• 87th Annual Georgia Public Health Association Meeting & Conference Report

      McWethy, Dianne; Abbott, Regina; Sims, Christy; Morgan, Brain; Harrison, Angie Peden; Gowan, David; Georgia Public Health Association (2016)
      The 87th Annual Meeting of the Georgia Public Health Association (GPHA) was held in Atlanta, Georgia, on March 22-23, 2016, with pre-conference (March 21st) and post-conference (March 23rd) 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. In recent years the venue for the GPHA annual conference has been Atlanta, with the 2017 GPHA Annual Meeting and Conference also scheduled to be held in Atlanta. Several new initiatives were highlighted as part of this year’s conference. These included three pre-conference workshops, expansion of academic sponsorships, an enhanced exhibit hall integrated with the poster sessions, silent auction, breaks and President’s Reception, an information booth, and an inaugural administration section track. The 2016 Annual Meeting & Conference added the Certified in Public Health (CPH) Continuing Education (CE) designation. The theme for the conference was Understanding Public Health: Research, Evidence and Practice, which reflects the science of public health. Specifically, the program addressed strengthening health systems in the United States and other countries through public health informatics; national accreditation of local health departments; applying an epidemiological approach to promoting reading proficiency for young children; an examination of factors related to health and educational disparities; continuing efforts to eliminate 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; 45 were accepted for poster and 40 for workshop presentations. Four plenary sessions with keynote speakers covered the development of collaborative methods to strengthen information capacity of public health systems, including accreditation and the linkage between early brain development and reading success. Concurrent workshops focused on board of health training, public health accreditation, capacity building, collaboration, health disparities, impacts of climatic variability on public health, monitoring systems for travelers from Ebola-affected countries, policy, and regulation. Twelve (12) awards were presented, including Legislator of the Year Award to Senator Dean Burke for his legislative efforts critical to the success of public health initiatives. These efforts included a bill creating the Maternal Mortality Committee within the Georgia Department of Public Health and his efforts related to potential Medicaid innovations for public health. The SellersMcCroan Award went to Lee S. Caplan, MD, MPH, PhD, Professor, Department of Community Health and Preventive Medicine, Morehouse School of Medicine for his efforts in securing funding from the National Cancer Institute to develop and implement a Cancer Prevention and Control Research Training Program that focuses on cancer disparities. The conference attracted 475 registrants primarily through pre-registration (n=461) with limited onsite registration (n=15). Although there was a decrease in overall conference attendance (19%), the number of exhibitors (n=36) and sponsorships (n=17) remained constant as compared to 2015. There was a significant increase in the number of posters (n=9), while the number of workshops remained the same (n=40). Of registrants reporting GPHA section participation, representation included: Academic (13%); Administration (25%); Boards of Health (11%); Career Development (4%); Emergency Preparedness (1%); Environmental Health (7%); Epidemiology (7%); Health Education and Promotion (8%); Information Technology (3%); Maternal and Child Health (5%); Medical/Dental (1%); Nursing (10%); and Nutrition (1%). There was a significant increase in the Administration Section (15%) which is likely attributable to the addition of the Administration Track. Yvette Daniels, JD, of the Department of Public Health was instrumental in working to revitalize the Maternal and Child Health Section and the Safety and Health Preparedness (formerly Emergency Preparedness) Section participation at the Annual Meeting and Conference. There was 100% participation in the conference from the state’s 18 public health districts. The online conference evaluation completed by a representative sample of registrants indicated areas of potential improvement as: alignment of breakout session topics with conference theme, enhancement of the use of information technology and social media for the conference agenda/syllabus, change pre-workshops to post-workshops, and consider repetitive sessions. Most rated the conference as “good” or “excellent.”
    • 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.
    • 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.
    • 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.
    • 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.
    • A Central Georgia asthma prevalence assessment of school-age children and compliance with Senate Bill 472

      Gaddis, Cheryl; Smith, Jimmie (Georgia Public Health Association, 2016)
      Background: A common theme among the counties of the North Central Health District is the disparity between the number of asthma-related visits of African-American and white children ages 1-14 to the emergency department. In 2013, 858 children ages 1-14 in the district had emergency room visits related to asthma. The purpose of this study was to assess North Central Health District (NCHD) schools to determine the prevalence of self-reported asthma by parents and school age children and the adequacy of students’ access to maintenance inhalers at school, and to identify schools that qualify for Asthma Friendly School Recognition. Methods: The “Asthma School Policy Assessment” from the 2015 Georgia Asthma-Friendly Schools Toolkit and Recognition Guidance was used to assess policies and practices for addressing asthma with school staff, parents, and children within the NCHD schools. The Lead School Nurses in each of the 13 counties were contacted in the fall of 2015 via email to request their participation in the assessment. Each was sent a link via email to complete the consent and assessment online; Lead Nurses then sent the link to their team nurses. Data were analyzed using descriptive statistics. IRB approval was obtained from Mercer University. Results: The findings from the study indicate that 75% of the reporting schools have asthmatic students enrolled. The number of students with asthma ranged from 5 to 79 per school. However, only two reporting schools could identify a medication policy that allows children to possess and self-administer asthma medication. Furthermore, none of the schools reported having all five policies necessary to obtain Asthma Friendly School recognition. Conclusions: The results indicate a need for school health nurse training to ensure schools implement and adhere to policies to reduce asthma disparities among school age children as outlined in the 2015 Georgia Asthma-Friendly Schools Toolkit and Recognition Guidance.
    • 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.
    • Community preparedness: Expanding existing partnerships with academia to build resilience through experiential learning

      Cleveland, Nina; Palen, Mark; University of Georgia (Georgia Public Health Association, 2016)
      Background: Sustainability and mitigation in preparedness after grant money is gone has suddenly become a hot topic in the public health emergency preparedness world. By the same token, funding provided by the Federal Emergency Management Agency (FEMA) for individual preparedness initiatives has not had the desired mitigation impacts. The question becomes, are there alternative approaches that reach more individuals to build a culture of preparedness in communities? One solution involves the leveraging of academic and regional public health partnerships with their Medical Reserve Corps Units (MRC), to train college students in individual preparedness. The purpose of this study is to describe best practices and discuss the incorporation of experiential learning and training activities into an Introduction to Public Health course at the University of Georgia. It also describes the development of a strong academic and practice partnership though the use the agencies’ MRC units. Methods: Three experiential learning activities, rooted in the constructs of perceived susceptibility, perceived benefits and self-efficacy were introduced into the course. First, didactic elements addressing the purpose and structure of public health response, individual preparedness and the role of Medical Reserve Corps volunteers in response were incorporated. Second, the public health partner developed a lecture covering public health emergency preparedness and response using a real world-sheltering example and coupled it with a tabletop exercise. Finally, students were given a final exam option where they built a home emergency kit. Results: Over the course of 3 years, approximately 500 students have been trained in individual preparedness. Students have demonstrated an increased foundational knowledge about the Medical Reserve Corps and public health preparedness in general. Furthermore, this collaboration increased the numbers of new MRC Volunteers and provided for a strong academic practice partnership. Conclusions: Through this collaboration, more students know how to take care of themselves and their families, decreasing the number of potential well worried. This collaboration has also strengthened the ties between the two institutions, leading to more opportunities for partnership.
    • A cross sectional study of mostly African-American men examining mental health and child behavior

      Jackson, Matt; Osborne, Melissa; Self-Brown, Shannon; Georgia State University (Georgia Public Health Association, 2016)
      Background: Home visiting receives bipartisan support at both the state and federal level, because several models have demonstrated significant results in both reduction of child maltreatment as well as parenting behavior modification. Yet, parenting research and services lack further engagement and involvement as a primary component. That is, even though research has shown that fathers play an integral role in child development, there is very little research done in which fathers are the primary focus; most of this research focuses on mothers. When it comes to serving children who are victims of child abuse and neglect, this is a problem at both the programmatic and legislative level. Methods: This study took place within the context of a broader NIH funded trial to examine the efficacy of an adapted (technologically enhanced) version of an evidence-based parenting program, SafeCare, for fathers. This was a cross-sectional examination of the results from a survey in which mostly African-American, at-risk fathers (n=84), reported on – using putative measures – parenting practices, mental health, and behavior of their children. This initial assessment used linear regression to examine the association between fathers’ mental health and their child’s externalizing and internalizing problem behaviors. Results: On average, higher levels of father depression and anxiety corresponded to higher scores for child behavior problems. That is, there was a significant correlation between the fathers’ anxiety and depression and the child’s problem behaviors. Conclusions: These findings suggest a need for acknowledging the father’s role in child development as well as any potential external factors that might have a pernicious effect on the father’s mental state[s]. In addition, more attention should be given to separating data within studies that examine both mothers and fathers in order to assess individual effects by each parent.
    • 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.
    • The effect of a nutrition intervention on parents living in a rural Georgia community

      Elliot-Walker, Regina; Hayes, Dawn; Oraka, Emeka; Lewis, Rashunda; Leon, Andre; Brenau University (Georgia Public Health Association, 2016)
      Background: Childhood obesity is a concern for public health organizations. Nearly one in four children living in rural communities are obese, and children living in rural Georgia communities are no exception. For rural communities, prevention efforts are needed to address challenges to reducing childhood obesity. The objective of the present effort was to increase the knowledge of parents in a rural community of the benefits of fruit and vegetable consumption and other healthy options. Methods: The “We Can Energize Families” curriculum, developed by the National Heart, Lung, and Blood Institute was implemented in a rural Georgia community. Pender’s Health Promotion Model, which encompasses the theory of persons taking a self-management approach in their health lifestyle, provided the framework. Participating in the study were 21 parents who had at least one child between the ages of 9-13. Outcome measures, adapted from the 16 measures relevant to the original “We Can Energize Families” objectives, were assessed, incorporating measures related to energy balance, portion size, healthy eating, physical activity, and screen time. Paired-T tests were used to evaluate increases in parents’ knowledge of the benefits of consumption of fruits and vegetables. Statistical significance was determined at p < 0.05. Results: There were improvements in 9 of the 16 measures, including knowledge of research and energy balance; attitudes regarding energy balance, portion size, and healthy eating; and behaviors regarding healthy eating, healthy food, physical activity, and screen time. However, improvements were not evident for behaviors related to portion size, knowledge or attitudes pertaining to physical activity, or attitudes regarding screen time. Conclusions: Particularly in rural communities, parents can contribute to prevention of childhood obesity. The present results demonstrate
    • 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.
    • 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 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.
    • Evidence to practice: Using data to see the faces of those we serve

      Ross, David; Public Health Informatics Institute (Georgia Public Health Association, 2016)
    • 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.
    • 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.
    • Fulfilling community health assessment requirements: Lessons learned from facilitating state-wide community health forums

      Walker, Ashley; Peden, Angela; Tedders, Stuart H.; Barron, John; Jackson, Aaron; Williams, Nicholas; Ugwu, Bethrand; Georgia Southern University (Georgia Public Health Association, 2016)
      Background: A prerequisite for National Public Health Accreditation is completion of a Community Health Assessment (CHA) that presents an exhaustive profile of the population served by a particular public health agency. Methods: The Georgia Department of Public Health (GA DPH) contracted with the Center for Public Health Practice and Research at Georgia Southern University to facilitate five state-wide community health forums. Results: Evaluation of the forums yielded qualitative data illustrating current challenges faced by Georgians, as well as assets that could be leveraged to improve health status. Conclusion: Lessons learned from these state-wide community health forums can be applied to improve the overall process of gathering data for a comprehensive CHA throughout Georgia or other areas interested in pursuing public health agency accreditation.
    • 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.
    • 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.