Center on Health and Homelessness

The Georgia State University School of Public Health has established a Center on Health and Homelessness that will conduct community-based research, provide learning opportunities for students and collaborate with stakeholders in Atlanta and beyond to develop and evaluate evidence-based solutions that address homelessness and its related health issues. The center is led by Dr. Shannon Self-Brown and Dr. April Ballard.

The center, which is funded by a lead gift from a generous donor, will leverage the expertise of faculty within the School of Public Health and across the university in fields such as evidence-based interventions, trauma, substance use, water, sanitation and hygiene, and implementation science.

In addition to strengthening connections among Georgia State, communities and organizations across Atlanta, the Center on Health and Homelessness creates hands-on learning opportunities for graduate students in public health to work alongside faculty and community partners on applied research projects.

The first project the center has undertaken is a community needs assessment. Focusing on metro Atlanta, the project is identifying existing resources and strengths, as well as needs for effectively addressing homelessness prevention and response. Results will allow the center to prioritize areas of need and identify potential collaborations to leverage faculty expertise in supporting improvements that address pressing challenges through program evaluation or pilot research projects.

Smoke Free SafeCare, NCI R01

Dr. Self-Brown (MPI) and Dr. Michelle Kegler of Emory University received $3.5 million grant to use systematic braiding to integrate two evidence-based programs, SafeCare, a positive parenting program to prevent child maltreatment and Some Things are Better Outside, a smoke-free homes program. An effectiveness-implementation hybrid trial type 1 will be employed to examine the impact of integrating two evidence-based programs:  Some Things are Better Outside (second-hand smoke [SHS] prevention program) and SafeCare (child maltreatment prevention program), on establishing a smoke-free home and implementation process outcomes.  Aim 1 focuses on the refinement of the standardized integration (systematic braiding) of the two programs into “Smoke-Free SafeCare (SFSC).” Aims 2 and 3 focus on the Hybrid Trial. Fifty certified SafeCare Providers will be recruited and randomly assigned to either SFSC or Standard SafeCare. Providers will each serve ten research families (N=500) who meet the inclusion criteria (Mother or another person residing in the home smokes at home). The primary outcome, smoke-free home status, will be measured via self-report at 4-timepoints (baseline, 8-weeks, 20-weeks, and 1-year), and validated via air nicotine monitor at 8 weeks and 1-year (Aim 2).  Process measures will be collected to examine how the braided intervention impacts provider fidelity, delivery time and costs, and other process measures (Aim 3). If effective, SFSC can be efficiently disseminated for widespread adoption by the National SafeCare Training and Research Center to the over 100 accredited SafeCare agencies across the United States that serve parents involved with child protection services, reducing cancer risk for a high-risk population.

SafeCare Kenya

Dr. Self-Brown is a Co-Investigator on an NICHD-funded R01 (MPIs Dr. Jenelle Shanley at Pacific University, Dr. Lisa Armistead at GSU, Dr. David Ndetei, Africa Mental Health Research and Training Foundation). The purpose of this R01 is to conduct a Hybrid Type 2 study to examine the implementation and effectiveness of the recently adapted evidenced-based program, SafeCare, as a primary prevention approach to address the country’s non-communicable disease (NCD) burden. SafeCare Kenya (SCK) improves parenting skills, reducing the likelihood of child maltreatment and subsequent risk for NCD. This project will continue the six-year partnerships amongst Africa Mental Health Research and Training Foundation (AMHRTF; Nairobi-based partner), Pacific University, Georgia State University and its National SafeCare Training and Research Center (SafeCare developers), and key country and regional stakeholders, including families, professionals, government, and researchers to scale-up and disseminate SCK. This project leverages Kenya’s Community Health Volunteers (CHV), the well-established and primary workforce for maternal and child physical health in Kenya, to implement the intervention. Virtual and in- person delivery modes will be examined to identify the best method for sustainability. Three specific aims will be accomplished in this 5-year study: (1) Determine clinical effectiveness of SCK using a parallel group multilevel-randomized trial. (2) Determine feasibility and probable utility of SCK implementation. (3) Initiate efforts to begin scale-up and sustainment of SCK across Kenya. We will recruit 312 families paired with 24 CHV randomly assigned to deliver SCK (16 Providers; 208 families) or care as usual (8 Providers; 104 families). Our project’s long-term goals are to: (1) build sustainable research and implementation capacity in Kenya and Africa and (2) disseminate a culturally relevant, evidence-based parenting program to promote children’s wellbeing and reduce risk of NCD across the lifespan.

National Center on Child Trafficking

Dr. Shannon Self-Brown has obtained a 5-year, $3 million dollar grant from the SAMHSA National Child Traumatic Stress Initiative to establish the National Center on Child Trafficking (NCCT). The NCCT is the first Category II SAMHSA grant received by any institution in the State of Georgia and will bring together a national network of experts in trauma, trafficking, and implementation science to develop, adapt, deliver, and disseminate products, resources, and interventions to improve outcomes for youth and families who have experienced commercial sexual exploitation and trafficking (CSET). The NCCT will increase and improve access to trauma-focused evidence-based mental treatments and trauma-informed interventions by (1) developing and disseminating national practice standards and consensus guidelines for mental health treatment crosscutting EBPs to mental health professionals, (2) delivering and evaluating training of Trauma Focused Cognitive Behavioral Therapy (TF-CBT) for CSET to therapists in 5 SAMHSA/HHS regions, developing resources for therapists and trainers to enhance dissemination and service delivery, (3) developing and disseminating standards, guidelines, and training addressing co-occurring trauma and substance use problems to mental health and substance abuse professionals, integrating the guidelines into an existing evidence-based trauma and substance use treatment, Risk Reduction through Family Therapy, and train therapists in the adapted model, (4) adapting and disseminating training in trauma-informed parenting, the Resource Parent Curriculum, adapted for youth who have experienced CSET, (5) adapting and disseminating training in trauma-informed residential care, Think Trauma to Think Trauma trainers, and training staff at targeted CSET congregate care/residential treatment placements, (6) developing and disseminating resources for MDT and CSET specialist professionals, including practice guidelines and training curricula (FORECAST) incorporating CSET response, and (7) developing Secondary Traumatic Stress/Compassion Fatigue awareness materials and strategies and delivering training in the practices to professionals serving Youth who have experienced CSET.

Project Intersect

Dr. Self-Brown is the Co-Director of Project Intersect with Dr. Kelly Kinnish, Clinical Director of the Georgia Center for Child Advocacy. Project Intersect is a National Child Traumatic Stress Network initiative funded by the Substance Abuse and Mental Health Services Administration. Project Intersect draws upon existing trauma-focused, evidence-based practices, as well as knowledge of the complex needs of those who have experienced commercial sexual exploitation.  Combining these existing practices and knowledge to serve our clients and train mental health providers throughout Georgia, Project Intersect continues to build and sustain a statewide network of therapists trained in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), as well as a separate intensive training in CSEC-specific applications of TF-CBT.  Treatment is then provided to clients by therapists who have participated in the training. In addition, Project Intersect seeks to facilitate training, trauma-informed skill development, and increased CSEC awareness for professionals working in systems that intersect with CSEC at high rates, including Juvenile Justice, Foster Care, and Homeless/Runaway youth-serving organizations.

Envision Project

Dr. Self-Brown is the Lead Evaluator on the Office of Victims of Crime-funded service grant, The Envision Project, awarded to the Georgia Center for Child Advocacy. The Envision Project provides educational and life-skills training and workshops to youth who have experienced commercial sexual exploitation or trafficking.

Secondary Data Analyses

Violence Against Children Surveys (VACS)

Violence Against Children Surveys are nationally representative surveys conducted collaboratively by CDC, Together for Girls, governments, and other international partners to measure the prevalence of physical, sexual, and emotional violence, and other social and health outcomes among children 13-24. The VACS surveys have been implemented in over 24 countries across Africa, Asia-Pacific, Latin America, and the Caribbean. PREVent Lab members have contributed to conference presentations and manuscripts using the VACS surveys from Lesotho, Nigeria, and Zambia.

National Longitudinal Study of Adolescent to Adult Health (Add Health)

The National Longitudinal Study of Adolescent to Adult Health (Add Health) is a longitudinal study of a nationally representative sample of over 20,000 adolescents who were in grades 7-12 during the 1994-95 school year, and have been followed for five waves to date, most recently in 2016-18. Over the years, Add Health has collected rich demographic, social, familial, socioeconomic, behavioral, psychosocial, cognitive, and health survey data from participants and their parents; a vast array of contextual data from participants’ schools, neighborhoods, and geographies of residence; and in-home physical and biological data from participants, including genetic markers, blood-based assays, anthropometric measures, and medications. Ancillary studies have added even more data over the years. Data from the project are available in various forms and have been analyzed in thousands of publications in peer-reviewed journals.

National Violent Deaths Reporting System

The National Violent Death Reporting System (NVDRS) is an active, state-based surveillance system that uses a Centers for Disease Control and Prevention web-based platform to link data from death certificates, law enforcement reports, and coroner/medical examiner records. Death certificates indicate both an underlying cause of death and a manner of death, for which the medical examiner or coroner is primarily responsible for certifying, whereas risk factors, contextual factors, and precipitating circumstances emerge from law enforcement reports and coroner/medical examiner records. Each incident includes two narratives: one based on information from the coroner/medical examiner records and one based on information from the law enforcement report, both of which provide details surrounding the fatal event.