• The association between dental coverage and self-reported health in older adults

      Yang, Frances M; Kao, Solon T; Lundeen, Joran S; Augusta University (Georgia Public Health Association, 2017)
      Background: For the older population of the United States, lack of dental insurance coverage is a substantial health problem. The purpose of the present study was to examine the longitudinal relationship between dental coverage and self-reported health among older adults. Methods: The Health and Retirement Study (HRS), a nationally representative biennial cohort study of community-dwelling individuals, includes 19,595 adults (aged 50 and older) living in the United States. For the 2010, 2012, and 2014 waves, the independent variable of dental coverage and the outcome of self-reported health were examined. Results: At each time point, dental coverage for older adults had a positive association with self-reported health (parameter estimate, β=0.340, standard error (SE)=0.039, p<0.0001), controlling for sociodemographic variables of age, sex, race/ethnicity, education, and the status of edentulism. There were no significant longitudinal effects for dental coverage associated with self-reported health. Conclusions: At each time point, the results show a positive association between having dental coverage and better self-reported health of older adults. This is relevant, because, in the United States, there is an increasing population of older people.
    • Dental students develop program addressing geriatric oral health at local nursing home

      Wilson, Nancy Lyn; Ciarrocca, Katharine; Chana, Monica; Augusta University, Georgia War Veterans Nursing Home (Georgia Public Health Association, 2017)
      Background: The elderly, especially those who reside in institutions and have a minority or low-income background, often have unmet oral health needs. As life expectancy increases, so will the need for oral health providers skilled in addressing the unique challenges presented by geriatric patients. Methods: Dentists for Della is a student organization at the Dental College of Georgia that aims to improve the oral health status of residents at the Georgia War Veterans Nursing Home (GWVNH) in Augusta, Georgia. The students conduct fundraising activities so that third and fourth year students can provide needed dental treatment at no cost to the residents. Students also regularly rotate at GWVNH in order to provide tooth brushing help, denture cleanings, and head and neck examinations, including oral cancer screenings. Results: Dentists for Della has funded approximately $40,000 worth of dental work since 2013. The program also provides an educational experience valued by students: the ability to interact with patients as early as their first semester of dental school. Conclusions: Dentists for Della is a vital program which not only provides educational opportunities in institutional public health dentistry and geriatrics for dental students, it also provides a much needed safety net for Georgia veterans with no ability to access other means of dental care
    • Dental College of Georgia teams up with Richmond County Health Department to help underserved patients

      Wilson, Lyn Nancy; Peacock, Mark; Cutler, Christopher; De Stefano, Jamie; Augusta University, Richmond County Board of Public Health (Georgia Public Health Association, 2017)
      Background: The Central Savannah River Area remains, for many of the poor, a dental health care shortage area. Each year, from December to March, fourth-year dental students perform outreach with faculty to search the community for unmet dental needs, including dental caries and periodontal disease, the treatment of which is required for the Central Regional Dental Testing Service (CRDTS) Exam, the dental licensing examination. Methods: Fourth year students at the Augusta University Dental College of Georgia recruit patients for free dental pre-screenings at health fairs, community centers, the Barnyard Flea Market, and the dental school. Persons with periodontitis are invited for further screenings at the dental school where they receive a free dental examination and dental radiographs. Many of these patients present with other dental needs requiring restorations, root canals, and extractions, conditions that potentially could disqualify them from receiving periodontal therapy during CRDTS. Through a collaborative effort with the Richmond County Health Department Dental Clinic, these patients receive the treatment for their acute dental needs, while also qualifying them for the periodontics portion of the exam. Results: Regardless of their qualification status for boards, the program provides referrals for patients to the Dental College of Georgia or the Richmond County Health Department, gives patients a chance to be informed about their oral health status, and gives qualifying patients the potential to receive discounted or even free dental work. The efforts of the senior dental students represent an oral public health service effective in achieving improvements in periodontal outcomes within our community. Conclusions: This program not only benefits the future dentists of Georgia by helping provide licensing board requirements, it also introduces dental students to a more diverse population and provides exposure to public health outreach. In addition, this program offers a valuable service to underserved populations who would otherwise have limited or no access to dental care.
    • STD services delivery arrangements in Georgia county health departments

      Williams, Karmen S; Shah, Gulzar H; Peden, Angie; Livingood, Bill; Willams & Williams Consulting Group, Georgia Southern University, University of Florida (Georgia Public Health Association, 2017)
      Background: Uniformity, standardization, and evidence-based public health practice are needed to improve the efficiency and quality of services in local health departments (LHDs). Among the highest priority and most common public health services delivered by LHDs are services related to sexually transmitted diseases (STDs) and sexually transmitted infections (STIs). Objective: The purpose of this study was to examine potential variations in the delivery of sexually transmitted disease (STD) services among county health departments (CHD) in Georgia, to determine if potential variations were due to varied administrative practices, and to understand delivery arrangements so that future cost studies can be supported. Methods: Web-based surveys were collected from 134 county health departments in Georgia in 2015. Results: Screening for gonorrhea, chlamydia and syphilis occurred in all the surveyed CHDs. Sixty-eight percent of the CHDs had one or more staff who performed investigations for persons already screened positive for STDs. Partner notification services provided by the CHD staff occurred in only 35 percent of the surveyed CHDs. Conclusions: Variances regarding diagnostic methodologies, work time expenditures, and staff responsibilities likely had an influence on the delivery of STD services across Georgia’s CHDs. There are opportunities for uniformity and standardization of administrative practices.
    • Community engagement to address socio-ecological barriers to physical activity among African American breast cancer survivors

      Smith, Selina A.; Whitehead, Mary S.; Sheats, Joyce Q.; Chubb, Brittney; Alema-Mensah, Ernest; Ansa, Benjamin E.; Augusta University, SISTAAH, Institute of Public and Preventative Health, Department of Community Health and Preventative Medicine (Georgia Public Health Association, 2017)
      Background: With high rates of obesity, low levels of physical activity (PA), and lack of adherence to physical activity guidelines (PAGs) among African American (AA) breast cancer survivors (BCSs), culturally appropriate interventions that address barriers to participation in PA are needed. Methods: To develop intervention content, members of an AA breast cancer support group participated in four 1-hour focus group discussions (related to the barriers to PA, strategies for overcoming them, and intervention content), which were audiotaped, transcribed, and analyzed. Results: The support group collaborated with researchers to construct the Physical Activity Intervention Developed (PAID) to Prevent Breast Cancer, a multi-component (educational sessions; support group discussions; and structured, moderately intensive walking, strength training, and yoga), facilitated, 24-week program focused on reducing multi-level barriers to PA that promote benefits (‘pay off’) of meeting PAGs. Conclusions: Community engagement fostered trust, promoted mutuality, built collaboration, and expanded capacity of AA BCSs to participate in developing an intervention addressing individual, interpersonal, organizational, and community barriers to PA.
    • Use of a teledentistry partnership program to reach a rural pediatric population

      Scaher, Tara E; Riggs, Bruce; Augusta University (Georgia Public Health Association, 2017)
      Background: Teledentistry is “the practice of using video-conferencing technologies to diagnose and provide advice about treatment over a distance.” Teledentistry has been defined as “the practice of using video-conferencing technologies to diagnose and provide advice about treatment over a distance.” This report describes the partnership of two rural Georgia public health districts. Augusta University Dental College of Georgia’s Department of Pediatric Dentistry partnered with a private practice dentist in Georgia with the goal of increasing access to care. Methods: A partnership was created that allowed dentists in a remote location to triage dental patients seen in a school-based clinic. Results: Over 3500 children were treated in a school-based dental clinic over a five year period and triaged for referral for further treatment via a teledentisty link. Conclusions: Teledentistry provides an option to reach rural populations for whom access to dental care is an issue.
    • The role of The Dental College of Georgia in meeting the oral health needs of Georgians

      Lefebvre, Carol; Augusta University (Georgia Public Health Association, 2017)
      As the state’s only dental school, The Dental College of Georgia (DCG) takes seriously its role in meeting the oral health needs of Georgia. Georgia is the largest state in physical size east of the Mississippi River, and it continues to be one of the fastest growing states in population. In 2016, the estimated population of Georgia was 10,310,371.1 Over the past 3 years, the number of single-county or low-income Dental Health Professional Shortage Areas (DHPSAs) in Georgia has increased to 131, an increase of 50 areas in 3 years.2
    • Factors associated with the utilization of community dental services among newly incarcerated adults

      Graves, Whitney; Blanks, Hairston Starla; Caplan, Lee S.; Erwin, Katherine A; Ditler, Cynthia S; Treadwell, Henrie M; Morehouse School of Medicine, Walden University, Georgia Department of Corrections (Georgia Public Health Association, 2017)
      Background: Given the high rates of risky behaviors and health conditions among incarcerated individuals and the relationship between oral and general health, receipt of quality dental care is essential to the overall health and well-being of this population. However, few recent studies have focused on access to care and the state of oral health among incarcerated populations in the U.S. For the current study, a secondary data analysis was conducted to: 1) assess factors associated with the use of dental services among a newly incarcerated prison population in Georgia and 2) consider barriers related to utilization of dental services pre- to post-release. Methods: Descriptive statistics were calculated, and bivariate and logistic regression analyses were conducted utilizing SAS 9.2 software. Results: Thirty-one percent (n=250) of survey respondents reported having a dental visit within the past year. Survey respondents who had a regular dentist (OR: 1.9; 95% CI: 1.325, 2.697), private dental insurance (OR: 1.5; 95% CI: 1.022, 2.245), or who reported pain as the reason for their last dental visit (OR: 2.2; 95% CI: 1.556, 3.130) were more likely to have utilized dental services within the past year. Conclusions: The findings highlight the role of social and economic resources and oral health needs on utilization of dental services. Additional practice and policy efforts are needed to address gaps in the dental care continuum that affect currently and formerly incarcerated adults in Georgia.
    • A review of strategies to increase access to oral health services

      Davis, Breyana; Plasphol, Sara; Armstrong State University (Georgia Public Health Association, 2017)
      Background: Leading Health Indicators (LHIs), a subset of objectives for Healthy People 2020, were selected to communicate at-risk health issues and actions that can be taken to address them. Nationally, the number of children, adolescents, and adults who visited the dentist in the past year has decreased, suggesting that oral health continues to be a problem caused by barriers preventing access to oral health services. This review aimed to identify strategies to increase access to oral health services that will be useful in moving toward the LHI objectives. Methods: Preliminary research was conducted on the LHI via the Healthy People 2020 website. Health-related, peer-reviewed articles were selected and evaluated to determine current strategies used to increase access to oral health services that would lead to achievement of the LHI objectives. Results: Evidenced-based literature shows that economic, educational, and personal barriers prevent access to oral health services. Through health promotion and educational interventions, however, good oral health can be established. Such improvements will lead to attaining the LHI objectives in moving towards the target goals of Healthy People 2020. Conclusions: Since primary prevention and early intervention procedures lead to improved oral health, such methods can be useful in reaching the LHI objectives and the target goal of Healthy People 2020.
    • Increasing breastfeeding duration and exclusivity in a sample of rural women: A pilot study

      Chopak-Foss, Joanne; Yeboah, Felicia; Georgia Southern University (Georgia Public Health Association, 2017)
      Background: Increasing breastfeeding exclusivity and duration is an objective of Maternal and Child Health (MICH-21.4 and 21.5) of the Healthy People 2020 initiative. Breastfeeding rates differ considerably between high-income and low-income women. Methods: This was a pilot project conducted to assess the feasibility of an intervention to increase breastfeeding practices overall and to improve exclusive breastfeeding rates among a sample of rural women enrolled in the Special, Supplemental Nutrition Program for Women, Infants and Children (WIC) in a rural Georgia county. Participants were recruited from the local regional hospital (n=27). Support group meetings were offered over a four-week period and began within five days of birth. At each meeting, data were gathered on demographic characteristics, pacifier use, initiation of cup feeding, and rates of breastfeeding duration and exclusivity. Results: More than 60% of the participants breastfed exclusively for the first week, but by the end of the fourth week, that number dropped to under 45%. Conclusions: Low-income women continue to be among the most challenging group in which to improve breastfeeding duration and exclusivity rates. Public health programs need to create innovative ways in which to improve breastfeeding rates. Lessons learned from the pilot study are described and suggestions for future study are provided.
    • Social networks as predictors of colorectal cancer screening in African Americans

      Alema-Mensah, Ernest; Smith, Selina; Claridy, Mechelle D; Ede, Victor; Ansa, Benjamin E.; Blumenthal, Daniel S.; Morehouse School of Medicine, Augusta University (Georgia Public Health Association, 2017)
      Background: Early detection can reduce colorectal cancer (CRC) mortality by 15%–33%, and screening is widely recommended for average-risk adults beginning at age 50 years. Colorectal cancer mortality rates are higher in African Americans than in whites, while screening rates are somewhat lower. Individual social networks can reduce emotional and/or logistical barriers to health-promoting but distasteful procedures such as CRC screening. The aim of this study was to examine social network interactions, and their impact on CRC screening among African Americans. We hypothesized a positive association between social network index (SNI) scores and CRC screening. Methods: In a community intervention trial with four arms, we previously demonstrated the efficacy of a small group educational intervention to promote CRC screening among African Americans. This intervention outperformed a one-on-one educational intervention, a reduced out-of-pocket expense intervention, and a control condition. In the present analysis, we compared the SNI scores for participants in the small group intervention cohort with a comparison group comprised of the other three cohorts. Social networks were assessed using the Social Network Index developed by Cohen. Results: Small group participants had a significantly higher network diversity score (Mean difference 0.71; 95% CI, 0.12-1.31; p=0.0017) than the comparison group. In the second component of the SNI score - -the number of people talked to over a two week period -- the small group intervention cohort also scored significantly higher than the comparison group. (Mean difference, 9.29; 95% CI, 3.963-14.6266; p=0.0004). Conclusions: The findings suggest that social interaction and support was at least partially responsible for the relatively high post-intervention screening rate in the small group intervention participants. Education in small groups could foster strong social networks. Strong and positive network diversity and a large number of people in social networks may enhance CRC screening rates among African Americans.