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Albany, GA, United States

Sarfaty M.,Thomas Jefferson University | Doroshenk M.,National Colorectal Cancer Roundtable | Hotz J.,Cancer Coalition of South Georgia | Brooks D.,Colorectal and Prostate Cancers | And 7 more authors.
CA Cancer Journal for Clinicians | Year: 2013

Community health centers are uniquely positioned to address disparities in colorectal cancer (CRC) screening as they have addressed other disparities. In 2012, the federal Health Resources and Services Administration, which is the funding agency for the health center program, added a requirement that health centers report CRC screening rates as a standard performance measure. These annually reported, publically available data are a major strategic opportunity to improve screening rates for CRC. The Patient Protection and Affordable Care Act enacted provisions to expand the capacity of the federal health center program. The recent report of the Institute of Medicine on integrating public health and primary care included an entire section devoted to CRC screening as a target for joint work. These developments make this the ideal time to integrate lifesaving CRC screening into the preventive care already offered by health centers. This article offers 5 strategies that address the challenges health centers face in increasing CRC screening rates. The first 2 strategies focus on improving the processes of primary care. The third emphasizes working productively with other medical providers and institutions. The fourth strategy is about aligning leadership. The final strategy is focused on using tools that have been derived from models that work. © 2013 American Cancer Society, Inc. Source

Kegler M.C.,Emory University | Alcantara I.,Emory University | Dubruiel N.,Emory University | Veluswamy J.K.,Cancer Coalition of South Georgia | And 2 more authors.
Journal of Primary Prevention | Year: 2013

Rural residents, particularly those in the South, are less physically active than their urban counterparts and often live in areas with limited walkability (e.g.; no sidewalks) and minimal access to recreational facilities. The purpose of this study was to gain an understanding of what makes certain rural residents physically active despite their environment. Qualitative interviews (N = 29) were conducted with physically active adults who live in rural areas (e.g.; outside of town) in southwest Georgia. Participants were 65.5 % male and 24.1 % African American, with a mean age of 55.9 years. Results suggest that physically active adults in rural areas are motivated by their health and perceive their local surroundings as a resource for physical activity. Understanding how these physically active adults take advantage of their living situations to be physically active has the potential to inform interventions that encourage physical activity in this high-risk population. © 2013 Springer Science+Business Media New York. Source

Honeycutt S.,Emory University | Green R.,Cancer Coalition of South Georgia | Ballard D.,Cancer Coalition of South Georgia | Hermstad A.,Emory University | And 4 more authors.
Cancer | Year: 2013

BACKGROUND Colorectal cancer (CRC) is a leading cause of cancer death in the United States. Early detection through recommended screening has been shown to have favorable treatment outcomes, yet screening rates among the medically underserved and uninsured are low, particularly for rural and minority populations. This study evaluated the effectiveness of a patient navigation program that addresses individual and systemic barriers to CRC screening for patients at rural, federally qualified community health centers. METHODS This quasiexperimental evaluation compared low-income patients at average risk for CRC (n = 809) from 4 intervention clinics and 9 comparison clinics. We abstracted medical chart data on patient demographics, CRC history and risk factors, and CRC screening referrals and examinations. Outcomes of interest were colonoscopy referral and examination during the study period and being compliant with recommended screening guidelines at the end of the study period. We conducted multilevel logistic analyses to evaluate the program's effectiveness. RESULTS Patients at intervention clinics were significantly more likely than patients at comparison clinics to undergo colonoscopy screening (35% versus 7%, odds ratio = 7.9, P <.01) and be guideline-compliant on at least one CRC screening test (43% versus 11%, odds ratio = 5.9, P <.001). CONCLUSIONS Patient navigation, delivered through the Community Cancer Screening Program, can be an effective approach to ensure that lifesaving, preventive health screenings are provided to low-income adults in a rural setting. © 2013 American Cancer Society. Source

Kegler M.C.,Emory University | Haardorfer R.,Emory University | Alcantara I.C.,Emory University | Gazmararian J.A.,Emory University | And 4 more authors.
American Journal of Public Health | Year: 2016

Objectives.Weassessed the effectiveness of an intervention targeting home food and activity environments to reduce energy intake and increase physical activity among overweight and obese patients from 3 community health centers in rural Georgia. Methods. We conducted a randomized controlled trial (n = 349) from 2011 to 2013, with follow-up at 6 and 12 months. Health coaches delivered the 16-week intervention by using tailored home environment profiles showing areas in need of improvement and positive aspects of the home environment, behavioral contracts for healthy actions, and mailed support materials. Results. Participants were mostly African American women (84.8%), with a mean age of 50.2 years and a mean body mass index (weight in kilograms divided by the square of height in meters) of 38.3. Daily energy intake decreased more for the intervention than control group at 6 (-274 vs-69 kcal) and 12 months (-195 vs-76 kcal). We observed no change for either objective or self-reported physical activity. At 12 months, 82.6% of intervention participants had not gained weight compared with 71.4% of control participants. Conclusions. The intervention was effective in changing home environments and reducing energy intake. Source

Bascombe T.M.S.,Emory University | Scott K.N.,Cancer Coalition of South Georgia | Ballard D.,Cancer Coalition of South Georgia | Smith S.A.,Emory University | And 2 more authors.
Health Education Research | Year: 2016

Use prevalence of alternative tobacco products and marijuana has increased dramatically. Unfortunately, clinical guidelines have focused on traditional cigarettes with limited attention regarding these emerging public health issues. Thus, it is critical to understand how healthcare professionals view this issue and are responding to it. This qualitative study explored knowledge, beliefs and clinic-based practices regarding traditional and alternative tobacco products (cigar-like products, smokeless tobacco, hookah, e-cigarettes) and marijuana among rural and urban Georgia primary healthcare providers. The sample comprised 20 healthcare providers in primary care settings located in the Atlanta Metropolitan area and rural southern Georgia who participated in semi-structured interviews. Results indicated a lack of knowledge about these products, with some believing that some products were less harmful than traditional cigarettes or that they may be effective in promoting cessation or harm reduction. Few reported explicitly assessing use of these various products in clinic. In addition, healthcare providers reported a need for empirical evidence to informtheir clinical practice. Healthcare providers must systematically assess use of the range of tobacco products and marijuana. Evidence-based recommendations or information sources are needed to inform clinical practice and help providers navigate conversations with patients using or inquiring about these products. © The Author 2016. Source

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