Since 1920, Cobb & Douglas Public Health (CDPH), with our partners, promotes and protects the health and safety of residents in Cobb and Douglas counties. We deliver 30 distinct public health programs for over 900,000 residents ranging from individual clinical services to population-based programs. Our vision is “Healthier Lives. Healthier Community”. In May 2015, CDPH became the first public health department in Georgia to be awarded accreditation by the Public Health Accreditation Board and among only 2% in the U.S. In 2017, the National Association of County and City Health Officials awarded CDPH with the Model Practice Award for the Power in Truth Conference (PIT) in recognition of its exemplary and replicable qualities in response to a local public health.

CDPH has been partnering with local schools and community partners to implement PIT since 2000. Primary participant objectives are to: (1) Define the burden of underage drinking, tobacco use, and substance abuse on community health. (2) Define the role of youth as advocates for prevention in many health areas. (3) Learn the basics of prevention strategies that deter the onset and continued use of alcohol, tobacco, and other substances. (4) Match issues impacting youth with proven local resources. PIT uses local data from CDPH’s Community Health Assessment, Georgia Department of Education, and Georgia Department of Public Health to identify risk factors for middle and high school youth. Since its inception, the conference has empowered over 8,300 of youth with techniques to help them avoid drugs, overcome negative social influences, and increase healthy behaviors.

PIT is generally a day-long, in-person conference that includes a keynote speaker, breakout sessions, lunch, and other engaging youth-focused activities. In July 2020 it became apparent that implementing PIT in its classic structure was not an option due to the Coronavirus (COVID-19) pandemic. The longstanding history of the program and diverse partnerships allowed CDPH to quickly pivot and develop a unique plan to host the conference in 2020 and maintain the program’s integrity. The Douglas County community came together and transformed the traditional conference into a month-long, virtual experience. Breakout sessions were filmed in advanced and uploaded to the 100XEDTV Virtual Platform. Each Douglas County middle and high school was provided with login credentials to access the conference material.

To prevent technology access from reducing educational equity, Douglas County School System accelerated its goal to give each student an electronic learning device by August 2020. PIT content was accessed 9,582 times between October 26^th - November 20^th, 2020. Logins that completed at least 80% of a breakout session met the threshold for adequate knowledge gained. The content was accessed 2,459 times to the 80% standard. In comparison, the 510 students that attended PIT in 2019 yielded 1,020 views since each student participated in 2 breakout sessions. While the digital experience increased the program’s reach, it also reduced expenses. Digitizing PIT appeared to be a great way to implement the program in 2020 and may be a crucial element for programmatic growth post-COVID.

The Power in Truth Conference (PIT) has been Douglas County’s approach to implement health promotion and educate youth about the effects of risky behaviors since 2000. Motor vehicle crashes, homicide, and suicide are the leading causes of death for Douglas County youth ages 10-24 according to 2015-2019 Georgia Department of Public Health data. The 2019-2020 Georgia Department of Education Student Health survey shows 1 in 3 middle and high school students in Douglas County report being picked on or teased within the last 30 days. Additionally, student views on risky behaviors like vaping, marijuana use, and prescription drug abuse adversely decline as they matriculate school. These statistics have been met with overwhelming community support and commitment to providing prevention practices that meet youth where they are.

The COVID-19 pandemic provided an added subset of stressors for Douglas County youth which could negatively impact their health, safety, and wellbeing. In July, with COVID-19 rates at an all-time high in our community and state, it was clear that either PIT had to be canceled, drastically downsized, or transformed. The traditional 500+ in-person conference exceeded the mass gathering limit under the Governor’s Executive Order and was not compliant with CDPH’s best practice mitigation guidance. Additionally, it was unknown when students would physically return to school due to COVID-19 and what school would look like due to COVID-19 preventive measures like social distancing and mask recommendations. Cobb & Douglas Public Health (CDPH) staff approached the school system with a digital alternative that was cost efficient, convenient, and had the capacity to expand the conference reach.

Reaching more students has always been a challenging goal. The maximum capacity of the conference is about 500 students due to several variables including school transportation, the amount of substitute teachers needed to replace school chaperones, and facility space. Prior to the 2020 conference, the most successful way to expand PIT’s reach had been by encouraging schools to share the information gained during the conference by hosting learning opportunities year-round. This approach engaged 2,158 students during the 2019-2020 school year. Using technology to digitize the foundation of the conference had the capacity to significantly increase the program’s reach, but it was not a feasible option for the school system previously. Prior to the COVID-19 pandemic, student access to technology was limited. Laptops or tablets were not widely provided by the school and limited to those who could afford it. Digitizing the conference at that time would lead to inequities amongst which students could participate and how teachers could integrate the information into the curriculum. Over the summer, however, the Douglas County School System worked with local partners to ensure students had access to a laptop and WiFi from home. This allowed Douglas County School System to successfully offer in-person and virtual learning options to all students and made schools more open to using a virtual conference as part of their curriculum.

Initially virtual learning was new and exciting but with the reduction of social gatherings due to COVID-19, it began to feel stale and cold. CDPH stressed the need for the digital content to have the same energy as the in-person conferences that students had grown accustomed to in the past. CDPH requested the virtual material be formatted in a manner that mirrored the familiar layout used by YouTube or Netflix. This would make the content more engaging and provide the feeling that the students were casually watching TV and not participating in a stiff video conference. Additionally, CDPH staff created a brief opening video to air in place of the keynote speaker that set the tone for the day. The theme of the conference was “Keepin’ It 20/20 in 2020”. The original concept was to play off the visual acuity pun and refocus youth. The year 2020, however, had become a symbol representing all the negative things happening. The video refocused this theme by addressing the tough things that occurred in 2020, providing some comedic relief, and encouraging youth to continue to be positive and steadfast.

Local subject matter experts filmed and edited prerecorded content that was used to create the remaining virtual content. Based on the data, breakout sessions were made on the following topics: alcohol, cyberbullying, marijuana, financial literacy, healthy relationships, human trafficking, mental health, stress management, taking action/youth advocacy, and vaping. The breakout sessions used in 2020 about vaping, alcohol, financial literacy, and marijuana were edited recordings from the 2019 conference. CDPH had partnered with high school students and a local government access cable television channel to film the 2019 sessions at no cost. The videos captured the facilitator from the audience’s perspective and provided a glimpse of what the traditional conference looked like. The content was recorded in real time and only edited to include snapshots of the facilitator’s PowerPoint or video display. The remaining sessions used in 2020 were created by using voiceover technology, Zoom, Microsoft PowerPoint, and YouTube. Most of the presentations were recorded in one take and required no further editing. The recordings were displayed on TeamTRI’s 100XEDTV Virtual Platform where attendees could watch at their leisure. The 100XEDTV Virtual Platform provided 24 hours a day standby assistance to help students with any technical questions.

The Power in Truth Conference is the product of a partnership between Cobb & Douglas Public Health (CDPH), the Live Healthy Douglas Coalition (LHD), Douglas County School System (DCSS), generous community sponsors, and local subject matter experts. LHD is a partnership of community organizations and individuals dedicated to promoting healthy lifestyles and the delivery of essential health services in Douglas County. It was formed in 2011 through the Mobilizing for Action through Planning and Partnerships process to assess and address focused health improvement goals in Douglas County. Partners included in the 2020 conference included University of Georgia Cooperative Extension, Parents Educating Parents & Professionals Inc., Douglas Community Organizing Resources for Excellence, and passionate community members like retired principal John Stone. In 2014, the PIT conference was adopted by the youth behavior sector of LHD as a primary method to address healthy lifestyles strategies for adolescents age 10-19. As a result, PIT focuses more attention on topics identified in the Community Health Assessment and prioritized in the Community Health Improvement Plan. CDPH chairs the youth behavior group of the Live Healthy Douglas Coalition and is the fiscal agent for the program.

Each year the LHD partners involved with PIT strategize how the conference can be more cost effective, reach more people, and expand learning components beyond the day of the conference. While this overarching objective lingered, the main goal for 2020 was just to have a conference that was not negatively impacted by COVID-19. On a monthly basis, coalition members met virtually to plan the conference. These planning efforts included: selecting breakout sessions based on public health trends, securing subject matter experts to host sessions, identifying a virtual platform, and raising funds for the event all while continuing to monitor and navigate through the endless barriers and obstacles presented as a result of COVID-19.

Cost made digitizing the conference difficult. While CDPH is the fiscal agent of LHD, each member is responsible for fundraising. PIT is fully funded through community sponsorships and donations. As a result, half of the conference planning period is dedicated to fundraising efforts. $34,725 was spent for the 2019 conference. COVID-19’s financial impact in the community resulted in only $9,000 being raised for the 2020 conference — merely a third of what was traditionally collected. Funders included Georgia Department of Public Health, Children’s Healthcare of Atlanta, Kiwanis Club of Douglas County, DeNyse Signs, and CareSource. To discuss the feasibility of bringing this conference to an online platform with a limited budget, the coalition met with various technical authorities. These meetings ultimately led to the selection of the 100EdTV platform through a partnership with TeamTRI.

DCSS is one of the conference’s most important partners. In 2020, they expanded their partnership further by designating 3 staff members, Sean Roach - Coordinator of Student Support and Health Services, Mandy Johnson - Executive Director of College and Career Programs, Counselors, CTAE, Dual Enrollment, and Workforce Development and Casey Bethel - K-12 Science, STEM, and Computer Science Coordinator to serve as Power in Truth liaisons. These liaisons were tasked with identifying 2-3 staff members in each of the 5 high schools, 8 middle schools, and 4 alternative schools who would serve as PIT advisors. These advisors were tasked with ensuring students had access to the necessary login credentials to participate in digital experience. They were also required to integrate the breakout session content into their respective curriculums to ensure youth accessed the material. Some advisors watched the content as a class while others assigned the content as homework and followed it up with classroom discussion. Gift cards, stickers, and leftover promotional materials from 2019’s conference was shared with schools for PIT advisors to leverage as incentives.

All of the breakout out session content was provided by local subject matter experts. In 2019, several of the sessions were recorded collectively through a partnership with DCTV23 and New Manchester High School’s Audio and Visual Program. Content leveraged for 2020 included the recorded alcohol session by Cobb County’s DUI Task Force, the financial literacy session by Regions Bank, the vaping session by UGA Extension Office and CDPH, and the marijuana session by the Douglas County Sheriff’s Office. Subject matter experts reviewed the content to assure that the messages were still relevant in 2020. New video content for the 2020 program included a healthy relationships session recorded by S.H.A.R.E House, a mental health session recorded by the Georgia Crisis and Access Line, a stress management session recorded by ReConnected to Life, a human trafficking session recorded by Street Grace, a bullying/cyberbullying session recorded by UGA Extension, and a taking action (finding your place in change) advocacy-focused session recorded by Douglas Violence Prevention Task Force. The breakout session material was made available to conference attendees for 30 days and these recorded sessions were also provided to schools, upon request, after the close of the conference on November 20^th, 2020.

In July, Douglas County School System made the decision to push back the semester start date to August 17^th, 2020. Simultaneously, Cobb & Douglas Public Health (CDPH) pivoted from planning an in-person conference to a virtual one. The school system adopted a staggered schedule which allowed middle school students who signed up for traditional learning to start school September 8^th and high school students to start on September 14^th. Students who requested traditional, in-person learning would attend school Monday - Thursday. Friday was reserved as a remote learning day for all students. These changes made a virtual conference more favorable as it was compatible to both learning tracks. On October 5^th, it was decided this model would remain for the rest of the semester.

While a digital conference seemed to be the best option for PIT 2020, it was apparent that the conference’s success this year would be an indicator for how future conferences would look (i.e. in-person, virtual, or a hybrid). The Douglas County School System encouraged CDPH to research TeamTri’s 100EdTV digital platform options. They had experience with the business through continuing education opportunities for staff and thought they may be an affordable option. CDPH explained to TeamTri the goals of the program and constraints of the budget to warrant maximum results. TeamTri offered two options for users: 1). Individual login credentials could be provided to each student for $4.99/student or 2). Generic logins could be given to each school that could be shared with an unlimited number of students for $250/school. Due to the limited budget, the generic school-based login option was selected.

When held in-person, conference organizers collect surveys in selected breakout sessions and at the end of the day. These are used to gauge participation satisfaction and to track predicted behavior change. In addition, conference organizers also track and register students when the event is in-person so there is an accurate count of projected attendees for reporting purposes and resource acquisitions for the event. By transitioning the conference to a virtual space and providing the schools with logins that could be shared throughout the district, a method for tracking participant data became a concern. TeamTRI offered to incorporate the conference survey materials into the online platform while also providing services that tracked program engagement and platform traffic by school. At the conclusion of the event, raw data was sent to CDPH to analyze.

TeamTri’s school-based login method cost a total of $4,550. $360 was spent on $30 Amazon gift cards to thank the dedicated subject matter experts who provided digital content for breakout sessions. Any remaining cards were raffled to PIT advisors for their commitment. A community partner pledged $3,000 to help sponsor lunch for the 2020 event before it was decided the conference would become a digital experience. The funds were turned into Chick-fil-A gift cards and were distributed to schools to use as incentives. The final cost of the virtual experience was $7,910. Providing lunch for conference attendees and volunteers is generally the program’s biggest expense at about $6,500. The keynote speaker budget is $3,000 and facility fees are usually $800. All patrons wear conference T-shirts that are branded with sponsor logos that cost about $5,000. The remaining funds are spent on conference supplies (e.g. educational materials, venue décor, and promotional items for youth). By eliminating the need for these budgeted items, the virtual experience cost three-times less than last year’s in-person event.

When the conference is held in person, students are hand-selected by school counselors and teachers. Schools are encouraged to select a mix of at-risk youth: those with known struggles and students who may hold leadership positions at school with plans to further integrate the knowledge gained into their individual schools. This approach to information sharing has been effective in the past but limiting. By utilizing a virtual program, an opportunity formed for every student in the Douglas County System to attend PIT while also spending a fraction of the cost normally associated with putting on the event in person.

The platform also turned the 1-day conference into a month-long experience which further increased accessibility. The conference material was available on TeamTRI’s 100EdTV platform from October 23^rd to November 20^th. The first week of the conference was heavily monitored to ensure engagement. CDPH connected with schools with no or low engagement to help troubleshoot issues. After one week, PIT had 4,138 logins. The content was accessed a total of 9,582 times over the course of the 30-day virtual experience. Breakout session videos were watched 2,459 times to at least 80% completion. Due to time constraints, students could only attend 2 breakout sessions during the in-person conference. Removing that limitation yielded 83% more engagement during 2020’s digital experience.

 All students were asked to complete a brief survey after participating in the virtual conference. Of the 2,524 students that completed the PIT survey, 93% of students indicated 2020 was their first time participating in the conference. Although the structure of the conference was different and included more participants, the overall satisfaction with the conference remained the same. When asked how much the students enjoyed the conference on a scale of 1 to 5 with 5 being the most enjoyable, the average response was 4.6 in both 2019 and 2020.

The results from the PIT 2020 Virtual Experience show a virtual conference is more accessible, has a greater reach, and is more cost-effective. It is likely the conference will continue to be a digital experience post-COVID given the immense success this year. Moving forward, CDPH would prefer issuing individual student login credentials as opposed to shared school accounts. This would produce a more in-depth analysis of student attendance and engagement. It is also probable that every student who participated in the conference did not complete the requested survey. To increase compliance, CDPH plans to work further with the school system and digital platform vendor to make the survey a mandatory requirement for conference completion.