Institute of Public Health

Research

Gerontology
Dr. Strasser created and conducted a 25 item electronic survey of Georgia area Coroners to determine perceived knowledge and practices in elder abuse issues. Other studies indicate that gaps exist between coroners’ medical knowledge and knowledge regarding abuse issues. A unique intervention to improve the knowledge of coroners may help identify blatant signs and cases of elderly abuse and neglect as a cause of death and establish better accountability before a body is sent to a crematorium or funeral home. Survey respondents reported little knowledge between distinguishing signs of physical abuse from aging (57%) as well as the Georgia law regarding mandatory reporting of elderly abuse (65%) . The results illustrate a disparity in elderly abuse issues however present a specific opportunity for enhancing training efforts for coroners. 

Dr. Strasser created and conducted a 25 item electronic survey of Georgia area Coroners to determine perceived knowledge and practices in elder abuse issues. Other studies indicate that gaps exist between coroners’ medical knowledge and knowledge regarding abuse issues. A unique intervention to improve the knowledge of coroners may help identify blatant signs and cases of elderly abuse and neglect as a cause of death and establish better accountability before a body is sent to a crematorium or funeral home. Survey respondents reported little knowledge between distinguishing signs of physical abuse from aging (57%) as well as the Georgia law regarding mandatory reporting of elderly abuse (65%) . The results illustrate a disparity in elderly abuse issues however present a specific opportunity for enhancing training efforts for coroners. 

SAFE CARE Grant
Georgia State University Institute of Public Health and EcoAction nonprofit organization are involved in developing a quality assurance and action plan. Based on the findings from the community participatory research “Dirty Truth Campaign” Dr. Strasser is now in charge of designing an action plan designed to address the findings. Funded through a grant from the Environmental Protection Agency and CARE, the action plan is modeled after MAP (Mobilizing Action through Planning and Partnerships from the National Association of County and City Health Officials (NACCHO). The plan creates a direction for an epidemiological assessment of the area and establishes a coalition and community partnership component. The next steps will be to implement the action plan in the community and evaluating the statistical findings. 

• ECO-ACTION

Improving Water Sanitation
Dr. Stauber and a team from UNC Chapell Hill conducted a randomized control trial to document the ability to improve water santitation through the use of a concrete biosand filter. By studying household water treatment technologies, Dr. Stauber and colleagues conducted measured the effectiveness of reducing E.Coli and improving sanitation through the biosand filter. The study lasted 10 months and was conducted in the Dominican Republic, a developing country that still attributes many of its preventable deaths to diarrheal disease. The project was successful in improving sanitation, access, and education regarding the use of the new biosand filter and, consequently, bettered the lives of those people living in these communities. The project showed a decline of 40% of diarrheal disease in the communities that used the biosand filter  (Stauber 2009). In this specifically, the intervention households had significantly improved water quality and incidence of diarrheal disease compared to the control group. A random intercepts logistic regression shows, intervention households who used the Biosand Filter had .53 times the odds of diarrheal disease as control households.  Dr. Stauber feels that improving access to water and sanitation and improving household hygiene can have a tremendous impact on the burden of disease attributable to the environment, particularly in developing countries. Dr. Stauber is conducting similar research and work in several African countries.

Sources: 
Stauber CE, Ortiz GM, Loomis DP , Sobsey MD.  “A Randomized Controlled Trial of the Concrete Biosand Filter and its Impact on Diarrheal Disease in Bonao, Dominican Republic." Am. J. Trop. Med. Hygiene 80(2), 2009, pp. 286–293.

Health Promotion

Statewide Leadership Council on Childhood Obesity Policy Leadership for Active Youth (PLAY)
Policy Leadership for Active Youth (PLAY) is a collaborative effort between three of the state’s research universities and statewide partners to address childhood obesity through changes in organizational and state level policy. The initiative is led by the Institute of Public Health at Georgia State University, with support from Healthcare Georgia Foundation. Since 2004, PLAY has been a catalyst for statewide organizations and institutions to begin recognizing that childhood overweight is not solely a public health problem. It is a problem for which all sectors have a role to play. The initiative is helping the state’s organizations to connect an emerging evidence-base of knowledge around effective interventions to institutional policies, programs and advocacy for Georgia. PLAY provides valuable leadership and technical assistance for Georgia as the state continues working to ensure a bright and healthy future for its youth.

In fall 2004, PLAY established a Statewide Leadership Council consisting of representatives from approximately 35 organizations representing school, family, community, and healthcare sectors in Georgia. Leadership Council members include advocates, educators, nutrition and physical activity specialists, clinicians, policymakers, and community leaders. The Council is chaired by Dr. Jeffrey Koplan, former Director of the Centers for Disease Control (CDC) and Chair of the IOM Committee on Childhood Obesity. The Council convenes quarterly for dialogue, issue analysis, agenda setting, and collaboration around childhood overweight. The Council has committed leadership and strong membership. It has become a focal point for childhood overweight prevention in Georgia.

For more information about PLAY, visit http://publichealth.gsu.edu/PLAY

Community Connection Project for HIV+ Former Prisoners
Georgia Department of Corrections is the sixth largest prison system in the country, and it admits and releases over 19,000 offenders each year. Over 2% of them are HIV-positive, a proportion that is four times that in the general population. While GDoC has made considerable advances in arranging social services for reentrants, it has not been in a position to monitor their return to their home communities, to assure that services are used, or to assist reentrants in establishing new social connections. Research documents that a primary reason for failure in prisoner release programs is that former inmates often return to the same social environments. The Community Connection project, lead by Dr. Richard Rothenberg of GSU’s Institute of
Public Health, hopes to furnish the vital link in transition from prison life to civilian life that can help ameliorate many of the adverse outcomes that often result from returning to the ‘same crowd.’ The Community
Connection project links reentrants with citizen ‘sponsors’ in the neighborhoods to which they return. With guidance and support from project case managers, these citizen sponsors help re-entrants find employment, safe housing, critical medical care and social services. The Community Connection project hopes to benefit both the reentrant him/herself and society, by reducing recidivism, assuring adequate medical care (thereby reducing costs), and potentialy interrupting the transmission of HIV.

New research on social networks focuses on the role of social, sexual, and drug-using networks in the transmission of HIV and STDs
During the past 15 years, Dr. Rothenberg has conducted studies in the inner city areas of Atlanta that enroll participants "in the street," asks for information about their risk-taking, and tests them for infection.  Participants are asked to enumerate their networks and introduce the researchers to their associates.  Such studies, in both adults and adolescents, have helped to define the important network characteristics that support disease transmission.  The data have been used as well in a number of modeling projects. A current investigation seeks to understand the relationship of the geographic range of persons at risk to the potential for disease transmission. Preliminary results suggest that endemic transmission of HIV and STDs in these inner city areas is maintained by interlocking network connections, multiple simultaneous risks, and the marked geographic constriction of persons in these area.  Such constriction is illustrated by the accompanying diagram that shows the degree of overlap of persons' geographic range.
 

Dr. Swahn is conducting research on adolescent substance use and its link to suicidal and violent behavior. She has published several manuscripts on the role of early alcohol use initiation in suicide attempts among adolescents that are nationally representative as well as those who live in disadvantaged, urban areas.  In 2008, Dr. Swahn received two grants to examine in more depth the role of risk factors for suicide attempts. One of these grants focuses on the risk factors for suicide attempts that can be found across sociocultural contexts and risk continuum. The other grant and project focuses specifically on the role of early alcohol use initiation in suicide attempt among youth and young adults using longitudinal data of a nationally representative cohort. Currently Dr. Swahn is conducting cross-cultural comparisons of the role of early alcohol use suicidal behavior among youth in France and of youth in Zambia.   She has recently also examined the interrelatedness of different forms of violence among youth in the U.S. as well as youth in several African countries. In addition, further research on exploring methodological issues related to defining and quantifying high-risk behaviors, especially among urban youth is being conducted.