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.


December 14, 2007

1. HRSA Unveils Free Online Health Literacy Training for Health Professionals
2. Supplement Highlights New Recommendations on Child and Adolescent Overweight and Obesity
3. Article Assesses State and Regional Disparities in Childhood and Adolescent Obesity
4. Authors Examine Unmet Mental Health Need Among Children with Special Health Care Needs

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1. HRSA UNVEILS FREE ONLINE HEALTH LITERACY TRAINING FOR HEALTH PROFESSIONALS

Unified Health Communication 101: Addressing Health Literacy, Cultural Competency, and Limited English Proficiency is a free online learning experience designed to help health professionals improve their patient-communication skills, increase their awareness and knowledge of factors that affect their communication with patients, and implement patient-centered communication practices. The course, developed by the Health Resources and Services Administration, comprises five modules and is estimated to take a total of 5 hours to complete. The course may be completed at the user's own pace and may be taken for credit (CEU/CE, CHES, CME, and CNE) or not for credit. More information, including registration instructions, is available at
http://www.hrsa.gov/healthliteracy/training.htm.

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2. SUPPLEMENT HIGHLIGHTS NEW RECOMMENDATIONS ON CHILD AND ADOLESCENT OVERWEIGHT AND OBESITY

Assessment of Child and Adolescent Overweight and Obesity presents a review of the literature and recommends revised approaches to the prevention, assessment, and treatment of childhood obesity. The December 2007 supplement to Pediatrics was supported in part by an educational grant from Gerber Products Company and by the Centers for Disease Control and Prevention's Division of Nutrition, Physical Activity, and Obesity; the American Medical Association; and the Health Resources and Services Administration's Maternal and Child Health Bureau grant to the University of Alabama at Birmingham. Contents include four articles, one on each of three obesity-management areas and one overarching support document. Recommendations cited in the supplement were developed using both available evidence and expert opinion. The recommendations recognize the importance of social and environmental change to reduce the obesity epidemic and also identify ways health professionals and health care systems can be part of broader efforts. The supplement is available at http://pediatrics.aappublications.org/content/vol120/Supplement_4.

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3. ARTICLE ASSESSES STATE AND REGIONAL DISPARITIES IN CHILDHOOD AND ADOLESCENT OBESITY

"Documenting and monitoring of geographic variation is crucial to the understanding of the extent of existing disparities in childhood obesity that go beyond the disparities commonly shown by such social groups as those characterized by sex, race/ethnicity, and socioeconomic status," write the authors of an article published in the Journal of Community Health, Online First (November 30, 2007). The prevalence of childhood obesity has risen almost three-fold in the past three decades. While gender and racial and ethnic disparities in the prevalence of U.S. childhood obesity are frequently examined, geographic disparities are rarely analyzed. The purpose of the study described in this article is to (1) estimate current obesity prevalence among children and adolescents ages 10-17 in nine geographic locations using a large, nationally representative sample of U.S. children; (2) examine the extent of regional and state disparities in childhood and adolescent obesity; and (3) identify individual- and area-level socioeconomic, demographic, and behavioral predictors of these geographic disparities.

Data for this study came from the National Survey of Children's Health, conducted by the National Center for Health Statistics with funding and direction from the Maternal and Child Health Bureau. The sample of the present analysis was 46,707 children and adolescents ages 10-17.

The authors found that
The authors conclude that "prevention efforts should target both individual socioeconomic and behavioral risk factors as well as modifying the contextual social and environmental factors in order to reduce geographic disparities in childhood obesity."

Singh GK, Kogan MD, van Dyck PC. 2007. A multilevel analysis of state and regional disparities in childhood and adolescent obesity in the United States. Journal of Community Health Online First (November 30, 2007), http://www.springerlink.com/content/101596/?Content+Status=Accepted.

Readers: More information is available from the following MCH Library resources:

- Overweight and Obesity in Children and Adolescent (knowledge path) at
http://www.mchlibrary.info/KnowledgePaths/kp_overweight.html

- Racial and Ethnic Disparities in Health (knowledge path) at
http://www.mchlibrary.info/KnowledgePaths/kp_race.html

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4. AUTHORS EXAMINE UNMET MENTAL HEALTH NEED AMONG CHILDREN WITH SPECIAL HEALTH CARE NEEDS

"Although perceived need for mental health treatment was greatest among CSHCN [children with special health care needs] with a chronic EBDP [emotional, behavioral, or developmental problem], mental health needs were also reported for 9 [percent] of [U.S.] children with chronic medical conditions that are not emotional or behavioral in nature," state the authors of an article published in the November-December 2007 issue of Ambulatory Pediatrics. The article describes rates of need among a national sample of CSHCN, distinguishing children with chronic EBDPs from children with primarily medical chronic conditions. The authors specifically examine whether race and ethnicity and language are associated with unmet need for the child and family members who have a mental health need attributed to the child's special health care needs. Additional possible factors associated with unmet need for children and family members are also explored.

Data for the study were drawn from the National Survey of Children with Special Health Care Needs, which included a sample of 38,866 CSHCN (ages 17 and younger) and provided information about functional limitations, impact of the condition on the family, sociodemographics, health insurance, and access to care. Dependent variables included parental report of (1) the child's need for mental health treatment or counseling, (2) family member need for treatment or counseling resulting from the child's special health care needs, (3) the child's unmet need for mental health services, and (4) family members' unmet need for mental health services. Covariates included health condition characteristics (type, impact, and stability of the child's condition), sociodemographics (gender, family income, maternal education), presence and type of health insurance, and medical home characteristics (having a usual source of care and a regular clinician). The analysis examined rates of need and unmet need for children and family members overall and by presence of an EBDP.

The authors found that
"Our study shows that unmet need for mental health treatment [or] counseling is greatest among CSHCN with chronic emotional, behavioral and developmental problems but also affects children with primarily medical chronic conditions and family members of CSHCN," state the authors. They add that "underserved populations, as indicated by greater parental perception of unmet need, include African-American CSHCN and family members of Hispanic children with potential limited English proficiency."

Inkelas M, Raghavan R, Larson K, et al. 2007. Unmet mental health need and access to services for children with special health care needs and their families. Ambulatory Pediatrics 7(6):431-438. Abstract available at http://www.ambulatorypediatrics.org/article/PIIS1530156707001438/abstract.

Readers: More information is available from the following MCH Library resources:

- Children and Adolescents with Special Health Care Needs (knowledge path) at
http://www.mchlibrary.info/KnowledgePaths/kp_CSHCN.html

- Children and Adolescents with Emotional, Behavioral, and Mental Health Challenges (knowledge path) at
http://www.mchlibrary.info/KnowledgePaths/kp_Mental_Conditions.html

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MCH Alert © 1998-2007 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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