A Systematic Review of Lifestyle Interventions for Chronic Diseases in Rural Communities

Background: Rural Americans suffer disproportionately from lifestyle-related chronic diseases (e.g., obesity, diabetes, hypertension, cardiovascular disease, and breast cancer). Interventions that consider the distinctive characteristics of rural communities (e.g., access to healthcare, income, and education) are needed. As an initial step in planning future research, we completed a systematic review of dietary intake and physical activity interventions targeting rural populations. Methods: Manuscripts focused on dietary intake and physical activity and published through March 15, 2016, were identified by use of PubMed and CINAHL databases and MeSH terms and keyword searches. Results: A total of 18 studies met the inclusion criteria. Six involved randomized controlled trials; 7 used quasi-experimental designs; 4 had a pre-/post-design; and 1 was an observational study. Eight studies were multi-site (or multi-county), and 3 focused on churches. Primary emphasis by racial/ethnic group included: African Americans (6); Whites (2); Hispanics (3); and two or more groups (7). Most studies (17) sampled adults; one included children. Two studies targeted families. Conclusions: Additional lifestyle intervention research is needed to identify effective approaches promoting healthy diet and exercise and chronic disease prevention in rural communities. Studies that include rigorous designs, adequate sample sizes, and generalizable results are needed to overcome the limitations of published studies

How can we promote mentored student research in Georgia?

N/

A Review of Community-Based Participatory Research Studies to Promote Physical Activity Among African Americans

Background: As part of the planning process for new research, the literature on community-based participatory research (CBPR) approaches for promoting physical activity in African American communities was systematically reviewed. Methods: Studies published through October 31, 2015 that employed CBPR methods were identified using PubMed and CINAHL databases and MeSH terms and keyword searches. Results: A total of 15 studies met the search criteria. One focused on CBPR and physical activity among African American school children and adolescents, 13 on adults, and one on both children and adults. Seven studies employed CBPR methods to promote physical activity in church settings. Eight of the studies had a pre-/post-test design, three had a quasiexperimental design, three had a randomized controlled design, and one was a case study. Conclusions: Additional CBPR studies and faith-based interventions are needed to identify effective ways to promote physical activity in African American communities to address health disparities. Of particular interest are those that have an adequate sample size and a rigorous design, to overcome limitations of previous studies

86TH Annual Georgia Public Health Association Meeting & Conference Report

The 86th annual meeting of the Georgia Public Health Association (GPHA) and joint conference with the Southern Health Association was held in Atlanta, Georgia, on April 13-14, 2015, with pre-conference (April 12th) and post-conference (April14th) Executive Board meetings. As Georgia’s leading forum for public health researchers, practitioners, and students, the annual meeting of the GPHA brings together participants from across the state to explore recent developments in the field and to exchange techniques, tools, and experiences. Historically, the GPHA conference has been held in Savannah (n=24); Jekyll Island (n=20); Atlanta (n=16); Augusta (n=4); and Gainesville (n=1). There was no annual meeting during the early years (1929-1936); during World War II (1941-1943 and 1945); and for four years during the 1980s. Between 2006 and 2010, GPHA held one-day annual meetings and business sessions with educational workshops. Several new initiatives were highlighted as part of this year’s conference. These included a “move and groove” physical activity lounge, registration scholarships for students with a dedicated meet-and-greet reception, an expanded exhibit hall, presentation and approval of three resolutions (related to healthy foods at official activities and events; weapons at official activities and events; and memorials), and approval of the 2015 legislative policy positions and amended association bylaws. The theme for the conference was Advocacy in Action for Public Health. Specifically, the program addressed ensuring access to care; protecting funding for core programs, services, and infrastructure; eliminating health disparities; and addressing key public health issues important to the state of Georgia. One hundred and nine (109) abstracts were submitted for peer review; 36 were accepted for poster and 40 for workshop presentations. Four plenary sessions with keynote speakers covered the intersection between advocacy and policy, Georgia’s response to the Ebola crisis, palliative care, and essentials of advocacy in action for public health. Concurrent workshops focused on Board of Health training, public health accreditation, capacity building, collaboration, patient-centered outcomes, synthetic cannabinoid use, the HIV care continuum, use of data for informed decision making, environmental threats, organizational development, epidemiology, policy, and regulation. Thirty-two (32) awards were presented, including Lawmaker of the Year Award to Governor Nathan and First Lady Sandra Deal for their active and engaged role in promoting public health in Georgia; and the Sellers-McCroan Award to Commissioner Brenda Fitzgerald, Georgia Department of Public Health (DPH) State Health Officer, for her leadership of the Georgia Ebola Response Team and leadership of the newly formed department. The conference attracted 569 registrants primarily through pre-registration (n=561) with limited onsite registration (n=8). For this year’s conference, there was a significant increase in attendance (36%) and exhibitors (33%) relative to 2014. Of registrants reporting GPHA section participation, representation included: academic (5%); administration (10%); boards of health (13%); career development (15%); emergency preparedness (2%); epidemiology (5%); health education and promotion (2%); information technology (2%); maternal and child health (3%); medical/dental (3%); nursing (10%); nutrition

Legislative Smoking Bans for Reducing Exposure to Secondhand Smoke and Smoking Prevalence: Opportunities for Georgians

Background: Secondhand smoke, which is also referred to as environmental tobacco smoke and passive smoke, is a known human carcinogen. Secondhand smoke also causes disease and premature death in nonsmoking adults and children. Methods: We summarize studies of secondhand smoke in public places before and after smoking bans, as well as studies of cardiovascular and respiratory disease before and after such bans. Results: To protect the public from the harmful effects of secondhand smoke, smoke-free legislation is an effective public health measure. Smoking bans in public places, which have been implemented in many jurisdictions across the U.S. and in other countries, have the potential to influence social norms and reduce smoking behavior. Conclusions: Through legislative smoking bans for reducing secondhand smoke exposure and smoking prevalence, opportunities exist to protect the health of Georgians and other Americans and to reduce health care costs. These opportunities include increasing the comprehensiveness of smoking bans in public places and ensuring adequate funding to quit line services

Reducing Disparities by way of a Cancer Disparities Research Training Program

Background: For minority populations, there is a continuing disparity in the burden of death and illness from cancer. Research to address this disparity should be conducted by investigators who can best understand and address the needs of culturally diverse communities. However, minorities are under-represented in health-related research. The goal of this project was to develop and evaluate an approach to motivating and preparing master’s degree students for careers dedicated to cancer disparities research. Method: A Cancer Disparities Research Training Program (CDRTP) was initiated in 2010. The program consists of coursework, practicum experiences, and research opportunities. Assessment of the curriculum is based on monitoring achievement of evaluation indicators and includes a quantitative assessment and qualitative approach. Results: In its first three years, the program graduated 20 trainees, all of whom were minorities (18 African Americans and two Asians). When asked about career goals, two-thirds of the trainees indicated interest in pursuing careers in research on cancer prevention and control. The trainees expressed high satisfaction with the courses, instructor, materials, and curriculum. Although trainees had suggestions about course details, evaluations overall were positive. Across focus groups, three recurrent themes emerged regarding activities to enhance the student experience: having a wider variety of topics, more guest speakers, and field trips. Conclusion: The CDRTP was intended to recruit students – primarily African Americans – into research on prevention and control of cancer disparities. Although final evaluation of the program’s overall outcome will not be available for several years, a preliminary evaluation indicates the program is being successful

TEACH Kitchen: a Chronological Review of Accomplishments

Background: The Eating and Cooking Healthy (TEACH) Kitchen was founded at the Medical College of Georgia in 2015 as a nutrition-based intervention to combat the high prevalence of obesity and obesity-related chronic diseases in the area of Augusta, Georgia. Despite the importance of diet in the management of chronic diseases, inadequate nutrition education among patients and healthcare providers presents a barrier. The purpose of TEACH Kitchen is to address this gap. Methods: TEACH Kitchen is as a student-led initiative that promotes healthy cooking among medical students and patients with chronic diseases. Healthy nutrition and cooking classes are held during the academic year. Participants spend four weeks on each of four modules: obesity, hypertension, hyperlipidemia, and diabetes mellitus. Data collection, which began in January 2017, is currently on going. TEACH Kitchen has collaborated with Augusta University, Sodexo, and Kohl’s. Results: Currently, TEACH Kitchen has enrolled 14 patients and 6 children. Anticipated results include measurements of preand post-intervention changes in knowledge, attitudes, beliefs, and competence in nutrition, as well as differences in clinical indicators, including body mass index, blood pressure, lipid profile, and HbA1c. Conclusions: TEACH Kitchen is the first medical school-based nutrition/cooking education initiative in Augusta, Georgia. It provides patients and medical students with hands-on healthy nutrition/cooking experience with the goal of decreasing the prevalence and improving the outcome of obesity-related diseases

Application of a Fath-Based Integration Tool to Assess Mental and Physical Health Interventions

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 FaithBased 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. Key words: faith-based integration and interventions, faith and health studies, religion and spirituality, integrative healt

Attitudes Toward Breast Cancer Genetic Testing in Five Special Population Groups

Purpose: This study examined interest in and attitudes toward genetic testing in 5 different population groups. Methods: The survey included African American, Asian American, Latina, Native American, and Appalachian women with varying familial histories of breast cancer. A total of 49 women were interviewed in person. Descriptive and nonparametric statistical techniques were used to assess ethnic group differences. Results: Overall, interest in testing was high. All groups endorsed more benefits than risks. There were group differences regarding endorsement of specific benefits and risks: testing to “follow doctor recommendations” (p=0.017), “concern for effects on family” (p=0.044), “distrust of modern medicine” (p=0.036), “cost” (p=0.025), and “concerns about communication of results to others” (p=0.032). There was a significant inverse relationship between interest and genetic testing cost (p Conclusion: Cost may be an important barrier to obtaining genetic testing services, and participants would benefit by genetic counseling that incorporates the unique cultural values and beliefs of each group to create an individualized, culturally competent program. Further research about attitudes toward genetic testing is needed among Asian Americans, Native Americans, and Appalachians for whom data are severely lacking. Future study of the different Latina perceptions toward genetic testing are encouraged

Promoting Colorectal Cancer Screening Among Haitian Americans

Background: Few studies have examined colorectal cancer screening among Haitian Americans, although striking disparities in colorectal cancer screening and mortality are well-documented among U.S. Blacks. Race, socioeconomic status, and place of birth are factors associated with colorectal cancer incidence and mortality patterns. Methods: In this article, we summarize published studies on colorectal cancer screening among Haitian Americans, identified through bibliographic searches in PubMed and CINAHL through August 2015, and offer recommendations for further research. Results: Only one qualitative study and three quantitative surveys have examined colorectal cancer screening among Haitian Americans. A qualitative study found important differences in perceptions of the curability of colorectal cancer, preventive practices, and preferred sources of information among Haitian Americans and other ethnic subgroups of U.S. Blacks. Awareness of colorectal cancer screening tests, risk perception, healthcare provider recommendation, and self-reported use of screening are suboptimal among Haitian Americans and other subgroups. In preliminary quantitative studies, Haitian immigrants have been found to have lower colorectal cancer screening rates than other groups such as African Americans. Conclusions: Culturally appropriate educational interventions are needed to encourage Haitian American adults aged \u3e 50 years to undergo screening for colorectal cancer and to ensure that they are well informed about the value of healthy eating and physical activity