National Center for Education in Maternal and Child Health
Search past issues of
the MCH Alert and other MCH Library resources at http://www.mchlibrary.info/databases/search.lasso
October 29, 2004
1. Self-Study Modules Available to Help Health and Early
Childhood Professionals Promote Oral Health for Infants and Young
Children
2. Surgeon General's Report Encourages Promotion of Bone
Health Throughout the Lifespan
3. Joint Position Statement Released on Adolescent Access
to Care and Reporting of Sexual Activity and Abuse
4. Article Identifies Longitudinal Predictors of Physical
and Sexual Dating Violence in Adolescence
5. Longitudinal Analysis Examines Risk and Protective
Factors of Physical Violence Against Impoverished Women
6. Study Examines Association Between Sleep-Disordered
Breathing and Performance in 5-Year-Olds
************************************************************
1. SELF-STUDY MODULES AVAILABLE TO HELP HEALTH AND EARLY CHILDHOOD
PROFESSIONALS PROMOTE ORAL HEALTH FOR INFANTS AND YOUNG CHILDREN
Open Wide: Oral Health Training for Health Professionals is a series of
four self-contained online modules designed to help health and early
childhood professionals working in community settings (e.g., Head Start
and WIC staff) promote oral health in the course of promoting general
health for infants, children, and their families. The modules were
prepared by the National Maternal and Child Oral Health Resource Center
and the Center for the Advancement of Distance Education at the
University of Illinois at Chicago with support from the Maternal and
Child Health Bureau. Topics include tooth decay, risk factors for tooth
decay, and prevention of tooth decay; oral health risk assessment and
oral health screening; and anticipatory guidance for parents. Each
module includes an overview, learning objectives, key points, a
self-assessment quiz, online resources, and an evaluation form. A
glossary and a list of presentations, print materials, and videotapes
are also presented. The modules are available at http://www.mchoralhealth.org/OpenWide/index.htm.
************************************************************
2. SURGEON GENERAL'S REPORT ENCOURAGES PROMOTION OF BONE HEALTH
THROUGHOUT THE LIFESPAN
Bone Health and Osteoporosis: A Report of the Surgeon General presents
scientific evidence related to the prevention, assessment, diagnosis,
and treatment of bone disease and provides a tool for educating
Americans about how they can promote bone health throughout their
lives. The report, commissioned by Congress, was initiated by a federal
interagency work group, followed by a Surgeon General's Workshop
convened in December 2002. Experts from across the country provided
guidance and insights. The report presents information on the magnitude
of the problem, challenges in diagnosis and treatment, the impact of
disease on minority populations, promising prevention strategies, how
to improve professional education and promote public awareness, and
ways to enhance access to key health services. The report is intended
for use by policymakers; national, state, and local public health
officials; health system leaders; health professionals; community
advocates; and individuals. The executive summary and full report,
along with other relevant materials, are available at http://www.surgeongeneral.gov/library/bonehealth.
************************************************************
3. JOINT POSITION STATEMENT RELEASED ON ADOLESCENT ACCESS TO CARE AND
REPORTING OF SEXUAL ACTIVITY AND ABUSE
Protecting Adolescents: Ensuring Access to Care and Reporting Sexual
Activity and Abuse presents guidance and principles in the development
of public policy concerning adolescents' access to health services,
including sexual and reproductive health services. The position
statement, published in the November 2004 issue of the Journal of
Adolescent Health, was developed jointly by the American Academy of
Family Physicians, the American Academy of Pediatrics, the American
College of Obstetricians and Gynecologists, and the Society for
Adolescent Medicine. The statement includes supporting commentary on
state requirements for reporting sexual abuse and sexual activity, the
number of sexually active adolescents, communication between
adolescents and health professionals, clinical assessment of sexual
abuse and sexual coercion, access to confidential health care, and
legal requirements and interpretation of laws that may impede
provider/patient relationships.
American Academy of Family Physicians, American Academy of Pediatrics,
American College of Obstetricians and Gynecologists, Society for
Adolescent Medicine. 2004. Protecting adolescents: Ensuring access to
care and reporting sexual activity and abuse. Journal of Adolescent
Health 35(5):420-423.
************************************************************
4. ARTICLE IDENTIFIES LONGITUDINAL PREDICTORS OF PHYSICAL AND SEXUAL
DATING VIOLENCE IN ADOLESCENCE
"Our findings suggest groups to target with interventions to prevent
serious physical and sexual dating violence, content for interventions,
and approaches to delivering interventions," state the authors of an
article published in the November 2004 issue of Preventive Medicine.
Between 8% and 20% of adolescents have been victims of serious physical
dating violence; however, the risk factors targeted by most adolescent
dating violence programs have been identified from cross-sectional
studies that cannot distinguish causes from consequences of dating
violence. The study described in this article used data from a cohort
of adolescents assessed first in the eighth or ninth grade and then
annually for 4 or 5 years, respectively, to identify potentially
modifiable predictors of the onset of and chronic victimization from
serious physical and sexual dating violence. Because the authors use a
social ecological framework to identify the predictors to be examined,
their findings can potentially guide the development of interventions
that move beyond the typical individual-level approach to dating
violence prevention, to approaches that target change in systems, such
as families, peer groups, and societal norms.
The authors assessed two subsamples of adolescents from a primarily
rural county in North Carolina. The first subsample included 1,291
adolescents who reported at baseline that they had never been victims
or perpetrators of dating violence. The second subsample consisted of
219 adolescents who reported at baseline having already been victims of
mild forms of dating violence.
The authors found that
- Significant baseline multivariate predictors of male onset of
serious physical dating violence victimization included having been hit
by an adult with the intention of harm, having low self-esteem, having
poor conflict-resolution skills, and having been in a physical fight
with a peer. The same three variables, as well as having a friend who
had been a victim, drinking alcohol, and being non-Hispanic white, also
predicted male chronic victimization.
- The only significant baseline multivariate predictor of female
onset of serious physical dating violence was having been hit by an
adult with the intention of harm. That variable, as well as living in a
single-parent household, predicted female chronic victimization.
- Significant baseline multivariate predictors of female onset of
sexual dating violence victimization included having a friend who had
been a victim and being depressed. These two predictors, as well as
holding traditional gender stereotypes, predicted female chronic
victimization.
- Adolescents already experiencing mild forms of dating violence at
baseline were 2.4 times more likely than their non-victimized peers to
become victims of serious physical dating violence and 1.3 times time
more likely to become victims of sexual dating violence.
The authors conclude that "risk factors varied by gender and outcome,
suggesting the need for gender- and outcome-specific interventions, a
departure from current practice."
Foshee VA, Benefield TS, Ennett ST, et al. 2004. Longitudinal
predictors of serious physical and sexual dating violence victimization
during adolescence. Preventive Medicine 39(5):1007-1016.
Readers: More information about adolescent violence prevention is
available from the MCH Library's knowledge path at http://www.mchlibrary.info/KnowledgePaths/kp_adolvio.html,
and organizations resource list at http://www.mchlibrary.info/action.lasso?-database=Organizations&-layout=Web&-response=/databases/OrgLists/orgs_adolviolence.html&-MaxRecords=all&-DoScript=auto_search_adolviolence&-search.
************************************************************
5. LONGITUDINAL ANALYSIS EXAMINES RISK AND PROTECTIVE FACTORS OF
PHYSICAL VIOLENCE AGAINST IMPOVERISHED WOMEN
"This study highlights the persistence of physical violence in indigent
women's lives and identifies plausible, prospective risk factors for
violence," state the authors of an article published in the
September/October 2004 issue of Women's Health Issues. The authors note
that although violence is an especially significant health threat among
traditionally underserved women in the United States, no study has
examined what may be responsible for prospective risk and persistence
of physical violence among impoverished women. The article describes a
comprehensive, prospective investigation of risk and protective factors
for violence in a representative probability sample of women living in
shelters and Section 8 low-income housing in Los Angeles County,
California.
Study participants included 810 women ages 18-55 who completed
structured interviews at baseline and at 6-month follow-up. Measures
included physical violence during the past 6 months, physical or sexual
violence before age 18, substance use, income from survival strategies
(e.g., panhandling, selling drugs, selling sexual favors),
psychological distress, and social support. The authors assessed the
potential influence of risk and protective factors on whether a woman
had experienced physical violence at follow-up. They also determined
whether the association of a predictor with having experienced violence
at follow-up differed depending on whether a woman was in the sheltered
or housed sample.
The authors found that
- Just over 30% of the women had experienced physical or sexual
violence before age 18.
- Approximately 15% of the women had experienced physical violence
during the 6 months before the baseline interview and during the 6
months before the follow-up interview.
- Experiencing physical or sexual violence during childhood, having
two or more sexual partners rather than just one, experiencing
psychological distress/risk for mental health problems before the
baseline interview, and reporting poor social support at baseline
predicted having experienced physical violence at follow-up.
- A woman who had experienced physical violence at baseline had
twice the odds of having experienced it at follow-up.
- Being sheltered and having a longer interval between baseline and
follow-up interviews was associated with greater risk of having
experienced physical violence at follow-up.
"To our knowledge, this is the first study of impoverished women that
has been able to address what may be responsible for prospective risk
and persistence of physical violence," state the authors, adding that
the findings "highlight opportunities to reduce risk of experiencing
violence through enhancing women's social support and mental health."
Wenzel SL, Tucker JS, Elliot MN, et al. 2004. Physical violence against
impoverished women: A longitudinal analysis of risk and protective
factors. Women's Health Issues 14(5):144-154.
************************************************************
6. STUDY EXAMINES ASSOCIATION BETWEEN SLEEP-DISORDERED BREATHING AND
PERFORMANCE IN 5-YEAR-OLDS
"In a community sample of 5-year-old children, parent-reported symptoms
of sleep-disordered breathing (SDB) are associated with impaired
behavioral control and with significantly poorer performance on a broad
range of neurocognitive tests," state the authors of an article
published in the October 2004 issue of the Journal of Pediatrics. The
authors note that few published studies use standardized measures to
assess the neurocognitive effects of SDB in children. The article
describes a study to examine the association of SDB symptoms (frequent
snoring, noisy breathing during sleep, or witnessed sleep apnea) with
performance on standardized measures of attention, planning, memory,
and general cognitive ability in a large, population-based sample of
5-year-olds.
All children in the study had been previously enrolled in the Infant
Care Practice Study (ICPS), a multicenter, prospective longitudinal
study to describe newborn sleep practices and to document changes in
infant sleep position over time. Sociodemographic variables (maternal
race/ethnicity, marital status, and educational status) were collected
by interview at the time of enrollment in the ICPS (between February
1995 and December 1998). Beginning in March 2000, a questionnaire was
mailed within 2 months of the child's fifth birthday to all
English-speaking mothers of children in the ICPS born in Massachusetts
with birthweight >2,500 g. Parents reported their child's height,
weight, frequency of upper respiratory and ear infections, history of
tympanostomy and adenotonsillectomy, daytime sleepiness, wheezing,
asthma, respiratory allergy, and SDB symptoms. A neurocognitive
assessment was conducted in one 3- to 4-hour session (children with
Full Scale IQ less than 70 were excluded from analysis). The 205
children with complete data on sleep symptoms and laboratory-based
neurocognitive assessments were the subjects of this study.
The authors found that
- Parent-reported SDB symptoms were present in 30% of the study
children; the prevalence of SDB symptoms was similar in boys and girls.
- Children with SDB symptoms had significantly poorer performance
than did those without SDB symptoms on measures of attention and
planning, memory, and overall intellectual ability.
- There were no consistent differences between boys and girls in
the association of SDB symptoms with either neurocognitive or behavior
measures.
- The findings persisted when children with evidence of obstructive
sleep apnea were excluded from the analysis.
"The possible persistence of neurocognitive effects of early childhood
SDB into later childhood and their impact on academic performance
require further investigation," conclude the authors.
Gottlieb DJ, Chase C, Vezna RM, et al. 2004. Sleep-disordered breathing
symptoms are associated with poorer cognitive function in 5-year-old
children. Journal of Pediatrics 145(4):458-464.
************************************************************
To subscribe to MCH Alert, send an e-mail message to MCHAlert-request@list.ncemch.org with SUBSCRIBE in the subject line.
You do not need to enter any text in the body of the message.
To unsubscribe from MCH Alert, send an e-mail message to MCHAlert-request@list.ncemch.org with UNSUBSCRIBE in the subject line.
You do not need to enter any text in the body of the message.
************************************************************
MCH Alert © 2004 by
National Center for Education in Maternal and
Child Health and Georgetown University. MCH Alert is produced by
MCH Library Services at the National Center for Education in Maternal
and Child Health under its cooperative agreement (6U02 MC 00001) with
the Maternal and Child Health Bureau, Health Resources and Services
Administration, U.S. Department of Health and Human Services. The
Maternal and Child Health Bureau reserves a royalty-free, nonexclusive,
and irrevocable right to use the work for federal purposes and to
authorize others to use the work for federal purposes.
Permission is given to
forward MCH Alert to individual
colleagues. For all other uses, requests for permission to
duplicate and use all or part of the information contained in this
publication should be sent to MCH Alert Editor, National Center for
Education in Maternal and Child Health, at mchalert@ncemch.org.
The editors welcome your
submissions, suggestions, and questions.
Please contact us at the address below.
EDITORS: Jolene
Bertness, Tracy Lopez
COPYEDITOR: Ruth
Barzel
National Center for
Education in Maternal and Child Health
Georgetown University
Mailing address: Box
571272, Washington, DC 20057-1272
Street address: 2115
Wisconsin Avenue, N.W., Suite 601, Washington,
DC 20007-2292
Phone: (202) 784-9770
Fax: (202) 784-9777
E-mail: mchalert@ncemch.org
Web site: http://www.mchlibrary.info/alert/index.html
************************************************************