Research

The EPRC has a strong history of evaluating community coalitions to address chronic diseases and their risk factors. While these coalitions have successfully worked to reduce unhealthy behaviors such as tobacco use within North America they have generally not been applied in low- and middle-income countries (LMICs). Local public health in many LMIC’s focuses heavily on communicable disease and environmental health, with less attention paid to non-communicable disease and risk factors such as tobacco use. This is particularly important for countries with high rates of smoking and secondhand smoke exposure such as Georgia and Armenia.

The Georgia and Armenia Teams for Healthy Environments and Research (GATHER) study represents an effort to:

1. Build capacity for these countries to conduct high-quality mixed methods tobacco research
2. Test the Community Coalition Action Theory as a framework for impacting local community-driven policy change

Partners from the Georgia National Center for Disease Control and Armenia National Institute of Health have collaborated with the EPRC and George Washington University to train practitioners within local communities to build coalitions for tobacco control policy. To date, 14 community-based multi-sectoral coalitions have conducted situational analyses, and developed and implemented action plans to promote smoke-free environments. Data collection for this community randomized trial includes population-based surveys, coalition member surveys, document review and key informant interviews. Data analysis is underway and results will be available soon. Findings will serve as a catalyst for future action-oriented science and evidence-based practice to support tobacco control progress in this region and broadly.

Despite the growing number of evidence-based cancer prevention and control interventions and strategies to reduce the burden of cancer, most are not well adopted in local communities. The Emory CPCRN will increase the translation of cancer and HPV vaccine evidence into local communities. Wider use of effective interventions can significantly reduce cancer morbidity and mortality.

The Emory CPCRN has 6 inter-related aims and will:

1. Maintain and strengthen the Emory CPCRN infrastructure to support and enhance capacity-building for cancer prevention and control and implementation science research and practice at Emory and in rural communities across Georgia;
2. Cultivate and strengthen partnerships with communities, public health agencies, community-based organizations, and cancer control research and practice networks to promote community-based participatory approaches to preventing cancer and reducing health disparities;
3. Conduct national and local trainings to build capacity on adoption and implementation of evidence-based approaches in collaboration with our Southwest GA partners and regional cancer coalitions;
4. Assess factors related to HPV vaccination using the P3 (Practice, Provider, and Patient-Level) model to inform intervention development through a qualitative study in Southwest Georgia;
5. a. Evaluate a multi-level intervention employing implementation strategies of mini-grants and technical assistance on HPV vaccine series initiation and completion among clinical and community organizations in SW Georgia; b. Assess implementation outcomes and factors related to implementation success using the Consolidated Framework for Implementation Research (CFIR) through a mixed-methods study; and
6. Disseminate and translate research findings to local, regional and national cancer control researchers and practitioners.

The Emory CPCRN proposed aims will enhance the capacity of clinical and community organizations in Southwest Georgia and the state through training, research and dissemination efforts. We will contribute a model for testing intervention strategies for clinical and community organizations to adopt evidence-based interventions for increasing HPV vaccination rates.

Aim 5a & 5b: HPV Mini-Grants Program (June 2022-current)
HPV Vaccination Toolkit: This toolkit contains a collection of evidence-based strategies to improve HPV vaccination rates using a multi-level approach. This toolkit was developed for the purpose of the HPV Vaccine Mini-grants Program run by Emory CPCRN. The purpose of the program was to implement a multi-level intervention using evidence-based strategies to promote and increase HPV vaccination rates in rural communities.

The Emory Prevention Research Center and Emory CPCRN provides funding and technical assistance to community organizations and health systems who offer the HPV vaccine in Southwest Georgia.

Emory CPCRN will evaluate the implementation of the multi-level intervention at each mini-grant recipient site. Sites can range from pediatric, family medicine, or internal medicine practices to university health centers, health departments or other public and private health clinics. Recipients receive funding up to $10,000 to support HPV vaccination delivery program expenses and receive assistance from Emory CPCRN staff in conducting their program. The multi-level intervention will include 2 out of the 3 levels (patient or caregiver; provider; or health system) for education, training, or organizational change. After the year, we will assess changes in HPV vaccination rates and barriers and facilitating factors related to implementation of the multi-level intervention.

The CPCRN is supported by the Division of Cancer Prevention and Control in CDC. The 4 funded sites are: Baker, Dougherty, Mitchell, and Seminole County Health Departments. The sites can choose evidence-based strategies to promote vaccination at 2 of 3 levels: patient, provider, or practice level. Emory Rollins School of Public Health is providing a Min-grants Program toolkit, and technical assistance in their implementation. The principal investigator is Dr. Cam Escoffery and the Program Director is Courtney Petagna, MPH. Emory CPCRN is excited to work with all of these sites to increase HPV vaccination in southwest Georgia.

SIP24-008 Managing Epilepsy Well (MEW Coordinating Center)

Co-Principal Investigators: Cam Escoffery, PI (Emory University), Elaine Kiriakopoulos and Barbara Jobst, MPI (Dartmouth-Hitchcock)

The Managing Epilepsy Well (MEW) network is a thematic research network dedicated to improving quality of life and wellbeing for individuals living with epilepsy. Our current funding cycle is comprised of several collaborating centers: Emory Prevention Research Center and Dartmouth-Hitchcock Medical Center (coordinating center), Arizona Prevention Research Center, and NYU-CUNY Prevention Research Center. The MEW Network will continue to collaborate with previous MEW Network sites including University of Washington and Case Western Reserve University. The MEW Network works close with and collaborates with the Epilepsy Foundation, American Epilepsy Society, and other community epilepsy organizations.

The mission of the MEW Network is to advance the science related to epilepsy self-management by facilitating and implementing research, conducting research in collaboration with network members and community stakeholders, and broadly disseminating research findings. Emory University and Dartmouth-Hitchcock are actively working on evaluating the cost-effectiveness and evaluation of implementing two evidence-based self-management programs: 

• HOBSCOTCH: A one-on-one coaching program that helps individuals with epilepsy improve their cognitive function and quality of life.
• Project UPLIFT: A group-based program that empowers individuals with epilepsy to manage their mental health through mindfulness and cognitive-behavioral techniques.

For more information, visit the Managing Epilepsy Well Network website.

The goal of Vax Up! Southwest Georgia is to conduct and evaluate an applied public health project that refines the communities of focus; diagnoses social and behavioral drivers of vaccine uptake; and designs, implements, and scales up effective interventions to increase vaccine confidence and uptake in the 24-county region of Southwest Georgia. Building on a 17-year partnership between Emory University and key stakeholders in Southwest Georgia, the EPRC is poised to join the national network of academic, public health, and community partners to work together to implement behavioral interventions to increase uptake of COVID-19 vaccines, especially among communities disproportionately affected by COVID-19. By participating in the Connecting Behavioral Science to COVID-19 Vaccine Demand (CBS-CVD) network, the proposed project aligns with the mission of the EPRC, which includes a goal to reduce health disparities in rural Georgia and beyond. The priority population of this project is Non-Hispanic Black persons and those living in rural communities. This project will be conducted in three overlapping phases over the 12-month period, April 15, 2021-April 16, 2022:

• Phase I Collect Data for Action: We started by expanding our current work group to include members of the relevant county health departments and others. A survey of COVID-19 Vaccine opinions was distributed electronically to community members starting in March and April 2021 to 138 survey participants. Additionally, 35 participants (including 16 who took part in the initial survey) also participated in follow-up key informant interviews to further understanding of the barriers and facilitators of vaccine confidence and uptake. The qualitative and quantitative data were used to develop a training manual for natural helpers. This manual sought to build on the existing CDC vaccine toolkit curricula.
• Phase II Build Evidence Base on Solutions to Increase Vaccine Confidence and Uptake: We will conduct three natural helper trainings, one in each of three regions of our catchment area. Each training will prepare approximately 20 natural helpers to deliver tailored educational outreach, schedule vaccination appointments, follow-up with community members, and document their work. The natural helpers will be deployed in a phased manner and supported through monthly update sessions that support their effectiveness and ability to make mid-course corrections in their approach.
• Phase III Evaluate Solutions and Strengthen Community Engagement: Our process evaluation will monitor fidelity to the intervention protocol (via an Event Form that is submitted electronically at the conclusion of each event) and Community Member Follow-up Form that is used to overcome barriers to appointment adherence (to both first and second doses as needed). The outcome evaluation will monitor vaccination uptake among those reached by the intervention as well as county-level vaccine rates.

The BreatheEasy Georgia Homes Program aims to reduce secondhand smoke exposure in multiunit housing in Georgia by supporting and recognizing apartment communities that implement smoke-free policies. The program provides resources and technical assistance to apartment communities interested in adopting a smoke-free policy at their property(ies), and provides free BreatheEasy Smoke-free Recognition to those that adopt a policy. The Emory Prevention Research Center coordinates the BreatheEasy Georgia Homes Program in partnership with the Georgia Department of Public Health, the Atlanta Apartment Association, and other public health and housing stakeholders committed to promoting smoke-free homes for Georgia residents. This includes an active Learning Community of partners across the state who disseminate BreatheEasy resources in their local communities. Read more about the program and view all of the available resources for apartment owners, managers, and residents, including a listing of recognized smoke-free properties, on the BreatheEasy GA Homes website: http://breatheeasygahomes.org/

(coming soon)

(coming soon)