
Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.
May 27, 2005
1. New Edition of Overweight in Children and Adolescents
Knowledge Path Released
2. Brief Reviews Efforts to Increase Women's Awareness
and Use of Preventive Care
3. Educational Materials Promote Communication from Birth
4. Report Presents Findings from Assessment of
Epidemiologic Capacity in State and Territorial Health Departments
5. Survey Explores Emergence of Doulas as Childbirth
Paraprofessionals
6. Article Examines Immigrant Families' Awareness of
Health and Community Resources
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1. NEW EDITION OF OVERWEIGHT IN CHILDREN AND ADOLESCENTS KNOWLEDGE
PATH RELEASED
The new edition of Knowledge Path: Overweight in Children and
Adolescents is an electronic guide to recent, high-quality resources
and information tools for identifying, preventing, managing, and
treating overweight in children and adolescents. Produced by the MCH
Library, the knowledge path includes information on (and links to) Web
sites and electronic publications, databases, and electronic
newsletters. It is intended for use by health professionals,
policymakers, educators, and families who are interested in tracking
timely information on this topic. The knowledge path is available at http://www.mchlibrary.info/KnowledgePaths/kp_overweight.html.
MCH Library knowledge paths on other maternal and child health topics
are available at http://www.mchlibrary.info/KnowledgePaths/index.html.
The MCH Library welcomes feedback on the usefulness and value of these
knowledge paths. A feedback form is available at http://www.mchlibrary.info/KnowledgePaths/feedback.html.
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2. BRIEF REVIEWS EFFORTS TO INCREASE WOMEN'S AWARENESS AND USE OF
PREVENTIVE CARE
Women's Health: Successes and Challenges in Prevention and Promotion
summarizes new policies and programs on women's health at the federal
and state levels, research and evidence-based efforts, and successful
prevention and treatment options. The National Institute for Health
Care Management Foundation (NICHM), with support from the Health
Resources and Services Administration's Maternal and Child Health
Bureau, convened a forum of leaders in women's health from federal
government offices on women's health, along with medical directors and
those working on programs related to women's health within health
plans. The action brief recaps forum presentations on the successes and
challenges faced in the development and implementation of women's
health prevention and promotion programs. A list of additional
resources for women's health information is provided. NIHCM has also
published a background paper, Women's Health: Prevention and Promotion,
which highlights current programs and research on successful women's
health prevention and treatment options. The action brief and paper are
available at http://www.nihcm.org/childframe.html.
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3. EDUCATIONAL MATERIALS PROMOTE COMMUNICATION FROM BIRTH
The Centers for Disease Control and Prevention's Early Hearing
Detection and Intervention (EHDI) Program has released several
educational materials to help promote communication from birth for all
children. Two spiral-bound booklets, titled Just in Time for Pediatric
Primary Care Providers and Just in Time for Families, provide an
overview of the EHDI process, 1-3-6 plan, risk factors, communication
choices, and early intervention. Other materials include a CD-ROM, a
fact sheet, posters, and parent guides. A brochure about CDC's EHDI
programs in states to identify infants with hearing loss through
universal screening has also been produced. The materials are available
at http://www.cdc.gov/ncbddd/ehdi/edmaterials.htm.
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4. REPORT PRESENTS FINDINGS FROM ASSESSMENT OF EPIDEMIOLOGIC CAPACITY
IN STATE AND TERRITORIAL HEALTH DEPARTMENTS
"Further attention to recruitment and training are needed to increase
the number of trained epidemiologists and improve the public health
infrastructure in the United States," state the authors of a report
published in the May 13, 2005, issue of Morbidity and Mortality Weekly
Report. In November 2001, the Council of State and Territorial
Epidemiologists conducted a survey of state and territorial health
departments to assess their core epidemiologic capacity. The survey was
completed just before distribution of approximately $1 billion in
terrorism preparedness and emergency response funds in fiscal year
2002. The funds were intended to improve the U.S. public health
infrastructure. Results of the 2001 survey, published in 2003,
indicated inadequate capacity among health departments to fully perform
essential public health services in six of eight key epidemiology
program areas. The report summarizes the results of a 2004 follow-up
survey to (1) assess epidemiologic capacity in the United States and
its territories in the same eight program areas, (2) estimate the
number of additional epidemiologists needed for full performance, and
(3) identify education and training needs.
Study participants, (state epidemiologists or their designees in all 50
states, three of eight territories, and the District of Columbia)
completed an online survey during May-September 2004. The response rate
was 91.5%.
The authors found that
- There was a 26.9% increase from 2001 in the overall number of
epidemiologists working in state and territorial health departments.
- There was increased capacity in two program areas: (1) terrorism
preparedness and emergency response and (2) maternal and child health.
- There was decreased capacity in six programs areas: (1)
infectious disease, (2) chronic disease, (3) environmental health, (4)
injury, (5) occupational health, and (6) oral health.
- Almost one-third (28.5%) of epidemiologists lacked any formal
training or academic coursework in epidemiology.
The authors conclude that "creation of a strong public health
infrastructure fully capable of performing essential services will
require additional trained epidemiologists in state and territorial
health departments."
Boulton ML, Abellera J, Lemmings J, et al. 2005. Assessment of
epidemiologic capacity in state and territorial health departments --
United States, 2004. Morbidity and Mortality Weekly Report
54(18):457-459. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5418a2.htm.
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5. SURVEY EXPLORES EMERGENCE OF DOULAS AS CHILDBIRTH PARAPROFESSIONALS
"Our survey findings suggest that a number of challenges . . . present
significant obstacles to the further growth of doulas as childbirth
paraprofessionals in the United States," state the authors of an
article published in the May/June 2005 issue of Women's Health Issues.
The number of people who are seeking doula certification and who are
offering doula services for a fee or as part of a hospital-based
maternity care team is growing. However, little sociological or health
services research focuses on doulas or how they are practicing. The
article presents findings from the first national survey of doulas in
the United States. The authors (1) present descriptive information
about doulas' sociodemographic and practice characteristics, (2)
compare the background and practice characteristics of certified and
not-yet-certified doulas to identify similarities and differences, (3)
document doulas' attitudes toward and perspectives on salient aspects
of their work, and (4) identify important questions for future research.
The study population was drawn from all current members (N=5,109) of
five professional doula associations who were residents of the United
States and who were either certified doulas or had started the
certification process. In June 2003, study participants were asked to
answer a mailed questionnaire. Surveys were completed by 626 doulas
(471 certified and 155 not-yet certified), for an overall response rate
of 64.4%.
The authors found that
- Doulas as a group are primarily white, well-educated married
women with children and household incomes well above the median in the
United States.
- Very few certified doulas are earning significant income from
this work.
- While almost all doulas find their work emotionally satisfying
and rewarding, only about one out of three certified doulas describe
their work as financially rewarding.
- Approximately one out of four doulas are using doula work as
preparation for a career in midwifery.
- The vast majority of certified doulas believe that insurance
reimbursement for doula services is desirable.
- A significant number of doulas do not feel supported or respected
by physicians, obstetrical nurses, other clinicians, and health care
administrators.
The authors conclude that "additional research is needed to better
understand the unique role and contributions of doulas/labor assistants
to maternity care teams in the 21st century."
Lantz PM, Low LK, Varkey S, et al. 2005. Doulas as childbirth
paraprofessionals: Results from a national survey. Women's Health
Issues 15(3):109-116. Abstract available at http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6TD8-4G5B13V-4&_user=655954&_handle=V-WA-A-W-Y-MsSAYVA-UUW-U-AAAECEZBEV-AAADADDAEV-ABWWBYCUE-Y-U&_fmt=summary&_coverDate=06%2F30%2F2005&_rdoc=4&_orig=browse&_srch=%23toc%235192%232005%23999849996%23595587!&_cdi=5192&view=c&_acct=C000035538&_version=1&_urlVersion=0&_userid=655954&md5=d1647b74c3db762917d37f2867083db7.
Readers: More information on the provision of continuous caregiver
support during childbirth is available from the MCH Library's knowledge
path, Preconception and Pregnancy, at http://www.mchlibrary.info/KnowledgePaths/kp_pregnancy.html.
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6. ARTICLE EXAMINES IMMIGRANT FAMILIES' AWARENESS OF HEALTH AND
COMMUNITY RESOURCES
"Immigrant parents are at particularly high risk of alienation from
systems of health care and support services that are available to
low-income and other vulnerable populations in the United States,"
write the authors of an article published in the March 2005 issue of
the Maternal and Child Health Journal. U.S. census data indicate that
20% of children lived with a foreign-born householder in 2002; these
children tended to be younger and more likely to be living in poverty
than those living with U.S.-born householders. Despite studies showing
lower mortality and morbidity risks among immigrants compared to
U.S.-born infants, children, and adults, other measures of well-being
have been less favorable. The study described in this article discusses
the prevalence of resource awareness by immigrant status of parents and
isolates the independent risk factors that contribute to immigrants'
lack of awareness of family resources in their communities.
The study used data from the 1999 National Survey of America's
Families, which includes 35,938 children under age 18. The analysis
assessed parents' immigrant status (U.S.-born citizens, naturalized
U.S. citizens, and noncitizens) and parents' knowledge of specific
programs in the community where they or their families can go for six
types of support services, including (1) for a teenager to get help to
stay out of trouble with pregnancy, drugs, or crime; (2) for a family
to go for help getting housing, food, or money in an emergency; (3) for
a family to go if the parents and children are arguing a lot; (4)
resources that step in if parents cannot or will not take care of their
children; (5) resources that can help if a family member is being
violent to a child or adult in the family; and (6) for someone to go to
get help to stop abusing drugs or alcohol.
The authors found that
- Lack of awareness of community resources was most common among
noncitizens; at least two-thirds of this group was unaware of community
resources for each of the six services.
- Naturalized citizens reported levels of awareness of community
resources that were in between the levels of U.S.-born citizens and
noncitizens.
- Parents of preschool children, Hispanics, Asians, blacks, those
with a high-school education or less, and those not currently employed
reported lower levels of community resources than their counterparts.
The authors conclude that "it is critical that community resources use
all available means to reach immigrant communities in their languages
and with culturally acceptable messages, to alert them to the
availability of the essential services that they can provide."
Yu SM, Huang ZJ, Schwalber RH, et al. 2005. Parental awareness of
health and community resources among immigrant families. Maternal and
Child Health Journal 9(1):27-34. Abstract available at http://www.springerlink.com/app/home/contribution.asp?wasp=04ecbff2b5e4413a8e95a8616717b55a&referrer=parent&backto=issue,5,14;journal,1,33;linkingpublicationresults,1:105600,1.
Readers: More information about culturally competent services is
available from the MCH Library's bibliography at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_cultcomp.html&-MaxRecords=all&-DoScript=auto_search_cultcomp&-search and organizations resource list at http://www.mchlibrary.info/action.lasso?-database=Organizations&-layout=Web&-response=/databases/OrgLists/orgs_cult.html&-MaxRecords=all&-DoScript=auto_search_cult&-search.
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MCH Alert © 1998-2005 by National Center for Education in Maternal
and
Child Health and Georgetown University. MCH Alert is produced by
Maternal and Child Health Library at the National Center for Education
in Maternal and Child Health under its cooperative agreement
(U02MC00001) with the Maternal and Child Health Bureau, Health
Resources and Services Administration, U.S. Department of Health and
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Please contact us at the address below.
MANAGING EDITOR: Jolene Bertness
CO-EDITOR: Tracy Lopez
COPYEDITOR/WRITER: Ruth Barzel
MCH Alert
Maternal and Child Health Library
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Washington, DC 20057-1272
Phone: (202) 784-9770
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