Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html
March 12, 2010
1. Professional Resources Focus on School-based and
School-Linked Oral Health Services for Children and Adolescents
2. Web Site Features New Resources to Support States'
Efforts to Use Child Health Data Effectively
3. Monograph Highlights a Public Health Framework for
Children's Mental Health
4. New Survey Provides More Complete Data on Infants'
Hearing Screening, Diagnostic, and Intervention Status
5. Analysis Reconfigures Reported Statistics to Focus on
the Risks of Formula Use Rather Than the Benefits of Breastfeeding
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1. PROFESSIONAL RESOURCES FOCUS ON SCHOOL-BASED AND SCHOOL-LINKED
ORAL HEALTH SERVICES FOR CHILDREN AND ADOLESCENTS
The National Maternal and Child Oral Health Resource Center has
published two new resources to help health professionals, program
administrators, and policymakers working in and with schools to address
the oral health needs of children and adolescents. The resources,
produced with support from the Health Resources and Services
Administration's Maternal and Child Health Bureau, include the
following:
Pain and Suffering Shouldn’t Be an Option: School-Based and
School-Linked Oral Health Services for Children and Adolescents (fact
sheet) provides information about the importance of good oral health
during childhood and adolescence. Topics discussed include school
readiness, disparities, oral trauma, nutrition, dental sealants,
fluoride varnish, and school-based and school-linked services. The fact
sheet is available at http://www.mchoralhealth.org/PDFs/schoolhealthfactsheet.pdf
Resource Highlights: Focus on School-Based and School-Linked Services
provides a short list of high-quality journal articles, materials, and
Web sites on this topic. Topics of other Resource Highlights include
early childhood caries, fluoridated community water, Head Start, health
literacy, and pregnancy and periodontal health. All Resource Highlights
are available at http://www.mchoralhealth.org/highlights/index.html
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2. WEB SITE FEATURES NEW RESOURCES TO SUPPORT STATES' EFFORTS TO USE
CHILD HEALTH DATA EFFECTIVELY
The Data Resource Center for Child and Adolescent Health has recently
retooled its Web site so visitors can create custom data profiles,
including new health disparities snapshots, using data from the 2007
National Survey of Children's Health. The Web site, a project of the
Child and Adolescent Health Measurement Initiative at the Oregon Health
and Science University that was produced with support from the Health
Resources and Services Administration's Maternal and Child Health
Bureau, is intended for use by researchers, policymakers, families, and
others in obtaining national, regional, and state-level data on a broad
range of topics relating to children’s health and well-being. The
Custom Data Profiles Web page allows users to (1) search and compare
results on over 80 indicators of child health and well-being, (2)
compare child health indicator results for children with and without
special health care needs within a state or nationwide, (3) compare
nationwide results for Rural Urban Commuting Area designations, and (4)
compare nationwide results for five race and ethnicity categories:
Hispanic (all races) and non-Hispanic Asian, African-American, white,
and other/multiracial. The 2007 Custom Data Profiles Web page is
available at http://nschdata.org/StateProfiles/ProfileSelection07.aspx
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3. MONOGRAPH HIGHLIGHTS A PUBLIC HEALTH FRAMEWORK FOR CHILDREN'S MENTAL
HEALTH
A Public Health Approach to Children's Mental Health: A Conceptual
Document presents a framework, based on well-established public health
concepts, that communities can use to strengthen the mental health and
resilience of all children. The monograph was produced by the National
Technical Assistance Center for Children's Mental Health at Georgetown
University's Center for Child and Human Development with support from
the Substance Abuse and Mental Health Services Administration's Center
for Mental Health Services. It was written for a broad range of leaders
who have a role in bringing about change in their systems or
organizations and influencing children's mental health and well-being.
The first five chapters of the monograph provide background information
and justification for a public health approach to children's mental
health, a foundation upon which collaborators can build a common
language, a brief overview of public health, a sense of how public
health is applicable to children's mental health, and a conceptual
framework for a public health approach to children's mental health. The
last chapter provides leaders with strategies to put the public mental
health intervention framework into action. More information is
available at http://gucchdtacenter.georgetown.edu/public_health.html
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4. NEW SURVEY PROVIDES MORE COMPLETE DATA ON INFANTS' HEARING
SCREENING, DIAGNOSTIC, AND INTERVENTION STATUS
"Data from the 2005 and 2006 CDC HSFS [Centers for Disease Control and
Prevention Hearing Screening and Follow-up Survey] made it possible to
assess more accurately national progress toward achieving the 1-3-6
Plan benchmarks outlined in goal 28-11 of Healthy People 2010," state
the authors of an article published in the March-April 2010 issue of
Public Health Reports. Early Hearing Detection and Intervention (EHDI)
programs routinely collect and report data related to Healthy People
2010 goal 28-11. The goal focuses on increasing the proportion of
newborns screened for hearing loss by age 1 month, having a diagnostic
audiologic evaluation by age 3 months, and being enrolled in
appropriate early intervention services by age 6 months. These
benchmarks are commonly referred to as the 1-3-6 Plan. EHDI data
related to the 1-3-6 Plan for the period 1999-2004 were gathered
through a voluntary survey sent annually to jurisdictions. This survey
was retired after collecting data for year 2004 owing to limitations
with the data being captured. To help meet the need for more complete
and comparable data, a new Web-based survey tool (the HSFS) was
designed by CDC's EHDI program, in collaboration with partners that
included the Health Resources and Services Administration. This article
summarizes the recent data that have been collected, discusses what the
data indicate about the status of efforts to identify infants with all
degrees and types of hearing loss, and identifies areas within the EHDI
process that may benefit from continued efforts.
CDC EHDI used the Web-based HSFS to collect aggregate data for 2005 and
2006. Forty-nine EHDI jurisdictions reported data on screening,
diagnosis, and intervention (part 1 of the HSFS) for 2005, and 50
jurisdictions reported data for 2006. The analysis presented here
assessed how many infants not passing the final hearing screening were
actually documented to receive follow-up services (diagnostic
evaluation and intervention services) and the number loss to follow-up
(LFU) or loss to documentation (LTD). The researchers calculated the
percentage of infants LFU or LTD for diagnosis by dividing the number
of infants reported as not receiving a diagnosis for the reason "unable
to contact/unresponsive/unknown" by the number reported as not passing
the final hearing screening. They calculated the percentage LFU or LTD
for intervention by dividing the number reported as not receiving
intervention services for the reason "unable to
contact/unresponsive/unknown" by the number reported with a permanent
hearing loss.
The authors found that
- An estimated 90.8 percent (2005) and 91.2 percent (2006) of
infants were screened for hearing loss.
- Of all infants screened, 2.0 percent (2005) and 2.1 percent
(2006) did not pass their final or most recent hearing screening.
- EHDI jurisdictions were unable to document a diagnosis finding
for 66.5 percent (2005) and 64.2 percent (2006) of those infants who
were reported as not passing their final hearing screening.
- The rate of LFU or LTD for diagnosis for those infants reported
as not having passed the final hearing screening was 59.9 percent in
2005 and 46.3 percent in 2006.
- The rate of LFU/LTD for intervention was estimated to be 33.9
percent in 2006.
"Additional efforts are needed to ensure infants and children with
hearing loss are documented to receive a timely diagnosis and enrolled
in EI [early intervention] services before 6 months of age," conclude
the authors.
Gaffney M, Green DR, Gaffney C. 2010. Newborn hearing screening and
follow-up: Are children receiving recommended services? Public Health
Reports 125(2):199-207. Abstract available at http://www.publichealthreports.org/archives/issueopen.cfm?articleID=2375
Readers: More information is available from the following MCH Library
resource:
- Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
Services in Medicaid: Knowledge Path at
http://www.mchlibrary.info/KnowledgePaths/kp_EPSDT.html
- Newborn Screening: Bibliography of Materials from MCHLine at
http://www.mchlibrary.info/databases/bibliography.php?target=auto_search_neoscrn
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5. ANALYSIS RECONFIGURES REPORTED STATISTICS TO FOCUS ON THE RISKS OF
FORMULA USE RATHER THAN THE BENEFITS OF BREASTFEEDING
"The presentation of the results in this manner provides the reader
with data to view exclusive breastfeeding as normal and formula use as
the health-risk behavior," state the authors of an article published in
the March 2010 issue of Birth. Exclusive breastfeeding is the
recommended source of nutrition for the first 6 months of an infant's
life. Despite the strength of the data and the recommendations
supporting 6 months of exclusive breastfeeding, analytical approaches
to the study of infant feeding rarely set exclusive breastfeeding as
the norm against which any other form of feeding should be compared.
The article describes a secondary analysis undertaken to provide health
professionals with quantitative and qualitative information to counsel
clients in a manner consistent with U.S. and international
recommendations for exclusive breastfeeding. The authors review
available evidence and re-express it as risks, or health costs.
Specifically, they present the results to reflect the increase in risk
of adverse outcomes resulting from formula use.
The analysis focused on studies included in the U.S. Agency for
Healthcare Research and Quality-sponsored review of breastfeeding and
maternal and infant health outcomes in the developed world. The studies
addressed eight childhood conditions, including acute otitis media,
atopic dermatitis, lower respiratory tract infections, asthma, type 1
diabetes, and type 2 diabetes. The analysis evaluated only studies that
reported "exclusively breastfed," "fully breastfed," or "totally
breastfed," as a comparison group.
The authors found that
- "Any formula use" was associated with increased incidence of
otitis media, asthma, type 1 diabetes, type 2 diabetes, atopic
dermatitis, and hospitalization secondary to lower respiratory tract
infections in infants in multiple studies.
- In many of the studies, the positive association did not achieve
statistical significance.
- No study found a protective effect of formula use.
"We assume that when more studies portray their results in this format,
we will begin to see a widespread adjustment in the language and hence
the attitudes and practices related to infant feeding, favoring the
healthful normative practice of exclusive breastfeeding," conclude the
authors.
McNiel ME, Labbok MH, Abrahams SW. 2010. What are the risks associated
with formula feeding? A re-analysis and review. Birth 37(1):50-58.
Abstract available at http://www3.interscience.wiley.com/journal/123302749/abstract
Readers: More information is available from the following MCH Library
resource:
- Breastfeeding: Resource Brief at
http://www.mchlibrary.info/guides/breastfeeding.html
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and
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