MCH Alert


Maternal and Child Health Library

This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.


January 12, 2007

1. Report Presents Recommendations for Enhancing Developmental Care Linkages in Communities, States, and Nationwide
2. Spanish Versions of Bright Futures Developmental Tools Available
3. Supplement Covers Salient Issues That Must Be Addressed in Efforts to Prevent Depression in Children and Adolescents
4. Analysis Examines Relationship Between Case Management Protocol and Child Blood Lead Concentrations
5. Article Assesses Effect of Reading Articles on Dieting or Weight Loss on Weight-Control Behaviors Among Adolescents

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Special Notice:

January is National Birth Defects Prevention Month, and January 8-14, is National Folic Acid Awareness Week. Fortification of enriched cereal-grain products with folic acid to help prevent pregnancies affected by a neural tube defect (NTD) (e.g., spina bifida or anencephaly) became mandatory in the United States in January 1998. A recent report, published in the January 5, 2007, issue of Morbidity and Mortality Weekly Report, uses data from the National Health and Nutrition Examination Survey to assess folate status in women of childbearing age by race/ethnicity from the 1999-2000 survey through the 2003-2004 survey. The report is available at
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5551a2.htm?s_cid=mm5551a2_e.

More information about National Birth Defects Prevention Month is available at http://www.nbdpn.org/current/resources/bdpm2007.html. More information about National Folic Acid Awareness Week is available at http://www.folicacidinfo.org/campaign.

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1. REPORT PRESENTS RECOMMENDATIONS FOR ENHANCING DEVELOPMENTAL CARE LINKAGES IN COMMUNITIES, STATES, AND NATIONWIDE

Pediatric Care Linkages to Improve Developmental Health reviews the current state of pediatric linkages for developmental care, emphasizing the important role of pediatric health professionals in providing developmental care and linking children to needed services and resources within the broader community. The report, published by the Commonwealth Fund, focuses primarily on how pediatric practices "connect" young children and their families to developmental services and supports, whether within the practice setting or beyond. Topics include the context in which pediatric developmental care and linkage takes place, working definitions and a typology for describing linkage strategies, key linkage strategies used by exemplary practices and programs, and recommendations and next steps for improved linkages. The report is available at
http://www.cmwf.org/usr_doc/Fine_beyondreferralpediatriccarelinkagesimprovedevelhlt_976.pdf.

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2. SPANISH VERSIONS OF BRIGHT FUTURES DEVELOPMENTAL TOOLS AVAILABLE

What to Expect & When to Seek Help: Bright Futures Developmental Tools for Families and Providers, now available in Spanish, are designed to help families and service providers from a range of disciplines support the healthy social and emotional development of children and adolescents. The tools are based on Bright Futures in Practice: Mental Health and were developed through a partnership between Bright Futures at Georgetown University and the National Technical Assistance Center for Children's Mental Health, with support from the Child, Adolescent and Family Branch, Center for Mental Health Services, Substance Abuse and Mental Health Services Administration. Four of the tools, each of which is designed to address a specific developmental stage (infancy, early childhood, middle childhood, and adolescence), provide information about healthy child development and parenting and offer guidance on when, where, and how to seek help from local, state, or national resources. A tool to help service providers locate community-based services for families and create a referral network is also included. The tools are available at http://www.brightfutures.org/tools/index.html.

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3. SUPPLEMENT COVERS SALIENT ISSUES THAT MUST BE ADDRESSED IN EFFORTS TO PREVENT DEPRESSION IN CHILDREN AND ADOLESCENTS

The December 2006 supplement to the American Journal of Preventive Medicine focuses on issues specific to prevention of depression in children and adolescents, with a primary emphasis on major depressive disorder. The articles included in the supplement were developed from presentations made at a National Institute of Mental Health-supported meeting held in June 2004 to consider research on prevention of depression in children and adolescents and to discuss new opportunities for expanding the empirical base for preventive interventions. Topics include risk and protective factors and models of depression prevention, the economic burden of depression in children and adolescents, the impact of depression-prevention programs, and translational research opportunities. The supplement does not cover exhaustively the current state of the science for child and adolescent depression prevention but does address many of the challenges and opportunities for reducing the burden of depression in children and adolescents. Specific implications for further work on the prevention of child and adolescent depression are included. The supplement is available at  http://www.sciencedirect.com/science?_ob=PublicationURL&_tockey=%23TOC%236075%232006%23999689993.8998%23639546%23FLA%23&_cdi=6075&_pubType=J&view=c&_auth=y&_acct=C000035538&_version=1&_urlVersion=0&_userid=655954&md5=1fca48ee30395a6068a6d29ddcfa1f24.

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4. ANALYSIS EXAMINES RELATIONSHIP BETWEEN CASE MANAGEMENT PROTOCOL AND CHILD BLOOD LEAD CONCENTRATIONS

"Home investigations for children with borderline elevated blood lead concentrations, combined with strong lead abatement policies, could lower current and future lead exposure among children," state the authors of an article published in the January 2007 issue of Preventing Chronic Disease: Public Health Research, Practice, and Policy. Childhood exposure to lead can have chronic consequences. In 1991, the Centers for Disease Control and Prevention (CDC) designated blood lead concentrations of 10 micrograms per deciliter or higher as the level of concern for children ages 6 and younger. Lead-poisoning-prevention programs have various case-management protocols for children with elevated blood lead concentrations, but the effect of these protocols on children's blood lead concentrations is unknown. The article describes findings from an analysis of childhood-blood-lead-surveillance data from six states to examine changes in blood lead concentrations among children ages 2 and younger to determine whether there is any relationship between blood lead concentrations and state or local case-management protocol.

Children's demographic information and blood-lead-test data were drawn from the CDC's childhood blood lead database, which is compiled from state childhood-blood-lead-surveillance data. The analysis was limited to the six states that (1) had laws requiring that the results of all blood lead tests on children be reported to the state health department, (2) submitted blood-lead-surveillance data from 1994 and 1995 to CDC, and (3) agreed to have their data used for analysis. The states included Iowa, Montana, New Mexico, Ohio, Rhode Island, and Wisconsin. The case-management protocol for a state or county was defined as the method of contact required under the protocol (i.e., mail, telephone, home visit) and the type of service delivered under the protocol (i.e., educational materials on lead exposure prevention alone or on lead source investigation). Each child with blood lead concentrations of 10-19 micrograms per deciliter was assigned a method of contact and a type of service according to information on case-management protocol provided by the coordinator of each state lead-poisoning-prevention program.

The analysis compared mean changes in blood lead concentrations; compared the mean number of months needed for blood lead concentrations to decline to less than 10 micrograms per deciliter; determined differences in the proportion of children whose blood lead concentration was less than 10 micrograms per deciliter at the end of follow-up; and examined the relationship between case-management protocol and changes in blood lead concentration over the entire follow-up period, controlling for the age of the child.

The authors found that
The authors conclude that "although a systematic evaluation of the effect of different types of programs is needed, our results suggest that blood lead concentrations of less than [20 micrograms per deciliter] can be significantly reduced with protocols that include home visits and lead source investigations."

Whitehead NS, Leiker R. 2007. Case management protocol and declining blood lead concentrations among children. Preventing Chronic Disease: Public Health Research, Practice, and Policy 4(1):1-12. Available at http://www.cdc.gov/pcd/issues/2007/jan/06_0023.htm.

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5. ARTICLE ASSESSES EFFECT OF READING ARTICLES ON DIETING OR WEIGHT LOSS ON WEIGHT-CONTROL BEHAVIORS AMONG ADOLESCENTS

"The results indicate that frequency of [reading magazine articles about dieting or weight loss] does, in fact, predict later weight-control behavior in female adolescents," write the authors of an article published in the January 2007 issue of Pediatrics Electronic Pages. Unhealthy weight-control practices, clinical eating disorders, and subclinical disordered eating are significant problems for adolescents, especially adolescent girls. Researchers have identified multiple concurrent and prospective predictors of problematic eating behavior, including body mass index (BMI), body dissatisfaction, and perceived pressure to be thin from peers, family, and the media. The study described in this article builds on previous research by examining whether reading magazine articles about dieting or weight loss predicts eating behaviors and psychological outcomes over 5 years during adolescence.

Data from the study come from Project EAT (Eating Among Teens), a 5-year longitudinal study of eating, activity, weight, and related variables in 2,516 middle-school and high-school students. Participants were recruited for time 1 from 31 Minnesota public junior and senior high schools during the 1998-1999 school year. The study sample at time 1 consisted of 4,746 adolescents in grades 6-12. Project EAT II obtained data during the 2003-2004 school year (time 2), enrolling 2,516 adolescents from the original sample. Measures included (1) frequency of diet/weight loss magazine article reading, (2) BMI and weight status, (3) weight importance, (4) weight-control behaviors, (5) binge eating, (6) body satisfaction, (7) depressive symptoms, (8) self-esteem, and (9) sociodemographic characteristics.

The authors found that
The authors conclude that "the results of the current study . . . highlight the importance of media in influencing adolescent girls' physical and emotional health and suggest a need for interventions to moderate this effect."

van den Berg P, Neumark-Sztainer D, Hannan PJ, et al. 2007. Is dieting advice from magazines helpful or harmful? Five-year associations with weight-control behaviors and psychological outcomes in adolescents. Pediatrics Electronic Pages (119)1:e30-e37. Abstract available at http://pediatrics.aappublications.org/cgi/content/abstract/119/1/e30.

Readers: More information is available from the Bright Futures Web site at http://www.brightfutures.org; from the MCH Library's knowledge paths, Child and Adolescent Nutrition, at http://www.mchlibrary.info/KnowledgePaths/kp_childnutr.html, Mental Health in Children and Adolescents, at http://www.mchlibrary.info/KnowledgePaths/kp_mentalhealth.html, 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; and from MCH Library's the organizations resource list, Eating Disorders, at http://www.mchlibrary.info/action.lasso?-database=Organizations&-layout=Web&-response=/databases/OrgLists/orgs_eatdis.html&-MaxRecords=all&-DoScript=auto_search_eatdis&-search.

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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 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.
 
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