• Missed opportunities for diagnosing HIV via routine screening in an inner-city primary care clinic

      Hankin, Abigail; Turbow, Sara; Spicer, Jennifer; Freiman, Heather; Shah, Bijal; Travis, Natasha; Emory University (Journal of the Georgia Public Health Association, 2015)
      Background: Although routine, opt-out HIV screening has been recommended for nearly a decade, clinical practice has not kept pace. Here, we examine missed opportunities for HIV screening among patients newly diagnosed with HIV via a routine non-targeted opt-out HIV screening program in a primary care clinic at an inner-city safety-net hospital. Methods: Select demographic and clinical data were analyzed for all persons with a new HIV diagnosis between July 9, 2013 and August 31, 2015. Retrospective reviews of medical records were performed to identify missed opportunities for HIV screening in the year prior to HIV diagnosis. Results: Among 6,582 patients tested for HIV as part of the screening program, 27 patients had a new HIV diagnosis (0.41%). In the year prior to diagnosis, 19 (70%) of these had contact with the healthcare system but were not tested for HIV. At the visit associated with the new HIV diagnosis, 70% of patients did not present with an indication for risk-based HIV screening or symptoms potentially associated with HIV-related infections. Conclusions: Despite CDC recommendations for routine, non-targeted, opt-out HIV screening in all healthcare settings, 70% of patients newly diagnosed with HIV via routine screening in a primary care clinic had contact with the healthcare system in the year prior to the new HIV diagnosis but were not tested for HIV. These findings highlight the importance of routine, non-targeted screening to identify patients with HIV as well as continued provider and patient education about the value of routine HIV screening.
    • Promoting colorectal cancer screening among Haitian Americans

      Coughlin, Steven S.; Lubetkin, Erica I.; Hay, Jennifer L.; Raphael, Renald; Smith, Selina A.; University of Massachusetts; Emory University; The City College of New York; Medical College of Georgia; Georgia Regents University (Journal of the Georgia Public Health Association, 2015)
      Background: Few studies have examined colorectal cancer screening among Haitian Americans, although striking disparities in colorectal cancer screening and mortality are well-documented among U.S. Blacks. Race, socioeconomic status, and place of birth are factors associated with colorectal cancer incidence and mortality patterns. Methods: In this article, we summarize published studies on colorectal cancer screening among Haitian Americans, identified through bibliographic searches in PubMed and CINAHL through August 2015, and offer recommendations for further research. Results: Only one qualitative study and three quantitative surveys have examined colorectal cancer screening among Haitian Americans. A qualitative study found important differences in perceptions of the curability of colorectal cancer, preventive practices, and preferred sources of information among Haitian Americans and other ethnic subgroups of U.S. Blacks. Awareness of colorectal cancer screening tests, risk perception, healthcare provider recommendation, and self-reported use of screening are suboptimal among Haitian Americans and other subgroups. In preliminary quantitative studies, Haitian immigrants have been found to have lower colorectal cancer screening rates than other groups such as African Americans. Conclusions: Culturally appropriate educational interventions are needed to encourage Haitian American adults aged > 50 years to undergo screening for colorectal cancer and to ensure that they are well informed about the value of healthy eating and physical activity.
    • Sexual health education in Georgia: A role for reducing sexually transmitted infections among adolescents

      Gates, Madison L.; Walker, Veronica; Webb, Nancy C.; Georgia Regents University (Journal of the Georgia Public Health Association, 2015)
      Background: In Georgia, sexually transmitted infections (STIs) are a substantial health issue, particularly among young adults in vulnerable and minority populations. The United States Preventive Services Task Force recommends that sexually active adolescents and at-risk adults receive behavioral counseling and education in primary care settings, community organizations, departments of health, and schools Methods: The present approach used in Georgia for educating adolescents at high risk for STIs about these diseases was assessed. The data collected included standards for sexual health education, survey results from educators and students, and observations from a pilot study with adolescents detained by the juvenile justice system. Results: In Georgia, most health educators for middle (87.3%) and high (93.8%) schools have health and/or physical education backgrounds. They indicated a need for further education about STIs. For grades 6-12, 24% of students reported that they had not received HIV/AIDS education during the academic year. Preliminary observations from a study with juvenile detainees indicate that this population has limited knowledge about STIs, their effects and modes of transmission. Conclusion: Sexual health education, including that for HIV/AIDS, is essential to curtail the STI crisis, and educational endeavors should be culturally sensitive and evidence-based. In Georgia, many citizens, including teachers, are not adequately equipped to make informed decisions regarding STI risk. Georgia, home to the Centers for Disease Control and Prevention, is in a unique position to adapt evidence-based sexual health interventions for its population.
    • Social and behavioral implications of National Collegiate Athletic Association sickle cell trait screening: The athletes’ perspective

      Lawrence, H Raymona; Scott, Alison; Haywood, Carlton; Robinson, Kayin; Mason, Mondi; Georgia Southern University, The College of William and Mary, Johns Hopkins University, University of Georgia, City and County of Denver Department of Environmental Health (Journal of the Georgia Public Health Association, 2015)
      Background: In August 2010, the National Collegiate Athletic Association (NCAA) implemented a policy mandating sickle cell trait (SCT) testing for all Division I collegiate athletes. Subsequently, all Division II-III athletes were also compelled to undergo SCT testing. This decision has met with controversy among healthcare providers, researchers, and sickle cell advocates. However, there is little information concerning the athletes’ perspective of this policy. The purpose of this paper is to report the findings of a qualitative study that explored college athletes’ perceptions of sickle cell trait SCT, NCAA policies on SCT testing, and potential implications of SCT screening. Methods: The participants were eighteen male and female athletes (ages 18-24), members of NCAA-governed teams who were on the study campus from April-August 2010. Athletes participated in focus groups that gathered their perceptions of the SCT, the NCAA SCT policy, and social and behavioral implications of a SCT diagnosis. Results: Athletes lacked knowledge of the SCT and the implications of a positive screening test result, desired health education about SCT, were conflicted about sharing health information, and feared loss of playing time if found to carry the SCT. Conclusions: The study revealed athletes’ perceptions of the SCT and mandated NCAA SCT testing that should be addressed by college health professionals.
    • Use of geographical information systems to identify counties in Georgia with high risk for childhood lead poisoning

      Rustin, R Christopher; Kuriantnyk, Christy; Lobsinger, Byron; Charles, Simone; Georgia Department of Public Health; Michigan University (Journal of the Georgia Public Health Association, 2015)
      Background: For children in Georgia, lead poisoning is a substantial public health problem. Primary risk factors include low socioeconomic status and poor-quality housing built prior to 1978. The Environmental Health Team of the Georgia Department of Public Health (DPH) utilized geographical information system (GIS) technology and census housing data to identify counties in which children have high risk for lead poisoning. The purpose of this research was to update and refine previous maps developed with older technology and on a different geographic scale so that targeted public health interventions can be developed. Methods: Data related to stratified and median housing age data were derived from the 2013 5-year American Community Survey. With ESRI ArcMap 10.2 geographic information software, the data were geospatially linked to the state’s county shapefile for development of spatial maps. Results: A series of spatial maps were developed utilizing housing risk factors of age and occupancy status. Refined spatial maps were developed for: 1) the percentage of homes built prior to 1978 and prior to 1950 per county; 2) owner- and renter-occupied housing stratified by age and color-coded per county; and 3) counties in which children were at high risk for lead poisoning. Conclusions: The data from this research provides information for the DPH Lead and Healthy Homes program of areas in the state where targeted interventions are needed. The updated maps can be used to educate policy makers, healthcare providers, and community leaders in regard to prevention of lead poisoning.