• After initial accreditation - The PHAB Annual Report

      Roberts, Gurleen; Frantz, Emily; Kennedy, Jack; Cobb & Douglas Public Health (Georgia Public Health Association, 2017)
      Background: Cobb & Douglas Public Health (CDPH) was the first health district in Georgia to achieve accreditation by the Public Health Accreditation Board (PHAB) (accredited on May 12, 2015). Since then, two additional health districts, DeKalb (3-5) and Gwinnett, Newton, and Rockdale County Health Departments (3-4), have achieved accreditation. Efforts are underway among health districts statewide to become accredited, yet, little is known about life after accreditation. This presentation will highlight CDPH’s approach to submitting the PHAB Annual Report, which is required of health departments in order to maintain their accreditation status. Methods: CDPH will provide an overview of the PHAB Annual Report process and requirements. We will also share the process we used to construct a one-year timeline to prepare for the submission of the Annual Report and organize the Accreditation Team. CDPH will also provide a preview of the electronic submission process using ePHAB. Finally, CDPH will share tips, including lessons learned while preparing and submitting the Annual Report during July-August 2016. We will also discuss our experiences since submission and feedback received from PHAB’s Evaluation and Quality Improvement Committee. Results: CDPH will share knowledge and experiences related to the submission and feedback received of its first PHAB Annual Report, which was submitted August 2016. Conclusions: Health departments devote a tremendous amount of time, money, and energy to become accredited; however, the journey continues through the submission of PHAB Annual Progress Reports and reaccreditation planning.
    • Analysis of hypertension control rates among participants in the Georgia Hypertension Management and Outreach Program

      Byers, Sara; O'connor, Jean; Powell-Threets, Kia; Padgett,Kia; Hallow, Melissa; University of Georgia, Emory University, Georgia Department of Health (Georgia Public Health Association, 2017)
    • Application of a faith-based integration tool to assess mental and physical health interventions

      Saunders, Donna; Leak, Jean; Carver, Monique; Smith, Selina; Refreshing Springs Outreach, Medical College of Georiga (Georgia Public Health Association, 2017)
      Background: To build on current research involving faith-based interventions (FBIs) for addressing mental and physical health, this study a) reviewed the extent to which relevant publications integrate faith concepts with health and b) initiated analysis of the degree of FBI integration with intervention outcomes. Methods: Derived from a systematic search of articles published between 2007 and 2017, 36 studies were assessed with a Faith-Based Integration Assessment Tool (FIAT) to quantify faith-health integration. Basic statistical procedures were employed to determine the association of faith-based integration with intervention outcomes. Results: The assessed studies possessed (on average) moderate, inconsistent integration because of poor use of faith measures, and moderate, inconsistent use of faith practices. Analysis procedures for determining the effect of FBI integration on intervention outcomes were inadequate for formulating practical conclusions. Conclusions: Regardless of integration, interventions were associated with beneficial outcomes. To determine the link between FBI integration and intervention outcomes, additional analyses are needed.
    • The association between nutrition, physical activity, and weight status among adults in Georgia

      Nguyen, Trang; Thapa, Janani; Zhang, Donglan; Pullekines, Elizabeth; University of Georgia (Georgia Public Health Association, 2017)
      Background: Obesity is classified as having a body mass index (BMI) greater than 30 and is associated with higher risks of type 2 diabetes, coronary heart diseases, hypertension, and other adverse health outcomes. In 2015, the prevalence of self-reported obesity among adults in Georgia was 30.7. The present study focused on how, in 2015, lifestyle factors, specifically nutrition and physical activity levels, related with weight status in Georgia. Methods: The dataset used for this analysis was from the 2015 Behavioral Risk Factor Surveillance System. The association between weight status (as measured by BMI) and nutrition and physical activity levels was examined by use of linear regressions, controlling for socio-demographic variables. Results: The sample consisted of 3,543 adult respondents in Georgia, of whom 2,285 (64.5%) were overweight or obese. Regarding the variables assessing nutrition, vegetable consumption had a significant association with weight status: one unit increase in consumption of vegetables decreased BMI by 0.009 (p=0.039). Conclusions: Vegetable consumption was negatively associated with BMI. Future research should examine, with more robust measures, the relationship between physical activity levels and weight status and determine how other lifestyle factors relate to weight status. This will become increasingly relevant, as the rates for obesity in Georgia and the United States continue to trend upward.
    • Associations between multi-level contextual factors and mental health service utilization in adolescents with comorbid depression and substance-use: Moderating role of school connectedness on racial/ethnic disparities in service utilization

      Thornton, Kate; Georgia State University (Georgia Public Health Association, 2017)
      Background: Comorbid depression and substance use has been a prevalent issue in adolescent health. Although rates have remained relatively stable, their level is still alarming and efforts to see a decrease have led leaders and organizations to call for research to better understand factors related to both depression and substance use as well as how these factors may change when these disorders occur together. Methods: Data from the National Survey on Drug Use and Health (NSDUH) were utilized to pursue the research objectives for this study. The NSDUH is an ongoing cross-sectional survey of the civilian and non-institutionalized population of the United States. Multi-level logistic regression procedures were used to determine the relationship between mental health care utilization and research variables in adolescents with comorbid depression and substance-use. Results: Multi-level modeling showed that the model that controlled for individual-level and family-level factors was able to best predict mental health care use (model 4, -2LL=945,303, p << 0.001). In addition, school attachment was shown to be positively associated with mental health care use in all models tested, including the best-fit model selected (OR=2.18;(95% CI 2.13, 2.22). Other contextual factors that were significantly associated with mental health care use were gender (OR=1.92;95% CI 1.88, 1.94), parental attachment (OR=1.72; 95% CI 1.70, 1.74), and poverty (OR=1.59; 95% CI 1.58, 1.62). In addition, the school attachment and race/ethnicity interaction term was found to be significant with an odds ratio of 3.02 (95% CI 2.96, 3.22). Conclusions: This research has shown the importance of contextual factors, specifically the school environment, on the service use of comorbid adolescents. Particularly interesting in the world of mental health promotion is the use of schools as key coordinators in providing specialty mental health services to adolescents, especially for those who suffer from service use disparities.
    • Better nutrition by increased knowledge of food nutritional components

      Hayworth,Lisa; Hendricks, Tangela; Matthews, Nicole; Brenau University (Georgia Public Health Association, 2017)
      Background: The purpose of this project was to teach nutritional concepts related to MyPlate to children and families who participate in the Boys and Girls Club of Hall County (BGCHC). MyPlate is the nutrition guide published by the US Department of Agriculture; it is a pie chart depicting a plate divided into five food groups. The educational event occurred at a fall festival sponsored by the BGCHC. The intent was to offer a fun and interactive game to allow children to learn from a hands-on experience. Methods: Participants in the game were between 4 and 12 years of age and were from low income families. A matching game was developed for associating foods with the correct category of MyPlate. Results: Sixty-three percent of the children selected healthy plates with 3 out of 5 categories correct; 37% chose the unhealthy plates. Seventy-three percent of the participants stated they had previous knowledge of MyPlate. Conclusions: The conclusion reached by the Brenau University nursing students was that the concepts of MyPlate need re-enforcement throughout the community and over time.
    • Breaking the chains: A public health approach to modern day slavery

      Nosin, Rachael; Deloitte Consulting (Georgia Public Health Association, 2017)
      Background: Modern day slavery is a $150 billion industry and the second largest criminal enterprise, behind drug trafficking.1 Approximately 21-30 million men, women, and children are modern day slaves worldwide, and over 200 cases of human trafficking were confirmed in GA in 2016 alone.2, 3 In 2006 Georgia incorporated a statute against trafficking of persons for labor or sexual servitude into its criminal code (see O.C.G.A. § 16-5-46). The penalties for this crime are stiff, and those convicted face a minimum of 10 years in state prison and up to a $100,000 fine. This is not enough, however. There is a need to identify this as a public health issue and work to create Georgia’s “Freedom Ecosystem,” a network of key players, including state government, businesses, consumers, and non-profit organizations. Together, these players can make strides in ending and preventing modern day slavery. Methods: Human trafficking is prevalent across our state, partly due to factors related to supply, demand, and facilitation. By applying a public health lens to human trafficking, we may deconstruct the issue across the socio-ecological model to identify the root causes and the most strategic approaches to overcoming systemic barriers, identifying and aiding victims, and empowering survivors. To do so, the Freedom Ecosystem can be used as a framework for harnessing change. Results: Through external interviews and research, we identified nine ways that organizations play a role in the Freedom Ecosystem. Conclusions: Members of Georgia’s private sector, civil society, government, funding communities, academia, and the broader public can use a collective-action framework with a public health lens to promote prevention and advance freedom from modern-day slavery.
    • C the light! Exploring dynamic changes in hepatitis C epidemiology, screening, and treatment

      Miller, Lesley; Travis, Natasha; Lom, Jennifer; Fluker, Shelly-Ann; Emory University, Grady Memorial Hospital (Georgia Public Health Association, 2017)
      Background: Hepatitis C is common, deadly and curable. A major public health epidemic, it affects close to 4 million Americans, and kills more Americans than HIV, hepatitis B and tuberculosis combined. New all-oral therapies for hepatitis C can cure over 90% of those treated with few side effects and with a short 12-week course. However, many people with hepatitis C are unaware of their infection and access to curative therapy remains limited, especially for underserved populations. Methods: Our workshop will focus on areas of dynamic change in hepatitis C. We will discuss the changing epidemiology, focusing on the epidemic of new infections among young injection drug users. We will discuss hepatitis C screening recommendations and how these are applied in medical and public health settings, including barriers and facilitators to screening and linkage to care. We will describe current available therapies for hepatitis C and challenges to accessing these medications. Results: We will present results of our screening and linkage to care cascade, as well as the impact of our primary care-based hepatitis C clinic on antiviral treatment outcomes. We will focus on ways that workshop attendees can apply these principles to hepatitis C screening in their individual settings throughout the state of Georgia. Conclusions: We will conclude by making the compelling argument that combining public awareness of the disease, screening, linkage to care and treatment can lead to hepatitis C elimination in an unexpectedly short time frame.
    • Can summer camp improve childhood asthma management? Outcomes from Augusta Area Asthma Camp

      Flakes, Terrill; Augusta University (Georgia Public Health Association, 2017)
      Background: Childhood asthma is the most common chronic condition in the U.S., affecting 8.6% of children.1 Asthma is particularly an issue in Georgia where 16.2% of children have been diagnosed with this condition.2 Research suggests an association between pediatric asthma education and a decrease in emergency room visits and hospitalizations, and improved quality of life (QOL).3,4 The Augusta Area Asthma Camp, a free week-long educational day camp, was created to address a critical need for asthma education in the community by increasing parent and child knowledge and self-management of asthma symptoms while providing typical summer camp activities in a safe environment. Yet camp effectiveness has not been evaluated. This study explored differences in parent and child related asthma outcomes before and after attending Asthma Camp. Methods: In summer 2016, children attending Asthma Camp along with their parents/legal guardian were consented and asked to complete pre- and post-camp surveys that collected information about asthma control, education, self-management of symptoms, and physical activity. Paired samples t-tests were used to determine pre- and post-camp differences. Results: Children (n=43) ranged from 6-13 years (M=8.53, SD=1.80) with the majority Black (65.1%), male (62.8%), from single parent (41.5%), low-income (73.1%), and nonsmoking households (84.65%). Child asthma education scores were low both before (65%, SD=0.22) and after (69%,SD=0.11) camp. Children reported a significant increase in the number of physically active days/week pre (M=3.66, SD=1.99) to post (M=5.48,SD=1.33) camp t(28)=-4.14,p=0.00. While we noticed slight improvement in child symptoms (preM=5.38,SD=1.30; postM=5.66,SD=1.24), activity limitations (preM=5.90,SD=1.16; postM=6.01,SD=1.13), emotional function (preM=5.57,SD=1.68; postM=5.68,SD= 1.84), and total QOL (preM=5.47,SD=1.25; postM=5.76,SD=1.24) and parent management strategies (preM=3.19,SD=0.52; postM=3.31,SD=0.92) and support (preM=0.50,SD=0.57; postM=0.55,SD=0.59), differences were not statistically significant. Conclusions: Asthma camp can increase child physical activity and shows promise for improving asthma education, self-management, and parental support. A larger sample and more sensitive measures may improve our ability to detect changes in the participants.
    • Characteristics of reported symptoms among confirmed and suspect cases of Zika virus in Georgia, 2016

      Thompson, Ashton; Georgia Department of Public Health (Georgia Public Health Association, 2017)
      Background: In May 2015, Zika virus was detected in Brazil. The virus has since spread through several countries in the Americas. Knowledge of the major symptoms of Zika virus infection was based on historic data from two previous outbreaks in the Pacific Islands. Currently-known Zika-specific symptoms include rash, conjunctivitis, arthralgia, and fever. Epidemiologists at the Georgia Department of Public Health (GDPH) began surveillance for travel-related Zika virus infections in January 2016. Surveillance data from GDPH contributes to better characterization of the current Zika clinical picture and more efficient triage of suspect cases for laboratory testing and prevention measures. Methods: For each patient approved for Zika testing, GDPH epidemiologists created an entry in the Zika Active Monitoring System (ZAMS) within the State Electronic Notifiable Disease Surveillance System (SendSS). Patients are categorized as “asymptomatic” or “symptomatic” and reported symptoms are noted. For symptomatic patients, clinical data are compared to determine differences in the distribution of symptoms in Zika negative and positive patients. Results: GDPH has approved testing for 383 symptomatic suspect Zika patients as of October 19, 2016; 88 (23%) were confirmed Zika infections. Among symptomatic positive patients, the most common Zika-specific symptom was maculopapular rash (95%); other common symptoms were headache and myalgia (27%). Among symptomatic Zika-negative patients, the most common Zika specific symptom was fever (62%), and the most common non-Zika specific symptom was headache (19%). Conclusions: Maculopapular rash is the most suggestive symptom of a true Zika virus infection, with 95% of symptomatic Zika positive patients in Georgia exhibiting the symptom. These data can be taken into consideration when updating the testing criteria for Zika virus. GDPH currently does not approve a patient for testing based on fever or non-Zika specific symptoms alone, and that guideline is reaffirmed by these results.
    • Characterizing discrepancies in school recovery after disasters

      Shah, Hazel; Georgia State University (Georgia Public Health Association, 2019-01-30)
      Background: Academic institutions provide consistency and routine to children. When disasters damage schools, students often suffer in a variety of ways, and racial minority students are often impacted disproportionately. However, minimal research exists exploring these discrepancies. This presentation examines racial disparities in school systems affected by Hurricane Ike (2008). Methods: This study, funded by the National Science Foundation, uses publicly available Texas Education Agency data from approximately 600 schools affected by Hurricane Ike. Schools were included in the study based on two criteria: if they were declared “disaster areas” by FEMA and if they were closed for at least 10 school days after Hurricane Ike. Results: Descriptive analyses were conducted comparing school characteristics and pass rates for all students in grades 3-11 on the Texas Assessment of Knowledge and Skills (TAKS) standardized test during pre- and post-hurricane school years (i.e., 2003 – 2011). Mean pass rates on the TAKS varied greatly by race/ethnicity and other factors. Of African American students, 60.7% (SD=17.4) passed the TAKS in 2004 compared to 69.9% in 2011 (SD=15.0); 68.0% (SD=15.7) of Hispanic students passed in 2004 as opposed to 76.23% (SD=12.2) in 2011; 78.8% (SD=14.8) of White students passed in 2004 versus 83.1% in 2011. Further analyses will explore various other determinants influencing academic performance. Conclusions: Preliminary findings show discrepancies at baseline in academic outcomes between racial/ethnic groups. These discrepancies persisted post-hurricane, though all groups saw an increase in pass-rates. Further research utilizing advanced statistical approaches and geographic information system (GIS) analysis could yield insights on variation of academic performance between schools and school districts, as well as physical exposure and risk factors. These insights can inform strategies for improving schools’ academic trajectories after disasters and optimizing community recovery as a whole.
    • A clinical trial to increase the identification, genetic counseling referral and genetic testing of women at risk for hereditary breast and/or ovarian cancer

      Bellcross, Cecelia; Stanislaw, Christine; Hermstad, April (Georgia Public Health Association, 2017)
      Background: Approximately 1/300 individuals in the general population are at risk for hereditary breast and ovarian cancer due to an inherited mutation in the BRCA1/BRCA2 genes. BRCA mutations are associated with dramatically increased risks for breast cancer, especially at younger ages, in addition to ovarian cancer. Enhanced screening and risk reduction strategies can significantly reduce associated morbidity and mortality. The United States Preventive Services Task Force (USPSTF) recommends identifying women at-risk for BRCA mutations for receipt of genetic counseling and if appropriate, testing. The Breast Cancer Genetics Referral Screening Tool (B-RST) is a validated screen endorsed by USPSTF to facilitate this process. This implementation study seeks to evaluate the most effective means of follow-up for screen-positive women to maximize the number who are referred to, and receive, cancer genetic counseling (CGC) services. Methods: B-RST (v3.0) was used in three Emory Healthcare breast-imaging centers. Screen-positive women were randomized into three methods of follow-up (patient initiated, physician notification, or staff phone call). Primary outcomes were to compare the number of screen positive individuals who were referred for, scheduled, and completed a CGC appointment among the three groups. Results: Of 3,419 women approached, 63% participated and 579 (27%) screened positive. Appointments were scheduled by 7% of Group 1 participants, 17% of Group 2 individuals, and 11% of Group 3 (p<0.001). Scheduling challenges included physician non-response to notification and unsuccessful direct contact. Of those scheduled, 73% completed the CGC appointment. Conclusions: Genomic medicine is receiving increased attention in the public health arena. Screening with B-RST 3.0 in mammography settings can improve identification of individuals at-risk for BRCA mutations and facilitate referral to CGC services. Despite B-RST’s ability to easily and accurately identify individuals appropriate for CGC, additional strategies are needed to facilitate completion of CGC in routine clinical practice.
    • Coastal septic tank inventory: data resources for future wastewater management planning

      Alcorn, Jessica; University of Georiga (Georgia Public Health Association, 2017)
      Background: The US Environmental Protection Agency estimates that more than one in five homes are served by decentralized wastewater treatment systems—commonly known as septic tanks. In coastal areas where it is impossible to extend sewer service due to either financial or hydrogeological constraints, septic tanks are an integral part of wastewater treatment. When maintained adequately and installed under appropriate conditions, septic tanks remove excess nutrients and dangerous pathogens from wastewater. As coastal infrastructure is increasingly threatened by recurrent flooding, extreme weather events, and future sea level rise, coastal communities will need to assess the adequacy of their wastewater management systems and plan for future changes. Methods: Through funding from the Coastal Resource Division of the Department of Natural Resources, UGA’s Marine Extension has completed digitization of historic septic tank records into the Digital Health Department database in five coastal counties. This presentation will discuss how septic tank records have been linked to unique parcel identification numbers; the methodology for identification of potential undocumented septic tanks; and online, interactive GIS mapping features to allow expanded access and applications of the data. The septic tank inventory offers two primary benefits. First, digitization of septic tank records increases the efficiency of local public health departments in fulfilling information requests. Second, mapping the septic tank data allows for identification of areas in the county where septic tanks might be at the highest risk of failure or where targeted water sampling might be beneficial. Results and Conclusions: This presentation will focus on enhancing awareness of the data resource that has been created and potential uses in local wastewater management planning that incorporates climate considerations. This presentation will also demonstrate how other relevant GIS datasets can be integrated with the septic tank inventory.
    • Coliphage as an indicator of the quality of beach water to protect the health of swimmers in coastal Georgia

      Gallard-Gongora, Javier; McGowan Mark, Kathryn; Jones, Jeff; Aslan, Asli; Georgia Southern Universit (Georgia Public Health Association, 2017)
      Background: Gastrointestinal disease affects millions of people in the United States and places a substantial economic burden upon healthcare systems. Recreational waters polluted with fecal material are a main source for transmission of gastrointestinal disease. Georgia beaches are monitored for the presence of fecal indicator bacteria, but these bacteria are not well associated with enteric viruses. The United States Environmental Protection Agency (US EPA) has recently proposed coliphage (a virus of Escherichia coli) as an alternative indicator of fecal contamination in recreational waters. The present study compares fecal indicator bacteria and coliphage concentrations at two Georgia beaches with adjacent creeks that have a history of pollution. Methods: For one year, samples and environmental data were collected from four sites on Jekyll Island, GA, during the peak swimming season and the off-season. Samples were processed using US EPA-approved methods for membrane filtration and plaque formation. Statistical analyses were performed using t-tests and Spearman correlations. Results: The highest numbers of enterococci and significant differences with coliphage were found at Saint Andrews Creek during the swimming season and the off-season. The enterococci concentrations at Clam Creek sites did not exceed recommended recreational water criteria. During the off-season, concentrations of enterococci and coliphages were different at Clam Creek sites, indicating a potential risk for presence of enteric virus when enterococci could not be detected. Conclusions: The US EPA has proposed to adapt coliphage concentrations as an alternative indicator of water pollution for routine beach monitoring nationally. The present study provides a background for adoption of this method in Georgia. Measures of enterococci do not provide sufficient information about the associated human health risk. Inclusion of these viral indicators will improve decision making for beach closures and for protection of the health of swimmers.
    • Cross-training and sustainability in environmental health-based mosquito control programs

      Kelly, Rosmarie; Georgia Department of Health (Georgia Public Health Association, 2017)
      Background: In Georgia, only a few county environmental health programs still do mosquito surveillance and control. This is partly due to a lack of sustainability in these seasonal programs and a pressure to move personnel from mosquito control to programs that are mandated by the state. There is also a lack of training available for mosquito control workers. Methods: Richmond County Mosquito Control (RCMC), a program within the Richmond County Environmental Health office, is one of the sustainable programs, and the RCMC program has dealt with these issues in some innovative ways. It is sustainable because it partners with other agencies to provide an integrated mosquito management (IMM) approach to local mosquito control. Because training and education are important components of an IMM program, RCMC provides annual training for all mosquito control personnel. Because mosquito control is largely a seasonal program in Georgia, Richmond County has hired retired people to do mosquito control work during the mosquito season. These employees are seasonal workers; one person is kept on full time to manage the program. Richmond County Mosquito Control collaborates with the Phinizy Center for Water Sciences to provide surveillance and mosquito identification. Richmond County Mosquito Control approaches training in several ways. First, RCMC is active in the Georgia Mosquito Control Association. Second, by collaborating with the Phinizy Center for Water Sciences both students and mosquito control employees can learn from one another to the benefit of both programs. Finally, there is a yearly training for all employees with guest speakers providing information on various topics of interest, including: a review of the data that have been collected, information on new and existing treatments and practices, a review of the National Pollutant Discharge Elimination System (NPDES) pesticide discharge management plan procedures, and an overview of business decisions to improve the program and update procedures. Results: Recently, the RCMC program has expanded to deal with the potential threat of Zika virus transmission in Georgia. In addition to its swimming pool remediation project and its goats in retention basin enclosure project, the special projects group has added another project, maintaining retention/detention ponds to help reduce local mosquito breeding. In order to train the mosquito control employees and Phinizy Center students to do this job, they are working with the county engineer to learn the inspection requirements for an MS-4 permit. Finished inspection forms are provided to the county and to the Environmental Protection Division of the Georgia Department of Natural Resources. In addition, employees are training at the Phinizy Center to learn mosquito identification and surveillance, and to look at the fate of stormwater after it exits the ponds.
    • Development/enhancement of the assessment (monitoring and evaluation) knowledge and skills of workers in public health and related settings

      Telfair, Joseph; Georgia Southern University (Georgia Public Health Association, 2017)
      Background: A critical task of public health is the development and assessment of programs to address needs, concerns and issues of populations. The overall purpose of this workshop is to enhance the core public health workforce functional knowledge and skills (competencies) in the areas of program development and evaluation leading to improvements in population health and reducing health disparities. Methods: The hour long workshop will serve as an introduction and review of methods of program monitoring and assessment (M & A). The training approach will be an oral presentation with PowerPoint slides and hands -on practice that will include review of M & A terminology and review of M & A basic methodologies. Results: (Outcomes) Participants will become familiar with the basic terms and methods of program monitoring and assessment (M & A). Conclusions: The topics of this workshop will primarily benefit state and local health departments and public health districts that share services and face challenges in building or enhancing their functional public health knowledge and skills, improvement efforts and the documentation of those efforts.
    • Differences in reported benefits in older adults after participation in a nutrition incentive program

      Cook, Miranda; Kane, Rachael; Emory University (Georgia Public Health Association, 2017)
      Background: A healthy food incentive program doubles the value of food stamp dollars at farmers’ markets, addressing financial barriers to healthy eating for low-income Supplemental Nutrition Assistance Program (SNAP), or food stamps, recipients. Older adults sometimes have more trouble purchasing and eating healthy food due to illness, a lack of social support, or mobility problems, in addition to financial reasons. Methods: Surveys were administered to 87 SNAP recipients redeeming healthy food incentives at farmers’ markets. Data were stratified by age in order to test benefits experienced from program participation and the program’s efficacy in reducing barriers to healthy eating. Results: Older program participants (aged 66+) were less likely to report experiencing community benefits from the program than younger participants (age 66+: 20.0% vs. age 18-65: 62.9%; p=0.0292). However, older participants were more likely to report experiencing other benefits (age 66+: 60% vs. age 18-65: 8.6%; p=0.054). Reported health benefits did not differ significantly by age group (age 66+: 40.0% vs. age 18-65: 54.3%; p = 0.09502). Additionally, no difference was detected between age groups reporting price as their biggest barrier to healthy eating (p = 0.2569). However, older program participants were less likely to report that the healthy food incentive program addressed their barrier (age 66+: 66.7% vs. age 18-65: 96.1%; p=0.0092). Conclusions: Older program participants may be experiencing different benefits than younger ones, with younger participants reporting more community benefits such as feeling more connected to one’s community or supporting local farmers more often and older program participants reporting other benefits more frequently.
    • Discussion of public health education and training, and the needs of the future public health workforce.

      Nelson, Gary; Healthcare Georgia Foundation (Georgia Public Health Association, 2017)
      Georgia enjoys a wealth of public health capacity ranging from governmental public health to academic programs as well as local, state, and internationally acclaimed organizations. Leadership is evident across public health policy, practice and research. In the closing plenary of the 2017 Annual Meeting-Faces of Public Health, GPHA engages leaders in our field in a spirited conversation on the public health workforce. The esteemed panel representing state, national, and international public health organizations will reflect on the needs of a 21st Century workforce: prepared to respond beyond emergencies and identified threats; able to adapt to an increasing complex technological, political and economic environment; committed to affecting the economic and social determinants of health inequities; and collaborating to advance the knowledge base aligned with core public health functions and essential services. Are professional standards, qualifications and credentials appropriately calibrated for the needs and opportunities ahead? How has the underlying science base for public health practice, leadership and research changed? As stewards of population health, is the workforce equipped to provide thought leadership on health policy and legislation? What’s working and what’s not working in the recruitment, preparation, and retention of Georgia’s large and diverse public health workforce? The audience will be invited to join the panel in this engaging dialogue.
    • Effect of Medicaid status on up–to-date vaccination rates among two-year-old children in Georgia, 2015

      Machado, Fabio; Tuttle, Jessica; Drenzek, Cherie; Georgia Department of Health (Georgia Public Health Association, 2017)
      Background: The annual Georgia Immunization Study (GIS) employs a retrospective cohort design to determine the up-to-date (UTD) immunization rate of 24-month-old children in Georgia. Previous results have shown lower vaccination rates in the second year of life, particularly for DTaP. We sought to determine if a discontinuation of Medicaid coverage after the infant year contributed to lower immunization rates in the second year. Methods: A stratified random sample of 2,002 Georgia children born in January 2013 was drawn from electronic birth records. Immunization history and Medicaid status were obtained from the Georgia Registry of Immunization Transactions and Services (GRITS). Parents and providers of children inadequately immunized according to the Advisory Committee on Immunization Practices’ (ACIP) immunization schedule were contacted for additional information. UTD immunization rates were compared among participants based on Medicaid status (Medicaid both years, first year only, second year only, never on Medicaid). The relationship between Medicaid status and specific immunizations was also explored. Reasons for loss of Medicaid among children who were not UTD were sought via parent interview. Significance testing was performed using Chi-Square tests in SAS version 9.4. Results: Children covered by Medicaid both years or never covered by Medicaid were more likely to be UTD by 24 months (90.4% and 84.5%, respectively) than children no longer covered by Medicaid in their second year of life (49.2%). These children also demonstrated a significantly lower immunization rate for the 4th DTaP dose (p<0.0001). Conclusions: A discontinuation of Medicaid coverage after the first year of life was associated with a lower UTD immunization rate among 24 month old children, particularly the 4th DTaP dose. Although reasons for discontinuation of Medicaid were beyond the scope of this study, lower vaccination levels among this group may reflect a lack of understanding of vaccine support services, and deserves further examination.
    • EMS 2020: A multi-year SWOT and financial analysis of Georgia’s emergency medical services system

      Owens, Charles; Georgia Southern University (Georgia Public Health Association, 2017)
      Background: As Georgia’s Emergency Medical Services (EMS) system approaches 50 years in operation, the Georgia EMS Association and Georgia Southern University’s Center for Public Health Practice and Research began an evaluation of the strengths, weaknesses, opportunities, and threats facing Georgia’s EMS system. Methods: During the first year of the study, eight meetings were held across Georgia involving EMTs, physicians, hospital administrators, emergency planners, and state policy makers to identify strengths, weaknesses, opportunities, and threats facing the system. Results: Results obtained during the first year of this study offered valuable insight into current and future factors affecting the ability of Georgia’s EMS system to provide effective care to an expanding population. Conclusions: Quality of care, financial solvency, community paramedicine models, and reimbursement strategies were discussed and numerous strategies were evaluated to improve EMS operations in both urban and rural populations.