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Public Health

Tari Ajeh, MPH Candidate
Adolescent Health in Palm Beach County: A review of the “Birth to 22” Initiative

“As a new member of the American Public Health Association (APHA), and a first-time attendee of the annual APHA conference, it was exciting and overwhelming in equal parts to navigate through all the sessions that offered a glimpse into all the most current, cutting edge public health research available. Armed with my schedule, courtesy the handy APHA conference app, I headed to my very first oral session, with a focus on adolescent health. At the session, there were two speakers, who were giving information on and results of adolescent targeted initiatives they were currently working on in different areas of the country. The main speaker at the session spoke on the “Birth to 22” initiative in Palm Beach County, Florida- a youth facilitated initiative to improve the health outcomes of minorities in the county.

Palm Beach County is home to the 11th largest school district in the country and although it is a predominantly Caucasian county, there are large disparities in the county, especially with regard to housing and health outcomes. The main purpose of this initiative therefore, was to get the perspective of people who ordinarily would have no say in local policies that directly affect health outcomes in the communities. The program which is centered around community conversations is facilitated by minority youth and provides a good model and framework to get youth more involved in their communities. The initiative was also involved with community projects such as weekend food packing for homeless youth and the establishment of community gardens to promote healthy eating and exercise for the members of the community. The concept of having young people actively involved in the governance, policy making and improvement of their communities is an exemplary one and one that should be emulated and replicated in the myriad struggling minority communities across the country.”


Arpita Hazra, MPH Candidate
Cardiovascular Disease

“I am very fortunate to be given a chance by our MPH program to attend the Annual Public Health Conference in Atlanta. I attended business meetings, socials and oral presentations that were themed on primary care, maternal and child health, aging and the cardiovascular disease risk factors.

I enjoyed the oral presentation on cardiovascular disease risk factors the most. There were many different subtopics that were presented and discussed at length in this session. The doctoral candidate from Drexel spoke in detail about how early menarche can increase risk of cardiovascular diseases in later life for women. High BMI in young girls can lead to early menarche which in turn sets the trend for increased cardiovascular risk factors in adulthood. It is interesting to note that our future health patterns are created and embedded in our system so early in life. Another speaker from California spoke about a project in Nigeria where they are using faith based healthcare screening tools. Here I learned how faith based institutions in Nigeria are actually providing healthcare services and screening for cardiovascular diseases and sickle cell disease during baby showers and religious ceremonies every weekend in the church as there is high attendance.

In this same session there was another interesting presentation from a biostatistician from Puerto Rico on blood pressure measurement. Even after so many years blood pressure measurement does not seem to be exact science and people are suggesting ways to get more exact numbers. This presenter stressed on the importance of simultaneously measuring the pressure on both arms and averaging it. This seems cumbersome to me when I think of it but his explanation was valid and made scientific sense.

Attending the Annual Public Health Conference in Atlanta was a very fulfilling experience. Public health is a huge spectrum and this conference helped me experience various components of the public health spectrum in a short time.”


Maryam Hussain, MPH Candidate
Cancer Prevention

“The American Public Health Association conference in Atlanta, Georgia provided early career and well-established public health professionals with new strategies to tackle challenges we are facing today. The New Innovations of Cancer Screening session discussion was centered on cancer prevention, screening and evaluation of health systems changing interventions to increase uptake of colorectal cancer (CRC) screening and vaccination for HPV. First, Roshan Paudel, MPH, spoke about the Health Resources and Services Administration (HRSA) involving federally qualified health centers (FQHCs) to measure and report on colorectal cancer screening rates.  Federally Qualified Health Centers are community based health centers serving those who have limited access to health care and provide high quality health care. The initiative began in 2012 when FQHCs were beginning to get concerned with securing follow up care for patients with abnormal diagnosis because of the high costs of these services. The American Cancer Society, the Centers for Disease Control and Prevention (CDC) and the National Colorectal Cancer Roundtable began the Links of Care pilot program. The program promoted collaboration amongst FQHCs who were serving low income patients and involved specialty providers to secure those services. This project facilitated partnership between private gastroenterology groups offering free diagnostic colonoscopy services. The partnerships were built upon strong communication and care coordination with clear commitment from medical volunteers; this followed a “fair share” model. It was important for this program to recognize the long term benefits towards communities and businesses which were avoiding high costs of care in the future. Minnesota’s largest Community Health Center, West Side Community Health Services, was one of the three pilot sites which had shown tremendous increase in uptake of CRC screening rates from 17% in 2013 to 60% in December of 2016. Over 260 donated colonoscopies have been performed by two large independent gastroenterologist groups. This program emphasized the fact that partners are willing to provide services when the outcome is clear and compelling. The burden is shared among local providers and the responsibility is shared across all parties.

An additional example of improved integration between public health and primary care was given by Dr. Amy DeGroff, Ph.D., MPH. She spoke about the funding provided by the CDC to 30 state, university and tribal grantees for the Colorectal Cancer Control Program in 2015. The CDC requires that grantees partner with health systems that serve underserved populations in efforts to increase screening rates for CRC through the implementation of evidence based interventions. The use of evidence based interventions was a common theme throughout many discussions at the APHA conference. The CDC designed a mixed methods evaluation of the program to examine the implementation, outcomes and cost-effectiveness. Evidence based interventions included client reminders, provider assessment and feedback, and provider reminders. Overall the program had shown to increase uptake slightly after one year of implementation and expressed that the challenges lied in collecting reliable screening rates from electronic health records.

The focus was shifted from colorectal cancer screening rates to Human Papillomavirus vaccines, cervical cancer and HPV related cancers in Georgia by Janet Y. Shin, MPH. She spoke about the collaboration between the Georgia Comprehensive Cancer Control Program, Northwest Georgia Regional Cancer Coalition and the Adolescent Health and Youth Development Program. The partners offered 14 educational events regarding HPV and cervical cancer specifically targeting underserved adolescents and their parents. In 2016 pre and post-test surveys were administered to participants at the events. Their knowledge score percentages were calculated and compared between both surveys to see if knowledge scores increased after attending the educational events. Results had shown that scores had increased from 16.0 in pretest surveys to 22.8 in post-test surveys (51.7% to 73.7% after the intervention). Additionally the adult participant’s intention to vaccinate their children increased. This community-based education initiative promoted HPV vaccination and enhanced knowledge about HPV and related cancer to reduce the cancer risk in that population.

The different discussions during this session were prime examples of multiple core competencies of public health. The first competency that was met was applied principles of governance which included creating visions, empowering other and fostering collaboration. Roshan Paudel’s discussion involved clear and defined outcomes between the partners which fostered smooth collaboration leading to increased CRC screening rates. The second competency met was effective performance on inter professional teams. Each of the discussions during this session emphasized the importance of partnerships and working on a team. The opportunity that Hofstra University’s MPH program provided, allowed me to partake in many discussions with such reputable professionals in the same field that I hope pursue and I will be forever appreciative of this.”


Kelsey Kirk, MPH Candidate
Obesity Prevention

“As an individual with a deep passion for promoting proper nutrition, I was thrilled to discover the large number of nutrition-related poster and presentation sessions scheduled during this year’s APHA conference. While every session I attended was pertinent to addressing major public health nutrition issues, I struck a particular interest in the session titled “Healthy Stores for Healthier Communities: Role of Retail Stores in Improving Nutrition.”

Research surrounding food retail settings is an emerging focus of obesity prevention efforts. In many communities, especially those experiencing food insecurity, there are limited options for families to shop for healthy food. This session outlined several strategies for increasing availability, visibility, affordability, promotion, and sales of healthy foods and beverages, particularly in smaller food stores.

The first presenter, Leah Chapman, MPH, discussed her intervention for establishing partnerships and utilizing sales data to conduct healthy food choice research. The goals and actions of this intervention were similar to those I planned to outline in my Culminating Experience (CE) project. She emphasized that while it’s difficult to obtain sales data from smaller retail stores, it is often a critical objective measure for evaluating healthy food interventions. The second presenter, Megan Lott MPH, RD, discussed effective marketing strategies of healthful foods in small retail food stores. Between these two presentations, I gathered vital information to focus my CE project into its final stage, and upon returning home, connected with Ms. Chapman to further discuss her project, and how I can apply her findings to my project!”


Tracey Tran, MPH Candidate
Early Career Professionals Workshop

“My experience at APHA was really wonderful, and I am so grateful to be able to attend. There was so much of the public health field that I was exposed to and it was a great experience to be a part of. In addition to all the public health related sessions, there were a few sessions on professionalism offered. I attended one “Early-Career Professionals Workshop.” In this workshop, subjects such as updating a resume to a CV, how to negotiate salaries, tips on searching for jobs, and applying to them, etc. were discussed. The focus of the session was for professionals who are new in their careers, which I thought was beneficial for myself as I will be graduating soon and on the hunt for a job. They offered tips on how to communicate and how to ask questions. I learned that even the little things that seem so straightforward and obvious need to be executed effectively to obtain maximum result. Additionally, there was a portion of the session dedicated to developing a personal “bumper sticker” which is essentially a snapshot of who you are. I realized during this part of the session that I tend to talk in circles when I am introducing myself to people. It is so important that these introductory phrases are clear, concise, but are still effective in engaging the other person, highlighting your assets, and allowing for further follow up questions. I am so glad that I attended this session because it provided me with tips and tricks for becoming a more competitive applicant in the job pool.”


Margaret Wayne, MPH Candidate
Climate Changes Children’s Health

“Choosing which session to write about was ten times harder than choosing which presentations to attend. I finally settled on the one I enjoyed the most, which I also almost did not attend. Climate changes children’s health: The role of the Pediatric Environmental Specialty Unit Network in addressing these issues. I have very little interest in environmental health, but had not attended any sessions that corresponded to the theme of the conference and have an interest in children’s health. My feet were killing me, and this room happened to be the closest of the three I was interested in, and at a networking event, I had been encouraged to attend something that may not be my main focus.

The session began with a brief history of the Pediatric Environmental Health Specialty Units (PEHSUs). PEHSUs focus on case management to promote equality for children. They provide information to key providers (doctors, teachers, nurses, parents, community groups) to help promote the health of children through healthy environments. There is a focus on environmental justice, which is the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income, with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies. 

This has a dramatic impact on maternal and child health, with poor mothers more likely to have preterm births; limited access to fresh food and decreased green space results in obesity; and asthma rates are significantly higher in low socioeconomic status populations. Children are twice as likely to have asthma and three times as likely to die from asthma related complications if they live in urban areas. Older homes and older schools mean children are three times as likely to be exposed to lead. Even climate change killing crops is limiting the supply of healthy foods, driving up costs, and further limiting access. Many of these risk factors are the result of the built environment, and most can be corrected through utilization of the proper resources and advocacy. There is a cycle of poverty and environmental injustice that needs to be broken. PEHSUs are trying to end it through education, advocacy, and outreach, and so should we.

To make a change, you have to learn about the issue and what resources you have to enact change. To learn, you have to be present. I learned that health problems can be addressed in a whole host of unique ways, but the most important is being present.”