• The importance of early brain development

      Fitzgerald, Brenda; Georgia Department of Health (Georgia Public Health Association, 2016)
    • Integrating food and language nutrition to reach Georgia’s children in early care and education environments

      O'Connor, Jean; Ejikeme, Chinwe; Fernandez, Maria; Powell-Threets, Kia; Idaikkadar, Audrey; Kay, Christi; Vall, Emily; Ross, Kimberly; Fitzgerald, Brenda (Georgia Public Health Association, 2016)
      Background: Educational attainment and health are mutually reinforcing outcomes. Good health supports children in the achievement of academic milestones, such as grade-level reading, and is associated with higher socio-economic status, longer life expectancy, and lower lifelong chronic disease. Improving health outcomes and increasing the potential for high educational attainment is necessary for reducing disparities, improving population health, and reducing morbidity. Early childhood and associated settings present opportunities to address lifelong health. Methods: To guide the development of programs to reach large numbers of children, we reviewed the literature associated with interventions during early childhood to promote healthy food consumption patterns and language development—“food and language nutrition.” Results: Identified in the systematic review were 12 articles. A recurrent theme was the social-ecological model, widely used in the studies identified through the literature review. Conclusions: The findings suggest a theoretical framework and key considerations that could guide the development of integrated interventions to improve food and language nutrition. With these findings, the authors propose a conceptual model and outline a public health program to address food and language nutrition together in early care settings in the state of Georgia, with the potential for application in other geographic areas.
    • A preliminary examination of elevated blood lead levels in a rural Georgia county

      Rustin Chrstopher; Sun, Yu; Calhoun, Chris; Kuriatnyk, Christy; Georgia Southern University, Georgia Department of Health (Georgia Public Health Association, 2016)
      Background: Rural areas are often viewed as lower risk for lead poisoning and toxic exposures seriously impacting development of the brain and central nervous system; this report examines the prevalence of elevated blood lead levels for children <6 years of age in rural Ben Hill County, GA. Methods: Lead surveillance data from the Georgia Department of Public Health (DPH) were analyzed using SAS®v-9.3 to calculate the prevalence of elevated blood lead levels (≥5ug/dL) among those children in Ben Hill County who had been tested for lead; the results were compared to Georgia and national data. Results: A preliminary analysis of 2010-2015 screening data for Ben Hill County indicates that 8.73% (95%- CI: 7.4%-10.1%) of children that were tested for lead exceeded the Centers for Disease Control reference level (≥5ug/dL) and is approximately 3.5 and 2.4 times higher, respectively, when compared to the National (2.5%) and State (3.64%) percentages of children exposed to lead at or above the reference level. Conclusions: While these data are preliminary and more analysis is planned to ascertain the full breadth, source, and scope of the problem, it highlights lead poisoning risks rural communities face that are often overlooked in population-based risk analysis and research on lead exposure in children.
    • Screening for developmental delay in Georgia's family shelters: Formative evaluation of a quality improvement initiative

      So, Marvin; Agbayani, Luistita; Gutierrez, Mariel; Griffins, Josef; Emory University; Atlanta Children's Shelter; Greenbriar Children's Shelter; Interfaith Hospitality Network (Georgia Public Health Association, 2016)
      Background: Children in families experiencing homelessness are at elevated risk for cognitive, motor, speech, and other developmental delays. Given the prevalence of family homelessness in Georgia and across the U.S., investigating the feasibility of implementing developmental screeners while families are in shelters is warranted. Methods: Three pilot shelters were selected for the development and implementation of Quality Improvement (QI) Teams, who used Plan-Do-Study-Act (PDSA) Cycles to make progress towards universally screening children for delay. We employed a formative evaluation to (1) characterize screening rates and shifts in shelter as a result of QI initiatives, and (2) identify barriers and facilitators to implementing QI interventions in family shelters. Results: Screening rates in all three shelters increased over the study period between 13-50%. Primary implementation facilitators included team members with experience in QI principles; having a medical provider on the team; possessing an “improvement culture;” and having diverse perspectives represented. Primary barriers included a lack of time or commitment in QI team leaders; medical providers with limited time in shelter; lack of training on how to represent and discuss QI data; and restrictive organizational policies. Conclusions: Family shelters demonstrate promise for implementing developmental screeners for at-risk children. Although challenges have been identified, facilitating factors are prevalent and underscore the importance of QI team preparation, composition, and cohesion. The relative availability, low-cost, and potential for impact of developmental screeners offer credence to their uptake and implementation within shelter clinical contexts.