MCH Alert

Maternal and Child Health Library

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May 19, 2006

1. Report Suggests Strategies for Integrating Youth Development into State-Funded Programs That Address Adolescent Issues
2. Report Highlights Survey Findings on Parent Report of Diagnosed Autism
3. Article Presents Study Findings on Correlates of Dieting Behavior Among Overweight and Non-Overweight Adolescents
4. Analysis Investigates Paternal Age As a Risk Factor for Low Birthweight
5. Authors Assess Unmet Need and Access to Health Care Among Children with Special Health Care Needs



Incorporating Youth Development Principles into Adolescent Health Programs: A Guide for State-Level Practitioners and Policy Makers focuses on how youth development concepts may be applied within the context of specific public health functions and program responsibilities to achieve improved health and well-being among adolescents. The paper, produced by the Forum for Youth Investment, presents an overview of the youth-development approach, which calls for a focus on adolescents’ capacities, strengths, and developmental needs and not solely on their problems, risks, or health-compromising behaviors. The overview is followed by a summary of specific strategies for integrating youth development principles within each of five different public health functional areas: (1) commitment to adolescents and youth development, (2) partnerships and collaboration for health and youth development, (3) programs and services, (4) education and technical assistance, and (5) data collection and surveillance. Examples of how states have implemented the strategies, as well as additional resources, are also provided for each of the five areas. The report is intended for use by adolescent health coordinators and other health professionals and policymakers in incorporating youth development into state-funded programs that address adolescent issues. The report is available at



"These estimates suggest that, as of 2003-2004, autism had been diagnosed in at least 300,000 U.S. children ages 4-17," state the authors of a report published in the May 5, 2006, issue of Morbidity and Mortality Weekly Report. The report describes the results of an analysis of two nationally representative surveys in which parents were asked whether their child ever received a diagnosis of autism. The purpose of the analysis was to estimate the population-based prevalence of parental report of diagnosed autism in the United States and to assess parental reporting of child social, emotional, and behavioral strengths and difficulties and special health care needs among children with and without reported autism.

Data for the analysis were drawn from the 2003-2004 National Health Interview Survey (NHIS) and the first-ever National Survey of Child Health (NSCH), collected during January 2003 to July 2004.

The authors found that
"The consistency in estimates between the two surveys suggests high reliability for parental report of autism," state the authors, adding that "these surveys might be useful to assess health, education, and social service needs of children with autism."

Shieve LA, Rice C, Boyle C, et al. 2006. Mental health in the United States: Parental report of diagnosed autism in children aged 4-17 years United States, 2003-2004. Morbidity and Mortality Weekly Report 55(17):481-486. Available at

Readers: More information is available from the MCH Library's knowledge path, Autism Spectrum Disorders, at



"Findings from the present study show that the risks associated with dieting appear similar for overweight and non-overweight teens," state the authors of an article published in the May 2006 issue of the Journal of Adolescent Health. Dieting behavior has been shown to co-occur with a variety of negative correlates in adolescents. Dieting could be a reasonable, health-promoting behavior for adolescents who are overweight, while simultaneously carrying health risks for those not overweight. Alternatively, dieting could carry similar risks for all adolescents, regardless of their weight status. The goal of the study described in this article was to examine correlates of dieting in overweight and non-overweight adolescents utilizing a large community sample.

Data for the study were drawn from Project EAT (Eating Among Teens), a survey of 4,746 public middle- and high-school students in the greater Twin Cities area of Minnesota to assess nutritional, weight-related, and psychosocial factors. Self-reported and observed measures of height and weight and growth charts from the Centers for Disease Control and Prevention were used to calculate the students' body mass index (BMI) and to classify them into one of two groups: non-overweight (BMI less than 15th to less than 85th percentile) and overweight (BMI greater than or equal to 95th percentile). Other measures included dieting for weight-loss purposes, extreme weight-control behaviors (EWCBs), body satisfaction, depressive symptoms, self-esteem, substance use, and demographic variables. The initial analysis identified differences in the proportion of each dependent variable by overweight status. Separate analyses were used to calculate the odds of each dependent variable for dieters compared to nondieters, stratified by gender and by overweight status, and to control for grade level, white race, and socioeconomic status. The research also determined if the associations between dieting and each dependent variable were significantly different for overweight vs. non-overweight adolescents.

The authors found that
"The psychosocial and behavioral risks of dieting . . . may outweigh the potential benefits, even for overweight teens," conclude the authors.

Crow S, Eisenberg ME, Story M, et al. 2006. Psychosocial and behavioral correlates of dieting among overweight and non-overweight adolescents. Journal of Adolescent Health 38(5):569-574. Abstract available at!&_cdi=5072&view=c&_acct=C000035538&_version=1&_urlVersion=0&_userid=655954&md5=abcb9697e18faa0b8e4102214e3088fe.

Readers: More information is available from the Bright Futures Web site at and from the MCH Library's knowledge path, Overweight in Children and Adolescents, at



"Using a population-based urban sample and adjusting for maternal age and other risk factors, we found that increased paternal age is positively associated with the probability of low birthweight," state the authors of an article published in the May 2006 issue of the American Journal of Public Health. The article describes findings from the first study to investigate the association between paternal age and low birthweight in an urban population.

The study sample was drawn from a national longitudinal birth cohort and included 4,621 births. Maternal and paternal age, birthweight, maternal demographic characteristics, and the child's gender were obtained from maternal reports. The analysis examined (1) the association between the mother's age and low birthweight (less than 2,500 g), with adjustment for maternal demographic characteristics and the child's gender; (2) the association between the father's age and low birthweight, with adjustment for maternal demographic characteristics (other than age) and the child's gender; and (3) the association between the father's age and low birthweight, with the mother's age and other covariates controlled. The analysis also explored racial and ethnic differences in the associations between low birthweight and parents' ages.

The authors found that
"Our finding that paternal age is an independent risk factor for low birthweight in an urban population suggests that more attention needs to be paid to paternal influences on birth outcomes and, more generally, to the interactive effects of urban environments and individual risk factors on health," conclude the authors.

Reichman N, Teitler J. 2006. Paternal age as a risk factor for low birth weight. American Journal of Public Health 96(5):862-866. Abstract available at



"This analysis has extended what is known about serviced need, unmet need, and access problems for a diverse sample of CSHCN [children with special health care needs] and their families by examining, individually, six core specialty services and four specific types of access problems," state the authors of an article published in the March 2006 issue of the Maternal and Child Health Journal. Children who have a special health care need are more vulnerable than other children to poor health outcomes. Therefore, providing quality health care for CSHCN is critical. The purpose of the present analysis is to extend what is known about parent reports of service need, unmet need, and access problems for their CSHCN by examining individual types of services and selected types of problems.

The authors used data from the 1998-1999 Family Partners Survey, a 20-state survey of families with CSHCN. The final sample consisted of 2,200 families.

The analysis generated six key findings related to parent report of service need, unmet need, and access problems that have important implications for health care policy and practice. These findings are as follows:
The authors conclude that "the results underscore the importance of finding new ways to link children with behavioral health problems to mental health services, implementing the medical home concept, increasing the number of specialty pediatricians and home health providers, and expanding coverage for a wider range of mental health services, particularly in private health plans and through secondary coverage."

Warfield ME, Gulley S. 2006. Unmet needs and problems accessing specialty medical and related services among children with special health care needs. Maternal and Child Health Journal 10(2):201-216. Abstract available at,9,10;journal,2,40;linkingpublicationresults,1:105600,1.

Readers: More information is available from the MCH Library's knowledge path, Children and Adolescents with Special Health Care Needs, at


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