public, there is a shortage of published research describing cancer incidences for White, Black, and other residents in Georgia. The objective of this research is to provide an overview of the trends in incidence of cancer in Georgia. Methods: Incidence data were obtained from the Surveillance, Epidemiology, and End Results (SEER) 9 program, supported by the National Cancer Institute, spanning the years 1982 to 2011. To assess trends over time, age-adjusted cancer incidence rates relative to the 2000 Standard US population and annual percent changes (APCs) were calculated using SEER*Stat software. Results: In Georgia, cancer incidence rates for women increased from 365.1 per 100,000 in 1982 to 404.2 per 100,000 in 2011, with an overall APC of 0.3% (95% confidence interval: 0.2 to 0.4), but, for men, cancer incidence rates showed a slight decline from 528.0 per 100,000 in 1982 to 513.7 per 100,000 in 2011 (APC of 0.2%, 95% CI: -0.6 to 0.1). For Black, White, and Other (Asian/Pacific Islanders/American Indians) females, there were increases in incidence in this period, with APC values of 0.6, 0.4, and 0.3, respectively. For all males and for Black and White males, there were overall decreases in incidence, with APC values of -0.2. For Other males, however, the APC value was -0.9. Conclusions: In Georgia, increases in cancer incidence rates occurred during 1982-2011 among the female population and within various racial groups in this population, but there was relative stability in incidence rates among the male population, except for Other males.
    • Understanding the role of social norms in organ donation decision making among African American adults

      Lucido, Briana; Center for Disease Control and Prevention (Georgia Public Health Association, 2016-08-18)
      Background: African Americans (AAs) comprise a disproportionate number of those waiting on the national transplant list and are underrepresented among registered organ donors. While barriers to organ donation are well understood, little research has explored factors that facilitate interest in donation. Because AAs are often characterized by strong extended relationships and shared decision-making, social norms may be an influential factor in donation behavior. Utilizing the Theory of Reasoned Action, this study demonstrated the application of theory to understand the role social norms play in donation decisionmaking, among AAs. Methods: Self-administered questionnaires were completed by 425 AA adults residing in the metropolitan Atlanta area. Social norms were measured using a Likert scale consisting of two items that addressed perceptions of favorability of donation and levels of influence a loved one has over the participant’s donation decision making. Main outcomes assessed were donation intentions and expression of donation intentions via designation on one’s driver’s license. Results: Logistic regression results indicate that a loved one’s level of favorability of donation is associated with both intention (OR=2.14, p≤0.01) and expression (OR=1.71, p≤0.01); however, findings approached significance with the level of influence a loved one has on intentions (OR=1.47, p=0.07) but was not associated with expression (p>0.05). Conclusions: The results suggest that a loved one’s level of favorability has an effect on donation decision making, but, conversely, a loved one’s level of influence does not impact donation decision making. Focusing on social norms and encouraging communication may prove useful for future interventions to improve engagement in donation among AAs.
    • Unveiling the mysteries of palliative care

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

      Jones, Jeffery; Bangar, Ankit; Chang, Patrick; Tarasenko, Yelena; Georgia Southern University (Georgia Public Health Association, 2015)
      Background: Studies of public health departments have found mixed results regarding the relevance of governance through local boards of health (LBOHs). Some studies find that LBOHs can be an important component in higher performance by local health departments. Other analyses, however, find no advantage for local health departments having or not having a LBOH. The hypothesis was that a typology of LBOHs nationwide can define different types of LBOHs based on their powers and responsibilities. Methods: Using national profile sample data from the National Association of Local Boards of Health, LBOHs were categorized using 34 variables based on four domains of responsibilities and duties: enforcement powers, regulatory powers, human resource powers, and budgetary powers. Correlations between types of LBOHs defined by this typology were then computed, and whether they shared significant characteristics in terms of the race, ethnicity, sex, and educational demographics of their board members was determined. ArcGIS was used to analyze the data spatially for regional and national patterns. Results: LBOHs vary considerably across the country - from LBOHs with no budgetary, enforcement, regulatory, or human resources authorities to those that have all four. Conclusions: Different types of LBOHs may have different influences on their associated local boards of health. This study provides a typology for future research to allow analysts to distinguish different types of LBOHs nationally.
    • 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.