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Community-based approaches to reduce chronic disease disparities in Georgia 以社区为基础的方法减少格鲁吉亚的慢性病差距
Pub Date : 2017-01-01 DOI: 10.21633/jgpha.6.403
Latrice Rollins, T. Akintobi, April Hermstad, D. Cooper, L. Goodin, J. Beane, Sedessie Spivey, Amy Riedesel, Olayiwola Taylor, R. Lyn
Background: Among underserved and racial/ethnic minority populations in Georgia, there are profound health disparities and a burden of chronic diseases. Such diseases, which are preventable, are influenced by risk factors, including poor nutrition, physical inactivity, lack of quality health care, and tobacco use and exposure. Awardees of the Racial and Ethnic Approaches to Community Health (REACH) and Partnerships to Improve Community Health (PICH) are implementing community-based initiatives using evidencebased, policy, systems, and environmental approaches to reduce racial and ethnic health disparities and the chronic disease burden in underserved urban and rural Georgia communities. Methods: Within the context of a social ecological framework, the REACH and PICH awardees selected interventions. Their impact in the areas of tobacco use and exposure, chronic disease prevention and management, and nutrition are described. Results: To date, the interventions of Georgia’s PICH and REACH awardees have reached approximately 805,000 Georgia residents. Conclusions: By implementing strategies for community-based policy, systems, and environmental improvement, Georgia’s PICH and REACH awardees are reducing tobacco use and exposure; increasing access to healthy foods; and providing chronic disease prevention, risk reduction, and management opportunities for underserved communities in urban and rural Georgia communities. Their efforts to address chronic disease risk factors at various social and ecological levels are contributing to a reduction in racial/ethnic health disparities and the chronic disease burden in Georgia.
背景:在格鲁吉亚服务不足和种族/少数民族人口中,存在严重的健康差距和慢性疾病负担。这类疾病是可以预防的,但受到各种风险因素的影响,包括营养不良、缺乏身体活动、缺乏高质量的保健以及吸烟和接触烟草。种族和民族方法的获奖者社区卫生(REACH)和合作伙伴关系,以改善社区卫生(PICH)正在实施基于社区的倡议,使用循证,政策,系统和环境的方法,以减少种族和民族的健康差距和慢性疾病负担在服务不足的城市和农村格鲁吉亚社区。方法:在社会生态框架的背景下,REACH和PICH获奖者选择干预措施。描述了它们在烟草使用和接触、慢性病预防和管理以及营养等领域的影响。结果:到目前为止,格鲁吉亚的PICH和REACH获奖者的干预措施已经覆盖了大约805,000名格鲁吉亚居民。结论:通过实施以社区为基础的政策、制度和环境改善战略,格鲁吉亚的PICH和REACH获奖者正在减少烟草使用和接触;增加获得健康食品的机会;并为乔治亚州城乡社区服务不足的社区提供慢性病预防、降低风险和管理机会。他们努力解决各种社会和生态层面的慢性病风险因素,有助于减少格鲁吉亚的种族/族裔健康差距和慢性病负担。
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引用次数: 9
The Association Between Nutrition, Physical Activity, and Weight Status Among Adults in Georgia 格鲁吉亚成年人营养、体力活动和体重状况之间的关系
Pub Date : 2017-01-01 DOI: 10.21633/jgpha.7.103
Tran Nguyen, Janani Thapa, D. Zhang, Elizabeth Pullekines
Background: Obesity is classified as having a body mass index (BMI) greater than 30 and is associated with higher risks of type 2 diabetes, coronary heart diseases, hypertension, and other adverse health outcomes. In 2015, the prevalence of self-reported obesity among adults in Georgia was 30.7. The present study focused on how, in 2015, lifestyle factors, specifically nutrition and physical activity levels, related with weight status in Georgia. Methods: The dataset used for this analysis was from the 2015 Behavioral Risk Factor Surveillance System. The association between weight status (as measured by BMI) and nutrition and physical activity levels was examined by use of linear regressions, controlling for socio-demographic variables. Results: The sample consisted of 3,543 adult respondents in Georgia, of whom 2,285 (64.5%) were overweight or obese. Regarding the variables assessing nutrition, vegetable consumption had a significant association with weight status: one unit increase in consumption of vegetables decreased BMI by 0.009 (p=0.039). Conclusions: Vegetable consumption was negatively associated with BMI. Future research should examine, with more robust measures, the relationship between physical activity levels and weight status and determine how other lifestyle factors relate to weight status. This will become increasingly relevant, as the rates for obesity in Georgia and the United States continue to trend upward.
背景:肥胖被归类为身体质量指数(BMI)大于30,并与2型糖尿病、冠心病、高血压和其他不良健康结果的高风险相关。2015年,格鲁吉亚成年人自我报告的肥胖率为30.7%。目前的研究集中在2015年,生活方式因素,特别是营养和体育活动水平,如何与格鲁吉亚的体重状况相关。方法:本分析使用的数据集来自2015年行为风险因素监测系统。在控制社会人口变量的情况下,使用线性回归检查体重状况(以BMI衡量)与营养和身体活动水平之间的关系。结果:样本包括佐治亚州的3543名成年受访者,其中2285人(64.5%)超重或肥胖。在评估营养的变量中,蔬菜摄入量与体重状况有显著关联:蔬菜摄入量每增加一个单位,体重指数就会下降0.009 (p=0.039)。结论:蔬菜摄入量与BMI呈负相关。未来的研究应该用更有力的方法来检验身体活动水平和体重状况之间的关系,并确定其他生活方式因素与体重状况的关系。随着佐治亚州和美国的肥胖率继续呈上升趋势,这将变得越来越重要。
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引用次数: 0
A multi-county health district’s journey to accreditation: The challenges and benefits 多县卫生区认证之旅:挑战与益处
Pub Date : 2017-01-01 DOI: 10.21633/jgpha.7.111
Tara Echols
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引用次数: 0
A Screening tool for Identification of Victims of Commercial Sexual Exploitation of Children 识别儿童商业性性剥削受害者的筛选工具
Pub Date : 2017-01-01 DOI: 10.21633/jgpha.7.145
M. Livings, J. Greenbaum, Rayleen Lewis, Jeremiah D. Williams, S. Self-Brown, B. Lai
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引用次数: 0
Characteristics of reported symptoms among confirmed and suspect cases of Zika virus in Georgia, 2016 2016年格鲁吉亚寨卡病毒确诊和疑似病例报告症状特征
Pub Date : 2017-01-01 DOI: 10.21633/JGPHA.7.123
A. Thompson
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引用次数: 0
LEADing together: Partnerships for a Healthier DeKalb 共同领导:为更健康的迪卡尔布建立伙伴关系
Pub Date : 2017-01-01 DOI: 10.21633/jgpha.7.133
April Hermstad, Mj Gathings, Jen Isher-Witt, Felicia Arriaga, C. Robinson
Background: In 2014, the DeKalb County Board of Health (DCBOH) received a three-year Racial and Ethnic Approaches to Community Health (REACH) grant to work with community partners to address health disparities among African Americans in DeKalb County. The project, called Local Efforts toward Addressing Disparities in DeKalb (LEAD DeKalb), relies on a network of partnerships to implement community-based interventions that promote healthy eating and physical activity among African Americans throughout low-income parts of DeKalb County.
背景:2014年,迪卡尔布县卫生委员会(dboh)获得了一项为期三年的种族和族裔社区卫生方法(REACH)赠款,用于与社区合作伙伴合作,解决迪卡尔布县非洲裔美国人之间的健康差距。这个项目被称为“解决迪卡尔布地区差异的地方努力”(LEAD DeKalb),它依靠一个伙伴关系网络来实施以社区为基础的干预措施,促进迪卡尔布县低收入地区非洲裔美国人的健康饮食和体育活动。
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引用次数: 0
Trends in HIV Testing among Adults in Georgia: Analysis of the 2011-2015 BRFSS data 格鲁吉亚成人艾滋病毒检测趋势:2011-2015年BRFSS数据分析
Pub Date : 2017-01-01 DOI: 10.21633/jgpha.7.137
B. Ansa
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引用次数: 4
Characterizing Discrepancies in School Recovery After Disasters 灾后学校恢复差异特征分析
Pub Date : 2017-01-01 DOI: 10.21633/jgpha.7.138
H. Shah
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引用次数: 0
The burden and social determinants of asthma for adults in the state of Georgia. 佐治亚州成人哮喘的负担和社会决定因素。
Pub Date : 2017-01-01 DOI: 10.21633/jgpha.6.406
Mark Ebell, Christian Marchello, Jean O'Connor

Background: Asthma is a serious chronic health condition, and social determinants may affect its prevalence.

Methods: Data from the Behavioral Risk Factors Surveillance Survey (BRFSS), the Georgia Asthma Call-back Survey (ACBS), and the Georgia hospital and emergency department survey for patients with a diagnosis of asthma were used. All data were from the years 2011 through 2014. SAS and SUDAAN software were used to calculate weighted prevalence estimates and to perform univariate and multivariate analyses of the association between social determinants, other risk factors, and asthma outcomes.

Results: The prevalence of asthma was highest among non-Hispanic blacks, women, and persons with less than a high school education, with an annual household income below $25,000, and in rural parts of the state (south and northwest Georgia). Those without insurance for more than three years had a higher prevalence of asthma than those who had insurance or had been uninsured less than 6 months. Although the percentage without insurance declined from 2012 to 2014, more than 1 in 5 adults of working age with asthma still lacked health insurance, and more than half had been without it for more than 3 years. One-third of Georgians with asthma could not see a doctor, at least on one occasion, because of cost, and more than a third were currently paying off medical bills. Approximately one quarter did not report having a personal physician, and a similar percentage reported having more than one year since their last check-up. In multivariate analyses, women (adjusted odds ratio [aOR] 1.61), smokers (aOR 1.54), and persons with a higher BMI (aOR 1.56) were all independently associated with having asthma.

Conclusions: For the state of Georgia, there are associations between social determinants, such as education, income, and geography, and the prevalence of asthma, and many patients lack access to care. Addressing social determinants, including having affordable health insurance, is necessary to improve management of asthma.

背景:哮喘是一种严重的慢性健康状况,社会决定因素可能影响其患病率。方法:采用行为危险因素监测调查(BRFSS)、乔治亚州哮喘回访调查(ACBS)和乔治亚州医院及急诊科对诊断为哮喘患者的调查数据。所有数据都是从2011年到2014年。使用SAS和SUDAAN软件计算加权患病率估计值,并对社会决定因素、其他危险因素和哮喘结局之间的关联进行单变量和多变量分析。结果:哮喘患病率在非西班牙裔黑人、女性、高中教育程度以下、家庭年收入低于25,000美元以及该州农村地区(乔治亚州南部和西北部)的人群中最高。那些没有保险超过三年的人比那些有保险或没有保险不到6个月的人有更高的哮喘患病率。虽然没有医疗保险的比例从2012年到2014年有所下降,但超过五分之一的工作年龄哮喘患者仍然没有医疗保险,超过一半的人没有医疗保险超过3年。三分之一的格鲁吉亚哮喘患者因为费用问题至少有一次无法去看医生,超过三分之一的人目前正在支付医药费。大约四分之一的人没有私人医生,同样比例的人表示距离上一次体检已经超过一年了。在多变量分析中,女性(调整优势比[aOR] 1.61)、吸烟者(aOR 1.54)和BMI较高的人(aOR 1.56)均与哮喘独立相关。结论:就乔治亚州而言,教育、收入和地理等社会决定因素与哮喘患病率之间存在关联,许多患者缺乏获得护理的机会。解决社会决定因素,包括提供负担得起的健康保险,是改善哮喘管理的必要条件。
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引用次数: 9
TEACH Kitchen: A Chronological Review of Accomplishments. 教学厨房:成就的时间顺序回顾。
Pub Date : 2017-01-01 DOI: 10.21633/jgpha.6.408
Jung Hee Chae, Benjamin E Ansa, Selina A Smith

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 pre-and 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.

背景:饮食和烹饪健康(TEACH)厨房于2015年在乔治亚医学院成立,作为一项以营养为基础的干预措施,以对抗佐治亚州奥古斯塔地区肥胖和肥胖相关慢性疾病的高发。尽管饮食在慢性病管理中的重要性,但患者和医疗保健提供者之间缺乏营养教育是一个障碍。TEACH Kitchen的目的就是解决这一差距。方法:教学厨房是作为一个学生主导的倡议,促进健康烹饪医学生和慢性疾病患者。健康营养和烹饪课程在学年期间举办。参与者在肥胖、高血压、高脂血症和糖尿病四个模块上各花四周时间。数据收集工作于2017年1月开始,目前正在进行中。TEACH Kitchen与奥古斯塔大学、索迪斯和科尔士公司合作。结果:目前,TEACH Kitchen已经招募了14名患者和6名儿童。预期结果包括测量干预前后在营养知识、态度、信念和能力方面的变化,以及临床指标的差异,包括体重指数、血压、血脂和糖化血红蛋白。结论:TEACH Kitchen是乔治亚州奥古斯塔市第一个以医学院为基础的营养/烹饪教育项目。它为患者和医学生提供了动手健康营养/烹饪经验,目标是降低肥胖相关疾病的患病率并改善其预后。
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引用次数: 4
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Journal of the Georgia Public Health Association
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