Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.
November 10, 2006
1. New Web Site Focuses on the History and Legacy of
Maternal and Child Health
2. Joint Policy Statement Released on the Provision of
Patient- and Family-Centered Care in the Emergency Department
3. Resource Designed to Aid in Development and
Sustainability of Effective Community-Based Participatory Research
Partnerships
4. Pilot Study Assesses the Validity of Women's Health
Care Minimum Data Set
5. Article Examines the Effects of Periodontal Disease
Treatment on Birth Outcomes
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1. NEW WEB SITE FOCUSES ON THE HISTORY AND LEGACY OF MATERNAL AND
CHILD HEALTH
MCH Timeline: History, Legacy, and Resources for Education and Practice
provides information on some of the most important events in the
history of maternal and child health (MCH) in the United States. The
Web site, developed by the Health Resources and Services
Administration's Maternal and Child Health Bureau (MCHB), displays a
timeline of events in MCH history from 1798 to the present. Events on
the timeline may be further explored by group (Public Health and
Medicine, Government and Policy), by topic (infant mortality, systems
of care, performance and accountability), by decade, or by title.
Detailed narratives containing images, historical perspectives, current
issues, and related resources are provided for select topics and
events. The Web site is intended primarily for use as an orientation
tool for individuals new to the MCH profession, MCHB grantees, and MCH
students. The Web site is available at http://www.mchb.hrsa.gov/timeline.
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2. JOINT POLICY STATEMENT RELEASED ON THE PROVISION OF PATIENT- AND
FAMILY-CENTERED CARE IN THE EMERGENCY DEPARTMENT
Patient- and Family-Centered Care and the Role of the Emergency
Physician Providing Care to a Child in the Emergency Department
addresses the particular challenges in, and opportunities for,
providing patient- and family-centered care (PFCC) in the emergency
department (ED) setting. The joint policy statement of the American
Academy of Pediatrics (AAP) and the American College of Emergency
Physicians (ACEP) defines PFCC as an approach to health care that
recognizes the role of the family in providing medical care; encourages
collaboration between the patient, the family, and the health
professional; and honors individuals' and families' strengths,
cultures, traditions, and expertise. Select topics include (1)
overcrowding and acuity in the ED, resulting in delay or disruption of
care and challenging the ability of ED staff to provide respectful and
sensitive care; (2) the lack of a previous relationship between the
patient, the family, and the health professional, making it difficult
to create an effective partnership; (3) the many cultural and societal
variations among families, making it difficult to identify a child's
legal guardian; and (4) situations unique to the ED, requiring
thoughtful advanced planning. AAP and ACEP recommendations are
included. The policy statement is available at http://aappolicy.aappublications.org/cgi/reprint/pediatrics;118/5/2242.
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3. RESOURCE DESIGNED TO AID IN DEVELOPMENT AND SUSTAINABILITY OF
EFFECTIVE COMMUNITY-BASED PARTICIPATORY RESEARCH PARTNERSHIPS
Developing and Sustaining Community-Based Participatory Research
Partnerships: A Skill-Building Curriculum is a tool for
community-institutional partnerships that are using or planning to use
a community-based participatory research (CBPR) approach to improving
health. The curriculum, developed by Campus-Community Partnerships,
focuses on developing and sustaining CBPR partnerships. The curriculum
comprises seven units addressing the following topics: (1) definitions,
rationale, key principles, benefits, and ethics of CBPR; (2)
identifying and selecting partners and setting priorities; (3)
establishing an organizational structure, a mission statement and
bylaws, and principles; (4) trust and communication in a CBPR
partnership; (5) securing and distributing funds; (6) disseminating
results; and (7) sustainability. Each unit contains learning
objectives, in-depth content information about the topic(s) being
presented, examples and interactive exercises, and citations and
suggested resources. The curriculum is available at http://depts.washington.edu/ccph/cbpr/index.php.
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4. PILOT STUDY ASSESSES THE VALIDITY OF WOMEN'S HEALTH CARE MINIMUM
DATA SET
"The WHCMDS [Women's Health Care Data Set] has evidence of validity for
describing aspects of women's health care as practiced by midwives,"
state the authors of an article published in the November/December 2006
issue of the Journal of Midwifery and Women's Health. While midwives
are well known for the provision of care during pregnancy and
childbirth, their role in providing preconception counseling, normal
gynecological care, family-planning services, perimenopausal and
postmenopausal care, and basic primary care is less well known. To
foster excellence in this area of clinical practice, midwifery leaders,
practitioners, educators, policymakers, and administrators need to
understand midwives' women's health care practices. The article
presents findings from a pilot study to assess the validity of the
WHCMDS for use in describing the structure, process, and outcomes of
women's health care provided by midwives.
Students of the Graduate Midwifery Program at Philadelphia University
participated in the pilot testing of the WHCMDS as a service-learning
project on behalf of the American College of Nurse Midwives Division of
Research. Each student (N=19) recruited a midwifery practice in which
she had a clinical affiliation and gained permission to pilot test the
WHCMDS according to site policies. Each midwife in each practice (N=65)
was asked to review the WHCMDS before using it and to answer questions
about his or her opinion of the instrument and about his or her current
well-woman health care data-gathering practices. Each student then
gathered data sets on the 30 most recent consecutive women's health
care encounters by certified nurse-midwives or certified midwives
(N=569). Following data collection, midwives were also asked if they
would recommend changes to the tool.
The authors found that
- The study sample included midwifery practices from the Northeast,
the Midwest, and the South. Demographically, the sample was
representative of national data with a few exceptions; the sample had
no home-birth practitioners.
- Of the 18 practices that responded, 15 (83%) said they did not
already gather data on their gynecology, well-woman, or primary-care
practices, and 3 (17%) said they did gather such data.
- The instrument accurately described the care rendered in 34 of 52
(65%) of the charts.
- The most common negative response to the instrument was that it
was too long and took too much time to complete.
"It is recommended that a very streamlined version of this instrument
be developed for clinical use and an amended version of this instrument
be retained to encourage research in this area of midwifery care,"
conclude the authors, adding that "basic descriptive research of
women's health care provided by midwives is still needed and should be
encouraged."
Farley CL, Tharpe N, Miller L, et al. 2006. Women’s health care minimum
data set: Pilot test and validation for use in clinical practice.
Journal of Midwifery and Women's Health 51(6):493-501. Abstract
available at http://www.jmwh.com/article/PIIS1526952306003333/abstract?browse_volume=51&issue_key=TOC%40%40JOURNALSNOSUPP%40MIDWOM%400051%400006&issue_preview=no&select1=no&select1=no&vol=.
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5. ARTICLE EXAMINES THE EFFECTS OF PERIODONTAL DISEASE TREATMENT ON
BIRTH OUTCOMES
"The treatment of periodontitis in pregnant women was safe and
effective in improving
periodontal disease. However, it did not significantly alter the rates
of preterm birth, low birth weight, fetal growth restriction, or
preeclampsia," write the authors of an article published in the
November 2, 2006, issue of The New England Journal of Medicine. Recent
studies suggest that periodontitis, an inflammatory disease caused
primarily by gram-negative bacteria that destroy tooth-supporting
connective tissue and bone, is associated with an increased risk of
preterm birth, as well as low birthweight and preeclampsia. The purpose
of the study described in this article was to assess whether
nonsurgical periodontal treatment in pregnant women reduces the risk of
delivery before 37 weeks and results in a higher birthweight and a
reduced proportion of infants who are small for gestational age. The
primary outcome was gestational age at the end of pregnancy. Secondary
outcomes included birthweight, the proportion of infants who were small
for gestational age, Apgar scores, and admissions to a neonatal
intensive care unit.
The study population consisted of women who had at least 20 natural
teeth and who were identified as having periodontal disease.
Researchers randomly assigned participants (women who were between 13
and 17 weeks of gestation at the beginning of the study) to receive
periodontal treatment either before 21 weeks (413 women) of pregnancy
or after delivery (410 women).
The authors found that
- In the time-to-event analysis, the treatment and control groups
did not differ significantly in gestational age at the end of pregnancy.
- There were no significant differences between the treatment and
control groups in birthweight.
- The treatment and control groups did not differ significantly in
the rates of any secondary outcomes, including preeclampsia.
- Treatment and control groups had a similar number of serious
medical adverse events, which included hospitalization for more than 24
hours for labor pains, hospitalization for any other reason, a
congenital anomaly in the infant, spontaneous abortion, stillbirth, or
neonatal death.
The authors conclude that "Additional studies would be needed to
determine whether the provision of periodontal treatment even earlier
in pregnancy or before conception might improve birth outcomes."
Michalowicz BS, Hodges JS, DiAngelis AJ, et al. 2006. Treatment of
periodontal disease
and the risk of preterm birth. The New England Journal of Medicine
355(18)1886-1894. Abstract available at http://content.nejm.org/cgi/content/abstract/355/18/1885.
Readers: More information is available from the Bright Futures Web site
at http://www.brightfutures.org/oralhealth/about.html;
from the MCH Library's organizations resource list, Oral Health, at http://www.mchlibrary.info/action.lasso?-database=Organizations&-layout=Web&-response=/databases/OrgLists/orgs_oralhealth.html&-MaxRecords=all&-DoScript=auto_search_oralhealth&-search;
and from the National Maternal and Child Oral Health Resource Center at
http://www.mchoralhealth.org.
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MCH Alert © 1998-2006 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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MANAGING EDITOR: Jolene Bertness
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COPYEDITOR/WRITER: Ruth Barzel
LIST ADMINISTRATOR: Beth DeFrancis Sun
MCH Alert
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