Assessing the Validity of Statistical Inferences in Public Health Research: An Evidence-Based, ‘Best-Practices’ Approach

Like many fields, public health has embraced the process of evidence-based practice to inform practice decisions and to guide policy development. Evidence-based practice is typically dependent upon generalizations made on the bases of the existing body of knowledge – assimilations of the research literature on a particular topic. The potential utility of scientific evidence for guiding policy and practice decisions is grounded in the validity of the research investigations upon which such decisions are made. However, the validity of inferences made from the extant public health research literature requires more than ascertaining the validity of the statistical methods alone; for each study, the validity of the entire research process must be critically analyzed to the greatest extent possible so that appropriate conclusions can be drawn, and that recommendations for development of sound public health policy and practice can be offered. A critical analysis of the research process should include the following: An a priori commitment to the research question; endpoints that are both appropriate for and consistent with the research question; an experimental design that is appropriate (i.e., that answers the research question[s]); study procedures that are conducted in a quality manner, that eliminate bias and ensure that the data accurately reflect the condition(s) under study; evidence that the integrity of the Type-I error – or false-positive risk – has been preserved; use of appropriate statistical methods (e.g. assumptions checked, dropouts appropriately handled, correct variance term) for the data analyzed; and accurate interpretation of the results of statistical tests conducted in the study (e.g., the robustness of conclusions relative to missing data, multiple endpoints, multiple analyses, conditions of study, generalization of results, etc.). This paper provides a framework for both researcher and practitioner so that each may assess this critical aspect of public health research

Racial Differences in Perception of Breast Cancer Risk in Rural Southeast Georgia

A university-public health collaborative was formed to more fully understand cancer risk among rural women in Georgia. Objectives: This study sought to gain an understanding of racial differences with regard to behavioral risk, perception of breast cancer risk, and perception of barriers to screening. Design: Differences in subjects’ risk and risk perception were assessed by creating, piloting, and administering a written survey at local health departments. Sample: A purposive sample of females enrolled in breast and cervical cancer screening programs in four rural counties in southeast Georgia (n = 147) were surveyed. Subjects were randomly invited to participate. Incentives were provided to enhance participation. Results: White females were significantly more likely than were black females to perceive pollution (OR: 4.63; p = 0.038), smoking (OR: 2.39; p = 0.018), age (OR: 3.01; p = 0.013), and hormone replacement therapy (OR: 3.17; p = 0.005) as factors influencing their breast cancer risk, and to perceive cost as a barrier to screening (OR: 2.89; p = 0.032). From a risk perspective, black females were more likely than white females to have had five-or-more pregnancies (p = 0.005), and to have given birth before age fifteen (p = 0.011). Conclusions: This study provided important baseline data about breast cancer risk necessary in developing effective health promotion programs

Rural Teens Communication With Their Parents on Sexual Health Issues

This article was first published in Georgia Association of Health, Physical Education, Recreation and Dance Journal

HIPAA’s Role in E-Mail Communications between Doctors and Patients: Privacy, Security, and Implications of the Bill

The confidentiality of a patient’s information has been sacred since the days of Hippocrates, the Father of Medicine. Today, however, merely taking an oath to respect a patient’s privacy has been overshadowed by regulations governing how certain healthcare establishments handle an individual’s health information on the web. Consequently, if a healthcare organization employs electronic mail as a means of communicating medical and/or health data to consumers, providers, and other appropriate parties, it must ensure such information is safeguarded, since using the Web poses concerns about the privacy and security of an individual’s information. E-mail between patients and physicians (or other health care providers) must be secured under the privacy rule of the Health Insurance Portability and Accountability Act; when transfer of protected health information (PHI) occurs, even if private, such a communication falls under HIPAA’s guidelines. In today’s electronic age, it is increasingly likely that protected health care information will be subject to fraud. HIPAA addresses the privacy and security of health care information in its Privacy and Security Rules, which enforce standards applied to PHI. This paper will focus on HIPAA’s role in e-mail communications in health settings, particularly as it relates to the privacy of the information exchanged between doctor and patient

A Primer on Public Health in Georgia: Applications to Physical Activity and the Obesity Epidemic

This presentation was given during the Georgia Association for Health, Physical Education, Recreation and Dance Annual Conference

Breast Cancer Screening in Southeast Georgia: An Epidemiologic Profile of Perceptual and Behavioral Factors Affecting Participation

Breast cancer is the second most deadly form of cancer among women in Georgia. In an effort to more fully understand cancer risk among residents in the southeast region, a university-public health collaborative was formed to establish point prevalence data and investigate factors associated with risk among a cohort of rural women. Specifically, this study sought to examine racial differences as they related to individual risk, perceptions of breast cancer risk, and perceptions of barriers to screening. Women enrolled in breast and cervical cancer screening programs in four rural counties in southeast Georgia were recruited into the study and surveyed (n = 147). Based on chi-square analyses (� = 0.05), participants were similar in terms of sociodemographic variables, such as age, marital status, level of education, and household income. However, black women were more likely to have had five-or-more pregnancies (p \u3c 0.0001), and to have given birth before age fifteen (p = 0.049). White women were more likely to perceive pollution (p = 0.038), smoking (p = 0.018), age (p = 0.013), and hormone replacement therapy (p = 0.005) as factors influencing breast cancer risk, and to have perceived cost as a barrier to screening (p = 0.032). Although limitations in the research design existed, this study served to contribute meaningful data to public health professionals in southeast Georgia. Specific public health implications in this region of the state will be discussed in detail

Parental Communication with Adolescents on Sexual Health Issues

This presentation was given during the American School Health Association Annual Conference

Smoking and High-Risk Drinking Behavior Among a Freshman Cohort of University Students

This presentation was given during the Georgia Southern University Annual Graduate Student Scholarship Day

A Public Health Approach to Health Promotion Program Planning

This article was published in the Georgia Association of Health, Physical Education, Recreation and Dance Journal

Early Initiation of Sexual Intercourse as a Marker of Multi-Problem Risk in College Students

This presentation was given during the Georgia Southern University Phi Kappa Phi Honor Society Annual Research Symposium