• The Eating and Cooking Healthy (TEACH) Kitchen: A Research Protocol

      White, Sashia; Alva-Ruiz, Roberto; Chen, Lucia; Conger, Jason; Kuang, Christopher; Murphy, Cameron; Okashah, Najeah; Ollila, Eric; Smith, Selina A.; Ansa, Benjamin E.; Augusta University (Georgia Public Health Association, 2016)
      Background: Diet-related chronic diseases, such as diabetes mellitus, hypertension, and hyperlipidemia have affected millions of individuals, resulting in disease-related complications and mortality. Strategies that may improve the outcome of chronic disease management include modification of lifestyle risk factors such as unhealthy diets. TEACH Kitchen is an experiential education program related to community nutrition, the goal of which is to teach patients management of chronic disease through dietary change. Methods: Adults (n=144) ≥18 years old and their children (n=144) 7-17 years old will complete four 2-hour sessions. Components of each session will include brief nutrition education (20 min), an interactive cooking session (1 hr), and after-dinner discussion (40 min). Pre- and post-session questionnaires will be administered to all participants for self-reported demographics, knowledge, attitude, and beliefs about healthy nutrition. Medical records will be used to collect information about adult participants’ demographics and clinical indicators (hemoglobin A1c, lipid profile, blood pressure, weight, height, and body mass index [BMI]). Descriptive analyses will be performed to determine socio-demographic characteristics using frequencies and proportions for all categorical data, and means for continuous variables. T-tests and multiple logistic regression analysis will be accomplished to compare the differences in means. Results: Differences in the pre- and post-session knowledge, attitude, and beliefs related to healthy eating will be evaluated for adults and children. The anticipated outcomes include enhanced education promoting healthy eating in the community, prevention of chronic disease complications related to poor diet, and prevention of obesity-related chronic diseases in children. Conclusions: Enhancement of chronic disease management among patients, and the prevention of obesity among children, can be accomplished through healthy cooking and diet.
    • Violence Related Injuries among Individuals Admitted to a Level I Trauma Center in Atlanta, 2011-2013

      Akinleye, Fahruk O.; Morehouse School of Medicine (Georgia Public Health Association, 2016)
      Background: Violence related injuries (VRIs) are a major public health problem in the United States (US). According to the Centers for Disease Control and Prevention (CDC), homicide is the 11th leading cause of death in the US and the third leading cause of death among persons aged 15-24 years old. Among African Americans aged 10-34, homicide is the leading cause of death and is the fifth leading cause of death among those 35-44 years old. One form of homicide that can result in injury resulting in death is firearm violence. The objective of this study is to assess the rates of VRIs among African American males who have been admitted to a Level I trauma center serving metropolitan Atlanta, Georgia. Methods: A retrospective analysis of trauma patients admitted to a level 1 trauma center for VRIs over a 3 year period from 2011 to 2013. Data were obtained from the Grady Memorial Hospital (GMH) trauma registry, which serves metropolitan Atlanta, GA. De-identified variables selected included gender, race/ethnicity, age, type of VRI, and year of admission. All analyses were conducted utilizing SAS version 9.2. Results: Of the total number of patients (n=2859) the majority were male (89%), African- American (80%) and between the ages of 20-40 years (61%). The majority of patients (55%) were admitted to the hospital for gunshot wounds followed by assault (33%) and stab wounds (12%). The numbers of VRI patients admitted were similar in each of the years 2011, 2012, and 2013, which represent 31%, 35%, and 34% of the total, respectively. Conclusions: Statistically significant differences were observed between gender, race and age with respect to all VRIs included in the analyses, particularly among African American males. Policy makers may consider targeting interventions accordingly to address VRIs. Further research is needed to identify other factors potentially associated with VRIs.
    • Black college women sexual health peer education at Clark Atlanta University

      Francis, Clarissa; Bradley, Josephine; Bass, Christopher; Scipio, Karla; Braithwaite, Ronald; Clark Atlanta University; Morehouse School of Medicine (Georgia Public Health Association, 2016)
      Background: This research was based on the premise that various factors, such as social determinants, cultural competency, use of statistics and location, contribute to the efficacy of the transmission of sexual health education. In the United States, African American women account for 60% of the cases of human immunodeficiency virus (HIV) of women. Considerable research has noted the high rates of HIV among African-American women. The present research, however, focused exclusively on Black college women at Clark Atlanta University (CAU). Methods: A mixed method approach using surveys and participant observation in an exploratory case study was used to evaluate responses of Black college women at CAU to sexual health peer education. Results: Most of the Black college women who attended an event sponsored by Health Services, the Health Peers Educating and Encouraging Responsible Students (H-PEERS), reported that it effectively impacted their overall sexual health. Conclusions: Although, the female students reported having prior knowledge of sexual health information prior to attending CAU, including risk reduction behaviors, they reported participating in sexual risky behaviors. Many of the female students whom reported attending an event sponsored by the H-PEERS effectively had an impact on their sexual health knowledge, attitudes and beliefs towards sex, sexual behaviors, and sexual health status. Further research is needed on how the overall sexual health of black college women at Historically Black Colleges and Universities (HBCU) and predominantly white schools (PWI), and how strategies, such as peer-led health education, differ in transmission and efficacy.
    • The association of stress with anxiety and depression: Evidence from a community health needs assessment

      Tournous, Nicloe La; Bagwell-Adams, Grace; University of Georgia (Georgia Public Health Association, 2016)
      Background: Mental illness affects approximately 1 in 5 Americans, making mental health an important area of study for public health. Much research has been conducted on two of the most prevalent mental health disorders, anxiety and depression. However, the association of stress with these disorders, especially specific types of stress (e.g., financial, health, relationship), has been under-studied at the local level. This study aimed to gain insight into the relationship between stress, anxiety, and depression in Athens-Clarke County, Georgia. Methods: Data collected in the 2015 Athens-Clarke County Community Health Needs Assessment were analyzed using linear regression models to explore the association between stress and anxiety and depression. Results: When the data were aggregated, the presence of stress in a respondent’s household was associated with a 17.8% (p<0.001; t=5.21) increase in the likelihood of reporting the presence of anxiety and a 10.0% (p<0.01; t=2.96) increase in the likelihood of reporting the presence of depression. Significant associations with mental health status were also found for race, insurance status, perceptions of neighborhood safety, and discrimination. Conclusions: The results demonstrated that, in Athens-Clarke County, Georgia, stress was significantly and positively associated with both anxiety and depression. Financial, home environment, and neighborhood safety stressors were the strongest predictors of household mental health disorders. These results have implications for public health policy and clinical professionals, including the possibility of tailoring treatment strategies to the types of stress present in a patient’s life. Further research is needed to explore this relationship in other communities.
    • Does actual overweight or perception of overweight elevate suicide risk in bullied vs. non-bullied students?

      Kalle, Ashley; Chung, Yunmi; Yoo, Wonsuk; Augusta University; Emory University; (Georgia Public Health Association, 2016)
      Background: For individuals in Georgia aged 10-14 and 15-24, suicide is the third leading cause of death. Those who are overweight are often bullied by their peers, and being bullying can lead to higher risks of suicidality. There is, however, mixed evidence about the relationship between high weight and suicide. Weight perception may be a stronger predictor of suicide than actual weight. The aim of the present study was to examine, in a national sample of high school students, the interaction between weight and bullying on suicide outcomes. Methods: A secondary data analysis was performed with data from the 2015 Youth Behavior Risk Surveillance Survey (YRBSS), a cross-sectional survey of high school students nationwide conducted by the Centers for Disease Control and Prevention. The predictor variables analyzed were actual overweight, overweight perception, and bullying. The outcome variables were suicide ideation, suicide planning, and suicide attempts. Results: For non-bullied students, perception of overweight was a predictor of suicide risk. Whether actual overweight or perception of overweight increases suicide risk in bullied students depended on the type of bullying. For being bullied at school only and being bullied at school and online, overweight perception increased suicide risks. For being bullied online, actual overweight increased suicide risks. Conclusions: Interventions that target bullied students and decrease body dissatisfaction may lower suicide attempts.
    • The mentoring cycle: A two-way exchange

      Plaspohl, Sara; Armstrong State University (Georgia Public Health Association, 2016)
    • Sexual risk-taking among at-risk alcohol and drug users presenting to emergency departments

      Howell, Rebecca; Johnson, Aaron; Augusta University (Georgia Public Health Association, 2016)
      Background: Alcohol use is linked to increased sexual risk-taking, including unprotected sexual contacts, and illegal drug use is associated with an increased likelihood of sexual risk-taking and at-risk alcohol use. Risky sexual behavior is co-morbid with anxiety, depression, and mood disorders. The purpose this study was to identify factors associated with sexual risk-taking among adult, at-risk alcohol or drug users presenting to emergency departments (EDs). Methods: Data were derived from self-report surveys conducted with a random sample of ED patients screening positive for at-risk alcohol or drug use. As part of an alcohol and drug assessment completed by a health education specialist, patients were asked questions about their sexual behaviors. If warranted, patients also received a brief intervention addressing their alcohol and/or drug use. A negative binomial regression was conducted to identify risk factors associated with sexual risk-taking, defined here as unprotected sexual contacts. Results: Six of nine factors included in the model were statistically significant. White race was associated with more unprotected sexual contacts relative to non-whites. Females had fewer unprotected sexual contacts relative to males. Both the frequency of drinking days and illegal drug use days in the last 30 days were associated with unprotected sexual contacts. As patient age increased, the number of unprotected sexual contacts decreased. Mental health problems, as measured by the Global Assessment of Individual Needs (GAIN) Internalizing subscale, were associated with more unprotected sexual contacts. Conclusions: Gender, race, age, frequency of drug and alcohol use, and mental health problems are risk factors associated with unprotected sexual contacts among at-risk alcohol users. In the ED, those administering brief interventions for unhealthy alcohol and drug use may consider including safe sex education and/or providing patients with preventive measures for sexually transmitted infections, particularly to those whose assessments indicate higher frequencies of alcohol and drug use or possible mental health problems.
    • Air pollution, physical activity, and markers of acute airway oxidative stress and inflammation in adolescents

      Pasalic, Emilia; Hayat, Matthew J; Greenwald, Roby; Georgia State University (Georgia Public Health Association, 2016)
      Background: The airway inflammatory response is likely the mechanism for adverse health effects related to exposure to air pollution. Increased ventilation rates during physical activity in the presence of air pollution increases the inhaled dose of pollutants. However, physical activity may moderate the relationship between air pollution and the inflammatory response. The present study aimed to characterize, among healthy adolescents, the relationship between dose of inhaled air pollution, physical activity, and markers of lung function, oxidative stress, and airway inflammation. Methods: With a non-probability sample of adolescents, this observational study estimated the association between air pollution dose and outcome measures by use of general linear mixed models with an unstructured covariance structure and a random intercept for subjects to account for repeated measures within subjects. Results: A one interquartile range (IQR) (i.e., 345.64 μg) increase in ozone (O3) inhaled dose was associated with a 29.16% average decrease in the percentage of total oxidized compounds (%Oxidized). A one IQR (i.e., 2.368E+10 particle) increase in total particle number count in the inhaled dose (PNT) was associated with an average decrease in forced expiratory flow (FEF25-75) of 0.168 L/second. Increasing activity levels attenuated the relationship between PNT inhaled dose and exhaled nitric oxide (eNO). The relationship between O3 inhaled dose and percent oxidized exhaled breath condensate cystine (%CYSS) was attenuated by activity level, with increasing activity levels corresponding to smaller changes from baseline for a constant O3 inhaled dose. Conclusions: The moderating effects of activity level suggest that peaks of high concentration doses of air pollution may overwhelm the endogenous redox balance of cells, resulting in increased airway inflammation. Further research that examines the relationships between dose peaks over time and inflammation could help to determine whether a high concentration dose over a short period of time has a different effect than a lower concentration dose over a longer period of time.
    • How can we promote mentored student research in Georgia?

      Webb, Nancy C; Smith, Selina A; Augusta University (Georgia Public Health Association, 2016)
    • Determinants of adherence to nutrition-related cancer prevention guidelines among African American breast cancer survivors

      Ramierz, Lindsey; Chung, Yunmi; Yoo, Wonsuk; Fontenot, Brittney; Ansa, Benjamin E.; Whitehead, Mary; Smith, Selina; Augusta University (Georgia Public Health Association, 2016)
      Background: Mortality rate for breast cancer is higher among African American (AA) women than for women of other racial/ethnic groups. Obesity, also higher among AA women, may increase the risk of breast cancer development and recurrence. Lifestyle factors such as healthy nutrition can reduce the rate of obesity and breast cancer. This study examined the determinants of adherence to nutrition-related cancer prevention guidelines among AA breast cancer survivors. Methods: AA breast cancer survivors (n=240) were recruited from a breast cancer support group to complete a lifestyle assessment tool for this cross-sectional study. Chi-square test and ordinal logistic regression analysis were used to examine the relationship between adherence to nutrition-related cancer prevention guidelines and potential predictors of adherence. Results: Majority of the survivors met the guideline for red and processed meat (n=191, 83.4%), but did not meet the guideline for fruits and vegetables (n=189, 80.4%). For survivors with annual household incomes < $25,000, the odds of meeting or partially meeting the guideline for fruits and vegetables was 75.4% less than for participants with incomes > $50,000 (OR= 0.25, 95% CI: 0.08, 0.80). Poor physical functioning (OR= 38.48, 95% CI: 2.26, 656.58), sleep disturbances (OR= 60.84, 95% CI: 1.61, 2296.02), and income > $50,000 (OR= 51.02, 95% CI: 1.13, 2311.70) were associated with meeting the guideline for red and processed meat. Conclusions: Many AA breast cancer survivors are not meeting the nutrition-related cancer prevention guidelines. For this population, more interventions that enhance access to and consumption of healthy diets are needed.
    • Intersecting motivations for leaving abusive relationships, substance abuse, and transactional sex among HIV high-risk women

      David, Naomi; Hussen, Sophia; Comeau, Dawn; Kalokhe, Ameeta; Emory University (Georgia Public Health Association, 2016)
      Background: Women bear a significant burden of the HIV epidemic in the United States. Women classified as ‘HIV high-risk’ often bring co-existing histories of intimate partner violence (IPV), drug use, and transactional sex. To help inform future comprehensive HIV prevention strategies, we aimed to explore common motivating reasons and barriers to leaving and/or terminating engagement in each of these risk-promoting situations. Methods: Between August and November 2014, in-depth interviews were conducted with 14 HIV high-risk women in Atlanta, Georgia who had experienced IPV in the previous 12 months, and used drugs and/or engaged in transactional sex in the previous five years. Participants were asked about histories of IPV, drug use, and/or engagement in transactional sex, and the motivating reasons and barriers to terminating each. Results: Women reported a range of motivating reasons for leaving IPV, drug use, and transactional sex. Overlapping themes included impact on children, personal physical health/safety, and life dissatisfaction. Financial need was identified as a common barrier to leaving. Conclusions: Future HIV prevention research should further explore the perceived impact of IPV, drug use, and transactional sex on physical health/safety, life dissatisfaction, one’s children, and financial need as motivators and barriers to reducing upstream HIV risk.
    • Predictors of mammogram and Pap screenings among US women

      Akuse, Sewuese; Tate, Koren; Addision, Tiffany; Drayton, Tierra; Kanda, Deborah; Sullivan, Kelly; Jiann-Ping Hsu College of Public Health; Georgia Southern University (Georgia Public Health Association, 2016)
      Background: The most common cancers among women are breast and cervical cancer. Although early detection of cancer has been shown to increase the likelihood of survival, many women are not screened for these cancers as often as practice guidelines recommend. The objective of this study was to examine the mammography and Papanicolaou (Pap) smear screening practices among women within the United States, and to determine predictors of screening. Methods: Data from the 2012 and 2014 Behavioral Risk Factor Surveillance System were used. The association between demographic predictors (age, marital status, education level, employment status, income, health insurance, and medical cost concerns) and having Pap or mammogram screening consistent with guideline recommendations was assessed using logistic regression analysis. Results: Pap and mammography screenings were positively associated with younger age, minority race, being married, having a higher level of education, being employed, having higher household income, having health insurance and not having financial concerns regarding affording doctor visits. Blacks and Hispanic women were more than twice as likely to have Pap screenings (Black: OR=2.16, 95% CI 1.97-2.36; Hispanic: OR=2.33, 95% CI = 2.11-2.58) and mammograms (Blacks: OR=2.11, 95% CI 1.88-2.36; Hispanics OR=1.82, 95% CI 1.60-2.07) compared to White women. Women earning less than $10,000 per annum were much less likely to have cervical cancer screenings (OR=0.57, 95% CI 0.51-0.65) compared to women with higher incomes while mammography screening was less likely among women who reported financial barriers to health care (OR=0.59, 95% CI 0.53-0.64). Conclusions: Women from minority ethnic groups were more likely to be screened for cervical cancer compared to White, non-Hispanic women. Women from low-income households and women who could not visit a doctor due to costs had the strongest association with lacking screenings.
    • Planning a national-level data collection protocol to measure outcomes for the Colorectal Cancer Control Program

      Satsangi, Anamika; DeGroff, Amy; Centers for Disease Control and Prevention (Georgia Public Health Association, 2016)
      Background: The Colorectal Cancer Control Program (CRCCP) of the Centers for Disease Control and Prevention (CDC) funded 30 grantees to partner with health systems with the goal of increasing screening for colorectal cancer (CRC). Methods: Evaluators applied CDC’s Framework for Program Evaluation to design a national level outcome evaluation for measuring changes in CRC screening rates in partner health systems. Results: The resulting evaluation design involves the collection and reporting of clinic-level CRC screening rates supplemented by various tools to support the reporting of high quality, reliable data. Conclusions: The CRCCP evaluation represents a strong design to measure the primary outcome of interest, CRC screening rates, and public health practitioners can benefit from lessons learned about stakeholder involvement, data quality, and the role of evaluators in data dissemination.
    • Engaging homeless service providers in educational efforts during a tuberculosis outbreak in Atlanta

      Nandi, Preetha; Worrell, Mary Claire; Andrews, Tom; Sales, Rose-Marie; McMichael, Jeff; Hampton, Kristen H; Goswami, Neela D.; Emory University; Georgia Department of Health; University of North Carolina (Georgia Public Health Association, 2016)
      Background: During an outbreak of tuberculosis (TB) in the homeless population of metropolitan Atlanta, education of homeless service providers (HSPs) about the implementation of local infection control measures was imperative to limiting the spread of TB and to preventing future outbreaks. Methods: By use of educational sessions and teaching posters, two interventions were designed to focus educational efforts from November 2014 to August 2015: 1) a spatially-targeted approach that identified HSPs within an area of Fulton County, GA (which includes downtown Atlanta) with high TB case density (cases per square mile) from 2009 – 2014, and 2) an organizational meeting approach that included scheduled meetings of professionals who had regular contact with homeless individuals at risk of TB infection. Results: Of the 18 HSPs targeted in the identified high-TB density area, 9 engaged in educational activities, and 9 were closed at time of contact or unreachable by email or phone. Through organizational meetings, 36 additional facilities were reached. Conclusions: The HSPs with successful contact were amenable to educational efforts, and a combination of spatially targeted and organizational meeting approaches with teaching aids was feasible in developing sustainable TB educational programs in the homeless community
    • Educational attainment and self-rated health among African-Americans in Pitt County, NC

      Chandrasekar, Eeshwar; Banta, Zimo; Ragan, Kathleen; Schmitz, Michelle; James, Sherman; Emory University (Georgia Public Health Association, 2016)
      Background: To help fill the knowledge gap regarding relationships between educational attainment and self-rated health (SRH) in minority populations, we analyzed the data of a community-based cohort of African-Americans residing in Pitt County, NC, between 1988 and 2001. Methods: Data from the Pitt County Study (a community-based, longitudinal survey of risk factors for hypertension and related disorders disproportionately affecting African-Americans) were used to explore associations between educational attainment and SRH, stratified by sex, in a cohort of individuals from 1988 (n=1,773), 1993 (n=1,195), and 2001 (n=1,117) using continuous, ordinal, and binary correlated data analyses. Results: For males and females with less than a high school education, the odds of reporting poor or fair health (compared to excellent, very good, or good health) were 2.75 (95% CI: 1.54-4.91) and 1.78 (95% CI: 1.15-2.75) times greater, respectively, than among those who completed a college degree or higher. Conclusions: Across all analyses, individuals with lower educational attainment reported lower SRH scores, and the association differed by sex. Social support may be a factor in these differences. More research is needed, however, to assess relationships between educational attainment, social support, and SRH for African-Americans and other minority populations.
    • Associations between major depression, health-risk behaviors, and medication adherence among HIV-positive adults receiving medical care in Georgia

      Clubreth, Rachel; Dube, Shanta; Maggio, David; Georgia State University; Georgia Department of Public Health (Georgia Public Health Association, 2016)
      Background: There are approximately 1.2 million people in the United States living with HIV, and 25.6% of HIV-positive adults suffer from depression. The purpose of this study is to examine the contribution of depression to substance use and medication adherence among HIV-positive adults receiving medical care for HIV in Georgia. Methods: Secondary data with a probability sample of 775 HIV-positive adults who took part in the 2009-2013 Georgia Medical Monitoring Project (MMP) were analyzed. Descriptive analyses and multivariate logistic regressions were conducted to assess relationships between depression and current cigarette smoking, injection drug use, other non-injection drug use, and medication adherence, adjusting for sociodemographic covariates (age, gender, race, and education). All analyses accounted for non-response and complex sampling design. Results: Among HIV-positive adults in Georgia, 8.5% met the criteria for major depression, including 13.7% of women and 6.5% of men. Heterosexual adults had a higher percentage of major depression (10.7%) compared to adults who identified as bisexual (7.4%) or homosexual (5.8%). Major depression was also higher among adults with a high school diploma or GED (12.7%) compared to adults with a higher level of education (5.2%). Major depression was associated with a greater odds of current cigarette smoking (AOR 2.7; 95% CI: 1.5, 5.2) and other non-injection drug use (2.5; 95% CI: 1.4, 4.4), after adjusting for sociodemographic variables. The three measures of medication adherence were not statistically significantly associated with major depression. Conclusions: As previously observed for the general population, we found, among HIV-positive adults, significant associations between depression and smoking and other non-injection drug use. Because HIV-positive adults have ongoing encounters with healthcare providers, screening and treatment for depression and other co-morbid substance use is needed to reduce an additional health burden in this population.
    • The Zika virus in the United States: A comprehensive review

      Lindsey, Daniel; Greenburg, Martin; Mercer University (Georgia Public Health Association, 2016)
      Background: With a series of outbreaks spanning the globe, the Zika virus has transitioned, in a short time, from an obscure virus to a public health emergency. Locally transmitted Zika has reached the United States, leading to increased concern regarding further transmission and the potential impact on public health. Methods: The present study was conducted to examine the propagation and effects of Zika in the United States by reviewing published literature regarding Zika in conjunction with updates from the Centers for Disease Control and Prevention. To gauge the regional response, including prevention and control efforts, interviews were conducted with public health and mosquito control officials. Results: Exposure to Zika may be through vectors, sexual activity with an infected partner, or congenitally to the unborn fetus. Regardless of the mode of transmission, Zika infection may result in serious neurological consequences in adults and especially in fetuses. Conclusions: Prevention of Zika infection is key to successful control of the virus. Vector control and surveillance as well as personal protection from virus exposure are necessary to avoid the potentially devastating effects of the virus. In an effort to prevent further spread, public health authorities are implementing strategies for public education, prevention, and containment.
    • Association between intimate partner violence and mentally unhealthy days in women in the U.S.

      Broadnax, Danielle; Waldrop, Reinetta Thompson; Claridy, Mechelle D; Booker, Elain Archie; Alema-Mensah, Ernest; Morehouse School of Medicine (Georgia Public Health Association, 2016)
      Background: In the United States (U.S.), intimate partner violence (IPV) is a serious public health concern, mainly affecting the health and well-being of women. The objective of this study was to identify the IPV and socio-demographic factors associated with mentally unhealthy days among women in the U.S. of ages ≥18 years. Methods: Data for this study were obtained from the 2007 Behavioral Risk Factor Surveillance System. Multivariable analyses were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (95% CIs) for factors associated with IPV and 14 or more mentally unhealthy days per month. Analyses were conducted using SAS 9.3. Results: The analyses show that the following factors increase the likelihood of self-reported 14 or more mentally unhealthy days: having a high school level of education or less (AOR: 1.732; 95% CI: 1.415-2.119) and having an income < $50,000. In addition, experiencing IPV such as: ever being threatened by a sex partner (AOR: 1.499; 95% CI: 1.264-1.779); having a sex partner ever attempt violence (AOR: 1.461; 95% CI: 1.224-1.743); having a sex partner ever become violent (AOR: 1.541; 95% CI: 1.303-1.823); and ever having unwanted sex with a partner (AOR: 1.929; 95% CI: 1.584-2.350) also increased the likelihood of self-reported 14 or more mentally unhealthy days per month. Conclusions: The results indicate that, for women in the U.S., IPV and socio-demographic factors have an effect on self-reported 14 or more mentally unhealthy days. Improving access to services that offer protection and guidance for women abused by their intimate partner could decrease the likelihood of self-reported 14 or more mentally unhealthy days and long-term negative mental health outcomes among women
    • An assessment of data related to inspections of risk factors for public swimming pools

      Shack, Shanita; Redmond, Maurice; Rustin, Christopher; Emory University; Georgia Southern University (Georgia Public Health Association, 2016)
      Background: The Georgia Department of Public Health (DPH) is mandated to ensure that public swimming pools are safe for those who use them. This mandate is carried out by the DPH and local environmental health professionals through regulations and inspections. In 2015, legislation was introduced proposing to reduce the authority of the DPH to inspect certain pool types (apartments, subdivision, condominiums) and thus reduce regulatory protections in place for swimmers. To ensure that the DPH had current information on the risks associated with pools, the EH team, with assistance from a graduate student, analyzed inspection data to evaluate risk factors associated with these pool types and summarized drownings and waterborne disease outbreaks (WBDOs). Methods: Pool inspection data (n=4,441 pools) for 2014 were retrieved from the Environmental Health Information System (EHIS) of the DPH. Data from the 2010 Census and epidemiological data on drownings and water-borne disease outbreaks (WBDOs) were also evaluated. Data were stratified by public health district and type/number of pools and analyzed for selected violations of health risk factors (pH, barriers, disinfectant residual). Drownings and WBDOs were described and summarized. Results: Approximately 55% of inspected pools were for apartments, condominiums, and subdivisions. These pool types were consistently cited by inspectors for the selected risk factors and ranked in the top five for these violations. In 2013, children aged 1-17 had the highest percentage (30%) of deaths from drowning. In 2001-2014, there were 28 WBDOs, with 39% occurring at public pool venues. Conclusions: Data from this research provided information on risks associated with pools and supported the importance of inspection programs for public swimming pools. The data were used to inform policy makers on the risks associated with the pool venues under legislative review. These data, combined with other risk factor information, were utilized by the DPH to inform training needs and to reinforce public health messaging on protecting swimmer health.