Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.
November 3, 2006
1. Report Presents Well-Child Care Change Ideas
2. New Resources Released for the Medical Homes DC Project
3. Authors Document the Public Costs of Adolescent
Childbearing
4. Article Examines Impact of School-Based
Dating-Violence-Prevention Program Among Latino Adolescents
5. Study Analyzes Public Health Preparedness Programs in
the United States
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1. REPORT PRESENTS WELL-CHILD CARE CHANGE IDEAS
A High-Performing System for Well-Child Care: A Vision for the Future
articulates changes needed to realize a high-performance system for the
delivery of well-child care.
The report, published by the Commonwealth Fund, is based on a review of
the current literature to assess key findings in well-child-care
research and important trends affecting the future of well-child care.
The report also draws on the ideas of leaders in child health care,
including pediatric health professionals and family advocates.
Information about the study methodology and trends affecting preventive
and developmental services are presented, followed by a template for
ideal well-child care and recommendations to the field from the
perspectives of families, the microsystem, the health care
organization, and the broader environment. The report is intended to
serve as a template for implementing changes in clinical practice and
as a guide for further policy and research efforts. The report is
available at http://www.cmwf.org/usr_doc/Bergman_high-performsyswell-childcare_959.pdf.
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2. NEW RESOURCES RELEASED FOR THE MEDICAL HOMES DC PROJECT
The Brookings Greater Washington Research Program, with support from
the Health Resources and Services Administration, has published two new
resources for the Medical Homes DC project. The Medical Homes DC
initiative, led by the DC Primary Care Association in collaboration
with the District of Columbia (DC) government, the Brookings
Institution, RAND, community health centers, and others, is designed to
address problems in the delivery system by expanding the reach and
improving the quality of primary health care services for DC residents
who have low incomes and are not insured. The two new resources are:
Health Status and Access to Care Among Low-Income Washington, DC
Residents. This research brief presents a baseline analysis of health
indicators, insurance status, and hospital admissions in DC. Findings
on the percentage of adults with health insurance, the percentage of
adults with a regular source of health care, adults with no regular
source of care, adult chronic disease burden, and potentially avoidable
hospitalization rates (by age and zip code) are included. A conclusion
and remaining questions are also presented. The brief is available at http://www.brookings.edu/metro/pubs/20061020_HealthStatus.pdf.
Leaders Among Us: Developing a Community Health Worker Program in
Washington, DC. This policy brief describes implementing a citywide
community health worker (CHW) program as a strategy to increase access
to and utilization of primary care. The brief provides an introduction
to and background information on the effectiveness of CHW programs and
the local context. Other topics of discussion include laying the
foundation for a CHW program in Washington, DC; creating a training
program and curriculum; employment opportunities for CHWs; building an
evaluation component into the CHW program; and funding a citywide CHW
program. A conclusion and an appendix containing information on core
roles and skills of CHWs are also included. The brief is available at
http://www.brookings.edu/metro/pubs/20061020_LeadersAmongUs.pdf.
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3. AUTHORS DOCUMENT THE PUBLIC COSTS OF ADOLESCENT CHILDBEARING
By the Numbers: The Public Costs of Teen Childbearing presents an
update of the national cost estimates for childbearing among
adolescents ages 19 and younger, as well as state-level cost estimates.
The report, published and disseminated by the National Campaign to
Prevent Teen Pregnancy with support from the William T. Grant
Foundation and Pfizer, Inc., contains information about the aggregate
costs of adolescent childbearing to adolescents and their families, the
public sector, and society. Other By the Numbers project resources
include (1) a one-page summary of key results, (2) a conference call
transcript and audio recording, (3) a resource for policymakers with
ideas on how to improve the prospects of children and families and
reduce public sector costs associated with adolescent childbearing, and
(4) a resource with suggestions on how practitioners and advocates can
highlight state costs in their communities. The resources are intended
for use by practitioners, policymakers, researchers, funders, and
others concerned about adolescent childbearing. The national report,
and other By the Numbers project resources, are available at http://www.teenpregnancy.org/costs/default.asp.
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4. ARTICLE EXAMINES IMPACT OF SCHOOL-BASED DATING-VIOLENCE-PREVENTION
PROGRAM AMONG LATINO ADOLESCENTS
"The Ending Violence curriculum has promise for heightening Latino
students' awareness and understanding of both the legal ramifications
of dating violence and the utility of the legal system (attorneys and
police) as a source of help with such violence," state the authors of
an article published in the November 2006 issue of the Journal of
Adolescent Health. Approximately 16-26% of U.S. adolescents report that
they dated someone who became violent with them, with a higher
incidence reported among Hispanic high school students than among white
high school students. To date, however, no studies have evaluated
violence-reduction programs among Latino populations. The article
presents findings on the impact of Ending Violence: A Curriculum for
Educating Teens on Domestic Violence and the Law. Consistent with
social learning theory, the curriculum aims to reverse acceptance of
violence by stressing that intimate partner violence is illegal and to
increase knowledge and help-seeking by providing information and
resources.
The randomized experimental design was conducted with ninth-grade
health classes in Los Angeles United School District. Eleven of 15
schools, each with a student population that was at least 80% Latino,
agreed to participate. Classes were assigned either to the intervention
condition (received Ending Violence) or the control condition (received
standard health curriculum) and were assessed pre- and
post-intervention and 6 months later. All measures were self-report.
The analysis included 1,384 students in the intervention group and
1,156 in the control group.
The authors found that
- Relative to controls, adolescents in the intervention group knew
significantly more about laws related to dating violence, were less
accepting of female-on-male violence, and were more likely to seek help
for violence at post-test.
- Relative to controls, adolescents in the intervention group
viewed police, lawyers, teachers, counselors, and school nurses as more
helpful and were more likely to consult these sources of help.
- Among adolescents in the intervention group, improvements in
knowledge levels persisted after 6 months, as did the adolescents'
perception that speaking with a lawyer as a response to dating violence
would be helpful.
- Adolescents with low English proficiency who were in the
intervention group were more likely to perceive a nurse or doctor as
helpful than were their counterparts in the control group.
The authors conclude that "improving legal knowledge regarding dating
violence may be a promising prevention element, and may help victims of
dating violence to seek help."
Jaycox LH, McCaffrey D, Eiseman B, et al. 2006. Impact of a
school-based dating violence prevention program among Latino teens:
Randomized controlled effectiveness trial. Journal of Adolescent Health
39(1):694-704. Abstract available at http://www.jahonline.org/article/PIIS1054139X06001790/abstract.
Readers: See also Curbing Teen Dating Violence: Evidence from a School
Prevention Program, a part of the RAND Corporation research brief
series, at http://www.rand.org/pubs/research_briefs/2006/RAND_RB9194.pdf.
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.
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5. STUDY ANALYZES PUBLIC HEALTH PREPAREDNESS PROGRAMS IN THE UNITED
STATES
"This study of state public health agency preparedness has provided new
information about state-level organizational structure, administration,
and support of preparedness programs," state the authors of an article
published in the November-December 2006 issue of Public Health Reports.
In spite of the plethora of terrorism preparedness activities and
recent published literature about preparedness and the pivotal role
played by the public health work force, little is known about the
organization of state public health programs around the country, their
administration, and the infrastructure supporting preparedness.
Moreover, the various approaches state public health preparedness
programs have taken to resolve their unique needs with respect to
federal funding sources have not been documented. The current study was
initiated to address this information gap related to public health
preparedness infrastructure at the state level.
For the study, in fall 2004 the Association of State and Territorial
Health Officials surveyed state health departments about the status of
current organizational characteristics of state-level preparedness
activities.
The authors found that
- Individuals representing 44 states and the District of Columbia
responded to the Web-based questionnaire for an overall response rate
of 88.2%.
- States tended to subdivide their organizations into regions for
preparedness purposes.
- More than half of the established preparedness regions were
created after September 11, 2001.
- Nearly three-fourths of the preparedness program directors
reported directly to either the state health official or a deputy
health official.
- Public health preparedness budgets from all sources for FY 2004
were widely variable, ranging from less then $10 million to more than
$45 million.
- The Centers for Disease Control and Prevention and the Health
Resources and Services Administration have greatly expanded statewide
public health preparedness work force and support, with nearly all
local public health agencies benefiting in some fashion.
- More than one-third of the states also contribute to the public
health preparedness budget.
The authors conclude that "integrating these results with the available
knowledge regarding the strengthening of the public health workforce
and proven strategies for promoting coordinated interagency
collaboration holds great potential for improving state public health
system preparedness performance, should terrorism again darken our
borders."
Beitsch LM, Kodolikar S, Stephens T, et al. 2006. A state-based
analysis of public health preparedness programs in the United States.
Public Health Reports 121(6):737-745. Available at http://www.publichealthreports.org/userfiles/121_6/16_PHR121-6_737-745.pdf.
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and
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