• Quality Rated childcare programs and social determinants of health in rural and nonrural Georgia

      Webb, Nancy C.; Gates, Madison L.; Augusta University (Georgia Public Health Association, 2016)
      Background: Early childhood is linked to school readiness and early school achievement. Through its Quality Rated (QR) program, which was designed to improve the quality of care in early childhood programs, the state of Georgia has been a trailblazer in funding universal preschool and in improving the quality of childcare programs. We have assessed differences in the availability of QR childcare programs in Georgia to learn if, in rural versus non-rural counties, there is a relationship between QR childcare programs and health-related outcomes. Methods: This cross-sectional study evaluated county-level data to evaluate the relationship between QR childcare programs and social determinants of health. County-level data for Georgia were extracted from the Georgia Department of Early Care and Learning, County Health Rankings and Roadmaps, and the Georgia Juvenile Justice Data Clearinghouse. Results: Counties without QR childcare programs had child mortality rates 3.5 times higher than those for the state overall. Other differences in health-related outcomes included, but were not limited to, teen birth rates, low birth-weight babies, children in poverty, housing problems, and food insecurity. Conclusions: It is now appropriate to address the prevalence of health disparities in rural areas of Georgia and focus on some of the disparities through the QR early childhood programs and other state agencies. Empowering rural communities to address health disparities may be the most favorable path toward diminishing these inequalities.
    • A systematic review of lifestyle interventions for chronic diseases in rural communities

      Smith, A Selina; Ansa, Benjamin; Augusta University (Georgia Public Health Association, 2016)
      Background: Rural Americans suffer disproportionately from lifestyle-related chronic diseases (e.g., obesity, diabetes, hypertension, cardiovascular disease, and breast cancer). Interventions that consider the distinctive characteristics of rural communities (e.g., access to healthcare, income, and education) are needed. As an initial step in planning future research, we completed a systematic review of dietary intake and physical activity interventions targeting rural populations. Methods: Manuscripts focused on dietary intake and physical activity and published through March 15, 2016, were identified by use of PubMed and CINAHL databases and MeSH terms and keyword searches. Results: A total of 18 studies met the inclusion criteria. Six involved randomized controlled trials; 7 used quasi-experimental designs; 4 had a pre-/post-design; and 1 was an observational study. Eight studies were multi-site (or multi-county), and 3 focused on churches. Primary emphasis by racial/ethnic group included: African Americans (6); Whites (2); Hispanics (3); and two or more groups (7). Most studies (17) sampled adults; one included children. Two studies targeted families. Conclusions: Additional lifestyle intervention research is needed to identify effective approaches promoting healthy diet and exercise and chronic disease prevention in rural communities. Studies that include rigorous designs, adequate sample sizes, and generalizable results are needed to overcome the limitations of published studies.
    • The two Georgias: Disparities in rural health and healthcare

      Nelson, D Gary; Healthcare Georgia Foundation (Georgia Public Health Association, 2016)
    • Using the Exercise is Medicine® on Campus platform to assess college students’ practice of physical activity in a rural setting

      Melton, Bridget; Williamson, A Jazmin; Bland, Helen; Zhang, Jian; Georgia Southern University (Georgia Public Health Association, 2016)
      Background: The college setting offers public health educators and exercise scientists a favorable environment to implement wide-spread change in levels of physical activities. With over two-thirds of all adults in the U.S. now categorized as obese or overweight (CDC, 2015), it has become necessary to increase physical activity levels on college campuses. Exercise is Medicine® on Campus (EIM®-OC) is a national initiative to increase physical activity on college campuses by creating an environment to change the subjective norm of diminished exercise movement and fitness among adults. The purpose of the present study was to use the EIM®-OC platform to assess college students’ beliefs and practices of physical activity by implementing this program in a rural setting. Methods: Implementation of EIM®-OC was conducted over a one-week period. More than 1,000 participants joined in the events led by a multi-disciplinary team. Data collected included self-reported daily physical activities, campus commuting, and level of exercise intensity. Descriptive statistics and chi-square reported frequencies and statistical differences. Results: Overall, the campus turnout for EIM®-OC events was 7.6% higher than national norms. Physical inactivity was statistically different between racial groups (P=0.04). Males reported engagement in physical activity primarily for enjoyment and social interactions. Active transport was lower in the rural community than in urban counterparts. Conclusions: Findings from this study described the successful engagement of a midsized rural campus population in an EIM®-OC campaign. The study revealed self-reported physical activity patterns of students comparable to national averages; however there was a disproportionate number of African Americans who did not participate in any vigorous physical activity.