Joseph Telfair

Georgia Southern University (College of Public Health) · (Dual) Community Health Behavior and Education;Environmental Health Sciences

Background Due to the challenges created by the COVID-19 pandemic, the public health field has an exceptional opportunity not only to address current challenges but also to rebuild and expand the workforce. Objectives The main objective of this presentation is to highlight the 2018-2022 academic year's progress of the practice-based learning exper...

Perinatal mental illness pertains to pregnancy-related mental health complications, which could last as long as one year post-delivery. Despite the high prevalence of PMI, there remains a poor accessibility and utilization of mental health services, especially in the rural America. Hence, using the Social Ecological Model (SEM), we aim to identify...

Objective To translate, cross-culturally adapt and validate the Sickle Cell Self-Efficacy Scale for application in the Brazilian cultural context. Methods This is a methodological study performed in 6 steps: 1- Forward translation; 2- Translation synthesis; 3- Back-translation; 4- Assessment by expert committee, with computation of the Content Val...

Objective: The primary aim of this study was to investigate whether students in minority race categories are more likely to experience race-related bias and hatred in their lifetime and since the onset of COVID-19, after controlling the effect of demographic and other variables. Methods: This quantitative study used primary data from the survey...

Background: Sickle cell disease (SCD) is an autosomal recessive blood disorder affecting approximately 100,000 Americans and 3.1 million people globally. The scarcity of relevant knowledge and experience with rare diseases creates a unique need for cooperation and infrastructure to overcome challenges in translating basic research advances into cl...

Background: Almost one-third of US adults (29%) have a tattoo, and almost half (47%) of millennials reported having a tattoo. With more people getting tattoos, there is an increased risk of infectious diseases, skin infections, and allergic reactions. Tattoo artists can influence these health risks with their standards of practice, tattoo inks, and...

BACKGROUND Almost one-third of U.S. adults (29%) have a tattoo, and almost half (47%) of millennials reported having a tattoo. With more people getting tattoos, there is an increased risk for infectious diseases, skin infections, and allergic reactions. Tattoo artists can influence these health risks with their standards of practice, tattoo inks, a...

Instrumentation with established reliability and validity is not yet routinely utilized to assess readiness for transition from pediatric to adult care for youth and young adults with chronic conditions, including sickle cell disease (SCD). The aim of this study was to develop a SCD specific readiness for transition assessment tool. Fifty-seven you...

Theories of self-care management, particularly the development of self-efficacy or confidence in one's ability to manage health-related goals, tasks, and challenges may provide a useful framework for developing programs to improve transition from pediatric to adult care for youth and young adults with sickle cell disease (SCD). The aim of this stud...

Health disparities exist among individuals living in rural and urban contexts in terms of access to health care and overall mortality. These disparities are typically greater for youth with disabilities living in rural areas, who face additional barriers in receiving health and support services specific to their disability. Parents are typically th...

This study aimed to examine insurance coverage, use of the healthcare system, satisfaction with care, transition from pediatric to adult healthcare services, and social and emotional support for individuals with genetic conditions. In June 2013, the National Genetics Education and Consumer Network surveyed US individuals with genetic conditions abo...

Purpose: The purpose of this qualitative study was to explore rural/urban differences in service providers’ perceptions of challenges and facilitators to services for children with special health care needs (CSHN) and their families in southeast Georgia. Methodology: A total of 23 individual interviews were conducted with service providers in one r...

Background: Schools are required to provide students with disabilities a free and appropriate education. At the age of 22, youth with disabilities must transition out of the school system into their community. The purpose of this study was to explore service provider’s perspectives of transition in rural and urban communities in Georgia. Methods: T...

Background: Children with disabilities and their families face a variety of barriers in accessing services throughout their lifespan. The purpose of this study was to explore rural/urban differences in barriers and facilitators of services for youth with disabilities and their families in southeast Georgia. Methods: Twenty in-depth interviews (N=...

Purpose: The lack of an ongoing surveillance system for hemoglobinopathies in the United States impedes the ability of public health organizations to identify individuals with these conditions, monitor their health-care utilization and clinical outcomes, and understand the effect these conditions have on the health-care system. This article descri...

A growing body of literature addresses the need for transition programs for young adults with sickle cell disease (SCD); however, studies assessing transition readiness are limited and there are few validated instruments to use. To conduct a pilot study to assess transition readiness of patients with SCD in our transition program and to evaluate a...

A review of the current literature on the relationship between health outcomes and level of education provides points for consideration by providers and policymakers wishing to address social and economic determinants of health and health disparities.

The purpose of this presentation is to provide for discussion, a brief overview of Human Rights issues affecting children in child-headed households.

Introduction: Sickle Cell Disease is one of the most common genetic disorders in the United States, affecting approximately 89,000 individuals. Efforts have been made to provide educational materials for individuals with SCD, focused primarily on early childhood. However, little is known about the actual use of these existing materials and the perc...

The challenges of child-headed households, as part of the broader issue of child and family poverty, result from a myriad of adverse events including HIV/AIDS mortality among adults, violent conflict, mal-distribution of resources, lack of social and structural support for families and so forth. While programs and services to address these challeng...

Program evaluation is an important tenet of public health education and health promotion. Existing in many different forms, the knowledge gained by evaluation is used to inform current and future health practices, policy decisions and programmatic funding. In recent years, there has been a growing recognition that current frameworks are only assess...

Sickle cell disease (SCD), the most common genetic disease screened for in the newborn period, occurs in ∼1 in 2400 newborns in the general population and 1 in 400 individuals of African descent in the United States. Despite the relative high prevalence and low pediatric mortality rate of SCD when compared with other genetic diseases or chronic dis...

There are many issues surrounding the screening of collegiate athletes for their sickle cell disease carrier status (or sickle cell trait), a genetic condition. This paper summarizes the establishment of expert advice given to the Secretary's Advisory Committee on Heritable Disorders in Newborns and Children (SACHDNC) on the issue. The SACHDNC has...

Sickle cell disease (SCD) is a chronic, lifelong illness affecting the lives of millions from birth through adulthood. Individuals with SCD require care and vigilance from specialized medical professionals to ensure the possibility of full and productive lives. However, in times of crisis, persons with SCD often face systemic issues in emergency ca...

The objective was to present the 'voice' of adolescents with sickle cell disease (SCD) as part of the discussion of transition issues by identifying and documenting their expressed concerns and expectations, as well as what program priorities they perceive would facilitate a smooth transition to adult care. Cross-sectional data were collected by me...

Knowledge and Perceptions of Couples' VCTa by Cohabitation, Education, and Gender among Lusaka Respondents. (DOC)

Demographic Profile, Knowledge and Perceptions of Couples' VCTa in Intervention and Control Neighborhoods. (DOC)

Knowledge and Perceptions of Couples' VCTa by Cohabitation, Education, and Gender among Kigali Respondents. (DOC)

Most incident HIV infections in sub-Saharan Africa occur between cohabiting, discordant, heterosexual couples. Though couples' voluntary HIV counseling and testing (CVCT) is an effective, well-studied intervention in Africa, <1% of couples have been jointly tested. We conducted cross-sectional household surveys in Kigali, Rwanda (n = 600) and Lusak...

Transition of young adults with sickle cell disease (SCD) from pediatric to adult medical care is an important priority, given medical advances that have transformed SCD into a lifelong chronic condition, rather than a disease of childhood. Successful transfer from pediatric to adult care has its foundation in collaboration among the young adult, t...

To assess the lay public's knowledge of, and beliefs about, genetics and genetic testing to create an educational initiative that promotes acceptance and utilization of genomic medicine in primary health care. A telephone survey of English-speaking adults in Guilford County, North Carolina was conducted in 2006 to identify community members' educat...

NBS Program: In 2002, Sickle Cell Disease Association of America (SCDAA) and the Maternal and Child Health Bureau (MCHB) of HRSA began a joint 6-year effort entitled the National Sickle Cell Disease and Newborn Screening Program (SCD NBS). The program participants are 17 hospitals, community (CBOs) and state grantees and one National Coordinating C...

In 2005, 31.2% of Alabama adults had been told they had high blood pressure, compared to 25.5% for the U.S. The proportion of African-American in Birmingham is 73.5%. It follows that the city will have a higher rate of stroke risk factors than reported for the state. Specifically in Alabama, 32.6% African-Americans had high blood pressure, a major...

This descriptive study was intended to identify actual actions, steps and processes of Children with Special Health Care Needs (CSHCN) programs to develop, implement, sustain and assess culturally and linguistically competent policies, structures and practices. An online 52-item mixed format survey of Maternal and Child Health (MCH) CSHCN directors...

The US Secretary of Health and Human Services' Advisory Committee on Heritable Disorders and Genetic Diseases in Newborns and Children provides guidance to reduce the morbidity and mortality associated with heritable disorders, with a special emphasis on those conditions detectable through newborn screening. Although long-term follow-up is necessar...

In Zambia the HIV/AIDS epidemic has resulted in many single female-headed households. Strong patriarchal laws and customs prevent widows and children from maintaining economic assets. This study examines the impact of a video-based motivational intervention promoting future planning in 1,504 HIV-infected couples in Lusaka, Zambia. Following a group...

The psychometric properties of a disease-specific instrument used to assess self-efficacy in adolescents with sickle cell disease, the Sickle Cell Self-Efficacy Scale, were evaluated in a sample of 131 adolescents ranging from 11 to 19 years of age. This nine-item instrument was associated with a one-item, general self-efficacy question and an item...

Most new HIV infections in Africa are acquired from cohabiting heterosexual partners. Couples' Voluntary Counselling and Testing (CVCT) is an effective prevention strategy for this group. We present our experience with a community-based program for the promotion of CVCT in Kigali, Rwanda and Lusaka, Zambia. Influence Network Agents (INAs) from the...

Provision of "culturally competent" medical care is one of the strategies advocated for reducing or eliminating racial and ethnic health disparities. This report identifies five domains of culturally competent care that can best be assessed through patients' perspectives: 1) patient–provider communication; 2) respect for patient preferences and sha...

This document explores the opportunity for scholarship to enhance the evidence base for academic public health practice and practice-based research. Demonstrating Excellence in Practice-Based Research for Public Health defines practice-based research; describes its various approaches, models, and methods; explores ways to overcome its challenges; a...

Purpose: Effective communication between physicians and adolescents is critical to convey health information, provide counseling and identify emerging health problems. This article addressed two questions: (a) After an adolescent enrolls in a State Children's Health Insurance Program (SCHIP), is there a change reported in communication between the...

The purpose of the present study is to assess how the severity of a child's condition affects family functioning and the relationship with health care providers among children with special health care needs in Alabama. Using the data from the National Survey of Children with Special Health Care Needs (CSHCN), three variables were used as measures o...

Adolescents with sickle cell disease may have problems of adjustment during the phase of transition from pediatric to adult health care. It is important to identify factors that may help in the development of appropriate interventions. We were interested in possible similarities, in terms of adjustment to transition in two countries where health se...

Assuring quality health care for the diverse U.S. adolescent population is a subject of growing concern among health-care providers and policy makers. Health-care services and policies must appreciate that experiences of adolescents with special health-care needs include challenges that stretch beyond those unique to their conditions to include rel...

Interviews with leaders of community-based health initiatives help define meaningful evaluation in contexts in which communities are called on to contribute consent, resources, or participation in program development and research.

Until recently, few children with chronic illnesses such as sickle cell disease (SCD) lived past late adolescence. Substantial reductions in mortality mean a growing number of adolescents with SCD reach adulthood. Consensus among researchers and health care providers (HCP) from multiple disciplines is that critical attention to and more empirical r...

This study examined relationships between socioeconomic factors and the geographic distribution of 662 cases of sickle cell disease in Alabama in 1999-2001. Measures of community distress, physical functioning, and medical problems were used in analyzing utilization differences between individuals with sickle cell disease living in urban and rural...

This article summarizes the psychometric evaluation of the Chronic Illness Assessment Interview for Sickle Cell Disease (CIAI-SCD), an instrument based on a model of self-care for adult patients with chronic medical conditions. The CIAI-SCD was administered to 104 adults with sickle cell disease. A factor analysis identified three factors that refl...

The present study prospectively investigated the role of self-efficacy in predicting disease symptomatology and health services utilization for adult patients with sickle cell disease. These data are derived from a 12-month prospective cohort study of African American adults with sickle cell disease. Disease-specific perceptions of coping self-effi...

Research on sickle cell disorder has not focused attention on the socioeconomic background and geographic distribution of people with the disease. This study examines 1,189 persons with sickle cell disorder in North Carolina during 1991 to 1995. Three indices were developed using clients' medical, psychosocial and socioeconomic characteristics for...

The psychometric properties of a new, 9-item scale measuring disease-specific perceptions of self-efficacy were investigated in a community-based sample of adults (N = 83) with sickle cell disease (SCD). The Sickle Cell Self-Efficacy Scale (SCSES) was comprised of nine questions relating to participants' perceptions of their ability to function on...

To examine whether psychosocial factors play a more important role than biomedical risk factors in predicting adolescent adaptation to sickle cell disease (SCD); to determine whether psychosocial factors moderate the relationship between biomedical risk factors and adaptation. Ninety African American adolescents from the multisite Cooperative Study...

A trend in community-based evaluation studies is to include everyone affected by the work, the community, administrators and participants, in their design and implementation. This concept has been accepted by communities and community evaluators, but a concern persists that the scientific integrity, reliability, and validity of these studies are co...

Support groups have the potential to mitigate some of the developmental and condition-specific psychological and social issues common to sickle cell disease (SCD), yet little is known about how adolescents with SCD view and use these groups. As part of a larger study, 79 adolescents with SCD completed questionnaires assessing reasons for attending...

Research on sickle cell disorder has not focused attention on the socioeconomic background and geographic distribution of people with the disease. This study examines 1,189 persons with sickle cell disorder in North Carolina during 1991 to 1995. Three indices were developed using clients' medical, psychosocial and socioeconomic characteristics for...

A trend in community-based evaluation studies is to include everyone affected by the work, the community, administrators and participants, in their design and implementation. This concept has been accepted by communities and community evaluators, but a concern persists that the scientific integrity, reliability, and validity of these studies are co...

The success of a community-based program evaluation can be enhanced by using a screening tool to delineate the program's evaluative needs, resources, and commitments.

How to engage local program stakeholders meaningfully in evaluation is a continuing challenge for many community-based program evaluators. Lessons learned from a Smart Start evaluation in North Carolina are offered.

There has been little systematic study of the impact of support groups on the psychological well-being (PWB) of adolescents with sickle cell disease (SCD). Questionnaires, administered by group leaders of 12 SCD support groups, were completed and returned from 79 (80%) of the 99 African American adolescent SCD support group members recruited into t...

This study examined whether multidisciplinary health care providers (HCPs) perceived race of persons with sickle cell disease (SCD) as an influence in the delivery of health care. A total of 227 multidisciplinary HCPs completed the three-item Influence of Patient Race on Provision of Health Care Services Index (Cronbach's alpha = 0.77). Results sug...

There are no empirical studies which access the transfer needs/concerns of adolescents and young adults with sickle cell disease (SCD) and their primary caretakers. The overall purpose of this research was to determine the issues, concerns, and expectations of adolescents, young adults and primary caretakers with regard to transfer to adult care. P...

This paper focuses on the psychological and social factors that influence the adjustment process of children and adolescents with chronic conditions, primarily sickle cell disease. A review of the literature will reveal that psychological variables, such as anxiety and depression affecting adjustment, are the most studied. However, it will be point...

This article summarizes the psychometric evaluation of the Chronic Illness Assessment Interview for Sickle Cell Disease (CIAI-SCD), an instrument based on a model of self-care for adult patients with chronic medical conditions. The CIAI-SCD was administered to 104 adults with sickle cell disease. A factor analysis identified three factors that refl...

Objective: To examine whether psychosocial factors play a more important role than biomedical risk factors in predicting adolescent adaptation to sickle cell disease (SCD) ; to determine whether psychosocial factors moderate the relationship between biomedical risk factors and adaptation. Methods: Ninety African American adolescents from the multis...