• Surveillance, Epidemiology, and End Results (SEER) data for monitoring cancer trends

      Yoo, Wonsuk; Coughlin, Steven S; Augusta University (Georgia Public Health Association, 2019)
      Background: Monitoring cancer trends allows evaluation of the effectiveness of cancer screening or detection methods and determination of priorities in cancer control programs. Government officials and policy makers also use information on cancer trends to allocate resources for cancer research and prevention. 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 incidence rates for White, Black, and other residents in Georgia. The objective of this research is to provide an overview of how to use SEER data through analysis of the incidence rate for cervical cancer. Methods: Cervical cancer cases (ICD-O-3/WHO 2008 =’Cervix Uteri’, corresponding to C530-C539) were obtained from the SEER18 database. It includes the largest geographic coverage compared to SEER 9 and SEER 13 data. The incidence and incidence rates for cervical cancer were obtained, stratified by year (2000-2012), sex, race/ethnic groups, and region (Georgia and US). Age-adjusted incidence and incidence rates (to the 2000 US standard population) were calculated using SEER*Stat software, which is available, free of charge, on the SEER Web site: http://seer.cancer.gov. Results: Age-adjusted incidences and incidence rates in Georgia and the US from SEER 18 data were created by SEER*Stat. The incidence rates were stratified by age variable (5-year category), sex, race/ethnicity, and other socio-demographic variables. Annual percent changes (APC) and 95% CI were also obtained to characterize trends in cancer rates over time. The trends for age-adjusted incidence rates for regions (Georgia and the US) and race (white, black, others) were compared using APC. Furthermore, age-specific incidence and incidence rates for cervical cancer for Georgia and US for recent five years (2008-2012) were reported. Conclusions: The Surveillance, Epidemiology, and End results (SEER) program provides cancer researchers a convenient and intuitive system for viewing individual cancer records and producing statistics useful in studying the impact of cancer on a population.
    • Understanding public health: Research, evidence, and practice

      Hinman, Johanna M (Georgia Public Health Association, 2016)
    • The evidence for and from accreditation

      Bender, Kaye; Public Health Accreditation Board (Georgia Public Health Association, 2016)
      Background: Public health department accreditation administered by the Public Health Accreditation Board (PHAB) began in 2007 after a series of policy briefs, field demonstration initiatives, and completion of a national feasibility study. Methods: Evidence for accreditation was gathered from both national and state-based standards that had been tested and evaluated. Evidence from accreditation was obtained from surveys and focus groups. Results: Preliminary analyses have indicated that the accreditation program is having its intended impact, although longitudinal analyses are planned for the future when a larger number of health departments can respond to surveys over time. Conclusions: PHAB will continue to utilize long-term evaluation methods to describe the long-term impact of the accreditation process on health department performance.
    • Reducing and eliminating health disparities through prevention and public health

      Blumenthal, Daniel S.; Morehouse School of Medicine (Georgia Public Health Association, 2016)
      African Americans suffer more from health disparities than any other racial or ethnic group. In fact, African Americans have the highest mortality rate from every major cause of death. If public health is (as it fancies itself) social justice in health and health care, then it must address this injustice. The underlying cause of disparities is social determinants: income, education, discrimination, powerlessness, and other social factors. In the long run, a “level playing field” must be developed for these factors. But considerable progress in reducing disparities can be achieved through health promotion and disease prevention initiatives that focus on lifestyle determinants of health: tobacco control, improvements in diet, increases in physical activity, firearm control, and other wellknown measures
    • Nicotine poisoning trends in Georgia

      Fabayo, Oluwayomi; Chung, Alina; Kenneth, Ray; O'Connor, Jean; Georgia Department of Public Health (Georgia Public Health Association, 2016)
      Background: Nicotine is a toxic chemical that can cause adverse health effects. Nicotine poisoning can result from exposure to tobacco and other nicotine containing products. It can cause nausea, vomiting, abdominal pain, fever, dizziness, seizures, tachycardia, hypertension and edema. Nicotine poisoning can affect both adults and children. Methods: The Georgia Department of Public Health secured data from the Georgia Poison Center in order to analyze nicotinespecific poisoning calls, including e-cigarette poisoning calls. The data on tobacco/nicotine poisoning or exposure calls were collected from April 2009 to April 2015. The data on calls related to nicotine poisoning from e-cigarettes were collected from January 2011 to April 2015. Results: Approximately 1,513 tobacco/nicotine poisoning calls were received over 6 years. Of these, 1, 212 were related to exposures in children ages 0 to 5 years, including 853 from cigarette use, 474 from cigars and chewing tobacco, and 23 from Nicoderm, Nicorette and hookahs. Approximately, 164 calls on nicotine poisoning from e-cigarettes were received over 4 years. Of these, 93 were related to exposure in children ages 0 to 5 years. Ingestion accounted for 107 of the calls, while 22 had nicotine poisoning through dermal routes, 21 through inhalation/nasal routes and 12 through ocular routes. Conclusions: Nicotine poisoning is a major public health problem in Georgia; it is caused by tobacco products and electronic nicotine delivery systems. Adopting tobacco-free/smoke-free policies that include e-cigarettes in homes, workplaces and vehicles will prevent nicotine poisoning.
    • Assessing the cultural appropriateness of UPLIFT for African Americans with epilepsy: A community engaged approach

      Hunter-Jones, Josalin; Nellum, April; Olorundare, Elizabeth; McCloud, Candace; McCurdy. Matthew; McGee, Robin; Davis, Contessa; Thompson, Nancy; Quarells, Rakale; Emory Universtiyu (Georgia Public Health Association, 2016)
      Background: In trials of Project UPLIFT, a distance-delivered, mindfulness-based cognitive therapy intervention, there was improvement in the mental health of people with epilepsy/seizure disorder. In these trials, however, African Americans have been few. Thus, as this program is disseminated, it is desirable to ensure that it is culturally appropriate for minority populations. Methods: To determine the appropriateness of Project UPLIFT for African Americans, we engaged in three main research activities: 1) the formation and involvement of an epilepsy community advisory board; 2) qualitative interviews with healthcare providers who serve this community; and 3) focus groups with African American adults living with epilepsy or seizure disorder and main support persons of African American adults living with epilepsy or seizure disorder. Results: The epilepsy community advisory board provided recommendations for the most appropriate language to use when engaging and recruiting the target population. Healthcare providers indicated that psychosocial concerns of African American persons living with epilepsy seemed to be different from those among patients of other racial groups. They indicated that Project UPLIFT might be useful for this group. Focus groups revealed experiences of living with and supporting someone with epilepsy and provided favorable feedback on the UPLIFT intervention. Conclusions: Formative feedback indicates that Project UPLIFT may be useful for African Americans with epilepsy. These data will be used to guide a forthcoming randomized, controlled trial to assess the acceptability and feasibility of the intervention with this group.
    • Domestic violence intervention for Latino families: Baseline program evaluation data

      Cormier, Jacque-Corey; Nava, Nancy; Mora, Charmaine; Rodriguez, Rebecca; Georgia State University (Georgia Public Health Association, 2016)
      Background: In the United States, Latino families affected by domestic violence (DV) often face unique challenges influenced by changing ecologies and personal/political histories. Caminar Latino is Georgia’s first and only comprehensive DV intervention program for Latino families. The program is geared towards helping family members begin their journey towards non-violence. The purpose of this evaluation is to better understand how Caminar Latino is benefiting families within the program. Baseline data of interest included perceptions of power in the relationship among family members and whether mothers and/or youth had safety plans. Methods: A longitudinal, quasi-experimental research design was utilized to collect quantitative and qualitative data. This study was approved by Georgia State University’s Institutional Review Board. Study participants (N = 82) were men, women, and youth (8 – 17 years old only) selected from families that started the program between August 2014 and August 2015. Members of the research team read the survey questions in English or Spanish to all participants. A univariate analysis was utilized to assess baseline data. Results: There were major inconsistencies found regarding power distribution in the relationships. Half of women (50%) reported their partner having more power in the current relationship, while majority of men (77%) reported their partner and themselves sharing equal power. All men and women felt power should be equal in an ideal relationship. Only 13% of mothers and 44% of youth had a safety plan pertaining to violence. Conclusions: By examining DV in a manner consistent with the needs and preferences of families, and offering support directly within communities, community practitioners have the opportunity to capitalize on existing strengths and abilities of Latina women and families. Findings from this program evaluation provide Caminar Latino with a better understanding of the ways in which they can promote wellness and non-violence in Latino communities.
    • Bridging the gap between local public health and the healthcare community: The Public Health Talk

      Bharucha, Puja; Franklin, Rachel; Cobb and Duglas Public Health (Georgia Public Health Association, 2016)
      Background: District epidemiologists often rely on healthcare providers for medical information regarding reportable diseases in order to properly investigate cases. It becomes difficult when providers do not share patient information due to apprehension and/or lack of knowledge of HIPAA exemption laws. It is also challenging when the provider staff is not knowledgeable regarding disease specific information. When information is withheld, there is a delay in completing investigations, and high priority cases and outbreaks such as emerging infectious diseases can be missed or lost to follow up. Methods: The Public Health Talk (The Talk) initiative was established at Cobb and Douglas Public Health in 2014 by the Epidemiology Department. The Talk includes a comprehensive binder that consists of information about the reportable diseases, emerging infectious diseases, sexually transmitted infections and provides guidelines and protocols as recommended by the Georgia Department of Public Health. It provides a forum for local epidemiologists to informally meet and educate staff of healthcare facilities (physicians, nurses, office managers, administrative assistants, etc). Pre-talk and post-talk surveys were developed to assess knowledge gained of the staff to which The Talk was presented. Results: The initiative is ongoing, however, 31 Talks were completed by March 2016, but only 8 facilities were evaluated due to the delayed development of the surveys. It was found that 38% of staff members were not aware of the reportable diseases prior to the Talk. There was a noted increase in knowledge of local public health and the resources that are offered to healthcare facilities. Conclusions: Healthcare providers have begun to utilize public health to aid in assessing and diagnosing diseases. The initiative is evolving and continuously improving, including the development of newsletters to improve communication and the resource binder will be reorganized to have specific information that is needed by the specialty of the provider.
    • Partnership approach to establishing tobacco-free colleges and universities in Georgia

      Coleman, Anne-Marie; Ray, Kenneth; Toodle, Kia; Chung, Alina; O'Connor, Jean; Georgia Department of Public Health (Georgia Public Health Association, 2016)
      Background: Smoking rates in young adults ages 18-24 have been steadily declining since 2011 (2011:25.0%, 2012:22.3%, 2013:16.5% (BRFSS). The Georgia Department of Public Health (GDPH) partnered with the Georgia Board of Regents to adopt the 100% Tobacco Free Colleges/Universities policy. Methods: The Behavioral Risk Factor Surveillance System (BRFSS) is a state-based surveillance system, administered by the GDPH in collaboration with the CDC. The survey began in 1984 with 15 states participating, including Georgia. The data from this survey were used to inform key shareholders of smoking prevalence to encourage policy adoption as a method of decreasing tobacco use. The GDPH used the CDC’s Partnership Toolkit to recruit and retain partnerships with various multi-sector organizations in working towards systems change. Results: The Georgia Board of Regents—the governing body for the state’s system of colleges and universities –adopted the model 100% tobacco free colleges/universities policy resulting in a systems change of 31 campuses now having the model policy in place. The policy not only impacted the students who fall in the 18-24 age group, but the staff and visitors as well. Conclusions: Partnerships play a key role in creating systems changes. The partnership between the Georgia Board of Regents and the Georgia Department of Public Health contributed to the growing number of colleges and universities who are now 100% Tobacco Free. Using the CDC’s Partnership Toolkit allowed for sustainable partnerships leading to positive social change.
    • Formative research to develop a lifestyle application (app) for African American breast cancer survivors

      Smith, Selina; Whitehead, Mary; Sheats, Joyce; Fontenot, Brittney; Alema-Mensah, Ernest; Ansa, Benjamin E.; Augusta University (Georgia Public Health Association, 2016)
      Background: There is a proliferation of lifestyle-oriented mobile technologies; however, few have targeted users. Through intervention mapping, investigators and community partners completed Steps 1-3 (needs assessment, formulation of change objectives, and selection of theory-based methods) of a process to develop a mobile cancer prevention application (app) for cancer prevention. The aim of this qualitative study was to complete Step 4 (intervention development) by eliciting input from African American (AA) breast cancer survivors (BCSs) to guide app development. Methods: Four focus group discussions (n=60) and three individual semi-structured interviews (n=36) were conducted with AA BCSs (40-72 years of age) to assess barriers and strategies for lifestyle change. All focus groups and interviews were recorded and transcribed verbatim. Data were analyzed with NVivo qualitative data analysis software version 10, allowing categories, themes, and patterns to emerge. Results: Three categories and related themes emerged from the analysis: 1) perceptions about modifiable risk factors; 2) strategies related to adherence to cancer prevention guidelines; and 3) app components to address barriers to adherence. Participant perceptions, strategies, and recommended components guided development of the app. Conclusions: For development of a mobile cancer prevention app, these findings will assist investigators in targeting features that are usable, acceptable, and accessible for AA BCSs.
    • Hepatitis C and injection drug use: Testing and linkage to care

      Sutton, Marie; Youngner, Cole; Holloway, Winona; Emory University (Georgia Public Health Association, 2016)
      Background: The recent outbreak of HIV infection in Indiana linked to injection drug use demonstrates the importance of timely HIV and Hepatitis C surveillance and rapid response to interrupt disease transmission. An estimated 2.7 – 3.9 million Americans have chronic hepatitis C virus (HCV) infection. Of those, 50 – 70% are unaware of their infection. People who inject drugs account for more than half of new HCV cases. Within 5 years of beginning injection drug use, 50 – 80% of injection drug users (IDUs) become infected with HCV. Since 2007, HCV-related deaths have surpassed HIV-related deaths. CDC reported 19,368 death certificates listing HCV as a cause of death in 2013, adding that this figure represents a fraction of deaths attributable to HCV. Method: Imagine Hope, supported by a grant from a pharmaceutical company, initiated HCV rapid testing in April 2015. The Georgia-wide project includes 10 agencies serving substance-using populations, including 4 methadone clinics. The project offers free, routine HCV testing and linkage to care. Results: Over the first 12 months of testing, 3,226 clients received HCV antibody testing. Of those, 344 (10.7%) were HCV antibody positive (Ab+), with 186 completing confirmatory RNA testing. Confirmatory tests yielded 132 (71%) RNA positive cases; 56 (42.4%) of these were linked to care. Five clients have achieved sustained viral load suppression which is considered a cure for hepatitis C. Numerous others have begun direct acting antiviral regimens. Conclusion: HCV testing in substance abuse facilities is feasible. Among substance users, HCV prevalence is high and awareness of infection risk is low. Linkage to care is enhanced by the use of a navigator. RNA screening prior to the 1st medical appointment expedites linkage to care; RNA positive clients are more motivated to keep appointments and RNA negative clients do not clog an already burdened system of care for the uninsured.
    • Assessment of early intervention services to better child outcomes among Part C infants and toddlers

      Ibe, Brendan; Fowles, Tiffany; Csukas, Seema; Conner, Jackie; Kelley, Grace; Johnson, Donna; Bryant, Cynthia; Allen, Michelle; Georgia Department of Public Health (Georgia Public Health Association, 2016)
      Background: Early intervention services have been shown to improve child outcomes. Rapid proliferation of neural connections and circuits contribute to the rapid growth of the brain in the first three years of life. These neural circuits which create the foundation for learning are most flexible in this period and become increasingly more difficult to change thereafter. The purpose of this study is to examine the relationship between early enrollment in Georgia’s Part C birth to three early intervention program and improved child outcome ratings upon exiting the program at 3 years of age. The study used 2013 & 2014 Annual Performance Report (APR) data. Methods: This study included 6,309 participants who enrolled and received services in the Part C, Babies Can’t Wait (BCW) program. A Pearson’s correlation analysis was used to assess if there was an association between age at enrollment and improved child outcome score. One-way analysis of variance (ANOVA) was used to test the variances within the age groups for equality. Bonferroni post hoc test was used to compare the mean child outcome score across the enrollment age groups. Results: A statistically significant inverse correlation was found between enrollment age and improved child outcome score at 3 years of age. One-way ANOVA showed that the variances within the enrollment age groups were equal while the mean child outcome scores were not. Bonferroni post hoc test revealed that the mean child outcome score in the enrollment age group 0 to ≤ 6 months was significantly higher than the other age groups. Conclusions: Significantly better child outcomes were associated with enrollment in early intervention services before 6 months of age.
    • The influence of Georgia’s Quality Rated System on school readiness in pre-school children

      Phillips, Dena; Webb, Nancy; Augusta University (Georgia Public Health Association, 2016)
      Background: Georgia rates the quality of early childcare learning centers using a tiered quality improvement system. Georgia’s Quality Rated system (QR) designates a star level, (one star, two stars or three stars) to each center based on a portfolio of QR standards and an onsite assessment by Georgia Department of Early Care and Learning (DECAL). Childcare centers applying for QR status first submit a portfolio documenting how their practices align with QR standards centered on staff qualifications; child health, nutrition and physical activity; family engagement; holistic curricula and teacher-to-student ratios. Subsequently, an on-site assessment of the center is performed by DECAL using the Early Childhood Environment Rating Scale– Revised (ECERS-R). Methods: The Bracken School Readiness Assessment-3rd Edition (BSRA-3) was administered to children in various one-star (N=2), two-star (N=4) and three-star (N=6) childcare learning centers in Georgia. Children’s height and weight were recorded and BMI assessments were conducted. Results: Significant differences were found in school readiness scores based on quality rating with two and three star centers scoring higher than one star centers. Children in childcare centers at the one-star level (Mean = 95.00, SD = 16.80) performed lower than children in childcare centers at the two-star level (Mean = 103.67, SD = 16.55) and three-star level (Mean = 100.42, SD = 14.35). Multiple comparison tests did not reveal differences between two-star and three-star level centers. Conclusions: Higher levels of quality in QR childcare centers displayed more school readiness than centers with lower levels of quality. Future studies should examine differences in higher quality centers to further explore the influence of QR programs on school readiness.
    • Engaging African Americans in developing an intervention to reduce breast cancer recurrence: A brief report

      Smith, Selina A.; Whitehead, Mary S.; Sheats, Joyce Q.; Fontenot, Brittney; Alema-Mensah, Ernest; Ansa, Benjamin E.; Augusta University (Georgia Public Health Association, 2016)
      Background: To develop a culturally appropriate lifestyle intervention, involvement of its intended users is needed. Methods: Members of an African American (AA) breast cancer support group participated in two 4-hour guided discussions, which were audiotaped, transcribed, and analyzed to guide the content. Results: The support group collaborated with researchers to develop 24 experiential nutrition education sessions using a social cognitive framework and incorporating self-regulation skills (goal-setting, self-monitoring, problem-solving, stimulus control) and social support to enhance self-efficacy for changes in dietary intake. Conclusions: Community engagement fostered autonomy, built collaboration, and enhanced the capacity of AA breast cancer survivors to participate in developing a lifestyle intervention.
    • The effectiveness of text message reminder-recalls on Human Papilloma Virus vaccination coverage in Georgia

      Moon, Tamira; Dally, Nocolle; Sloat, Ben; Bryant, Kia; Grady, Sherrionda; Georgia Department of Health (Georgia Public Health Association, 2016)
      the Advisory Committee on Immunization Practices for adolescents ages 11 to 12 years, yet vaccine coverage remains low. The Georgia Comprehensive Cancer Control Program and Georgia Immunization Program implemented and evaluated a text-messaging campaign aimed at improving HPV vaccination coverage, using the Georgia Immunization Registry (GRITS). Methods: The text message reminder-recall campaign, aimed at the parents of adolescents 9 – 18 years, was launched in July 2015. A total of 208,792 adolescents in the GRITS database met the inclusion criterion, receipt of at least one dose of the three-dose series HPV vaccine. We determined the rate of HPV vaccine series completion for adolescents with a valid parent/guardian mobile phone number and for those without. Results: A total of 9,711 text messages were successfully sent to parents of adolescents 9 – 18 years. HPV vaccine series completion was 16% among adolescents whose parent/guardian received a text message as compared to 7% among those who did not. Conclusions: Text message reminder-recalls have a positive effect on HPV vaccine series coverage for adolescents in Georgia. Text messaging reminder-recalls may be an effective strategy to improve HPV vaccination coverage statewide.
    • Perinatal health and school trajectories

      Williams, Bryan; Weldon, Arianne; Fitzgerald, Brenda; Gary, Fran; Emory University (Georgia Public Health Association, 2016)
    • Attitude towards research among undergraduate nursing students

      Bhattacharya, Anunay; Tabi, Marian; Georgia Southern University (Georgia Public Health Association, 2016)
      Background: This study investigated undergraduate nursing students’ attitude towards research. It has been shown in numerous studies that there exists a negative attitude towards research among undergraduate students and this attitude acts as a barrier. This negative attitude affects the willingness and efforts of students to excel in a research course. Methods: A 15-item pre and post-test questionnaire was administered to undergraduate nursing students to identify the factors that may have an effect on their attitude towards research. The Georgia Southern University Institutional Review Board approved the study. Statistical analysis was performed using paired sample t-test and IBM SPSS 23.0. Results: Factors that affected students’ attitude towards research included ‘anticipatory anxiety taking a research course’ (p=0.005), ‘glad that research course was over’ (p=0.009), and ‘research is a boring field’ (p=0.040) were significant at the =0.05. However, students recognized the usefulness of research to their professional career (p=0.004) and indicated the importance of attending their research classes (p=0.039). Conclusions: With the drive to make a doctorate in nursing the entry level for advanced nursing practice, changing the mindset of undergraduate nursing students towards research is essential. Therefore, the selection of teaching methods and the development of content to promote student engagement can make a difference in students’ attitudes toward undergraduate research and optimize learning outcomes.
    • Evidence-based strategies identified to increase access to oral health services to promote a healthier lifestyle

      Davis, Breyana; Plaspohl, Sara (Georgia Public Health Association, 2016)
      Background: Leading Health Indicators (LHI) are a subset of Healthy People 2020 objectives, selected to communicate at- risk health issues and actions that can be taken to address them. The number of children, adolescents, and adults who visited the dentist in the past year has decreased nationally, suggesting that oral health continues to be a problem caused by barriers preventing access to oral services. Methods: Preliminary research was conducted on the LHI via the Healthy People 2020 website. Health-related peer reviewed articles were selected and reviewed. Results: Evidenced-based literature shows that economic, educational, and personal barriers prevent access to oral services. However, through health promotion and new intervention methods, good oral health can be established. Conclusions: Primary prevention leads to improved oral health status; thus, such methods can be useful in moving the LHI objective towards the Healthy People 2020 target goal.
    • Collecting physiological stress measures in research among high-risk parents for child maltreatment: A qualitative investigation

      Tiwari, Ashwini; Self-Brown, Shannon; Robinson, Charles; McCarty, Colleen; Carruth, Laura; Georgia State University (Georgia Public Health Association, 2016)
      among parents at high risk of child maltreatment (CM). However, no known studies on these programs have examined physiological biomarkers for stress, such as impaired levels of cortisol and dehydroepiandrosterone (DHEA), and telomere length. Further, no details are known regarding the feasibility of collecting biological markers from parents. This research examined qualitative findings from a multidisciplinary neurobiology and public health study that examined physiological responses to a six-week, evidence-based, behavioral parenting program, among a maternal population at risk of CM perpetration in Atlanta, Georgia. Methods: Eighteen high-risk mothers were assessed at pre-intervention and post-intervention for parental stress and behavior (i.e., self-report, observational), and non-invasive physiological markers for cortisol, DHEA, and telomere length, Hormones were measured using two salivary methods, passive drool and Salivette swabs, as well as hair samples. Telomere length was assessed using cheek swabs. Semi-structured interviews were conducted at baseline to examine the feasibility of collecting biological samples for parental stress research among a sub-sample of participants (n=13). Results: Early qualitative themes suggest interest in providing hair and cheek swab samples. Notable suggestions were made to improve saliva collection. Particularly, participants showed clear preference for swabbing methods over passive drool collection. Conclusions: These study findings add novel results to the parenting literature on parental stress and provide emerging evidence on parental willingness to engage in physiological research. Acceptance of collection methods encourages further examination of biomarker correlates using non-invasive and inexpensive methods in biobehavioral research.
    • Local youth groups in Georgia working towards policy, systems, and environmental changes

      Coleman, Anne-Marie; Ray, Kenneth; Toodle, Kia; Chung, Alina; O'Connor, Jean; Georgia Department of Public Health (Georgia Public Health Association, 2016)
      Background: The Georgia Youth Tobacco Survey (YTS) is a survey of public middle school (MS) and high school (HS) students. The Georgia YTS was first conducted in 2001. According to YTS, students who attended a tobacco free schools’ youth summit were significantly more likely to be aware of students who use tobacco products (MS: 21% for smoking and 20% for smokeless tobacco; HS: 42% for smoking and 39% for smokeless tobacco) on school property than students who did not attend a tobacco free schools’ youth summit (MS: 10 % for smoking and 9 % for smokeless tobacco; HS: 32 % for smoking and 35 % for smokeless tobacco. Methods: During the fall of 2014, the Chronic Disease Prevention Section of the Georgia Department of Public Health (DPH) hosted a youth summit for youth groups across the state. In total, 149 youth and 49 adult leaders attended the summit. The youth summit provided training for middle and high school youth to become tobacco use control advocates in their communities. The youth were involved in creating the messages they would deliver to their school boards. Results: The local youth groups who attended the summit in 2014 were instrumental in four school districts adopting the model 100% Tobacco-Free Schools policy: Lowndes County Schools and Irwin County Schools (Valdosta, GA); Emanuel County Schools and Jenkins County Schools (Augusta, GA). Conclusions: These findings support the growing literature on youth involvement in advocacy work towards policy change. Youth should be recruited to work with public health professionals in building coalitions to change community norms.