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Georgia Southern Examines Increasing Breastfeeding Duration and Exclusivity in Rural Women

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.

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.

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.

Increasing breastfeeding duration and exclusivity in a sample of rural women: A pilot study” was published in the Journal of the Georgia Public Health Association.

Dr. Joanne Chopak-Foss, Associate Professor of Community Health at the Jiann-Ping Hsu College of Public Health was the lead author and Ms. Felicia Yeboah, second year DrPH of Epidemiology student was the co-author.


Georgia Southern Examines STD Services Delivery Arrangements in Georgia County Health Departments

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 priorities and most common public health services delivered by LHDs are services related to sexually transmitted diseases (STDs) and sexually transmitted infections (STIs).

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.

Web-based surveys were collected from 134 county health departments in Georgia in 2015. 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.

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.

STD Services Delivery Arrangements in Georgia County Health Departments,” was recently published in the Journal of the Georgia Public Health Association.

Dr. Karmen S. Williams, alumni, was the lead author and Dr. Gulzar Shah, Associate Dean for Research, and Ms. Angie Peden, Assistant Director for the Center for Public Health Practice and Research at the Jiann-Ping Hsu College of Public Health were co-authors.


Georgia Southern Assesses Child Body Mass Index Perceptions

In the USA, African American children residing in rural areas are disproportionately affected by childhood obesity. One strategy for preventing childhood obesity is helping caregivers to recognize their child is overweight or obese. The purpose of this study is to assess African American caregivers’ perceived level of their child’s obesity status and concordance between caregiver’s reported height and weight of their children compared to the objective measure of their child’s height and weight.

Caregivers completed a paper-based survey about perceptions of their child’s weight status including body silhouettes (n = 119) and self-reported their child’s body mass index status (n = 68). Children’s (n = 71) height and weight were objectively measured. Spearman rho and independent sample t tests were calculated to assess the relationship between caregiver’s self-reported and objective BMI status. Caregiver’s visually perceived their child’s weight status to be underweight; yet, self-reported that their child’s body mass index status was obese. The Spearman’s rho correlation indicated a significant relationship between caregiver’s self-reported and objective body mass index (r = .39, p < .001). The independent sample t test reflected that the mean self-reported body mass index and objective body mass index were statistically significant with calculated body mass index perception. The investigation of three different methods for assessing body mass index perceptions may contribute to the development of tailored programs and interventions that include counseling strategies that increase parental education about their child’s body mass index.

Assessing Child Body Mass Index Perceptions Among African American Caregivers in a Rural Community,” was recently published in the Journal of Racial and Ethnic Health Disparities.

Dr. Dayna Alexander, alumni of the Doctorate of Public Health at the Jiann-Ping Hsu College of Public Health at Georgia Southern University (JPHCOPH) was the lead author. Drs. Moya L. Alfonso and Andrew Hansen, JPHCOPH faculty in the department of Community Health were co-authors.


Georgia Southern Collaborates on Mosquito Surveillance in Response to Zika Virus

Zika virus (ZIKV) was declared an international public health emergency by the World Health Organization on February 1, 2016. Due to the known and estimated range of the ZIKV mosquito vectors, southern and central US states faced increased risk of ZIKV transmission. With the state of Georgia hosting the world’s busiest international airport, a climate that supports the ZIKV vectors, and limited surveillance (13 counties) and response capacity, the Department of Public Health (DPH) was challenged to respond and prevent ZIKV transmission. This case study describes and evaluates the state’s surveillance capacity before and after the declaration of ZIKV as a public health emergency.

We analyzed surveillance data from the DPH to compare the geographical distribution of counties conducting surveillance, total number, and overall percentage of mosquito species trapped in 2015 to 2016. Counties conducting surveillance before and after the identification of the ZIKV risk were mapped using ArcMap 10.4.1. Using SAS (version 9.2) (SAS Institute, Inc, Cary, NC). We performed the independent 2 sample t test to test for differences in prevalence in both years, and a chi-square (χ2) analysis to test for differences between numbers of species across the 13 counties. In addition, weighted frequency counts of mosquitoes were used to test (χ2 ) an association between major mosquito vector species and 7 urban counties. Lastly, using data from 2012-2016, a time-trend analysis was conducted to evaluate temporal trends in species prevalence.

From 2015 to 2016, surveillance increased from 13 to 57 (338% increase) counties geographically dispersed across Georgia. A total of 76,052 mosquitoes were trapped and identified in 2015 compared to 144,731 (90.3% increase) in 2016. Significant differences between species (P<.001) and significant associations (P<.0001) between 7 urban counties and major mosquito vectors were found. Significant differences in prevalence were found between several species and year highlighting species-year temporal trends.

The DPH collaborative response to ZIKV allowed a rapid increase in its surveillance footprint. Existing and new partnerships were developed with the military and local health departments to expand and share data. This additional surveillance data allowed DPH to make sound public health decisions regarding mosquito-borne disease risks and close gaps in data related to vector distribution.

Georgia’s Collaborative Approach to Expanding Mosquito Surveillance in Response to Zika Virus: A Case Study,” was recently published in The United States Army Medical Department Journal.

Dr. Chris Rustin, assistant professor of environmental health sciences was the lead author, and Dr. Haresh Rochani, assistant professor of biostatistics along with JPHCOPH students, Mr. Deonte Martin, Mr. Varadan Sevilimedu, Mr. Sarbesh Pandeya, and Dr. Rosemarie Kelley, DPH, were co-authors.


Georgia Southern Analyzes the Massachusetts Healthcare Law

James Stephens

James Stephens

Healthcare in the United States has been one topic of the debates and discussion in the country for many years. The challenge for affordable, accessible, and quality healthcare for most Americans has been on the agenda of federal and state legislatures. There is probably no other state that has drawn as much individual attention regarding this challenge as the state of Massachusetts. While researching the topic for this article, it was discovered that financial and political perspectives on the success or failure of the healthcare model in Massachusetts vary depending on the aspect of the system being discussed. In this article the authors give a brief history and description of the Massachusetts Healthcare Law, explanation of how the law is financed, identification of the targeted populations in Massachusetts for which the law provides coverage, demonstration of the actual benefit coverage provided by the law, and review of the impact of the law on healthcare providers such as physicians and hospitals. In addition, there are explanations about the impact of the law on health insurance companies, discussion of changes in healthcare premiums, explanation of costs to the state for the new program, reviews of the impact on the health of the insured, and finally, projections on the changes that healthcare facilities will need to make to maintain fiscal viability as a result of this program.

An Analysis of the Massachusetts Healthcare Law,” was published in Hospital Topics.

Dr. James Stephens, MHA program director at the Jiann-Ping Hsu College of Public Health Georgia Southern University was the lead author and Dr. Julie Reagan, assistant professor of health policy and management was one of the co-authors.