This case study describes the design, implementation, and evaluation of an initiative to increase COVID-19 vaccine confidence and uptake among refugee and immigrant women in Clarkston, Georgia. Applying the principles and practices of human-centered design, Mothers x Mothers was co-created by Refugee Women\'s Network and IDEO.org as a series of gatherings for refugee and immigrant mothers to discuss health issues, beginning with the COVID-19 vaccine. The gatherings included both vaccinated and unvaccinated mothers and used a peer support model, with facilitation focused on creating a trusting environment and supporting mothers to make their own health decisions. The facilitators for Mothers x Mothers gatherings were community health workers (CHWs) recruited and trained by Refugee Women\'s Network. Notably, these CHWs were active in every phase of the initiative, from design to implementation to evaluation, and the CHWs\' professional development was specifically included among the initiative\'s goals. These elements and others contributed to an effective public health intervention for community members who, for a variety of reasons, did not get sufficient or appropriate COVID-19 vaccine information through other channels. Over the course of 8 Mothers x Mothers gatherings with 7 distinct linguistic/ethnic groups, 75% of the unvaccinated participants decided to get the COVID-19 vaccine and secured a vaccine referral.

BACKGROUND: Few validated brief scales are available to measure constructs that may hinder mpox-related prevention and care engagement, such as knowledge and stigma. Both are highly salient barriers to infectious disease care and disease understanding, precursors to evaluating one\'s risk and need to, for example, accept vaccination. To address this gap, we developed and validated the Mpox Stigma Scale (MSS) and Mpox Knowledge Scale (MKS).
METHODS: As part of a full-scale clinical trial, we offered an optional mpox survey to participants who self-identified as African American or Black, were 18-29 years old, and lived in Alabama, Georgia, or North Carolina (2023, N = 330). We calculated psychometric properties through confirmatory factor analyses (CFA) and applied Comparative Fit Index (CFI), Goodness of Fit Index (GFI), and Tucker-Lewis Index (TLI) values equal to or exceeding 0.90 and Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Square Residual (SRMR) values less than 0.08 to determine adequate model fit. We computed internal reliability using Cronbach\'s alpha and calculated Pearson or Spearman correlation coefficients between the MSS and MKS and related variables.
RESULTS: For the MSS, CFA results showed that the one-factor model fit the data well (χ2(df = 5, N = 330) = 34.962, CFI = 0.97, GFI = 0.99, TLI = 0.94, RMSEA = 0.13, SRMR = 0.03). For the MKS, the one-factor model provided a good fit to the data (χ2(df = 6, N = 330) = 8.44, CFI = 0.99, GFI = 0.99, TLI = 0.95, RMSEA = 0.15, SRMR = 0.02). Cronbach\'s alphas were MSS = 0.91 and MKS = 0.83, suggesting good to excellent reliability. The MSS was correlated with the MKS (r = .55, p < .001), stigmatizing attitudes (r = .24, p < .001), attitudes towards mpox vaccination (r=-.12, p = .030), and worry about contracting mpox (r = .44, p < .001). The MKS was correlated with worry about contracting mpox (r = .30, p < .001) and mpox disclosure (r=-.16, p = .003).
CONCLUSIONS: The MSS and MKS are reliable and valid tools for public health practice, treatment and prevention research, and behavioral science. Further validation is warranted across populations and geographic locations.
BACKGROUND: ClinicalTrials.gov NCT05490329.

UNASSIGNED: Rural patients have poor cancer outcomes and clinical trial (CT) enrollment compared to urban patients due to attitudinal, awareness, and healthcare access differential. Knowledge of cancer survival disparities and CT enrollment is important for designing interventions and innovative approaches to address the stated barriers. The study explores the potential disparities in cancer survival rates and clinical trial enrollments in rural and urban breast and lung cancer patients. Our hypotheses are that for both cancer types, urban cancer patients will have longer 5-year survival rates and higher enrollment rates in clinical trials than those in rural counties.
UNASSIGNED: We compared breast and lung cancer patients\' survival rates and enrollment ratios in clinical trials between rural (RUCC 4-9) and urban counties in Georgia at a Comprehensive Cancer Center (CCC). To assess these differences, we carried out a series of independent samples t-tests and Chi-Square tests.
UNASSIGNED: The outcomes indicate comparable 5-year survival rates across rural and urban counties for breast and lung cancer patients, failing to substantiate our hypothesis. While clinical trial enrollment rates demonstrated a significant difference between breast and lung cancer patients at CCC, no significant variation was observed based on rural or urban classification.
UNASSIGNED: These findings underscore the need for further research into the representation of rural patients with diverse cancer types at CCC and other cancer centers. Further, the findings have considerable implications for the initiation of positive social change to improve CT participation and reduce cancer survival disparities.

OBJECTIVE: We investigated the role of serum 25(OH)D (25-hydroxyvitamin D) in COVID-related health outcomes.
METHODS: We conducted a retrospective cross-sectional study using data of the National Center of Disease Control and Public Health, Georgia. We extracted patient data including length of hospital stay, transfer to the intensive care unit, requirement for oxygen therapy, treatment with glucocorticoids, and symptoms. After obtaining written informed consent, 384 individuals were enrolled. We divided participants into three groups according to 25(OH)D levels: group 1 = 25(OH)D <12 ng/mL (n = 83), group 2 = 25(OH)D 12-20 ng/mL (n = 141), and group 3 = 25(OH)D >20 ng/mL (n = 160).
RESULTS: The odds ratio (OR) for hospitalization in group 1 versus group 2 was 8.7 (95% confidence interval [CI] 3.6-21.3) and 5.6 for group 1 versus 3 (95% CI 2.7-11.9). Regarding oxygen therapy, OR = 28.41 for group 1 versus 2 (95% CI 3.7-220.5) and OR = 5.2 for group 1 versus 3 (95% CI 1.9-14.1). Regarding treatment with glucocorticoids, OR = 3.7 for group 1 versus 2 (95% CI 1.1-12.5) and OR = 8.4 for group 1 versus 3 (95% CI 1.8-40.7).
CONCLUSIONS: COVID-19-related morbidity was associated with decreased serum 25(OH)D levels. Future studies should investigate the potential role of vitamin D sufficiency in preventing SARS-CoV-2 infection and mortality.

This study aims to quantify the effectiveness of lockdown as a non-pharmacological solution for managing the COVID-19 pandemic. Daily COVID-19 death counts were collected for four states: California, Georgia, New Jersey, and South Carolina. The effectiveness of the lockdown was studied and the number of people saved during 7 days was evaluated. Five neural network models (MLP, FFNN, CFNN, ENN, and NARX) were implemented, and the results indicate that FFNN is the best prediction model. Based on this model, the total number of survivors over a 7-day period is 211, 270, 989, and 60 in California, Georgia, New Jersey, and South Carolina, respectively. The coefficients and weights of the FFNN for each state differ due to various factors, including socio-demographic conditions and the behavior of citizens towards lockdown laws. New Jersey and South Carolina have the most lockdowns and the least.

Collaborations are critical to address rural health challenges. We evaluated a new international collaboration between institutions in Georgia, the United States (US), and Scotland, United Kingdom (UK), to address rural health issues and to understand the barriers and facilitators to effective international collaboration efforts. A qualitative approach was used through in-depth interviews and focus groups with educators, researchers, and healthcare providers in the US and Scotland who were involved in the CONVERGE international rural health collaboration. Transcriptions were imported into the NVivo qualitative software program. A reflexive thematic analysis was employed to identify key themes from the collected data. Twelve interviews and two focus groups were conducted virtually with 17 participants. Two primary domains were identified from the thematic analysis: (1) motivators that increase engagement in international collaboration, and (2) mechanisms for, and barriers to, the continuity needed to create meaningful change. Six themes emerged related to commonality of issues, prospect of sharing knowledge, need of sustained funding and institutional support, and selection of human resources. Participants of CONVERGE were more likely to engage when they had a space to share ways to address challenging issues and integrate knowledge and practice. They were motivated by their desire for growth and the institutions they serve and emphasized that infrastructure support is vital for sustainable collaborations.

Objective: Although there are many international college students in the state of Georgia, few studies have been conducted on how social determinants affect their health outcomes and academic success. This study examined the effects of social determinants on the health outcomes and academic success of international college students in Georgia. Participants: Participants were international college students (n = 136) in Georgia. Methods: A mixed methods cross-sectional design was used for the study. Results: The lack of access to sufficient funds caused study participants to experience anxiety (39.0%), depression (20.6%), and stress (52.9%). Cultural differences (16.9%), lack of access to health care (15.4%), transportation (14.7%), poor housing (7.4%), and financial insecurity (54.5%) affected study participant health outcomes and academic success. Conclusion: Addressing financial insecurity, the lack of access to health care, poor housing, transportation issues, and cultural differences experienced by international college students in Georgia, is crucial to their health outcomes and academic success.

BACKGROUND: Decision-making is a complex process that relies on situational awareness and experience to create a potential list of actions while weighing the risks and benefits of each action. There is a paucity of data evaluating decision-making for individual service members (SM) during the performance of team-based military-relevant activities. Understanding individual performance and decision-making within the context of a team-based activity has potential to aid in the detection and management of mild traumatic brain injuries and assist with safe and timely return-to-duty decision making. The aim of this project was to evaluate cognitive and motor performance in healthy SM during an augmented reality military specific, team-based activity.
METHODS: Data from 110 SMs from Fort Moore Georgia were analyzed for this project. Service members completed 3 augmented reality room breaching and clearing scenarios (Empty Room, Civilian/Combatant, and Incorrect Position of a unit member) with 3 avatar team members. Participants wore a Microsoft HoloLens 2 (HL2) device and used a replica M4 weapon (Haptech Defense Systems) during scenarios. Three-dimensional position data from the HL2 headset was used to compute temporal measures of room breaching and clearing events while the number and timing of weapon discharge was monitored by the M4. Temporal outcomes included time to enter room, time to fire first shot, time in fatal funnel, and total trial time while motor outcomes were distance traveled and average movement velocity.
RESULTS: Pairwise comparisons between the Incorrect Position scenario and the Civilian/Combatant scenario demonstrated no difference in time to enter the room (2.36 seconds in both scenarios). Time to fire the first shot in the Civilian/Combatant scenario was longer (0.97 seconds to 0.58 seconds) while time in fatal funnel (2.58 seconds to 3.31 seconds) and time to trial completion (7.46 seconds to 8.41 seconds) were significantly longer in the Incorrect Position scenario.
CONCLUSIONS: Reaction time to fire the first shot, time in the fatal funnel, and total trial time reflect a change in information-processing and decision-making capabilities during military specific, ecological, team-based scenarios when altering the environment inside of the room and modifying avatar movements. Future studies are planned to evaluate the effects of mild traumatic brain injury on specific aspects of military team performance.

The United States grapples with over 30,000 new HIV infections annually, a challenge exacerbated by delayed diagnosis and treatment. HIV stigma hinders data collection and contributes to health disparities. High-quality data and a community-driven approach are critical to reducing these disparities. The collaborative effort of the Satcher Health Leadership Institute at Morehouse School of Medicine, and the Center for Minority Health and Health Disparities Research and Education at Xavier University of Louisiana, addresses systemic barriers perpetuating the HIV epidemic in Georgia and Louisiana. We influence policy, implement an HIV education curriculum, map resources, and display data via the Health Equity Tracker. Stigma surrounding HIV/AIDS impedes disclosure, creates data gaps, and affects care quality and access. Addressing these data gaps, influencing policy, and implementing education are crucial steps to improving outcomes for Black people living with HIV/AIDS. This framework aligns with the federal Ending the HIV Epidemic program\'s goals, advancing health equity for vulnerable populations.

BACKGROUND: Children of Black immigrant parents living in the US are at elevated risk of being overweight or obese, thus increasing their risks of morbidity and mortality as they age. Parents play a crucial role in shaping their children\'s nutrition through their food parenting practices. The Social Cognitive Theory (SCT) can explain Black immigrant mother\'s FPP and their children\'s dietary behavior. This study aimed to assess SCT\'s constructs, personal (maternal knowledge, attitudes, beliefs) and environmental factors (acculturation) in relation to the behavioral factor (food parenting practices) among a sample of Black immigrant mothers living in Metro Atlanta, Georgia.
METHODS: Convenience sampling was employed to recruit 30 Black immigrant mothers who lived in seven Metro Atlanta, Georgia counties in the summer of 2022. Four focus group interviews were conducted over two weeks. The qualitative data analysis was thematic.
RESULTS: Focus group data analysis revealed seven major themes: knowledge, attitude, belief, modeling, acculturation, coercive control, and structure, and six subthemes. Mothers discussed being intentional about encouraging healthy foods and limiting unhealthy foods for their children. Overall, acculturation influenced mothers\' food parenting practices. Since migrating to the US, some mothers\' nutrition changed in positive (e.g., eating more fruits) and negative ways (e.g., snacking more) because of schedules, cost, and access. Children ate a mixed diet, the mother\'s native diet and the American diet, and the former was considered healthier and affordable by most.
CONCLUSIONS: This is the first study to look at the food parenting practices of Black immigrants in the US. By identifying key factors that influence the food parenting practices of this population and their children\'s dietary habits, this study\'s findings are useful to practitioners or researchers who work with this population on nutrition.