Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html
February 11, 2011
1. New Edition of Oral Health Knowledge Path Available
2. USDA and DHHS Announce New Dietary Guidelines
3. Study Examines Parents' Perspectives on Child Care and Employment Challenges
4. Authors Investigate Coping Among Parents of Children with and Without a Health Care Home
5. Article Explores Use of Text Message Reminders to Promote HPV Vaccinations
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1. NEW EDITION OF ORAL HEALTH KNOWLEDGE PATH AVAILABLE
Oral Health for Infants, Children, Adolescents, and Pregnant Women:
Knowledge Path is an electronic guide to recent resources that analyze
data, describe effective programs, and report on policy and research
aimed at improving access to and the quality of oral health care. The
new edition of the knowledge path was produced by the Maternal and
Child Health Library (MCH Library) in collaboration with the National
Maternal and Child Oral Health Resource Center for National Children's
Dental Health Month (February 2011). The path contains information on
websites and resources from national and state organizations, distance
learning resources, databases, and newsletters and news and commentary.
Separate sections list resources for families and for schools. The
final part of the knowledge path presents resources on specific aspects
of oral health: child care and Head Start, dental caries, dental
sealants, fluoride varnish, pregnancy, school-based care, and special
health care needs. The knowledge path is available at http://www.mchlibrary.info/KnowledgePaths/kp_oralhealth.html and http://www.mchoralhealth.org/knwpathoralhealth.html
MCH Library knowledge paths on other topics are available at http://www.mchlibrary.info/KnowledgePaths/index.html. The library welcomes feedback on the usefulness and value of these knowledge paths. A feedback form is available at http://www.mchlibrary.info/feedback/index.html
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2. USDA AND DHHS ANNOUNCE NEW DIETARY GUIDELINES
Dietary Guidelines for Americans provide authoritative advice for
people ages 2 and older about how dietary habits can promote health and
reduce risk for major chronic diseases. The guidelines, published
jointly by the U.S. Department of Agriculture (USDA) and the U.S.
Department of Health and Human Services every 5 years since 1980, serve
as the basis for federal food and nutrition-education programs.
Recommendations in the 2010 (seventh) edition encompass two overarching
concepts: (1) maintaining calorie balance over time to achieve and
sustain a healthy weight and (2) consuming nutrient-dense foods and
beverages. The appendices contain resources that can be used in
developing policies, programs, and educational materials such as
guidance for specific population groups; key consumer behaviors and
potential strategies for professionals to use in implementing the
guidelines; food safety principles and guidance for consumers; and
using the food label to track calories, nutrients, and ingredients.
Additional appendices contain nutritional goals for age-gender groups;
estimated calorie needs per day by age, gender, and physical activity
level; and the USDA Food Patterns and Dietary Approaches to Stop
Hypertension Eating Plan. The guidelines are available at http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf
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3. STUDY EXAMINES PARENTS' PERSPECTIVES ON CHILD CARE AND EMPLOYMENT CHALLENGES
"We found that many families face child care problems that
significantly impacted their employment, with almost half of US
households with children in the 0- to 13-year age range affected at the
beginning of the current recession," state the authors of an article
published in the January-February 2011 issue of Academic Pediatrics.
Difficulties with obtaining child care and its associated effects on
parent employment have been investigated as part of the welfare-to-work
transition studies, particularly for mothers of young children. There
is evidence, however, that many families outside the welfare system
face similar child care and employment challenges, particularly if they
have a child with special health care needs or emotional or behavioral
disorders. The article examines (1) the type of employment problems
that parents directly attribute to difficulties in securing child care
by using a household approach and (2) whether having a child with
behavior problems and/or a serious chronic health condition is
independently associated with child-care-related employment problems in
the United States.
The study used household-level sampling from the nationally
representative random-digit-dial survey Gallup panel. The sample was a
subset of households that met eligibility criteria (having a child from
birth to age 13) and consented to a 15- to 20-minute telephone survey
about child care and employment (n=1,431; 92.85 percent). The data were
collected during late fall 2008 as the American economy severely
contracted.
The authors found that
- Overall, 46 percent of households reported at least one
child-care-related employment change. Being absent from work (21.4
percent) and changing the work schedule (27.3 percent) were the most
prevalent adaptations to child care problems, with more than one in
five households reporting these adaptations.
- There was no association between the gender of the respondent or
the highest level of education in the household and any of the
dependent variables. Being black or of Hispanic ethnicity was not
associated with increased likelihood of overall employment changes but
was associated with a report of decreased job performance because of
child care issues. Low-income households were more likely to report
having modified a job substantially because of child care problems but
were less likely to report child-care-related absenteeism.
- Having a child with diagnosed behavior problems or a serious
chronic health condition was associated with double to triple the odds
of many child-care-related employment problems. (About 16 percent of
the households with a child with behavior problems also had a child in
the household -- not necessarily the same child -- with a serious
chronic health condition.)
- Protective factors included living in a two-parent household and
the presence of a stay-at-home parent in the household. (Households
with a stay-at-home parent were more likely to report that child care
issues had resulted in someone in the household recently quitting a
job.)
"Family advocates, including pediatricians, should consider these
difficulties in their discussion with families and proactively support
parents in obtaining high-quality care and more parent-friendly labor
conditions," conclude the authors.
Montes G, Halterman JS. 2010. The impact of child care problems on
employment: Findings from a national survey of US parents. Academic
Pediatrics 11(1):80-87. Abstract available at http://www.academicpedsjnl.net/article/S1876-2859(10)00336-0/abstract
Readers: More information is available from the following MCH Library resource:
- Children and Youth with Special Health Care Needs: Knowledge Path (child care and early education programs) at
http://www.mchlibrary.info/KnowledgePaths/kp_CSHCN.html#childcare
- Children with Special Health Care Needs: Child Care (bibliography of materials from MCHLine) at
http://www.mchlibrary.info/databases/bibliography.php?target=auto_search_cccshn
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4. AUTHORS INVESTIGATE COPING AMONG PARENTS OF CHILDREN WITH AND WITHOUT A HEALTH CARE HOME
"Children who had a health care home were more likely to have parents
who reported coping very well," state the authors of an article in the
Journal of Pediatric Health Care published online on February 2, 2011.
Healthy People 2010 identified the need to increase the number of
children with special health care needs (CSHCN) with access to a health
care home. In addition to being associated with well-being and health
outcomes, aspects of the health care home, such as family-centered care
and care coordination, are likely associated with parents' ability to
cope with the day-to-day demands of parenting, but this relationship
has not been fully explored in a large sample of families. A contextual
approach to families with CSHCN recognizes the interdependence of
families with the health care system and the role of extra-family
factors in coping. The article describes a study to determine whether
certain provider-level factors, as a process of care, are associated
with parental coping with the day-to-day demands of raising a CSHCN,
while controlling for individual-level factors.
Data for this secondary analysis were from the 2007 National Survey of
Children's Health (NSCH). The subsample of CSHCN was the focus for this
study. The study sample included 18,352 CSHCN (19.2 percent of the
entire NSCH sample). The analyses explored relationships between level
of parental coping, process-of-care variables (including the presence
of a health care home and specific subparts of the health care home --
family-centered care and care coordination), predisposing variables
(child age and mother's education level), and enabling variables
(poverty and insurance status).
The authors found that
- Based on the health care home composite score, 51.4 percent
(n=9,435) of CSHCN in this sample had a personal doctor or nurse and
met criteria for adequate care on every component of the health care
home.
- Compared with children whose parents reported not coping well, a
significantly higher proportion of children who had a health care home
who did not receive help coordinating care and who did not need extra
help coordinating care had parents who reported coping very well.
- As parents' satisfaction with communication among health
professionals increased, the proportion of those coping not very well
decreased.
- Children were more likely to have a parent coping very well if
the child was older, the parent reported not needing additional help
with care coordination, and/or the score on the family-centered care
scale was higher.
- Maternal education level, poverty status, and insurance status were not significant in the model.
"The findings of this study highlight the interconnectedness of
families and systems of care," conclude the authors, adding that
"support and resources for parents of CSHCN are imperative so parents
can provide the best health care for their children."
Drummond A, Looman WS, Phillips A. 2011. Coping among parents of
children with special health care needs with and without a health care
home. Journal of Pediatric Health Care [published online on February 1,
2011]. Abstract available at http://www.jpedhc.org/article/S0891-5245(10)00386-X/abstract
Readers: More information is available from the following MCH Library resource:
- Kids and Teens with Special Health Care Needs: Resources for Families at
http://www.mchlibrary.info/KnowledgePaths/kp_CSHCN.html
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5. ARTICLE EXPLORES USE OF TEXT MESSAGE REMINDERS TO PROMOTE HPV VACCINATIONS
"Our study provides evidence that among parents choosing to enroll,
text message reminder-recalls can effectively promote on-time receipt
of subsequent HPV [human papillomavirus] vaccine doses," write the
authors of an article published in Vaccine online on February 5, 2011.
In 2006, the Advisory Committee for Immunization Practices recommended
the quadrivalent HPV vaccine to be included in the routine immunization
schedule for adolescent girls in the United States. More recently, a
permissive recommendation to immunize adolescent males was added.
Recognizing that adherence to the three-dose HPV vaccine regimen may be
challenging, immunization reminder-calls are widely recommended.
However, traditional mail or phone reminders have had limited impact on
adolescent populations. In the study described in this article,
researchers implemented and evaluated a text-messaging service to
remind parents when their daughter was due for her next HPV vaccine
dose.
Nine clinical sites located in New York City participated in this
practice-based intervention to improve adherence with HPV vaccination
guidelines. Five sites were hospital-affiliated, academic practices
serving primarily publicly insured adolescents. The remaining four were
private practices serving primarily privately insured children and
adolescents. The text-messaging reminder intervention was implemented
at all participating clinical sites during a 6-month intervention
period, January through June 2009. For all females ages 9-20 who
received the first or second dose in the HPV series (HPV1 and HPV2)
during the intervention period, the nurse or physician administering
the vaccine offered parents an enrollment card with instructions on how
to sign up for text messaging reminders for the next vaccine dose.
Parents who enrolled received up to three weekly text-message reminders
that their daughter was due for her next vaccine dose. The primary
outcome was the proportion of females who received their next vaccine
dose on time, defined as receipt within 1 month of its due date. To
measure the impact of the intervention, the researchers compared
on-time receipt of the next vaccine dose among females whose parents
signed up for text message reminders vs. two control groups: control
group 1 -- opt out (those who received the enrollment card during the
intervention but did not sign up) and control group 2 -- historical
(those who received HPV1 or HPV2 during the control period, before the
start of the intervention).
The authors found that
- During the intervention period, across the nine participating
sites, 364 females received HPV1 and 401 received HPV2 (256 received
both HPV1 and HPV2). Of the 765 eligible HPV vaccine events, 434
sign-up cards were distributed (56.7 percent of doses) and 128 (29.5
percent of those handed cards) signed up for the text message
reminders. Four parents who signed up were excluded post hoc. The final
intervention comprised 124 females.
- The intervention population were significantly more likely than the control populations to receive their next HPV dose on time.
- On-time receipt of the next dose occurred among 51.6 percent of
the intervention population, compared with 35.0 percent of control
group 1 -- opt out, and 38.1 percent of control group 2 -- historical.
- At 4 months following the vaccine due date, the intervention
population was still significantly more likely to have returned for the
next vaccine dose, although the magnitude of the difference between
intervention and control groups was slightly less at 4 months vs. 1
month.
- After controlling for insurance status and site of care, the
researchers found that intervention subjects were more likely than
either control population to receive their next HPV dose on time.
The authors conclude that "future studies should explore how to
increase parental interest in signing up for such interventions. In
addition, similar text messaging interventions should be conducted in
larger, more geographically diverse populations."
Kharbanda EO, Stockwell M, Fox H, et al. 2011. Text messaging to
promote human papillomavirus vaccination. Vaccine [published online on
February 5, 2011]. Abstract available at http://dx.doi.org/10.1016/j.vaccine.2011.01.065
Readers: More information is available from the following MCH Library resources:
- Immunizations: Resource Brief at
http://www.mchlibrary.info/guides/immunization.html
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and
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