Assessing a comprehensive approach to prevent sexual violence on campus: Implications for program improvement

Background: On college campuses, sexual violence (or sexual assault) is at epidemic proportions. As many as one in four college women experience sexual assaults, most of which are not reported, likely due to the adverse reactions stemming from social norms and attitudes about rape. To prevent sexual violence on college campuses, the multi-level factors influencing it necessitate implementation of a holistic approach channeled at all levels. The present multi-method study assessed the feasibility and effectiveness of a peer educator (PE)-facilitated program implemented as part of a comprehensive sexual assault prevention program in three small Georgia colleges. Methods: Student participants (N=128) were questioned on their attitude toward rape myths, intention to rape, and likelihood to intervene in a potential rape situation. Paired t-tests for pre-/post-test scores assessed statistical differences in mean levels of outcomes at the data collection points. In addition, a qualitative assessment explored the feasibility of implementing, on campus, a long-duration program for prevention of sexual violence. Results: The findings indicated that, after exposure to the program, participants demonstrated decreased rape myth beliefs and intention to commit rape and an increased likelihood to intervene in a potential rape situation. In addition, apart from attaining regular student attendance in the 10-week sessions of the program, implementation of the “One on Four & Beyond” program proved to be feasible. Conclusions: This preliminary, multi-approach study suggests the effectiveness of a school PE-facilitated prevention program as a component of a comprehensive approach in reducing sexual violence on campus. Future studies are necessary to enhance understanding of the impact of the program

Analysis of Hypertension Control Rates Among Participants in the Georgia Hypertension Management and Outreach Program

Background: This study utilized health department electronic medical records retrospectively to evaluate hypertension control rates achieved by the Georgia Hypertension Management and Outreach Program (HMOP), an education, screening, and treatment control program that provides services, including blood pressure screening and assessment, referral to physicians, counseling, educational material, disease case management, and treatment. Methods: Hypertension control rates after at least 6 months of study participation were determined for patients participating in the program for at least 6 months between 2010 and 2014, and for African American and uninsured subgroups. Results: The overall hypertension control rate was 61.1%, above the 2012 national average of 51.8%. The control rates for African Americans and the uninsured were 58.9% and 62%, respectively, compared to 41.7% and 28.7% nationally. Conclusions: Although potential bias sources in the use of retrospectively obtained electronic medical records should be considered, this analysis suggests that the Georgia HMOP provides substantial improvements in hypertension control for a population of patients with otherwise poor control. Key words: hypertension, blood pressure, cardiovascular diseases, African Americans, medically uninsure

Evaluating public and private partnership to improve food and language nutrition among children 0-5 years

Background: Racial and ethnic minority populations in Georgia experience increased rates of chronic disease and poor health and education outcomes, which can be prevented through enhanced public- private partnerships. Using the Centers for Disease Control and Prevention (CDC) evaluation framework, the Evaluation Subcommittee for the Georgia Partnership for Food and Language Nutrition Project comprised of representatives from various stakeholders affiliated with state agencies, academia, and community-based organizations developed an evaluation plan to improve the collaborative effort designed to improve food and language nutrition among children 0-5 years. The purpose of this mixed-methods study was to assess influential collaborative factors. Methods: An online assessment survey that included open-ended qualitative questions was administered to all stakeholders (n=15; response rate=67%) to assess the strengths and weaknesses of the partnership, its leadership effectiveness and partners’ perceptions about the partnership. Baseline descriptive statistics were calculated and content analysis was performed with the qualitative data to understand partners’ perceptions. Results: The partnership scored variably across four categories that determine partnership strengths. Five factors were identified as the strengths of the partnership: favorable political and social climate; members see collaboration as in their self interest; unique purpose of partnership mission and goals; skilled leadership; and sufficient resources to support its operation.However, other areas were found to need urgent intervention, including improving on the leadership of the Georgia Department of Public Health (GA-DPH). In addition, communication as well as process and structure factors were identified as weaknesses including: a need to establish informal relationships and develop communication skills; a lack of flexibility; and an absence of clear roles and policy guides. Conclusions: Developing an action plan to address identified weaknesses will help ensure the accomplishment of the expected health and education outcomes among targeted, minority Georgia communities

Integrating food and language nutrition to reach Georgia’s children in early care and education environments

Background: Educational attainment and health are mutually reinforcing outcomes. Good health supports children in the achievement of academic milestones, such as grade-level reading, and is associated with higher socio-economic status, longer life expectancy, and lower lifelong chronic disease. Improving health outcomes and increasing the potential for high educational attainment is necessary for reducing disparities, improving population health, and reducing morbidity. Early childhood and associated settings present opportunities to address lifelong health. Methods: To guide the development of programs to reach large numbers of children, we reviewed the literature associated with interventions during early childhood to promote healthy food consumption patterns and language development—“food and language nutrition.” Results: Identified in the systematic review were 12 articles. A recurrent theme was the social-ecological model, widely used in the studies identified through the literature review. Conclusions: The findings suggest a theoretical framework and key considerations that could guide the development of integrated interventions to improve food and language nutrition. With these findings, the authors propose a conceptual model and outline a public health program to address food and language nutrition together in early care settings in the state of Georgia, with the potential for application in other geographic areas

Assessing a comprehensive approach to prevent sexual violence on campus: Implications for program improvement

Background: On college campuses, sexual violence (or sexual assault) is at epidemic proportions. As many as one in four college women experience sexual assaults, most of which are not reported, likely due to the adverse reactions stemming from social norms and attitudes about rape. To prevent sexual violence on college campuses, the multi-level factors influencing it necessitate implementation of a holistic approach channeled at all levels. The present multi-method study assessed the feasibility and effectiveness of a peer educator (PE)-facilitated program implemented as part of a comprehensive sexual assault prevention program in three small Georgia colleges. Methods: Student participants (N=128) were questioned on their attitude toward rape myths, intention to rape, and likelihood to intervene in a potential rape situation. Paired t-tests for pre-/post-test scores assessed statistical differences in mean levels of outcomes at the data collection points. In addition, a qualitative assessment explored the feasibility of implementing, on campus, a long-duration program for prevention of sexual violence. Results: The findings indicated that, after exposure to the program, participants demonstrated decreased rape myth beliefs and intention to commit rape and an increased likelihood to intervene in a potential rape situation. In addition, apart from attaining regular student attendance in the 10-week sessions of the program, implementation of the “One on Four & Beyond” program proved to be feasible. Conclusions: This preliminary, multi-approach study suggests the effectiveness of a school PE-facilitated prevention program as a component of a comprehensive approach in reducing sexual violence on campus. Future studies are necessary to enhance understanding of the impact of the program

Evaluating public and private partnership to improve food and language nutrition among children 0-5 years

Background: Racial and ethnic minority populations in Georgia experience increased rates of chronic disease and poor health and education outcomes, which can be prevented through enhanced public- private partnerships. Using the Centers for Disease Control and Prevention (CDC) evaluation framework, the Evaluation Subcommittee for the Georgia Partnership for Food and Language Nutrition Project comprised of representatives from various stakeholders affiliated with state agencies, academia, and community-based organizations developed an evaluation plan to improve the collaborative effort designed to improve food and language nutrition among children 0-5 years. The purpose of this mixed-methods study was to assess influential collaborative factors. Methods: An online assessment survey that included open-ended qualitative questions was administered to all stakeholders (n=15; response rate=67%) to assess the strengths and weaknesses of the partnership, its leadership effectiveness and partners’ perceptions about the partnership. Baseline descriptive statistics were calculated and content analysis was performed with the qualitative data to understand partners’ perceptions. Results: The partnership scored variably across four categories that determine partnership strengths. Five factors were identified as the strengths of the partnership: favorable political and social climate; members see collaboration as in their self interest; unique purpose of partnership mission and goals; skilled leadership; and sufficient resources to support its operation.However, other areas were found to need urgent intervention, including improving on the leadership of the Georgia Department of Public Health (GA-DPH). In addition, communication as well as process and structure factors were identified as weaknesses including: a need to establish informal relationships and develop communication skills; a lack of flexibility; and an absence of clear roles and policy guides. Conclusions: Developing an action plan to address identified weaknesses will help ensure the accomplishment of the expected health and education outcomes among targeted, minority Georgia communities

Urban Farmers Markets as a Strategy to Increase Access to and Consumption of Fresh Vegetables among SNAP and Non-SNAP Participants

Inadequate access to healthy foods is an important determinant of dietary intake among low-income populations in the United States. This study reports the results of an evaluation of two urban farmers markets in metro Atlanta, which received funding to implement Electronic Benefits Transfer card readers to accept Supplemental Nutrition Assistance Program (SNAP) benefits as a form of payment.  In Spring 2013, 179 farmers market customers completed self-administered paper surveys to assess the extent to which they received SNAP benefits, their patterns of using the market, and their self-reported changes in access to and consumption of fresh vegetables as a result of the markets. Results indicate that 28% of surveyed customers received SNAP benefits; however, only 20% of SNAP recipients reported that they were from the immediately surrounding community (1 mile away or less). Among returning customers, 74.2% strongly agreed that the markets made it easier to purchase fresh vegetables, and 64.5% reported eating more fresh vegetables as a result of the markets. Results suggest that market customers perceive that the farmers markets increase their access to and consumption of fresh vegetables, particularly among SNAP recipients. However, greater outreach is needed to members of the immediately surrounding community, many of whom receive SNAP and may benefit from increased access to the produce sold at the farmers markets

Integrating food and language nutrition to reach Georgia’s children in early care and education environments

Background: Educational attainment and health are mutually reinforcing outcomes. Good health supports children in the achievement of academic milestones, such as grade-level reading, and is associated with higher socio-economic status, longer life expectancy, and lower lifelong chronic disease. Improving health outcomes and increasing the potential for high educational attainment is necessary for reducing disparities, improving population health, and reducing morbidity. Early childhood and associated settings present opportunities to address lifelong health. Methods: To guide the development of programs to reach large numbers of children, we reviewed the literature associated with interventions during early childhood to promote healthy food consumption patterns and language development—“food and language nutrition.” Results: Identified in the systematic review were 12 articles. A recurrent theme was the social-ecological model, widely used in the studies identified through the literature review. Conclusions: The findings suggest a theoretical framework and key considerations that could guide the development of integrated interventions to improve food and language nutrition. With these findings, the authors propose a conceptual model and outline a public health program to address food and language nutrition together in early care settings in the state of Georgia, with the potential for application in other geographic areas