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The Movement from Research Translation to Community Transformation 从研究翻译到社区转化的运动
Pub Date : 2020-01-01 DOI: 10.20429/jgpha.2020.080101
T. Akintobi
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引用次数: 0
Impact of School Tobacco-Free Policy and Tobacco Risk Education on Youth Cigarette and E-Cigarette Use 学校无烟政策和烟草风险教育对青少年卷烟和电子烟使用的影响
Pub Date : 2020-01-01 DOI: 10.20429/jgpha.2020.080107
Vahé Heboyan, B. Riggs
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.
背景:在过去的半个世纪里,吸烟率有所下降,然而,近年来电子烟的使用量增加了两倍多。烟草风险教育和无烟政策是帮助防止青少年使用烟草的重要政策工具。本研究评估了这些政策对青少年吸烟和电子烟使用的影响。方法:使用2013/2015年乔治亚州青少年烟草调查(GYTS)的数据来检验学校烟草控制政策中烟草使用状况的统计差异,并估计其对卷烟和电子烟使用的影响。数据包括5285名参与者,分别代表2013年初中(n= 2099)、2013年高中(n= 1775)和2015年高中(n= 1411)。当前香烟和电子烟的使用情况以过去一个月使用过香烟和电子烟来衡量。学生们被问及他们的学校是否有无烟政策,以及他们是否在课堂上被教导为什么他们不应该使用烟草。采用多元逻辑回归和卡方检验对数据进行分析。结果。高中生中香烟的使用有所减少,但电子烟的使用却有所增加。烟草使用行为与烟草控制政策之间存在很强的统计关联,然而,这些关联在所有队列中并不一致。男性、白人和西班牙裔学生的吸烟率要高得多。结论。电子烟的流行可能会对健康产生重大影响,并成为吸烟的门户。无烟草政策对青少年卷烟使用的积极影响是违反直觉的,这可能是烟草使用受到严重关注的学校采取无烟草政策的结果,因此吸烟率较高。未来的研究应该详细检查这些政策的效果、执行情况和存在时间,为这些政策的有效性提供更多的证据。
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引用次数: 0
Leveraging Community Health Worker Program to Improve Healthcare Access for Sickle Cell Disease in Georgia 利用社区卫生工作者计划改善格鲁吉亚镰状细胞病的医疗保健服务
Pub Date : 2020-01-01 DOI: 10.20429/jgpha.2020.080113
Jeanette Nu'Man, M. Greene
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.
格鲁吉亚镰状细胞基金会(镰状细胞基金会)制定并实施了一个名为"获得保健"的五年项目,利用社区资源和伙伴关系,增加格鲁吉亚服务不足地区和农村地区成年镰状细胞病患者获得保健服务的机会,提高保健质量,并协调保健工作。该项目分为三个阶段:(第一阶段)社区卫生工作者方案,通过卫生保健协调改善SCD患者的健康状况;(第二阶段)cme认可的提供者培训计划,以增加格鲁吉亚非专业提供者的知识,提高提供者为镰状细胞病患者提供护理和治疗的能力和信心;(3)镰状细胞门诊日-由血液病专家在资源匮乏和服务不足的地区提供专业护理,包括奥古斯塔、哥伦布、梅肯和萨凡纳和县。乔治亚州75个县的869人接受了护理协调服务,其中113人被安置在疗养院。368名(368名)保健提供者参加了6次面对面培训,30名参加了2次网络研讨会。伙伴关系包括当地镰状细胞协会和支持团体;地方卫生部门;医院/紧急部门;本地医学会;本地学术机构;利益相关者;格鲁吉亚公共卫生部;全球血液疗法;莫尔豪斯医学院乔治亚州有8427名居民患有SCD,是全国第四大SCD人口,在全国黑人和/或非裔美国人中,SCD发病率第二高。评估措施包括过程和输出数据监测,观察数据收集,即参与和预约跟踪,以及利用病例管理软件进行病例管理记录;调查问卷前后,衡量讲习班和研讨会所涉及的知识、态度和技能的变化。
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引用次数: 1
Racial Segregation as a Social Determinant of Health: Evidence from the State of Georgia 种族隔离是健康的社会决定因素:来自乔治亚州的证据
Pub Date : 2020-01-01 DOI: 10.20429/jgpha.2020.080106
Simon K. Medcalfe, Catherine P. Slade, Divesia Lee
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.
背景:​尽管进行了几十年的研究,但确定健康方面种族差异的原因仍然是公共卫生领域的一个有害问题。挑战包括进一步完善健康的定义,以及扩大健康的社会决定因素框架,以包括相关和相关的预测因素。种族隔离作为健康的社会决定因素,虽然研究不足,但人们对健康差距的讨论越来越感兴趣。本文实证研究了种族隔离与健康社会决定因素的其他预测因素之间的关系,以及它们对客观和主观健康结果的集体影响。方法:​使用普通最小二乘回归分析来分析Robert Wood Johnson 2018佐治亚州县健康排名的健康结果。在县一级,我们考虑了两类不同的健康结果作为因变量,包括健康状况的客观指标,如年龄调整后的死亡率,以及从个人生活质量的角度来看的更主观的指标,如自我报告的健康。代表种族隔离的自变量包括黑人-白人隔离和非白人-白人隔离指数。结果:​我们的研究结果是,种族隔离与客观的健康结果测量没有显著关联。相反,令人惊讶的是,黑人-白人和非白人-白人隔离程度较高的县表现出更好的自我报告健康状况。根据先前的文献,控制变量对健康结果具有预期影响。结论:​虽然隔离并不意味着健康状况较差,但较高的生活质量评估结果令人担忧,因为一个人对健康的看法可以预测健康行为和获得所需护理的机会。我们认为,种族隔离是健康框架和模式的社会决定因素的重要补充,值得在全国范围内继续进行多学科研究。
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引用次数: 1
Effects of CenteringPregnancy on Pregnancy Outcomes and Health Disparities in Racial Groups versus Traditional Prenatal Care 与传统产前护理相比,集中妊娠对妊娠结局和种族群体健康差异的影响
Pub Date : 2020-01-01 DOI: 10.20429/jgpha.2020.080108
Adrianne M Smith, Mehak Zainab, B. Lian
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.
背景:小组产前护理已被证明在减少种族/族裔群体之间妊娠结局的健康差异方面是有效的。在这里,我们评估CenteringPregnancy的有效性,这是一个团体产前护理项目,作为传统产前护理的替代方案。方法:一项回顾性队列研究进行了检查差异方面的几个妊娠结局,如低出生体重。结果:两组妊娠结局差异无统计学意义。然而,当按种族/民族进行分组时,非裔美国母亲从中心妊娠中获得了一些好处,她们的孩子平均晚一周出生(p=0.04),并且与接受传统护理的非裔美国母亲相比,她们的新生儿重症监护病房入院率(p=0.04)更少。结论:CenteringPregnancy组产前护理项目可能对非裔美国母亲特别有价值,并可能有助于减少在重要妊娠结局方面的种族/民族差异。我们的研究结果表明,在安德森诊所的临床实践中全面采用CenteringPregnancy将更好地为社区中服务不足、处于风险和弱势的母亲提供服务。
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引用次数: 2
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 重新定义我们对格鲁吉亚州枪支相关伤害影响的理解:IPRCE暴力预防工作队的白皮书
Pub Date : 2020-01-01 DOI: 10.20429/jgpha.2020.080112
O. Danner, L. Hudak, R. Bayakly, Carol Koplan, Alexander Kelly, Sharon Nieb, S. Heron
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.
背景:枪支相关伤害是困扰所有年龄、种族、种族和性别的弱势群体的危机。本白皮书的目的是根据现有文献和数据,描述与枪支有关的暴力对格鲁吉亚各地公民和社区的健康和福祉的影响。本白皮书的目的是从全州的角度审查和描述目前可获得的关于枪支暴力和伤害影响的数据,主要是因为它与格鲁吉亚的国家暴力死亡报告系统(NVDRS)报告有关。材料和方法:我们对基于web的伤害统计查询和报告系统(WISQARSTM)和NVDRS获得的数据进行了文献回顾和分析。我们使用这些数据来描述美国和乔治亚州枪支伤害和死亡的类型和程度。结果:我们确定所有类型火器伤害的总死亡率为27%。据估计,每年平均年龄调整后的枪支伤害率为每10万人31.5人。枪支伤害导致的自杀死亡率最高,达到6倍以上。此外,根据2017年疾病预防控制中心的报告,从2015年到2016年,全国枪支相关自杀的年平均死亡率为84%。结论:有必要加大对佐治亚州公民中与枪支有关的暴力的研究、教育和预防的投资。虽然由人际暴力引起的与枪支有关的严重攻击很常见,但自杀造成的死亡率要高出6倍以上。
{"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}
引用次数: 1
FitnessGram Assessment Results in Five Rural Counties of Georgia 乔治亚州五个乡村县的FitnessGram评估结果
Pub Date : 2020-01-01 DOI: 10.20429/jgpha.2020.080105
Tara L Underwood, Jimmie Smith, Dawood H. Sultan
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.
背景:儿童肥胖在美国比以往任何时候都更加普遍。居住在农村地区的青年往往面临更高的肥胖和超重风险,这主要是由于身体活动方面的障碍。尽管美国联邦政府规定了所有学龄儿童的每日体育活动要求,但大多数来自农村社区的青少年往往无法达到推荐的健康健身区(HFZ)目标。方法:FITNESSGRAM是一种测量和报告学生身体活动和身体质量指数(BMI)的工具,基于乔治亚州学生健康和体育合作伙伴关系(SHAPE)计划的建议。我们对位于佐治亚州中部农村的8所学校的学生进行了BMI和有氧运动测量,以确定他们的HFZ参与率和成绩。参与有氧能力评估的学生总数为1068人(来自6所初中和2所高中),参与BMI评估的学生总数为1097人(来自5所初中和2所高中)。结果:总体而言,大多数学校低于建议目标的50%。结论:需要采取更多措施来解决农村学校遵守联邦和州政策建议以及农村学龄儿童体育活动水平低的问题。
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引用次数: 0
Lessons Learned in the Early Stages of a Community-Academic Partnership to Address Health Disparities in a Rural Community 解决农村社区健康差距的社区-学术伙伴关系早期阶段的经验教训
Pub Date : 2020-01-01 DOI: 10.20429/jgpha.2020.080102
Tiffany R. Washington, B. Rivers, L. Raleigh, N. Hernandez, Mindy Le, A. Green, Jeffery Lawrence, H. Young
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.
在乔治亚州的农村地区,非裔美国人受到慢性疾病的困扰,如癌症、糖尿病和心血管疾病。利用社区参与性研究(CBPR)原则的社区-学术伙伴关系可以促进多层方案的调整和转化,以解决农村地区的慢性病预防和管理问题。本研究的目的是探讨CBPR进程的关键组成部分,该进程支持了格鲁吉亚农村社区领导人与学术伙伴之间建立的伙伴关系的早期阶段。定性方法用于收集和评估有关社区和学术合作伙伴之间初始参与的数据。研究结果表明,五个组成部分支持了最初的参与:利用大学的公共服务和外联部门与农村社区建立联系;围绕已确定的社区卫生需求创造协同效应;鼓励社区成员为研究设计提供意见,以确保研究目标反映社区价值观;加强社区伙伴的能力;并跟随社区的领导。研究结果为如何开始参与东南部农村社区提供了见解,以便加强对改善癌症、糖尿病和心血管疾病结果的举措的适应和转化。
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引用次数: 0
Making the Case for Community Health Workers in Georgia 为格鲁吉亚的社区卫生工作者辩护
Pub Date : 2020-01-01 DOI: 10.20429/jgpha.2020.080116
Gail G. McCray, B. Haynes, Adrianne Proeller, Christopher Ervin, Arletha Williams-Livingston
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.
背景:社区卫生工作者(CHW)可以成为减少哮喘、心脏病、糖尿病、癌症、艾滋病毒、孕产妇/儿童健康和精神卫生等慢性病不必要发病率和死亡率的重要循证对策。格鲁吉亚的城市和农村不同人口面临许多这些疾病的高风险。造成这些健康问题的不良结果的主要原因是非医疗方面的,包括健康的社会决定因素,即获得保健、交通、住房不足和卫生知识普及。卫生保健中心可以提高个人、家庭和社区改善自身健康的能力。从历史上看,卫生保健员对医疗团队解决这些问题的关注集中在标准化培训、资格认证以及卫生保健员独特角色和责任的挑战上。在这篇文章中,我们讨论了证据的有效性和投资回报,因为CHW干预措施被证明可以减少急诊科的访问量和慢性病的不必要住院。它们有助于连接社会和医疗资源,并确保患者,特别是弱势群体,不会被遗漏。方法:我们对证明有效和投资回报的CHW研究、项目和计划进行了扫描。我们还审查了乔治亚州卫生保健工作者的工作、时间表和利益相关者,以正式承认、提高专业水平,并充分整合卫生保健工作者作为医疗保健团队必不可少和可持续的成员。结果:有显著的证据表明卫生保健的有效性和卫生保健项目的成本效益。格鲁吉亚正在进行正式努力,以建立一支可持续和训练有素的卫生工作者队伍。结论:一支训练有素的卫生保健队伍可以对格鲁吉亚社区卫生实践和状况的转变做出重要回应,降低过高的发病率和死亡率,并促进卫生公平。格鲁吉亚应以其自身在卫生保健中心的丰富经验和有效性证据为基础,采取政策,将卫生保健中心充分纳入医疗保健系统。
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引用次数: 1
Improving Access to Hepatitis C Treatment for Uninsured Patients in Southeast Georgia 改善乔治亚州东南部无保险患者获得丙型肝炎治疗的机会
Pub Date : 2020-01-01 DOI: 10.20429/jgpha.2020.080103
Bonzo Reddick, MariAnna O'Ree
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
背景:在这个简短的报告中,我们讨论提高获得丙型肝炎治疗在格鲁吉亚东南部的无保险患者。方法:通过我们在当地安全网急诊科的丙型肝炎病毒(HCV)感染筛查项目,艾滋病综合资源急诊(CARE)倡议研究了对新诊断的HCV患者的护理联动率,并寻求改善对没有医疗保险的患者的护理联动的方法。结果:我们的多学科团队与当地联邦合格医疗中心(FQHC)和批发实验室服务合作,提供负担得起的护理选择,从而增加了与慢性HCV感染治疗相关的无保险患者的百分比。结论:创造性地使用非传统来源的非侵入性实验室检测,并与已有的社区伙伴合作,是使无保险和保险不足的慢性HCV感染患者获得护理的一种方法
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引用次数: 0
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Journal of the Georgia Public Health Association
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