Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.
December 1, 2006
1. 2007 Folic Acid Campaign Materials Released
2. Resource Center Launched to Promote Interdisciplinary
Collaboration
3. Study Assesses the Validity of Household-Reported
Pediatric Asthma
4. Authors Examine Effects of Medicaid Policies on Mental
Health Service Use Among Children in the Child Welfare System
5. Article Discusses the Public Roles of U.S. Physicians
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Special Notices
WORLD AIDS DAY
World Aids Day (December 1, 2006) serves to focus global attention on
the impact of HIV and AIDS. established by the World Health
Organization in 1988, World AIDS Day provides an opportunity for
governments, national programs, community organizations, and
individuals to demonstrate the importance of the fight against HIV and
AIDS. Materials (fact sheets, poster) and information about domestic
events to commemorate World AIDS Day are available from the Office of
Minority Health Resource Center's Web site at http://www.omhrc.gov/hivaidsobservances/world/index.html.
Information about international events is available at http://www.worldaidscampaign.info.
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LAST CALL: A QUICK READER FEEDBACK FORM
Thanks to all who have completed the MCH Alert Reader Feedback Form to
date.
This week, we will once again send a request for feedback in a separate
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1. 2007 Folic Acid Campaign Materials Released
The Folic Acid Now! campaign offers an online media tool kit and
consumer materials that community programs can customize and use during
National Folic Acid Awareness Week (January 8-14, 2007). The campaign
is sponsored by the March of Dimes and the National Alliance for
Hispanic Health and managed by the National Folic Acid Council (NCFA),
a project of the National Healthy Mothers, Healthy Babies Coalition.
The tool kit contains a media outreach worksheet and outreach activity
ideas, including activities for a Hispanic community. A fact sheet and
local press release (in English and Spanish) are also provided.
Consumer materials, including bookmarks, brochures, and stickers (in
English and Spanish) are also available for use in sharing the folic
acid message. Materials may be downloaded from the NCFA Web site, or
ordered free-of-charge. More information is available at http://www.folicacidinfo.org/campaign.
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2. RESOURCE CENTER LAUNCHED TO PROMOTE INTERDISCIPLINARY COLLABORATION
The Prevention Education Resource Center (PERC) is a Web-based
repository of educational materials that can be used to teach about
prevention and population health-related topics. PERC was launched by
the Association for Prevention Teaching and Research (formerly known as
the Association of Teachers of Preventive Medicine) as a core project
for the Healthy People Curriculum Task Force, and it serves to promote
collaboration across health care disciplines, professions, and
institutions by facilitating the exchange of teaching resources and
connecting educators. In addition to teaching materials for clinical
health professions education, PERC houses resources for public health
education and curriculum frameworks and materials for undergraduate
courses in public health and epidemiology. The PERC Web site provides
options for submitting materials for publication on PERC, locating
materials, and assigning ratings and posting comments about materials.
The Web site also offers a discussion forum for educators, an
e-newsletter, and a virtual bureau of education consultants in clinical
prevention and population health. The PERC Web site is available at http://www.teachprevention.org.
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3. STUDY ASSESSES THE VALIDITY OF HOUSEHOLD-REPORTED PEDIATRIC ASTHMA
"Insufficient evidence exists to infer that surveys of parental reports
of asthma overlook many children with active disease," state the
authors of an article published in the November-December 2006 issue of
the Journal of Pediatric Health Care. Parents' survey responses are an
important source of information about the prevalence of asthma in
children and adolescents and about trends and racial and socioeconomic
disparities in pediatric asthma. Recently, the validity of
household-reported asthma information for children and adolescents
living in the household has been questioned. The article reports
results from an analysis that examines confidence in the report of
asthma for children and adolescents obtained in an interview with the
household member most knowledgeable about household health care (MKA).
The analysis is based on data from the 1996 Medical Expenditure Panel
Survey (MEPS) Household Component for all children and adolescents from
birth through age 17 for whom there are data for the entire calendar
year (N=6,789). Pharmacy records were extracted from the MEPS Medical
Provider Component for all children and adolescents in the sample who
were reported to have filled "asthma medication" prescriptions but
whose MKA did not report asthma. Weighted percentages were estimated
for children and adolescents reported to have (1) asthma and (2) filled
"asthma medication" prescriptions. In addition, for each child and
adolescent in the sample who had a filled "asthma medication"
prescription but whose MKA did not report asthma (N=183) each
medication (N=381) and its associated ICD-9-CM codes were examined to
determine whether the medication was reasonable for the non-asthmatic
medical condition reported by the MKA. After this examination, weighted
percentages were estimated for (1) children and adolescents with an MKA
report of asthma/plausible alternative medical condition and (2)
children and adolescents without such a report or condition. The final
analysis examined whether sociodemographic differences exist between
children and adolescents with a report of asthma/plausible alternative
medical condition vs. those with no such a report or condition but who
had filled "asthma medication" prescriptions.
The authors found that
- MKAs reported asthma for 5.4% of children and adolescents in 1996.
- More children and adolescents (6.5%) had filled "asthma
medication" prescriptions than were reported to have asthma.
- Among children and adolescents whose MKAs reported asthma, more
than one-third (37.2%) did not have filled "asthma medication"
prescriptions.
- MKAs reported asthma for about half (52.7%) of children and
adolescents with filled "asthma medication" prescriptions.
- MKAs reported a plausible alternative medical condition for 61.2%
of children and adolescents with filled "asthma medication"
prescriptions but no MKA report of asthma.
- Children ages 5 and younger and females are more likely to have
no MKA report of asthma/plausible alternative medical condition than
were older children and males.
- Differences in reporting asthma/plausible alternative medical
condition were not statistically significant by child or adolescent
race or ethnicity, household income, or education level and
English-language proficiency of the MKA.
"Although the purpose of this study was to evaluate the validity of MKA
reports of asthma in survey data, clinical implications may be drawn,"
state the authors. First, making sure health professionals keep up with
the latest recommended treatments for asthma is critical. Second, the
results from the current study emphasize the importance of health
professional-parent communication. Third, families are the central
member of a child's health care team.
Joesch JM, Kim H, Kieckhefer GM, et al. 2006. Does your child have
asthma? Filled prescriptions and household report of child asthma.
Journal of Pediatric Health Care 20(6):374-383.
Readers: More information is available from the MCH Library's knowledge
path, Asthma in Children and Adolescents, at
http://www.mchlibrary.info/KnowledgePaths/kp_asthma.html.
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4. AUTHORS EXAMINE EFFECTS OF MEDICAID POLICIES ON MENTAL HEALTH
SERVICE USE AMONG CHILDREN IN THE CHILD WELFARE SYSTEM
"Our data suggests that access to mental health services already falls
below need in this nationally representative sample of children in
child welfare environments," state the authors of an article published
in the December 2006 issue of Children and Youth Services Review. The
article presents findings from an analysis of the effects of Medicaid
managed care policies on access to ambulatory and inpatient mental
health services among children in child welfare environments in the
United States.
Data for the analysis were collected from principal caregiver and
child-welfare-worker interviews conducted as part of the National
Survey of Child and Adolescent Well-Being (NSCAW), a study of children
coming into contact with child welfare agencies nationwide. Policy data
were drawn from the Caring for Children in Child Welfare study, a
telephone-administered key informant interview of NSCAW contact persons
in each county. The analysis examined the relationship between policy
variables and use of ambulatory and inpatient mental health services,
controlling for child-level characteristics and county-level health
resources.
The authors found that
- There was no significant relationship between managed care and
access to ambulatory mental health services.
- Children living in counties that carved out behavioral health
services had significantly lower inpatient mental health service use
than children in counties that did not deploy behavioral health
carve-outs, controlling for child-level sociodemographic, insurance,
and need variables.
"Adoption of health care delivery structures that further decrease
service utilization may have adverse consequences for the mental health
of children in the child welfare environments," state the authors. They
conclude that "integrative approaches are crucial in ensuring that
children in the child welfare system obtain the care they require for
their mental health needs."
Raghavan R, Leibowitz AA, Andersen RM, et al. 2006. Effects of Medicaid
managed care policies on mental health service use among a national
probability sample of children in the child welfare system. Children
and Youth Services Review 28(12):1482-1496.
Readers: More information is available from the Bright Futures Web site
at http://www.brightfutures.org/mentalhealth/index.html
and http://www.brightfutures.org/tools/index.html;
and from the MCH Library's knowledge path, Mental Health in Children
and Adolescents, at http://www.mchlibrary.info/KnowledgePaths/kp_mentalhealth.html,
and bibliographies, Adolescent Mental Health, at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_adolmenhlth.html&-MaxRecords=all&-DoScript=auto_search_adolmenhlth&-search
and, Children's Mental Health, at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_chldmenhlth.html&-MaxRecords=all&-DoScript=auto_search_chldmenhlth&-search.
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5. ARTICLE DISCUSSES THE PUBLIC ROLES OF U.S. PHYSICIANS
"This study provides some important evidence for professional leaders
and organizations, policy makers, and educators who may want to engage
more physicians in public health and health policy concerns," state the
authors of an article published in the November 22/29, 2006, issue of
JAMA, The Journal of the American Medical Association. Currently,
little is known about practicing physicians' attitudes about or the
extent to which they participate in community, political, or advocacy
activities. The study described in this article assessed the degree to
which physicians are supportive of assuming public roles and the
sociodemographic and practice factors that influence their attitudes
and activity in this regard.
The study used data from the Institute on Medicine as a Profession's
(IMAP's) Survey on Medical Professionalism. The IMAP survey collected
data about attitudes toward and participation in activities related to
physician professionalism from a nationally representative sample of
physicians in three primary care specialties (general internal
medicine, family practice, and pediatrics) and three nonprimary care
specialties (general surgery, anesthesiology, and cardiology).
The authors found that
- More than 90% of respondents overall, and more than 87% in each
specialty, rated community participation, political involvement, and
collective advocacy to be important. Furthermore, 51.9%, 38.6%, and
61.9% of physicians rated community participation political
involvement, and collective advocacy to be very important, respectively.
- Overall, respondents rated issues related to risky behaviors and
proximal causes of illness and injury, such as obesity and poor
nutrition, immunization, substance abuse, and road safety, as very
important.
- Approximately half of the respondents rated access-to-care issues
(universal health insurance or culturally appropriate care) as being
very important, fewer than half rated air pollution or illiteracy as
being very important, and only 22.6% rated unemployment as being very
important.
- Among respondents, 54.2% reported providing health-related
expertise to local community organizations, 25.6% reported being
politically active (other than voting), and 24.3% reported encouraging
a professional society to address a public health or policy issue that
is not primarily concerned with physician welfare.
- Compared with other specialties, more family practitioners, more
pediatricians, and fewer anesthesiologists reported participating in
community organizations. On the other hand, anesthesiologists and
general surgeons more often reported being politically active than
other physicians.
- Civic activity was significantly associated with
civic-mindedness, being from an underrepresented race or ethnicity,
being a preceptor of physicians in training, having a rural practice
location, and being a graduate of a U.S. or Canadian medical school.
The authors conclude that "confirming and understanding . . . potential
influences could provide important guidance to leaders and policy
makers who want to enlist the positive energy of physicians in
promoting public health at a societal level."
Gruen RL, Campbell EG, Blumenthal D. 2006. Public roles of US
physicians: Community participation, political involvement, and
collective advocacy. JAMA, The Journal of the American Medical
Association. 296(20):2467-2475. Abstract available at http://jama.ama-assn.org/cgi/content/abstract/296/20/2467.
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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
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MCH Alert
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