• Local efforts toward addressing health disparities in DeKalb County, Georgia

      Hermstad, April; Gilliam, Erikka; Spivey, Sedessie; Mendoza, Zipatly; Dekalb County Board of Health (Georgia Public Health Association, 2016)
      Background: In underserved African American communities throughout DeKalb County, the DeKalb County Board of Health (DCBOH) is implementing community-based initiatives using policy, systems, and environmental improvement approaches to reduce racial and ethnic health disparities by increasing opportunities for nutrition and physical activity. Methods: The initiatives are being implemented in priority census tracts where the population is at least 40% African American, 30% live below federal poverty level, and 25% did not graduate from high school. Communications promote awareness of the programs, and evaluation activities document processes and outcomes. Results: To date, implementation of five interventions has affected approximately 276,000 DeKalb residents. Conclusions: By implementing strategies for community-based policy, systems, and environmental improvement, DCBOH is increasing access to nutrition and physical activity opportunities for underserved African American communities in DeKalb County.
    • 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
    • Public Health for Young Adults Day: Recruiting the next generation

      Pung, Mary-Kate; Williams, Nicholas; Kirkland, Rachel; Peden, Angie; Walker, Ashley; Georgia Southern University (Georgia Public Health Association, 2016)
      Background: Public Health for Young Adults Day (PHYA Day) is a one-day program designed to educate high school-age students about the principles and values of the five core areas of public health. The goal of PHYA Day is to foster interest and ultimately increase recruitment into the field of public health. This goal is essential due to the impact of the economic recession of 2008. It was estimated that the local public health workforce decreased from 191,000 to 168,000 across the nation between 2008 and 2013. In spite of 2008’s recession, a well-trained, competent public health workforce remains an imperative component of effective public health service delivery. The researchers believe that PHYA Day encourages young people to explore the idea of a public health-focused career by increasing their knowledge of the field as a whole. Methods: A pre- and post-test survey was used to evaluate this program, determine if participants gained an interest in joining the public health workforce, and measure the learning outcomes of those participants. After gaining proper Institutional Review Board approval the evaluation was completed in April 2015. Results: When the averages of the post-test were compared to those of the pre-test the results showed that there was a significant gain in knowledge among participants. Conclusions: Based off of their findings the researchers were able to conclude that PHYA Day is effective in educating high school age students about the options that the public health field have to offer and therefore may increase the number of young adults choosing public health as a career.
    • Knowledge, attitudes, and practices regarding smoke-free policies in multi-unit housing in Georgia

      Lefevre, Adreienne; Kegler, Michelle C.; McDonald, Bennett; Liang, Lily; Haardoeerfer, Regine (Georgia Public Health Association, 2016)
      Background: Nonsmokers living in multi-unit housing (MUH) without a smoke-free (SF) policy are vulnerable to secondhand and thirdhand smoke exposure. This study aimed to investigate the presence and type of SF policies in MUH in Georgia. Another aim was to explore knowledge, beliefs, and attitudes of property managers and owners (PM/Os) regarding SF MUH policies, including e-cigarettes. Methods: Throughout 2015 PM/Os of MUH in Savannah and Atlanta were surveyed regarding SF policies in MUH. A list with contact information of PM/Os was obtained from the ASDE Survey Sampler. The participants were mailed an invitation letter and were called one week later to schedule the interview. To be eligible, the participant must have been an English-speaking adult working as a PM/O in MUH. The survey administered was adapted from a survey designed by CDC’s Office on Smoking and Health. All survey data were entered into SPSS and analyzed using SAS. Results: The greatest number of the 91 PM/Os surveyed were female (70.3%) and/or white (48.4%), with an average age of 41.7 years. Most properties were market-rate (71.3%) or were a mix of market-rate and subsidized units (17.2%). Forty-one PM/Os reported some smoking restriction, while 50 had no policy. Properties mainly prohibited smoking in common outdoor areas (n=18) or inside individual apartments (n=13). Policies included bans of non-cigarette combustible products (n=19), hookah (n=12), e-cigarettes (n=7), and smokeless tobacco (n=5). Most PM/Os reported high compliance and positive resident reactions to the policy. Comparing responses by policy status, no differences in knowledge nor support for tobacco control legislation were found, except for SF outdoor seating in restaurants, which was more frequently supported by PM/Os with smoking restrictions. Personal beliefs on restricting use of cigarettes and e-cigarettes in MUH did not differ significantly by policy status, but those with a SF policy were more supportive of prohibiting smokeless tobacco use in MUH. Conclusions: Implementing smoke-free policies in multi-unit housing is feasible and is generally supported by residents.
    • Psychotropic medications, weight gain and chronic diseases in a correctional setting: Impact on women’s health

      Gates, Madison L.; Ferguson, Elizabeth; Wilkins, Thad; Balance, Darra; Yoo, Wonsuk; Augusta University (Georgia Public Health Association, 2016)
      Background: Studies with non-incarcerated populations have found a relationship between psychotropic medications and metabolic side effects, such as weight gain. Few studies have investigated the relationship between psychotropic medications associated with weight gain in prisoners, despite data showing that 73% of female and 55% of male offenders have a mental health problem and 15% have had medications prescribed. Methods: This longitudinal study investigated the relationship among psychotropic medications and weight gain in prisoners. We hypothesized that women prescribed psychotropic medications gain more weight than men. Data were extracted from Department of Corrections’ electronic health records. All prisoners with active records that included weight pre and post initiation of psychotropic medication were included in the study. Results: Women were prescribed antidepressants in higher proportions compared to men (χ2 = 58.3, p < .01). The differences for antipsychotics were not significant (χ2 = 2.3, p = .13). There were no significant gender differences regarding the percentage of inmates who gained weight. In regard to changes in weight (kg), women on antidepressants gained more weight (mean 6.4 kg) compared to men (mean 2.0 kg), which was significant (p < .01). Although women prescribed antipsychotics gained an average of 8.8 kg compared to men prescribed antipsychotics, who gained an average of 1.6 kg, this difference was not significant (p = .12). Further, there were no weight gain differences in terms of race or age in contrast to non-incarcerated populations. Conclusions: The significant weight gain among women prisoners raises important questions about the effects of incarceration on women’s health. Despite the significantly greater weight gain among women prisoners, other correlates of weight gain found in non-incarcerated populations are not evident in corrections.
    • 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.
    • New recreational water quality criteria and their impact on beach advisories in Coastal Georgia

      Aslan, Asli; Benevente, Sara; Georgia Southern University (Georgia Public Health Association, 2016)
      Background: To monitor pollution of marine beaches in Georgia, enterococci have been used as indicators of fecal contamination. For the 1986 Recreational Water Quality Criteria (RWQC), the beach action value (BAV) was 104 colony-forming units (CFU)/100 ml; the new RWQC, instituted in 2012, is 70 CFU/mL, a 32.6% decrease. When the beach action value is reached, authorities are to issue a beach advisory for protection of swimmer health. The present study investigated changes in compliance with the 2012 RWQC at five high-use beaches in Georgia. Methods: In the summer of 2015, samples of water were collected from five beaches at Tybee Island. Enterococci concentrations were enumerated by USEPA-approved methods. Samples exceeding the 1986 and 2012 RWQC beach action values were compared with times that advisories were posted at these beaches. Results: At these beaches, advisories were posted four times during the summer. Since, in 2015, the previous RWQC was in use, these decisions were based on the guideline value of 104 colon-forming units (CFU)/100 ml. When the new beach action value (70 CFU/100 ml) was applied, retrospectively, for samples collected at these sites, we found that the number of advisories would have been doubled if this value had been in place at that time. Conclusions: Staring from January 2016, Georgia has adopted new water quality criteria to monitor beaches. Decreasing the beach action value to 70 CFU/100 ml strengthens beach monitoring programs because it allows for better prevention from waterborne diseases, thus protecting the health of swimmers.
    • 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.
    • 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 region-wide field placement program built on the foundation of mentorship and professionalism

      Carvallo, Michelle; Lloyd, Laura; Alperin, Melissa; Miner, Kathleen (Georgia Public Health Association, 2016)
      Background: The Region IV Public Health Training Center (R-IV PHTC) provides public health students from the eight states of HHS Region IV with essential practice experiences that demonstrate the value of working with underserved populations. The Pathways to Practice Scholars field placement program is built on a foundation of mentorship, professionalism, and community. Methods: Sixteen student scholars (13 graduate; 3 undergraduate) were selected to work during May-August 2015 in practice-oriented agencies serving underserved populations. Each scholar received a $1500 living allowance. Seven of 16 accepted an internship outside the state of their university. In conjunction with mentors, Scholars developed work plans based on Council on Linkages Core Competency domains. Requirements included a pre-, mid- and post-assessment, an executive summary/reflection, and a virtual webinar presentation. Results: Student Scholars worked at sites across eight states in state or local health departments, Area Health Education Centers (AHECs), and healthcare settings. Students identified Core Competency domains they developed most during the field placement: Communication, Analytical/Assessment, Leadership/Systems Thinking, and Community Engagement. The R-IV PHTC asked mentors to treat interns as valued employees and include them in activities beyond their specific project. Indicators of successful mentorship included expressed appreciation for student assistance and the desire to enrich the student experience while benefiting the agency mission. Mentors provided clearly defined projects for a short timeframe (10-12 weeks), adjusted to the students’ capacity and readiness, and offered opportunities to apply classroom skills to practice. They helped students develop immediately useful products in collaboration with community stakeholders. Conclusions: Mentors play a crucial role in the development and success of field placement students, but students and mentors share equal responsibility in fostering the relationship. Past case studies from this program demonstrate that some students find employment in these same agencies after graduation, and become mentors for future students, thus, creating a self-perpetuating learning communit
    • Meeting the public health workforce’s training priorities in Georgia and the southeast

      Lloyd, Laura; Alperin, Melissa; Carvalho, Michelle; Miner, Kathleen; Emory University (Georgia Public Health Association, 2016)
      Background: The mission of the Region IV Public Health Training Center (R-IV PHTC) is to build knowledge and skills in the public health workforce in the eight states of HHS Region IV by providing competency-based training. Workforce training needs are changing quickly and dramatically in light of new developments in public health practice and science, emerging diseases, changes in the health care environment, and the growing emphasis on inter-professional practice. Additionally, a 2014 survey conducted by the Association of State and Territorial Health Officials (ASTHO) found that at least 38% of the current public health workforce plans to retire by 2020. Therefore, it is increasingly crucial to prepare upcoming managers for leadership positions and to train entry-level workers to assume more advanced roles. Methods: To address current and emerging training needs in Georgia and the southeast, the R-IV PHTC continually identifies emerging priorities and effective training approaches. It explores training needs through a review of formal needs assessments, key stakeholder interviews, surveys of targeted audiences, informal partner communications, and training evaluation data. An interactive component of the GPHA session allowed participants to identify and discuss their own professional training needs. Results: Workforce development needs assessments data across several southeastern states identified recurring training needs for professionals in Tiers 1, 2 and 3 of the Council on Linkages Core Competency domains for Analytical/Assessment Skills and Financial Planning/Management. In Georgia, top competency training needs gathered from a variety of assessment methods included Cultural Competency, Communication, Financial Planning/Management, Public Health Science, and Leadership/Systems Thinking. Participants in the workshop’s interactive component expressed highest personal need for training in Financial Planning/Management, Analytical/Assessment Skills, and Policy Development/Program Planning. However, for others in their organizations, they identified a priority need for leadership training. Conclusions: The R-IV PHTC assesses training needs and provides training resources to respond to current and emerging public health workforce development needs in Georgia and the southeast.
    • Syphilis in Georgia, 2009-2014

      Moore, Kathryn; Parker, Leonardo; Wells, Joy; Georgia Department of Health (Georgia Public Health Association, 2016)
      Background: In the period of 2002-2014, Georgia has ranked among the top three states in the United States for rates of primary and secondary syphilis cases, creating a continuing need to analyze the data and to plan and implement disease prevention efforts. Methods: The present effort involved analysis of data from Georgia’s electronic disease reporting system, State Electronic Disease Surveillance System (SendSS), including demographic characteristics by year for the period of 2009-2014 and behavioral data obtained from interviews with communicable disease specialists. Results: In Georgia, from 2009-2014, primary and secondary syphilis, the infectious stages of the disease, were seen most commonly among black, non-Hispanic (77%) males (91%) between the ages of 20-29 (45%); 52% were males who have sex with other males. Conclusions: Analysis of the data provides a better understanding of the populations affected by syphilis. It can enhance discussions about disease surveillance, prevention, and strategies to decrease the burden of this disease.
    • 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.
    • 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.”
    • Evidence to practice: Using data to see the faces of those we serve

      Ross, David; Public Health Informatics Institute (Georgia Public Health Association, 2016)