Journal of the Georgia Public Health Association最新文献

{"title":"The Movement from Research Translation to Community Transformation","authors":"T. Akintobi","doi":"10.20429/jgpha.2020.080101","DOIUrl":"https://doi.org/10.20429/jgpha.2020.080101","url":null,"abstract":"","PeriodicalId":73981,"journal":{"name":"Journal of the Georgia Public Health Association","volume":"8 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67544988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of School Tobacco-Free Policy and Tobacco Risk Education on Youth Cigarette and E-Cigarette Use","authors":"Vahé Heboyan, B. Riggs","doi":"10.20429/jgpha.2020.080107","DOIUrl":"https://doi.org/10.20429/jgpha.2020.080107","url":null,"abstract":"Background: ​Smoking rates have declined over the last half-century, however, e-cigarette use has more than tripled in the recent years. Tobacco-risk education and tobacco-free policies are critical policy instruments to help prevent youth tobacco use. This study evaluates the impact of these policies on youth cigarette and e-cigarette use. Methods: ​Data from the 2013/2015 Georgia Youth Tobacco Survey (GYTS) is used to test for statistical differences in tobacco use status across school-based tobacco control policies and estimate their impact on cigarette and e-cigarette use. Data includes 5,285 participants representing 2013 middle school (n=2,099), 2013 high school (n=1,775), and 2015 high school (n=1,411). Current cigarette and e-cigarette use is measured as having used them in the past month. Students were asked if their school has a tobacco-free policy and if they were taught in classes about why they should not use tobacco. Multivariate logistic regression and Chi-squared tests are used to analyze data. Results. ​The use of cigarettes among high school students has decreased, however the use of e-cigarettes has increased. Strong statistical associations exist between tobacco-use behavior and tobacco-control policies, however, these associations were not consistent across all cohorts. Smoking disparities exist where males, White and Hispanic students smoked at much higher rates. Conclusions. ​The rise of e-cigarette popularity may have significant health effects and become a gateway to smoking cigarettes. The positive impact of tobacco-free policies on youth cigarette use is counter-intuitive and may be the result of adoption of tobacco-free policies by the schools where tobacco use is of a significant concern, hence, higher smoking rates. Future research should examine the effects of these policies, their enforcement, and length of existence in detail to provide more evidence into the effectiveness of these policies.","PeriodicalId":73981,"journal":{"name":"Journal of the Georgia Public Health Association","volume":"8 1","pages":"41-51"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67545197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging Community Health Worker Program to Improve Healthcare Access for Sickle Cell Disease in Georgia","authors":"Jeanette Nu'Man, M. Greene","doi":"10.20429/jgpha.2020.080113","DOIUrl":"https://doi.org/10.20429/jgpha.2020.080113","url":null,"abstract":"A five-year project, Access to Care was developed and implemented by the Sickle Cell Foundation of Georgia (SCFG) leveraging community resources and partnerships to increase access and improve the quality of healthcare and healthcare coordination in an adult sickle cell disease (SCD) population in underserved and rural areas of Georgia. The project is comprised of three phases: (Phase 1) the Community Health Worker Program to improve the health outcomes of individuals living with SCD through healthcare coordination; (Phase 2) the CME-accredited Provider Training Program to increase the knowledge of non-specialty providers in Georgia to increase provider capacity and confidence to provide care and treatment for individuals with sickle cell disease; and (3) Sickle Cell Clinic Days – specialty care provided by a hematologist in minimally resourced and underserved areas including Augusta, Columbus, Macon and Savannah and counties. Eight hundred and sixty-nine (869) individuals in 75 Georgia counties have received care coordination services with 113 placed in medical homes. Three hundred and sixty-eight (368) health care providers have participated in six face-to-face trainings and 30 have participated in two webinars. Partnerships include local sickle cell associations and support groups; local health departments; hospitals/Emergency Departments; local medical societies; local academic institutions; stakeholders; Georgia Department of Public Health; Global Blood Therapeutics; and Morehouse School of Medicine. With 8,427 residents living with SCD, Georgia has the nation’s fourth largest SCD population in the nation with the second highest SCD incidence among black and/or African American births in the nation. Evaluation measures include process and output data monitoring, collection of observational data, i.e., participation and appointment tracking, and case management recording utilizing case management software; pre-and post-questionnaires to measure changes in knowledge, attitudes, skills covered in workshops and seminars.","PeriodicalId":73981,"journal":{"name":"Journal of the Georgia Public Health Association","volume":"8 1","pages":"101-106"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67545141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Segregation as a Social Determinant of Health: Evidence from the State of Georgia","authors":"Simon K. Medcalfe, Catherine P. Slade, Divesia Lee","doi":"10.20429/jgpha.2020.080106","DOIUrl":"https://doi.org/10.20429/jgpha.2020.080106","url":null,"abstract":"Background: ​Despite decades of research, determining the causes of racial disparities in health remains a pernicious problem in the public health arena. Challenges include further refining definitions of health as well as expanding frameworks for social determinants of health to include relevant and related predictors. Racial segregation as a social determinant of health is understudied but of growing interest in the discourse on health disparities. This paper explores empirically the relationship between racial segregation and other predictors of social determinants of health and their collective impact on health outcomes defined in both objective and subjective terms. Methods: ​Ordinary least squares regression analysis was used to analyze health outcomes from the Robert Wood Johnson 2018 County Health Rankings for Georgia. At the county level we considered two distinct categories of health outcomes as the dependent variables, including objective measures of health status such as age-adjusted mortality and more subjective measures from the person’s perspective of quality of life such self-reported health. The independent variables representing racial segregation included the black-white segregation and nonwhite-white segregation indices. Results: ​Our findings are that racial segregation is not significantly associated with objective health outcome measures. Conversely and surprisingly, counties with higher levels of black-white and nonwhite-white segregation show better self-reported health. Control variables have the expected impact on health outcomes based on previous literature. Conclusions: ​While segregation does not suggest poorer health status, the findings of higher quality of life assessment is concerning as a person’s perspectives on their health predicts healthy behaviors and access to needed care. We suggest that racial segregation is an important addition to social determinants of health frameworks and models and worthy of continued multidisciplinary research on a national basis.","PeriodicalId":73981,"journal":{"name":"Journal of the Georgia Public Health Association","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41665120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of CenteringPregnancy on Pregnancy Outcomes and Health Disparities in Racial Groups versus Traditional Prenatal Care","authors":"Adrianne M Smith, Mehak Zainab, B. Lian","doi":"10.20429/jgpha.2020.080108","DOIUrl":"https://doi.org/10.20429/jgpha.2020.080108","url":null,"abstract":"Background: ​Group prenatal care has been shown to be effective in reducing health disparities in pregnancy outcomes between racial/ethnic groups. Here, we assess the effectiveness of CenteringPregnancy, a group prenatal care program offered as an alternative to traditional prenatal care. Methods: ​A retrospective cohort study was conducted to examine differences with respect to several pregnancy outcomes such as low birth weight. Results: ​There were no statistically significant differences between the groups on pregnancy outcomes. When the groups were stratified by race/ethnicity, however, African American mothers saw some benefit from CenteringPregnancy with their babies being born, on average, one week later (p=0.04) and having fewer NICU admittances (p=0.04) than their African American counterparts receiving traditional care. Conclusion: ​The CenteringPregnancy group prenatal care program may be especially valuable for African American mothers and may help reduce racial/ethnic disparities with respect to important pregnancy outcomes. Our results have implications that full adoption of CenteringPregnancy in clinical practice at the Anderson Clinic will better service communities of mothers who are underserved, at-risk and vulnerable.","PeriodicalId":73981,"journal":{"name":"Journal of the Georgia Public Health Association","volume":"24 1","pages":"52-57"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67544896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining Our Understanding of The Impact of Firearm-Related Injury in the State of Georgia: A White Paper by the Violence Prevention Task Force of IPRCE","authors":"O. Danner, L. Hudak, R. Bayakly, Carol Koplan, Alexander Kelly, Sharon Nieb, S. Heron","doi":"10.20429/jgpha.2020.080112","DOIUrl":"https://doi.org/10.20429/jgpha.2020.080112","url":null,"abstract":"Background: ​Firearm-related injury is a crisis that afflicts vulnerable populations of all ages, ethnicities, races and gender. The purpose of this white paper is to delineate the impact of firearm-related violence on the health and well-being of citizens and communities across Georgia based on the available literature and data. The aim of this white paper is to examine and characterize the currently available data on the impact of firearm violence and injury from a statewide perspective, principally as it relates to the National Violent Death Reporting System (NVDRS) report for Georgia. Materials and method: ​We performed a literature review to analyze data obtained through the Web-based Injury Statistics Query and Reporting System (WISQARSTM) and NVDRS. We used the data to characterize the types and extent of firearm injuries and deaths in the U.S. and Georgia. Results: ​We identified an overall mortality rate of 27% for all-types of firearm injuries. The estimated average annual age-adjusted firearm injury rate was 31.5 per 100,000 people. The case fatality rate for suicide due to firearm injury notably had the highest gun-related mortality rate by greater than 6-fold. Furthermore, from 2015 to 2016, the national mean annual case fatality rate was 84% for firearm-related suicide according to 2017 CDC report. Conclusion: ​Greater investment into research, education and prevention of gun-related violence among citizens in the state of Georgia is necessary. Although firearm-related aggravated assault due to interpersonal violence is common, the case fatality rate due to suicide has a greater than 6-fold higher rate of death.","PeriodicalId":73981,"journal":{"name":"Journal of the Georgia Public Health Association","volume":"8 1","pages":"90-100"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67545081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FitnessGram Assessment Results in Five Rural Counties of Georgia","authors":"Tara L Underwood, Jimmie Smith, Dawood H. Sultan","doi":"10.20429/jgpha.2020.080105","DOIUrl":"https://doi.org/10.20429/jgpha.2020.080105","url":null,"abstract":"Background: ​Childhood obesity continues to be more prevalent in the United States (US) than ever before. Youth who reside in rural areas tend to experience higher risks of obesity and overweight status, mainly due to barriers to physical activity. Even though the US federal government has mandated a daily requirement of physical activity for all school-age children, the majority of youth from rural communities tend to not achieve the recommended Health Fitness Zone (HFZ) goals. Methods: T​he FITNESSGRAM is the instrument that has been used to measure and report students’ physical activity and body mass index (BMI) based on the Georgia Student Health and Physical Education Partnership (SHAPE) program recommendations. We examined BMI and aerobic activity measurements for students in 8 schools located in rural middle Georgia to determine their HFZ participation rates and achievement. The total students who participated in the aerobic capacity assessment was 1,068 (from 6 middle schools and 2 high schools) and the total who participated in the BMI assessment was 1,097 (from 5 middle schools and 2 high schools). Results: ​Overall, the majority of the schools were below 50% of the recommended goals. Conclusions: ​Additional initiatives are needed to address rural school compliance with federal and state policy recommendations and the low levels of physical activity among rural school-age children.","PeriodicalId":73981,"journal":{"name":"Journal of the Georgia Public Health Association","volume":"8 1","pages":"23-31"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67545135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons Learned in the Early Stages of a Community-Academic Partnership to Address Health Disparities in a Rural Community","authors":"Tiffany R. Washington, B. Rivers, L. Raleigh, N. Hernandez, Mindy Le, A. Green, Jeffery Lawrence, H. Young","doi":"10.20429/jgpha.2020.080102","DOIUrl":"https://doi.org/10.20429/jgpha.2020.080102","url":null,"abstract":"In rural Georgia, African American men are burdened by chronic health diseases such as cancer, diabetes, and cardiovascular disease. Community-academic partnerships that leverage community-based participatory research (CBPR) principles can facilitate the adaptation and translation of multilevel programs to address chronic disease prevention and management in rural areas. The objective of this study was to explore key components of the CBPR process that bolstered the early stages of a partnership established between rural-residing community leaders and academic partners in Georgia. Qualitative methodology was used to collect and assess data regarding the initial engagement between the community and academic partners. Findings indicate that five components supported initial engagement: utilizing the public service and outreach arm of the university to connect with rural communities; creating synergy around identified community health needs; encouraging community members to provide input into the research design to ensure the research goals reflect community values; enhancing the capacity of community partners; and following the lead of the community. Findings provide insights into how to begin engaging rural communities in the southeast in order to strengthen the adaptation and translation of initiatives to improve cancer, diabetes and cardiovascular disease outcomes.","PeriodicalId":73981,"journal":{"name":"Journal of the Georgia Public Health Association","volume":"8 1","pages":"3-10"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67545002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Making the Case for Community Health Workers in Georgia","authors":"Gail G. McCray, B. Haynes, Adrianne Proeller, Christopher Ervin, Arletha Williams-Livingston","doi":"10.20429/jgpha.2020.080116","DOIUrl":"https://doi.org/10.20429/jgpha.2020.080116","url":null,"abstract":"Background: ​Community Health Workers (CHW) can be an important and evidence-based response to reduce unnecessary morbidity and mortality in chronic diseases like asthma, heart disease, diabetes, cancers, HIV, and maternal/child health, and mental health. Georgia’s urban and rural diverse populations are at high risk from many of these conditions. Largely the contributors to the poor outcomes for these health issues are non-medical and include social determinants of health, i.e., access to care, transportation, inadequate housing, and health literacy. CHWs can increase the capacity of individuals, families, and communities to improve their health. Historically, concerns of CHWs on healthcare teams to address these issues have centered on standardized training, credentialing, and challenges about the unique roles and responsibilities of CHWs. In this article, we discuss the evidence of effectiveness and return on investment as CHW interventions prove to reduce visits to the Emergency Departments and unnecessary hospitalizations from chronic diseases. They serve to connect social and medical resources and ensure patients do not fall through gaps, especially among the vulnerable populations. Methods: ​We conducted a scan of CHW research studies, projects and programs that demonstrate effectiveness and return on investment. We also reviewed CHW efforts in Georgia, timeline, and stakeholders to formally recognize, advance professionalism, and fully integrate CHWs as essential and sustainable members of the healthcare team. Results: ​There is significant evidence for the effectiveness of CHWs and the cost-benefit of CHW programs. Georgia has ongoing formal efforts to establish a sustainable and well-trained CHW workforce. Conclusions: ​A well-trained CHW workforce can be an important response to the transformation of Georgia’s community health practice and status, decreasing excess morbidity and mortality, and advancing health equity. Georgia should build on its own considerable experience with CHWs and the evidence of effectiveness to adopt policies to fully integrate CHWs into the healthcare system.","PeriodicalId":73981,"journal":{"name":"Journal of the Georgia Public Health Association","volume":"8 1","pages":"128-140"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67545328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Access to Hepatitis C Treatment for Uninsured Patients in Southeast Georgia","authors":"Bonzo Reddick, MariAnna O'Ree","doi":"10.20429/jgpha.2020.080103","DOIUrl":"https://doi.org/10.20429/jgpha.2020.080103","url":null,"abstract":"Background: ​In this brief report, we discuss enhancing access to hepatitis C treatment for uninsured patients in Southeast Georgia. Methods: ​Through our screening program for hepatitis C virus (HCV) infections in a local safety net emergency department, the Comprehensive AIDS Resources Emergency (CARE) Initiative studied the rates of linkage to care for newly diagnosed patients with HCV and sought ways to improve linkage to care for those who did not have health insurance. Results: ​Our multidisciplinary team partnered with a local federally qualified health center (FQHC) and a wholesale laboratory service to offer affordable care options, thus increasing the percent of uninsured patients who were linked to care for the treatment of their chronic HCV infections. Conclusions: ​The creative use of non-invasive laboratory testing from non-traditional sources, and collaboration with pre-existing community partners is one way to make the care of chronic HCV infection attainable by uninsured and underinsured patients","PeriodicalId":73981,"journal":{"name":"Journal of the Georgia Public Health Association","volume":"8 1","pages":"11-13"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67545056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}