Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html.
May 2, 2008
1. New Edition of Overweight and Obesity Knowledge Path
Available
2. Continuing Education Activity Focuses on Cultural and
Linguistic Competence in the Diagnosis and Treatment of Depression
3. Fact Sheet Examines States' Efforts to Safeguard
Adolescents' Confidentiality
4. Materials Available to Help Programs Plan Local
Activities to Promote Children's Mental Health
5. Report Offers Recommendations for State-Level Health
Care Reform to Address Health Care Inequality
6. Article Looks at the Ability of Primary Care
Physicians Treating High Proportions of Minority Patients to Deliver
High-Quality Care
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Special Notice: The content of summary #2 in the April 25, 2008, issue
of the MCH Alert has been revised and re-posted to the Web site. The
information on the source of the abortion data has been clarified. The
source is a combination of estimates from the Centers for Disease
Control and Prevention (CDC) and the Guttmacher Institute. This is
important because the CDC data alone are not complete for national
pregnancy rates. The wording has been changed as follows:
Estimates of induced abortions are from abortion surveillance
information collected from most states by CDC's National Center for
Chronic Disease Prevention and Health Promotion "and national estimates
of abortion totals from the Guttmacher Institute."
The revised summary titled, Report Presents Pregnancy Rates For
1990-2004, is available at http://www.mchlibrary.info/alert/2008/alert042508.html#2.
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1. NEW EDITION OF OVERWEIGHT AND OBESITY KNOWLEDGE PATH AVAILABLE
Overweight and Obesity -- Knowledge Path is an electronic guide to
recent resources about the prevention, identification, management, and
treatment of overweight and obesity in children and adolescents in
homes, schools, and communities. The knowledge path, produced by the
MCH Library, contains information on Web sites, publications,
databases, and newsletters and online discussion lists. Separate
sections identify resources for families, schools and after-school
programs, and child care settings. Another section presents resources
about the impact of media use. The knowledge path is available at http://www.mchlibrary.info/KnowledgePaths/kp_overweight.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. CONTINUING EDUCATION ACTIVITY FOCUSES ON CULTURAL AND LINGUISTIC
COMPETENCE IN THE DIAGNOSIS AND TREATMENT OF DEPRESSION
Incorporating Cultural and Linguistic Competence in the Diagnosis and
Treatment of Depression is an online continuing medical education (CME)
activity designed to help primary care physicians improve care for
clients from a wide range of racial and ethnic groups who experience
depression. The CME activity was developed by the National Center for
Cultural Competence with partial support from the Praxis Partnership
program, Initiative for Decreasing Disparities in Depression, and the
activity is jointly sponsored by the Georgetown University Hospital and
the Georgetown University Center for Child and Human Development. The
course provides an opportunity for physicians and other health
professionals to assess their awareness, knowledge, and skills in the
following six domains: (1) values and belief systems, (2) cultural
influences on illness and related problems, (3) depression and health,
(4) clinical management, (5) cross-cultural communication, and (6)
promotion of cultural and linguistic competence in systems of care and
communities. The activity also allows users to develop a personalized
plan for future learning. More information is available at http://www.gucchdgeorgetown.net/I3D.
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3. FACT SHEET EXAMINES STATES' EFFORTS TO SAFEGUARD ADOLESCENTS'
CONFIDENTIALITY
State Policies Affecting the Assurance of Confidential Care for
Adolescents provides an overview of states' minor consent laws and new
information on the use of explanation-of-benefit (EOB) statements by
state Medicaid agencies and their contracting managed care
organizations. The fact sheet, published by Incenter Strategies, The
National Alliance to Advance Adolescent Health, explains how and why
EOBs are used and addresses the implications of state policies for
adolescents and for health professionals. Conclusions and data on state
protections for sensitive services are included. The fact sheet is
available at http://www.incenterstrategies.org/jan07/factsheet5.pdf.
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4. MATERIALS AVAILABLE TO HELP PROGRAMS PLAN LOCAL ACTIVITIES TO
PROMOTE CHILDREN'S MENTAL HEALTH
National Children's Mental Health Awareness Day [May 8, 2008] Planning
Notebook is a technical-assistance tool that contains tips, resources,
and ideas to help shape Awareness Day activities. The notebook was
developed by the Caring for Every Child's Mental Health Campaign to
help System of Care and other Substance Abuse and Mental Health
Administration grantees promote positive youth development, resilience,
and recovery, as well as the transformation of mental health services
delivery for children and youth with serious mental health needs and
their families. This year's national event, Thriving in the Community,
is designed to (1) raise awareness about effective programs that
address children's mental health needs; (2) demonstrate how children's
mental health initiatives promote positive youth development, recovery,
and resilience; and (3) show how children with mental health needs
thrive in their communities. Planning materials, including historical
information and printable materials and graphics that may be customized
to meet program and audience needs, are available at
http://systemsofcare.samhsa.gov/nationalawareness/materialsNew.aspx
(English) and
http://systemsofcare.samhsa.gov/nationalawareness/materialsSP.aspx
(Spanish). More information about Awareness Day, including information
about sponsorship, is available at http://systemsofcare.samhsa.gov/nationalawareness/materials.aspx.
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5. REPORT OFFERS RECOMMENDATIONS FOR STATE-LEVEL HEALTH CARE REFORM TO
ADDRESS HEALTH CARE INEQUALITY
Identifying and Evaluating Equity Provisions in State Health Care
Reform identifies elements of state-level policies and proposals that
promote equitable health care access and quality for all populations
(equity benchmarks). The report also evaluates selected state health
care reform proposals (Massachusetts, Washington, Illinois,
Pennsylvania, California) or existing laws and regulations to determine
whether they address disparities relative to these equity benchmarks.
The report was produced by the Commonwealth Fund with assistance from
Families USA and with financial support from The Opportunity Agenda.
Topics include definitions and measurements of state health care
benchmarks, recently enacted laws and leading proposals of state health
insurance coverage expansion, and state Medicaid and State Children's
Health Insurance program contractual requirements. An executive
summary, conclusions, and recommendations are provided. Statistical
data are presented in tables and figures. The report is available at
http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=679040.
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6. ARTICLE LOOKS AT THE ABILITY OF PRIMARY CARE PHYSICIANS TREATING
HIGH PROPORTIONS OF MINORITY PATIENTS TO DELIVER HIGH-QUALITY CARE
"The results of this analysis suggest that aggregate characteristics of
populations at the community and practice levels have implications for
the care available to patients," state the authors of an article
published on April 22, 2008, in Health Affairs Web Exclusives. Although
there is broad consensus that racial and ethnic differences in the
quality of health care exist, there is much disagreement about the root
causes. This analysis explores whether physicians whose patient panels
(the set of patients they treat) consist of a disproportionate
percentage of minorities report more difficulties obtaining services
for their patients and delivering high-quality care than those treating
fewer minority patients. In addition, the authors explore whether
increasing resources flowing to high-minority practices, specifically
by increasing Medicaid reimbursement amounts, might improve physicians'
ability to provide high-quality care.
The analysis is based on data from the 2004-2005 Community Tracking
Study Physician Survey, supplemented by secondary information from the
Census Bureau and other sources. For this study, the authors focused on
the experiences of primary care physicians (PCPs): general internists,
family or general practitioners, and general pediatricians.
The authors found that
- About 52% of PCPs reported having patient panels with less than
30% minorities (low-minority practices), 36% reported 30-70% minority
patients (medium-minority practices), and 12% reported more than 70%
minority patients (high-minority practices).
- Physicians in high-minority practices received more than a third
of their practice revenue from Medicaid -- more than twice that of
physicians in low-minority practices.
- Compared to physicians in low- and medium-minority practices,
those in high-minority practices were more likely to report
quality-related difficulties, such as inability to provide referrals to
high-quality specialists, inability to spend adequate time with
patients, and other problems.
- More than a quarter of physicians in high-minority practices
disagreed that it was possible to provide high-quality care to all
patients, compared with 16% of physicians in low-minority practices.
- According to simulated responses, if Medicaid fees were raised to
Medicare levels, physicians' reports of difficulties providing care for
their patients would often decline.
The authors conclude that "in addition to raising payment rates for the
treatment of Medicaid patients, efforts to increase insurance coverage
or otherwise increase resources flowing to physicians who serve
low-income and minority populations would implicitly reduce
disparities."
Reschovy JD, O’Malley AS. 2008. Do primary care physicians treating
minority patients report problems delivering high-quality care? Health
Affairs 26(3):w222-w231. Abstract available at http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.3.w222.
Readers: More information is available from the following MCH Library
resources:
- Racial and Ethnic Disparities in Health -- Knowledge Path at
http://www.mchlibrary.info/KnowledgePaths/kp_race.html
- Culturally Competent Services -- Selected Resources at
http://www.mchlibrary.info/guides/culturalcompetence.html
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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
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MANAGING EDITOR: Jolene Bertness
CO-EDITOR: Tracy Lopez
COPYEDITOR/WRITER: Ruth Barzel
LIST ADMINISTRATOR: Beth DeFrancis Sun
MCH Alert
Maternal and Child Health Library
National Center for Education in Maternal and Child Health
Georgetown University
Box 571272
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Phone: (202) 784-9770
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