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.


September 19, 2008

1. Library Releases Online Resource Briefs on Genetics and Environmental Health
2. National Center Launches New e-Learning Feature on Spirituality, Religion, and Health
3. Article Identifies CSHCN Programs' Steps and Processes to Achieve Culturally and Linguistically Competent Policies
4. Study Examines Risk and Protective Factors and the Likelihood of Past Suicide Attempt in American Indian Youth
5. Clinical Trial Evaluates Intervention to Improve Postpartum Outcomes in African-American Women

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1. LIBRARY RELEASES ONLINE RESOURCE BRIEFS ON GENETICS AND ENVIRONMENTAL HEALTH

The MCH Library has announced the availability of two new topical resource briefs that provide information on Web sites and additional electronic resources for health professionals and families. The briefs include the following:

MCH Library resources these and other maternal and child health topics are available at http://www.mchlibrary.info/guides.html.

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2. NATIONAL CENTER LAUNCHES NEW E-LEARNING FEATURE ON SPIRITUALITY, RELIGION, AND HEALTH

Body/Mind/Spirit: Toward a Biopsychosocial-Spiritual Model of Health presents a framework for health professionals on spirituality and religion in health. The electronic resource, produced by the National Center for Cultural Competence, addresses the potential role of spirituality and religion in how an individual copes with illness, health care decision-making, and health outcomes. Topics include definitions of spirituality, religion, health, illness, and sickness; spirituality, religion, and healing; the biopsychosocial-spiritual model; spirituality of children; spiritual pain and distress; assessment of spirituality and religion; and professional development and training in the fields of medicine, nursing, social work, and mental health. Literature reviews, international and domestic documents, references, and other resources are included. The feature is available at http://www11.georgetown.edu/research/gucchd/nccc/body_mind_spirit.

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3. ARTICLE IDENTIFIES CSHCN PROGRAMS' STEPS AND PROCESSES TO ACHIEVE CULTURALLY AND LINGUISTICALLY COMPETENT POLICIES

"Achieving cultural and linguistic competence is . . . a long journey. . . . Based on this query of CSHCN [children with special health care needs] programs, it is apparent that states are at various points along that journey," write the authors of an article published in the September 9, 2008, issue of the Maternal and Child Health Journal. The need for culturally and linguistically competent health and mental health systems has recently been reaffirmed by the highest levels of U.S. government, the National Academy of Science, independent commissions, and professional associations and accreditation organizations. Addressing the cultural and linguistic needs of the U.S. population is challenging because of the population's increasing diversity. This descriptive study was intended to identify actual action steps and processes of CSHCN programs to develop, implement, sustain, and assess culturally and linguistically competent policies, structures, and practices.

The authors used two products provided by the National Center for Cultural Competence (NCCC) for programs serving children and youth with special health care needs and their families to support their progress in the areas of cultural and linguistic competence. Respondents were asked to report on whether their programs engaged in activities related to (1) the processes delineated by the NCCC as steps toward organizational change to implement cultural and linguistic competence and (2) service system actions at the organizational level that reflected the NCCC model for achieving organizational cultural and linguistic competence. Forty-two state and territorial Title V CSHCN directors participated in the study.

The authors found that
The authors conclude that "while many programs are taking isolated actions in response to population needs, the difficult work of deep organizational change that will lead to changes in policy and infrastructure is not wide-spread."

Telfair J, Bronheim S, Harrison S. 2008. Implementation of culturally and linguistically competent policies by state Title V Children with Special Health Care Needs (CSHCN) Programs. Maternal and Child Health Journal [published online ahead of print on September 19, 2008]. Abstract available at http://www.springerlink.com/content/0113111122815522/?p=aec570c6c2654899b880eb65aa358eae&pi=0.

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

- Culturally Competent Services: Resource Brief at
http://www.mchlibrary.info/guides/culturalcompetence.html

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4. STUDY EXAMINES RISK AND PROTECTIVE FACTORS AND THE LIKELIHOOD OF PAST SUICIDE ATTEMPT IN AMERICAN INDIAN YOUTH

"These findings for urban American Indian youth support the strategy of boosting protective factors while addressing key risk factors that impede the healthy development of young people," state the authors of an article published in the September-October 2008 issue of the American Journal of Health Behavior. Although there has been a general decline in youth suicides since 1992 across all racial and ethnic groups, increased suicide among those ages 10-19 underscores the need for prevention efforts. Suicide is the second leading cause of death for American Indian-Alaska Native youth. The article presents findings from a study to identify the strongest risk and protective factors relative to a past suicide attempt among males and females and examines these factors in combination to predict the likelihood of a history of a suicide attempt in a sample of urban American Indian youth.

Data for the study were drawn from surveys conducted between 1995 and 1998 as part of the Indian Youth Resiliency Impact Study. Study participants (youth ages 9-15; N=569) completed a self-report survey comprising items focused on a host of factors affecting health and well-being. The resilience paradigm guided the selection of items used to develop nine scales measuring risk and protective factors in the current study. The seven protective scales in the current analysis included (1) connectedness to others, (2) family caring, (3) parental prosocial behavior norms, (4) peer prosocial behavior norms, (5) perceived self-image, (6) positive mood, and (7) school connectedness. The two risk scales were (1) substance use and (2) violence perpetration. All analyses were conducted separately by gender. The researchers first examined bivariate relationships between the outcome, past suicide attempt, and risk and protective factors. Then, separate models were created for protective factors only and risk factors only. From these two models, the strongest risk and protective factors associated with a past suicide attempt were entered, and probability profiles were created.

The authors found that
"Our study points to the necessity of responding to indications of vulnerability to suicidal involvement for those in elementary as well as secondary schools," state the authors, concluding that "the identification of salient risk and protective factors for suicide . . . creates a road map for comprehensive assessment and effective intervention."

Pettingell SL, Bearinger LH, Skay CL, et al. 2008. Protecting urban American Indian young people from suicide. American Journal of Health Behavior 32(5):465-476. Abstract available at http://www.ajhb.org/2008/5/05SepOct0208Pettingell.pdf.

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

- Emotional, Behavioral, and Mental Health Challenges in Children and Adolescents: Knowledge Path at
http://www.mchlibrary.info/KnowledgePaths/kp_Mental_Conditions.html

- Racial and Ethnic Disparities in Health: Knowledge Path at
http://www.mchlibrary.info/KnowledgePaths/kp_race.html

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5. CLINICAL TRIAL EVALUATES INTERVENTION TO IMPROVE POSTPARTUM OUTCOMES IN AFRICAN-AMERICAN WOMEN

"This study suggests that a multiple risk factor intervention that addresses both psychosocial and behavioral risks can be effective in reducing those risks when delivered during pregnancy and reinforced during the postpartum period," state the authors of an article published in the September 2008 issue of Obstetrics and Gynecology. The purpose of the study was to evaluate the efficacy of a cognitive behavioral intervention delivered during pregnancy in reducing behavioral risks in the postpartum period. The risks addressed included depression, intimate partner violence, active smoking, and environmental tobacco smoke exposure in a population of African-American pregnant women.

Recruitment occurred at six prenatal care clinics between July 2001 and October 2003. Eligibility criteria included minority status, age 18 or older, 28 weeks of pregnancy or less, District of Columbia resident, English speaking, and reporting any of the four designated risks. A baseline interview gathered sociodemographic data and information on the designated risks. A total of 913 African-American pregnant women with risk reported at baseline were assigned to the intervention group (N=452) or to the usual care group (N= 461). Women assigned to the intervention group received behavioral counseling addressing the risk factors they reported. Two follow-up interviews were administered during the second and third trimesters. A final interview was conducted at 10.3 weeks postpartum on average.

Participant data were analyzed according to randomized group assignment, regardless of receipt of intervention, using an intent-to-treat approach. Each woman was characterized with respect to number of risks (one through four) at baseline. At postpartum, each women was categorized in one of three ways: (1) resolving all risks (RA); (2) resolving some, but not all, risks (RS); and (3) resolving no risks or increasing the number of risks (RN). Intervention effectiveness was measured contrasting the proportion of RA to the proportion of RN in the two groups. The proportions of participants resolving all or some risk were also compared between groups.

The authors found that
The authors conclude that "the intervention seems to have benefited these mothers in terms of risk behaviors in the short run and could ultimately influence the health and well-being of their infants long term. Extending similar services within existing outreach programs (eg, Healthy Families USA) may ensure better delivery of such interventions and require minimal additional infrastructural support."

El-Mohandes AAE, Kiely M, Joseph JG, et al. 2008. An intervention to improve postpartum outcomes in African-American mothers: A randomized controlled trial. Obstetrics and Gynecology 112(3):611-620. Abstract available at http://www.greenjournal.org/cgi/content/abstract/112/3/611.

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

- Preconception and Pregnancy: Knowledge Path at
http://www.mchlibrary.info/KnowledgePaths/kp_pregnancy.html

- Postpartum Depression: Knowledge Path at
http://www.mchlibrary.info/KnowledgePaths/kp_postpartum.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 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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MCH Alert
Maternal and Child Health Library
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