Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.
September 21, 2007
1. New Knowledge Path Focuses on Mental Conditions in
Children and Adolescents
2. Report Presents Case Studies in Collaboration on
Obesity Prevention
3. Article Evaluates Program to Improve Communication
Between Physicians and Low-Income Hispanic Families
4. Study Explores Associations of Family Meals During
Adolescence and Diet and Meal Patterns During Young Adulthood
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Special Notice: In recognition of National Child Health Day (October 1,
2007), the Health Resources and Services Administration's Maternal and
Child Health Bureau has compiled selected resources to help clinicians,
public health professionals, families, and communities promote health
and preventive services for infants, children, and adolescents. The
resources selected for this year’s observance focus on 10
health-promotion themes including family support, child development,
healthy weight, healthy nutrition, physical activity, oral health,
healthy sexual development and sexuality, safety and injury prevention,
and community relationships and resources. Posters, handouts, and other
resources are available for agencies and organizations interested in
sponsoring health-promotion events emphasizing prevention and well
child care. The resources are available at http://www.mchb.hrsa.gov/childhealthday.
Additional resources, including an archive of Child Health Day
materials, are available from the MCH Library at http://www.mchlibrary.info/childhealthday.html.
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1. NEW KNOWLEDGE PATH FOCUSES ON MENTAL CONDITIONS IN CHILDREN AND
ADOLESCENTS
Knowledge Path: Mental Problems and Disorders in Children and
Adolescents is an electronic guide to resources from the health,
education, social services, and juvenile justice literature on mental
conditions in children and adolescents. The knowledge path was produced
by the MCH Library to complement Knowledge Path: Healthy Social and
Emotional Development in Children and Adolescents. The new path
identifies tools for staying abreast of new developments in mental
health care and for conducting further research. Separate sections
contain resources for families and schools and resources about specific
conditions. The knowledge path is available at http://www.mchlibrary.info/KnowledgePaths/kp_Mental_Conditions.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.
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2. REPORT PRESENTS CASE STUDIES IN COLLABORATION ON OBESITY PREVENTION
Childhood Obesity: Harnessing the Power of Public and Private
Partnerships describes leading collaborations between state health
agencies and private health plans in addressing childhood obesity. The
report was produced by the Association of State and Territorial Health
Officials and the National Institute for Health Care Management, with
support from the Centers for Disease Control and Prevention's Division
of Partnerships and Strategic Alliances. The report profiles case
studies of collaborative obesity-prevention programs involving a large
health plan and the state health agency in Massachusetts, Pennsylvania,
and Tennessee. A fourth case involving different but related public and
private collaborators in North Carolina is also briefly presented. In
each case, the authors explore the ways in which partnerships between
the stakeholders developed, the successes and challenges encountered,
and the lessons learned. The report is available at http://www.nihcm.org/pdf/FINAL_report_CDC_CO.pdf.
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3. ARTICLE EVALUATES PROGRAM TO IMPROVE COMMUNICATION BETWEEN
PHYSICIANS AND LOW-INCOME HISPANIC FAMILIES
"Based on the results of our study, it appears that a nonagressive
implementation of Ask-Me-3 in a pediatric clinic serving a
predominantly low-income Hispanic clientele is effective in getting
about 20% of parents to ask their physician specific questions about
their child's health -- even many months after program implementation,"
write the authors of an article published in the September/October 2007
issue of the American Journal of Health Behavior. According to the 2005
National Assessment of Adult Literacy, between 40% and 50% of the adult
population has general literacy skills at only a basic or below-basic
level. Furthermore, according to a report from the Institute of
Medicine, individuals with limited literacy skills usually also have
limited health literacy, defined as a limited capacity to "obtain,
process, and understand basic health information needed to make
appropriate health decisions." The difficulties that individuals with
limited health literacy experience in the health care arena are
compounded for those who do not speak English fluently or at all.
Ask-Me-3 is a simple approach to facilitating communication between
health professionals and clients whereby clients are encouraged to ask
three questions when interacting with health professionals: (1) what is
my main problem?, (2) what do I need to do (about the problem)?, and
(3) why is it important for me to do this? The authors implemented
Ask-Me-3 in a largely pediatric practice primarily serving Hispanics to
determine whether parents of children in the practice accepted and used
the Ask-Me-3 questions.
Program orientation meetings were convened for physicians and staff in
a pediatric training clinic in San Antonio, TX. Ask-Me-3 posters were
hung on the walls of examination rooms and waiting rooms, and brochures
(in English and Spanish) were placed in all examination rooms and at
the reception desks. One hundred parents participated in
pre-implementation interviews, the purpose of which was to measure
satisfaction with clinic visits and to ascertain whether any had heard
of Ask-Me-3. Six months after program implementation, 393 parents
participated in post-implementation interviews about their awareness
and use of Ask-Me-3 and their satisfaction with clinic visits.
The authors found that
- Among the parents who participated in pre-implementation
interviews, none had heard of Ask-Me-3.
- In contrast to the baseline sample, 163 (41.5%) parents who
participated in post-implementation interviews had heard of Ask-Me-3.
Of these 163 parents, 82 (50.3%) reported actually using the questions
during their child's recent visit. All 82 (100%) of these parents felt
that their physicians were responsive in answering them and that the
questions helped them get more information about their child's health.
- Parents' mean rating of satisfaction pre- and post-implementation
did not differ significantly.
"Based on our results, Ask-Me-3 may be a useful tool for encouraging
the empowerment of populations similar to those studied in our
research," state the authors. They conclude that "use of a more
intensive implementation strategy may have increased the proportion of
Ask-Me-3 users."
Mika VS, Wood, PR, Weiss, BD, et al. 2007. Ask Me 3: Improving
communication in a Hispanic pediatric outpatient practice. American
Journal of Health Behavior 31(supp. 1):S115-S121. Abstract available at
http://www.ajhb.org/2007/s1/Suppl1507Mika.pdf.
Readers: The September/October 2007 supplement to the American Journal
of Health Behavior is devoted entirely to health literacy. Topics
covered include (among others) the health literacy skills of U.S.
adults; facilitating behavior change with low-literacy
patient-education materials; measuring adult literacy in health care;
physicians' use of unclarified medical jargon; teaching medical
students about health literacy; and integrating literacy, culture, and
language to improve health care quality for diverse populations. The
supplement is available at http://www.ajhb.org/2007/31-s1.htm.
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4. STUDY EXPLORES ASSOCIATIONS OF FAMILY MEALS DURING ADOLESCENCE AND
DIET AND MEAL PATTERNS DURING YOUNG ADULTHOOD
"Results of this study indicate that having more family meals during
adolescence is associated with improved diet quality during young
adulthood," state the authors of an article published in the September
2007 issue of the Journal of the American Dietetic Association.
Research has found that eating family meals is associated with better
nutritional intake and more healthful eating patterns in adolescents.
However, little research has considered the potential long-term
benefits of family meals. Studies have found that the frequency of
breakfast eating decreases during adolescence; however, little is known
about changes in meal structure as young people navigate the lifestyle
changes of early young adulthood (ages 18-24). Furthermore, although
research suggests that having family meals decreases with increasing
age among adolescents, little is known about the social nature of meals
during the transition to adulthood. The article describes meal patterns
of young adults and examines relationships between family meals during
adolescence and dietary quality and meal patterns during early young
adulthood.
Data for the study were drawn from Project EAT (Eating Among Teens)-II,
a population-based, longitudinal study of socio-environmental,
personal, and behavioral determinants of dietary intake and weight
status among young people. The study sample included 946 females and
764 males. Dietary intake and meal frequencies were measured at Time 1
(1998-1999, middle adolescence) and again at Time 2 (2003-2004, young
adulthood). Time 1 family meal frequency was used to predict each Time
2 outcome of interest (dietary intake, meal patterns). Additional
analyses were conducted, adjusting for baseline dietary intake, as well
as selected demographic variables (race and ethnicity, socioeconomic
status, age) and total energy consumption.
The authors found that
- The frequency of family meals at Time 1 was as follows: 1-2 times
per week for 22.1% of adolescents, 3-6 times per week for 41.9% of
adolescents, and 7 or more times per week for 18.6% of adolescents. The
prevalence of never having family meals was 17.4%.
- Time 1 family meal frequency was positively associated with Time
2 dietary intake as follows: among females, intakes of vegetables,
magnesium, potassium, and fiber were directly associated and soft
drinks inversely associated with Time 1 family meals; among males,
intakes of fruit, vegetables, dark-green and orange vegetables, and
potassium were directly associated with Time 1 family meals.
- Associations between Time 1 family meals and Time 2 meal patterns
were significant only for dinner frequency among males. Among males,
higher family meal frequency at Time 1 predicted a higher priority for
social eating and meal structure at Time 2.
- Stratified analyses conducted according to residence showed few
differences between young adults living with their parents or away from
their parents, and differences did not follow a consistent pattern.
Based on the study findings, the authors conclude that "food and
nutrition professionals should encourage families to share meals as
often as practically possible."
Larson NI, Neumark-Sztainer D, Hannan PJ, et al. 2007. Family meals
during adolescence are associated with higher diet quality and
healthful meal patterns during young adulthood. Journal of the American
Dietetic Association 107(9):1502-1510. Abstract available at http://www.adajournal.org/article/PIIS0002822307012928/abstract?browse_volume=107&issue_key=S0002-8223%2807%29X0271-2&issue_preview=no&select1=no&select1=no&vol=.
Readers: More information is available from the following MCH Library
resources:
- Child and Adolescent Nutrition (knowledge path) at
http://www.mchlibrary.info/KnowledgePaths/kp_childnutr.html
- Healthy Social and Emotional Development in Children and Adolescents
(knowledge path) at
http://www.mchlibrary.info/KnowledgePaths/kp_Mental_Healthy.html
- Overweight and Obesity in Children and Adolescents (knowledge path) at
http://www.mchlibrary.info/KnowledgePaths/kp_overweight.html
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and
Child Health and Georgetown University. MCH Alert is produced by
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