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 18, 2008

1. Tip Sheet Offers Ideas for Creating Clear, Easy-to-Understand Oral Health Materials
2. White Paper Discusses Oral Health Care Policy Options for Children from Families with Low Incomes
3. Authors Estimate Influences of Individual- and Neighborhood-Level Characteristics on Health Behaviors and Adequacy of Weight Gain During Pregnancy
4. Longitudinal Study Examines Family Meals and Disordered Eating in Adolescents
5. Article Investigates the Relationship Between Childhood Lead Poisoning, Adolescent Pregnancy, and Smoking

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1. TIP SHEET OFFERS IDEAS FOR CREATING CLEAR, EASY-TO-UNDERSTAND ORAL HEALTH MATERIALS

A Way With Words: Guidelines for Writing Oral Health Materials for Audiences with Limited Literacy provides ideas to help those who produce oral health educational materials make the materials easy for everyone to understand. The tip sheet, produced by the National Maternal and Child Oral Health Resource Center, offers suggestions for how to choose words; set an appropriate tone; and craft sentences, paragraphs, lists, and headings that communicate most effectively with people with limited literacy. Suggestions for how to design documents and how to present unfamiliar terminology are also presented. A list of resources for more information is included. The tip sheet is available at http://www.mchoralhealth.org/PDFs/AWaywithWords.pdf.

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2. WHITE PAPER DISCUSSES ORAL HEALTH CARE POLICY OPTIONS FOR CHILDREN FROM FAMILIES WITH LOW INCOMES

Pediatric Dentistry: How Can Dental Care for Low-Income Children Be Improved? describes the causes and consequences of oral diseases that disproportionately affect the nation's most vulnerable children. The white paper also discusses the many strategies available to address this problem. The white paper was published by the George Washington University School of Public Health and Health Services' Rapid Public Health Policy Response Project, with support from the Public Health and Policy Group of Pfizer, Inc. Topics include disparities in oral disease, unmet need for pediatric dentistry, and strategies to increase access to appropriate oral health services for children. The paper is available at http://www.gwumc.edu/sphhs/about/rapidresponse/download/Rapid6_Dental_D2.pdf.

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3. AUTHORS ESTIMATE INFLUENCES OF INDIVIDUAL- AND NEIGHBORHOOD-LEVEL CHARACTERISTICS ON HEALTH BEHAVIORS AND ADEQUACY OF WEIGHT GAIN DURING PREGNANCY

"In this study, we found a positive association between neighborhood physical incivilities [a combination of physical disorder and poor housing condition] and not engaging in vigorous leisure activity at 3 months before pregnancy and during the first trimester," state the authors of an article published in the November 2007 issue of the Journal of Urban Health: Bulletin of the New York Academy of Medicine. The association between neighborhood context and diet, physical activity, and weight gain in a pregnant population has not been previously explored. The purpose of the study described in this article was to identify possible modifiable neighborhood attributes that may have programmatic or policy implications for women's health and fetal outcomes. The authors describe how directly measured neighborhood characteristics in Raleigh, North Carolina, and its surrounding suburbs are associated with smoking, diet quality, vigorous leisure activity before and during pregnancy, and gestational weight gain.

Individual data and directly observable neighborhood attributes were collected as part of the Pregnancy, Infection, and Nutrition cohort, a prospective study of determinants of preterm birth. Women at 24-29 weeks' gestation were recruited between 1995 and 1999 from the University of North Carolina Residents' and Private Physicians' Obstetrics Clinics, the Wake County Department of Human Services, and the Wake Area Health Education Center Prenatal Care Clinics. The current study sample included 703 women whose addresses were within the city limits of Raleigh and its surrounding suburbs. Individual-level outcome variables included self-reported participation in any vigorous leisure activities at each of three time periods: 3 months before pregnancy, the first 3 months of pregnancy, and the second 3 months of pregnancy. Tertiles of the diet quality index, body mass index (using self-reported pregnancy weight and measured height), recalled pre-pregnancy weight, adequacy of weight gain, and distance to the closest supermarket were also assessed. For purposes of the study, "neighborhood" was defined as the census block group. Three scales were developed to capture neighborhood attributes: physical incivilities (condition of housing, yards, public spaces, vacant or burned property, litter, graffiti); territoriality (fences or hedges; decorations; neighborhood community-watch, security-warning, and no-trespassing signs); and social spaces (parks, sidewalks, porches, presence of people, presence of nonresidential visitors).

The authors found that   
The authors conclude that "physical incivilities and social space characteristics may be important to measure to improve our understanding of potential mechanisms through which neighborhood environments influence health."

Laraia B, Messer L, Evenson K, et al. 2007. Neighborhood factors associated with physical activity and adequacy of weight gain during pregnancy. Journal of Urban Health: Bulletin of the New York Academy of Medicine 84(6):793-806. Abstract available at http://www.springerlink.com/content/563j19r378hkq226/?p=9e07c03ea6da4466a89ab8a6c629c865&pi=6.

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4. LONGITUDINAL STUDY EXAMINES FAMILY MEALS AND DISORDERED EATING IN ADOLESCENTS

"The findings suggest that regular family meals during adolescence play a protective role for extreme weight control behaviors in adolescent girls but not boys," state the authors of an article published in the January 2008 issue of the Archives of Pediatrics and Adolescent Medicine. Disordered eating behaviors are of concern for adolescent health, given their high prevalence and harmful consequences. Research has suggested that family meals may play a role in preventing the onset of disordered eating behaviors. However, findings are limited by cross-sectional study designs or by recall of past mealtime experiences. The article explores the 5-year longitudinal associations between family meal frequency and disordered eating behaviors in adolescent girls and boys.

Data for the study were drawn from Project EAT, a longitudinal study of eating patterns and weight-related issues in adolescents. The study population included 2,516 Minnesota middle- and high-school students (1,386 girls and 1,130 boys) who completed in-class surveys and anthropometric measures during the 1998-1999 academic year (time 1), and who also completed a mail survey 5 years later (2003-2004 academic year; time 2). The analysis examined associations between time 1 family meal frequency and time 2 disordered eating behaviors (extreme weight-control behaviors, unhealthy weight-control behaviors, binge eating, and chronic dieting) and estimated the odds of engaging in each disordered eating behavior for those with 5 or more vs. those with fewer than 5 family meals per week. Models were run adjusting for sociodemographic characteristics and body mass index (BMI) (model 1), with additional adjustment for family connectedness and pressures to diet from parents (model 2) and further adjustment for time 1 disordered eating behaviors (model 3). All analyses were stratified by sex.

The authors found that
The authors conclude that health professionals can play an important role in "reinforcing the benefits of family meals, helping families set realistic goals for increasing family meal frequency given schedules of adolescents and their parents, exploring ways to enhance the atmosphere at family meals with adolescents, and discussing strategies for creating healthful and easy-to-prepare family meals. Schools and community organizations should also be encouraged to make it easier for families to have shared mealtimes on a regular basis."

Neumark-Sztainer D, Eisenberg ME, Fulkerson JA, et al. 2008. Family meals and disordered eating in adolescents. Archives of Pediatrics and Adolescent Medicine 162(1):17-22. Abstract available at http://archpedi.ama-assn.org/cgi/content/abstract/162/1/17.

Readers: More information is available from the MCH Library's knowledge path, Child and Adolescent Nutrition, at http://www.mchlibrary.info/KnowledgePaths/kp_childnutr.html.

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5. ARTICLE INVESTIGATES THE RELATIONSHIP BETWEEN CHILDHOOD LEAD POISING, ADOLESCENT PREGNANCY, AND SMOKING

"This paper indicates a potential link between a key aspect of the dilapidated built environment -- namely, lead poisoning -- and subsequent health outcomes years later among young women, who are more likely to have multiple pregnancies and to smoke cigarettes than female teens without a history of elevated lead levels," state the authors of an article published in the January 2008 issue of the Journal of Adolescent Health. Lead exposure, which leads to negative health outcomes, is usually from old lead-based paint in dilapidated buildings but can also come from lead found in soil around houses that have exteriors with peeling lead-based paint, as well as from lead-tainted water. Lead entering the bodies of very young children affects their developing brains in ways that continue to influence their behavior for many years. The purpose of the study described in this article was to analyze the effects of childhood lead poisoning on adolescent pregnancy and smoking.

The authors used data from the Syracuse Healthy Start (SHS) participants' database, which includes information on participants' childhood blood-lead levels, where available. The final sample included 719 pregnant adolescents ages 15-19 who were served by SHS and whose childhood blood-lead levels were on file with the county health department.

The authors found that
The authors conclude that "this research gives support to furthering the investigation of the lifetime effects of elevated blood lead levels among young children, toward decreasing the prevalence of poor health outcomes later in life."

Lane SD, Webster NJ, Levandowski BA. 2008. Environmental injustice: Childhood lead poisoning, teen pregnancy, and tobacco. Journal of Adolescent Health 42(1):43-49. Abstract available at http://www.jahonline.org/article/PIIS1054139X07002947/abstract?browse_volume=42&issue_key=S1054-139X%2807%29X0251-9&issue_preview=no&select1=no&select1=no&vol=.

Readers: More information is available from the MCH Library's organizations resource list, Environmental Health, at http://www.mchlibrary.info/action.lasso?-database=Organizations&-layout=Web&-response=/databases/OrgLists/orgs_environ.html&-MaxRecords=all&-DoScript=auto_search_environ&-search.

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MCH Alert © 1998-2008 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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