Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.
April 27, 2007
1. New Edition of Adolescent Pregnancy Prevention
Knowledge Path Available
2. Evaluation Focuses on Challenges Faced by Programs
Aiming to Reduce Adolescent Sexual Activity
3. MCHB Launches Web Site to Increase Awareness of
Perinatal Depression
4. Journal Supplement Highlights Public Health
Preparedness
5. Article Examines Effect of Medicaid Family Planning
Expansions of Unplanned Births
6. Authors Assess Impact of State Children's Health
Insurance Program on Adolescents in New York
************************************************************
1. NEW EDITION OF ADOLESCENT PREGNANCY PREVENTION KNOWLEDGE PATH
AVAILABLE
In recognition of National Day to Prevent Teen Pregnancy (May 2, 2007),
the MCH Library has released a new edition of Knowledge Path:
Adolescent Pregnancy Prevention. The knowledge path is an electronic
guide to current, high-quality resources that measure, document, and
monitor the problem; identify risk and protective factors; and report
on promising intervention strategies. The knowledge path is intended
for use by health professionals, policymakers, researchers, and others
who are interested in tracking information on this topic. Separate
sections identify resources for families and schools. The knowledge
path is available at http://www.mchlibrary.info/KnowledgePaths/kp_adolpreg.html.
MCH Library knowledge paths on other maternal and child health topics
are available at http://www.mchlibrary.info/KnowledgePaths/index.html.
The MCH Library welcomes feedback on the usefulness and value of these
knowledge paths. A feedback form is available at http://www.mchlibrary.info/KnowledgePaths/feedback.html.
More information about the National Day to Prevent Teen Pregnancy is
available at http://www.teenpregnancy.org/national.
************************************************************
2. EVALUATION FOCUSES ON CHALLENGES FACED BY PROGRAMS AIMING TO REDUCE
ADOLESCENT SEXUAL ACTIVITY
Impacts of Four Title V, Section 510 Abstinence Education Programs
examines the impacts of four selected Title V, Section V abstinence
education programs on adolescent sexual activity and related knowledge
and behavioral outcomes. The report, produced by Mathematica Policy
Research, Inc., includes an executive summary and introduction, an
overview of the programs and distinguishing program features, study
implications, and design and methods for the final impact evaluation.
Impacts on sexual abstinence and adolescent risk behaviors, knowledge
and perceptions of risks associated with adolescent sex, predictors of
sexual abstinence, and conclusions are discussed. The appendices
contain supporting tables, outlines of curricula, survey questions
underlying the outcome measures, and program impacts on potential
mediators of adolescent sexual activity. The report is available at http://www.mathematica-mpr.com/publications/PDFs/impactabstinence.pdf.
************************************************************
3. MCHB LAUNCHES WEB SITE TO INCREASE AWARENESS OF PERINATAL DEPRESSION
Depression During and After Pregnancy: A Resource for Women, Their
Families, and Friends contains tips on identifying depression in
mothers and offers steps to help treat it successfully. The Web site
was launched by the Health Resources and Services Administration's
Maternal and Child Health Bureau to increase awareness among women and
health professionals of the impact and pervasiveness of perinatal
depression. Selected topics include steps a woman can take if she
believes she is at risk of, or is experiencing, perinatal depression. A
section of the Web site is devoted to information for families and
friends. A list of print and electronic resources is also provided. The
Web site is available at http://www.mchb.hrsa.gov/pregnancyandbeyond/depression.
An accompanying 22-page booklet is also available at ftp://ftp.hrsa.gov/mchb/pregnancyandbeyond/depression.pdf.
************************************************************
4. JOURNAL SUPPLEMENT HIGHLIGHTS PUBLIC HEALTH PREPAREDNESS
The American Public Health Association has announced the released of
the first online-only supplement to the American Journal of Public
Health. The April 2007 supplement focuses on public health preparedness
and contains articles on health policy and ethics; government,
politics, and law; preparing for the future; and research and practice.
The supplement's table of contents is available at http://www.ajph.org/content/vol97/Supplement_1/?etoc.
************************************************************
5. ARTICLE EXAMINES EFFECT OF MEDICAID FAMILY PLANNING EXPANSIONS OF
UNPLANNED BIRTHS
"Overall, we find that Medicaid family planning expansions led to lower
birth rates," write the authors of an article published in the
March-April 2007 issue of Women's Health Issues. Medicaid has played an
important role in the provision of contraceptive care since the passage
of the Medicaid family-planning-related amendments in the early 1970s.
The clinical and economic benefits of contraception are well
documented; however, there is less empirical research regarding the
value of Medicaid family planning expansion benefits. This article
measures the effect of Medicaid family planning expansions on
birthrates and maternal and infant care expenditures and examines
whether health-care-related cost offsets are greater than program costs.
The authors studied all family planning demonstration programs
implemented before 2000. Eight expansions were based on income, and
five provided services for women who lost Medicaid eligibility
postpartum. Because the outcome variable is birthrate, effects of
expansions are measured beginning the year after the first full year of
implementation. State-level data were collected for all 50 states for
the period 1991-2001. The authors also examined net expansion costs of
five state expansions for which valid, comparable data were available.
The authors found that
- Average annual birthrates were significantly lowered by
income-based expansions; a statistically significant effect of
postpartum expansions was not found.
- Significant maternal and infant health care cost offsets were
identified in all income-expansion states for which data are available.
Theses health care cost offsets exceeded total program costs in most
cases.
The authors conclude that "overall, our results suggest that both types
of Medicaid family planning expansions either yield financial benefits
to states or, at the very least, are cost neutral." They continue, "The
experience of these early family planning expansions should be a guide
for other states considering family planning benefit expansions."
Lindrooth RC, McCullough JS. 2007. The effect of Medicaid family
planning expansions on unplanned births. Women's Health Issues
17(2):66-74. Abstract available at http://www.jiwh.org/content.cfm?sectionid=84&IssueSelected=137.
Readers: More information is available from the MCH Library's
bibliography, Cost Effectiveness of MCH Programs, at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_costeffec.html&-MaxRecords=all&-DoScript=auto_search_costeffec&-search.
************************************************************
6. AUTHORS ASSESS IMPACT OF STATE CHILDREN'S HEALTH INSURANCE PROGRAM
ON ADOLESCENTS IN NEW YORK
"Our study demonstrates that enrollment in SCHIP increased access to
care and improved the quality of care that was received by adolescents
in New York," state the authors of an article published in the April
2007 issue of Pediatrics Electronics Pages. The article describes the
characteristics and needs of adolescents who enrolled in SCHIP in New
York and the impact of SCHIP on their access to care, use of services,
and quality of services (parent-reported). The authors also describe
the impact of SCHIP on access to care and use of services from
adolescents' self-reports.
The study group included a stratified random sample of adolescents
newly enrolled in New York's SCHIP from four geographic regions and
three race and ethnicity groups. Adolescents and their parents were
interviewed by telephone 4 to 6 months after enrollment (Time 1) and
again 13 months after enrollment (Time 2). Time 1 interviews were
conducted between March 15, 2001, and September 15, 2001, and Time 2
interviews were conducted between December 15, 2001, and May 4, 2002. A
baseline interview was also conducted with a comparison group of
randomly selected parents of adolescents throughout New York who were
newly enrolled in SCHIP 1 year after the study group enrolled. Measures
included demographics; place of residence; previous health insurance;
health status; access measures (usual source of care, accessibility of
the usual source of care, assessment of unmet health care needs); use
measures (parent and adolescent reports of preventive care and other
types of visits, including any use of emergency department, outpatient,
or hospital-based services and prescription medication use); and
quality measures (parent and adolescent report of specific aspects of
care, ratings of the health professional, and specific preventive
services).
The authors found that
- A total of 1,118 participants in the study groups completed
baseline interviews, and 970 (87%) completed follow-up interviews; a
total of 401 participants in the comparison group completed interviews.
- When adjusted for demographics and previous insurance status, all
measures improved except for having an emergency department visit.
Enrollment in SCHIP resulted in increased rates of reporting a usual
source of care; more preventive care, specialty care, and prescription
medication use; fewer unmet needs; and more confidential care delivery.
- More parents reported that their adolescent's health professional
had counseled them on a variety of health issues during the year when
they were enrolled in SCHIP compared with the year before enrollment,
including guns and weapons, smoking, drugs, alcohol, sexuality, and
behaviors to expect from their adolescent.
- The proportion of adolescents who reported that their health
professional discussed various health issues with them also increased
significantly for condom use and healthy eating; a trend was also noted
for several other counseling items.
"The investments in SCHIP programs for low-income adolescents produce
significant improvements in health care access and quality," state the
authors, adding that the findings provide "strong evidence for
continuation and expansion of policies to provide health insurance to
all."
Klein JD, Shone LP, Szilagyi PG, et al. 2007. Impact of the State
Children's Health Insurance Program on adolescents in New York.
Pediatrics 119(4):e885-e892. Abstract available at http://pediatrics.aappublications.org/cgi/content/abstract/119/4/e885.
Readers: More information is available from the MCH Library's knowledge
path, Child and Adolescent Health Insurance and Access to Care, at http://www.mchlibrary.info/KnowledgePaths/kp_insurance.html
and bibliography, Children's Health Insurance, at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_chldhlthins.html&-MaxRecords=all&-DoScript=auto_search_chldhlthins&-search.
************************************************************
To subscribe to MCH Alert, send an e-mail message to
MCHAlert-request@list.ncemch.org
with SUBSCRIBE in the subject line.
You do not need to enter any text in the body of the message.
To unsubscribe from MCH Alert, send an e-mail message to
MCHAlert-request@list.ncemch.org
with UNSUBSCRIBE in the subject line.
You do not need to enter any text in the body of the message.
************************************************************
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.
Permission is given to forward MCH Alert, in its entirety, to others.
For
all other uses, requests for permission to duplicate and use all or
part of the information contained in this publication should be sent to
mchalert@ncemch.org.
The editors welcome your submissions, suggestions, and questions.
Please contact us at the address below.
MANAGING EDITOR: Jolene Bertness
CO-EDITOR: Tracy Lopez
COPYEDITOR/WRITER: Ruth Barzel
LIST ADMINISTRATOR: Beth DeFrancis Sun
MCH Alert
Maternal and Child Health Library
Georgetown University
Box 571272
Washington, DC 20057-1272
Phone: (202) 784-9770
Fax: (202) 784-9777
E-mail: mchalert@ncemch.org
Web site: http://www.mchlibrary.info/alert/default.html
************************************************************