Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.
January 13, 2006
1. MCH Library Releases New Resources on Screening and on
Community Programs
2. Report Highlights Progress in Estimating Frequency of
Birth Defects
3. Authors Evaluate Web Sites on Quality of
Consumer-Related Breastfeeding Education
4. Study Assesses Effect of Welfare Reform on Prenatal
Care Among Hispanic Women
5. Article Investigates Neighborhood Safety and
Overweight Status in Children
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1. MCH LIBRARY RELEASES NEW RESOURCES ON SCREENING AND ON COMMUNITY
PROGRAMS
The MCH Library has produced three new bibliographies and one new
organizations resource list on priority topics of interest to the
maternal and child health (MCH) community: neonatal screening, child
developmental screening, effective program practices, and effective
community programs. MCH Library bibliographies are drawn from
MCHLine(r), the MCH Library online catalog. Each bibliography includes
selected materials published primarily in 1998 or later; some are
written for health professionals and some for parents. The
bibliographies focus on publications from federal and state agencies,
from grantees of federal and state agencies, and from professional and
voluntary organizations. Unique materials on the history of MCH in the
United States, policy papers, reports, conference proceedings, manuals,
survey instruments, guidelines, and curricula are included. The three
new bibliographies are available as follows:
Neonatal screening is available at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_neoscrn.html&-MaxRecords=all&-DoScript=auto_search_neoscrn&-search.
Child developmental screening is available at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_devscrn.html&-MaxRecords=all&-DoScript=auto_search_devscrn&-search.
Effective program practices, a bibliography of publications that
identify best and promising practices and evidence-based practices in
community health programs, is available at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_effective.html&-MaxRecords=all&-DoScript=auto_search_effective&-search.
The new organizations resource list, titled Effective Community
Programs, identifies model programs and those that embody best and
promising practices. The resource list is available at http://www.mchlibrary.info/action.lasso?-database=Organizations&-layout=Web&-response=/databases/OrgLists/orgs_best.html&-MaxRecords=all&-DoScript=auto_search_best&-search.
MCH Library information products on other MCH topics are available at http://www.mchlibrary.info/products.html.
The MCH Library welcomes feedback on the usefulness and value of these
bibliographies and resource lists. A feedback form is available within
each product.
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2. REPORT HIGHLIGHTS PROGRESS IN ESTIMATING FREQUENCY OF BIRTH DEFECTS
There has been "substantial progress towards improved national
prevalence estimates for 18 selected major birth defects," according to
a report published in the January 6, 2006, issue of the Morbidity and
Mortality Weekly Report. To date, no national estimates based on
population-based surveillance data have been available for specific
types of birth defects other than neural tube defects (spina bifida and
anencephaly). The report describes estimates of national prevalence and
number of affected births in the United States each year during
1999-2001 for 18 selected major birth defects using population-based
active birth defects surveillance data.
Data for the analysis were drawn from the National Birth Defects
Prevention Network (NBDPN). NBDPN collects population-based
surveillance data for up to 45 major birth defects from 34
participating states. Pooled data from the 11 states that had (1)
active case-finding for 18 selected birth defects for 1999-2001 birth
years and (2) data reported to NBDPN for all 3 years (1999-2001) were
used to calculate prevalence estimates. Selected defects were chosen
because they are recognizable at or shortly after birth, and their
ascertainment is less likely to be affected by regional differences in
referral and clinical management practices than is the ascertainment of
other types of defects. National estimates were adjusted by race and
ethnicity and by maternal age.
The authors found that
- Ten of the 18 birth defects affected more than 1,000 infants each
year in the United States.
- The conditions with the highest prevalence included orofacial
clefts, which affect approximately 6,800 infants annually, and Down
syndrome, which affects approximately 5,500 infants annually.
The authors conclude that these findings "can help determine resource
needs for basic and public health research and assist in planning for
the health care and educational needs of the U.S. population."
Canfield MA, Ramadhani TA, Yuskiv N, et al. 2006. Improved national
prevalence estimates for 18 selected major birth defects -- United
States, 1999-2001. Morbidity and Mortality Weekly Report
54(51&52):1301-1305. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5451a2.htm.
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3. AUTHORS EVALUATE WEB SITES ON QUALITY OF CONSUMER-RELATED
BREASTFEEDING EDUCATION
"In the 21st century, new mothers are clearly using the Internet for
health education; therefore, it is essential that nurses know which Web
sites can be recommended for accurate breastfeeding information," state
the authors of an article published in the January/February 2006 issue
of MCN: Maternal and Child Nursing. The article presents findings from
an evaluation of the quality of 30 selected Web sites on
consumer-related breastfeeding education.
Web sites were identified for evaluation using two separate searches of
three of the most visited search engines on the Web (Google, Yahoo, and
MSN). The searches were performed between June 7 and 24, 2004. Quality
was defined and evaluated using the seven criteria of the Health
Information Technology Institute (HITI). These criteria included
credibility, content, disclosure, links, design, interactivity, and
caveats. The Flesch Reading Ease Score and Flesch-Kincaid Grade Level
scales were used to evaluate readability. The quality of the
breastfeeding content of each Web site was evaluated using eight
criteria based on the American Academy of Pediatrics' (AAP's) 1997
policy statement on breastfeeding.
Of the 30 Web sites evaluated, the authors found that
- Three (10%) were developed by nonprofit organizations, and 13
(43.3%) were developed by for-profit companies; other sites are
personal Web sites and the sites of government agencies, professional
organizations, and medical centers.
- Twenty-one (70%) identify the authors or developers.
- Five (16.7%) clearly state when the site was originally
established, and 11 (36.7%) indicate when the content was last updated.
- Seventeen (56.7%) are useful for someone looking for basic
information about breastfeeding.
- Nineteen (63.3%) report research studies, expert opinion, or
reputable organizations to support the breastfeeding information
contained on the Web site. Disclaimers are clearly included in 17
(56.7%) of the sites.
- Twenty (66.7%) include a mission or purpose statement.
- Eighteen (60%) contain quality links.
- Twenty (66.7%) have search engines that were easy to use.
- Twenty-six (86.7%) include a way for users to give feedback about
the Web site to the site administrator.
- Six (20%) contain moderated message boards or a chat room; four
of these six include a description of the credentials or experience of
the moderators.
- Twenty-nine do not contain caveats.
- Eight (26.7%) have a Flesch-Kincaid grade level that was eighth
grade or lower.
- Seven (23.3%) meet all eight AAP criteria.
Five sites were selected for recommendation, each of which contained
all eight of the AAP content criteria, met all the HITI, and had an
interesting and unique presentation of basic breastfeeding information.
Readability was considered in selecting the top five sites, but a site
was not excluded if it scored over an eighth-grade level.
The authors conclude that information in this article can be used by
health professionals to recommend breastfeeding Web sites and to
evaluate Web sites using HITI and AAP criteria.
Dornan BA, Oermann MH. 2006. Evaluation of breastfeeding Web sites for
patient education. MCN: Maternal and Child Nursing 31(1):18-23.
Abstract available at http://www.mcnjournal.com/pt/re/mcn/abstract.00005721-200601000-00006.htm;jsessionid=DCVhvliSsqT10ta89eCGdMySxndjXZrK6ZwTqY29Ugr9maQRQ1cB!600736187!-949856144!9001!-1.
Readers: More information is available from the MCH Library's annotated
bibliographies, Breastfeeding and Working Mothers, at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_brfeedwork.html&-MaxRecords=all&-DoScript=auto_search_brfeedwork&-search,
Breastfeeding: Consumer Education Materials, at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_brfeedcons.html&-MaxRecords=all&-DoScript=auto_search_brfeedcons&-search,
and Breastfeeding Promotion, Support, and Education, at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_brfeedprom.html&-MaxRecords=all&-DoScript=auto_search_brfeedprom&-search;
and from the organizations resource list, Breastfeeding, at http://www.mchlibrary.info/action.lasso?-database=Organizations&-layout=Web&-response=/databases/OrgLists/orgs_brfeed.html&-MaxRecords=all&-DoScript=auto_search_brfeed&-search.
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4. STUDY ASSESSES EFFECT OF WELFARE REFORM ON PRENATAL CARE AMONG
HISPANIC WOMEN
"In this study of 3,242 childbearing Hispanic women in California,
Florida, and New York, state of residence, a measure of PRWORA
[Personal Responsibility and Work Opportunity Reconciliation Act]
policy changes, was associated with use of prenatal care," state the
authors of an article published in the January 2006 issue of Obstetrics
& Gynecology. The 1996 PRWORA (i.e., welfare reform legislation)
imposed new restrictions on the use of federal Medicaid funds for some
groups of documented immigrants and retained prohibitions on the use of
federal Medicaid funds for undocumented immigrants (except for
emergency services). Under PRWORA, states were given the option of
providing benefits to federally ineligible groups using nonfederal
sources of funding. The article presents findings from a large,
prospective, multistate study to assess whether state-based differences
in the implementation of PRWORA influenced access to and use of
prenatal care among Hispanic women.
Women who delivered at one of seven hospitals in one of three states
(New York, California, and Florida) between March 1999 and February
2001 were recruited for the study. (Florida implemented the eligibility
restrictions, while California and New York preserved eligibility.)
Women were interviewed during the delivery hospitalization to assess
immigration status, demographic and other maternal characteristics, and
barriers to prenatal care. Information about use of prenatal care
(onset of care and number of prenatal visits) was abstracted from the
maternal medical record. The first analyses compared the distribution
of maternal characteristics by state immigration status groups and
assessed differences in onset of prenatal care and number of prenatal
visits by state of residence. The final analysis estimated the effect
of all variables on the risk of inadequate use of prenatal care
(initiated during the first trimester and less than six prenatal visits
or initiated after the first trimester).
The authors found that
- In Florida, U.S-born citizens, foreign-born citizens, documented
immigrants, and undocumented immigrants were all more likely to have
inadequate use of prenatal care than U.S-born citizens in New York.
- In New York, documented immigrants were 90% more likely to have
inadequate use of prenatal care than their U.S.-born citizen
counterparts.
"Our findings imply that the potential adverse effects of the PRWORA on
perinatal outcomes may be attenuated by state-level efforts to maintain
Medicaid eligibility for pregnant women, regardless of immigration
status," conclude the authors.
Fuentes-Affleck E, Hessol NA, Bauer T, et al. 2006. Use of prenatal
care by Hispanic women after welfare reform. Obstetrics &
Gynecology 107(1):151-160. Abstract available at http://www.greenjournal.org/cgi/content/abstract/107/1/151.
Readers: More information about access to and use of prenatal care is
available from the MCH Library's annotated bibliography at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_prenatal.html&-MaxRecords=all&-DoScript=auto_search_prenatal&-search
and from the organizations resource list at http://www.mchlibrary.info/action.lasso?-database=Organizations&-layout=Web&-response=/databases/OrgLists/orgs_prenat.html&-MaxRecords=all&-DoScript=auto_search_prenat&-search.
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5. ARTICLE INVESTIGATES NEIGHBORHOOD SAFETY AND OVERWEIGHT STATUS IN
CHILDREN
"Results from a diverse sample . . . indicate that parental perception
of the neighborhood as unsafe was independently associated with an
increased risk of overweight at the age of 7 years," write the authors
of an article published in the January 2006 issue of Archives of
Pediatrics and Adolescent Medicine. Recent data confirm that 15.8% of
children ages 6-11 in the United States are overweight (Body Mass Index
[BMI] greater than or equal to 95th percentile for age and sex). The
relationship between child overweight and the home environment and
parenting have received significant attention in the literature, but
the neighborhood and built environment as independent contributors to
child overweight have not been examined as thoroughly. The study
described in this article investigates the relationship between
parental perception of neighborhood safety and overweight in 7-year-old
children in 10 diverse regions of the country.
The study sample was composed of children and their parents enrolled in
the National Institute of Child Health and Human Development Study of
Early Child Care and Youth Development, a longitudinal study of
relationships between child behavior and development and key
developmental contexts. The final sample consisted of 768 children.
The authors found that
- The sample was approximately 50% male and 85% white. Ten percent
of the children in the sample were overweight.
- Parents of children who were overweight in first grade perceived
their neighborhoods as significantly less safe than parents of children
who were not overweight.
- There was a higher risk of overweight among children living in
the three less-safe neighborhood quartiles, compared with the risk for
those living in the safest neighborhood quartile.
- After adjusting for BMI score at age 4.5, the relationship
between parental perception of a less-safe neighborhood and child
overweight remained.
The authors conclude that "these results suggest the need to understand
the character of a child's neighborhood when making recommendations for
lifestyle and activity changes aimed at obesity prevention and
treatment."
Lumeng JC, Appugliese D, Cabral HJ, et al. 2006. Neighborhood safety
and overweight status in children. Archives of Pediatrics and
Adolescent Medicine 160(1):25-31. Abstract available at http://archpedi.ama-assn.org/cgi/content/abstract/160/1/25.
Readers: More information is available from the Bright Futures Web site
at http://www.brightfutures.org/physicalactivity/about.htm;
from the MCH Library knowledge paths, Overweight in Children and
Adolescents, at
http://www.mchlibrary.info/KnowledgePaths/kp_overweight.html
and Physical Activity and Children and Adolescents, at http://www.mchlibrary.info/KnowledgePaths/kp_phys_activity.html.
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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
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
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part of the information contained in this publication should be sent to
mchalert@ncemch.org.
The editors welcome your submissions, suggestions, and questions.
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
Georgetown University
Box 571272
Washington, DC 20057-1272
Phone: (202) 784-9770
Fax: (202) 784-9777
E-mail: mchalert@ncemch.org
Web site: http://www.mchlibrary.info/alert/index.html
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