1. Compendium Provides Actionable Ways to Improve Birth Outcomes
Forging a Comprehensive Initiative to Improve Birth Outcomes and Reduce Infant Mortality: Policy and Program Options for State Planning is a collection of recommendations to states on how to address infant mortality. The recommendations are supplemented by specific action steps, state examples, and state case studies. The compendium, produced by the Association of Maternal and Child Health Programs, uses the Health Impact Pyramid as a framework to understand comprehensive approaches to improving birth outcomes and reducing infant mortality. Contents include recommendations for implementing health-promotion efforts; ensuring quality of health care for all women and infants; implementing maternal risk screening for all women of reproductive age, enhancing service integration for all women and infants; improving access to health care for women before, during, and after pregnancy; developing data systems to understand and inform efforts; and promoting social equity. The compendium also provides case studies from California, Delaware, Kentucky, Maryland, North Carolina, Ohio, and Texas. A worksheet, source documents, and a matrix of strategies are included as appendices. The compendium is available at http://www.amchp.org/programsandtopics/data-assessment/projects/Documents/AMCHP%20Birth%20Outcomes%20Compendium%202012.pdf.
2. Licensing Toolkits Focus on High-Impact Standards of Best Practice for Preventing Childhood Obesity
The National Resource Center for Health and Safety in Child Care and Early Education's Licensing Toolkits comprise tools and products to support states in ensuring that environments promote healthy weight. Each toolkit consists of three components: a licensing agencies' action sheet, a child care providers' action sheet, and a legislators' action sheet. The toolkits are intended to facilitate conversations among licensors, child care and early education providers, legislators, health professionals, and families about research and information that may influence licensing requirements, particularly in areas where new findings are rapidly accruing. Topics include avoiding or limiting foods high in sugar, using water and 100 percent juice, and limiting screen time. The toolkits are available at http://nrckids.org.
3. Supplement Looks at How Experiences and Exposures Across the Life Span Shape Health, Development, and Learning in Adolescence
The August 2012 supplement to the Journal of Adolescent Health examines the impact of experience in shaping the brain and behavior from the prenatal period through adolescence. The content is based on a conference held in April 2011 at the Johns Hopkins Bloomberg School of Public Health to consider the role of stress, adversity, and experience (broadly defined) during the prenatal, childhood, and adolescent periods. Together, the articles in the supplement illustrate the diversity of research methods being applied in this area, which span genomics, developmental psychobiology, neuro-imaging, and intervention research. The article abstracts are available at http://jahonline.org/supplements.
4. Report Describes Trends in HIV-Related Behaviors Among High School Students
These results suggest that "progress in reducing some HIV-related risk behaviors among high school students overall and in certain populations stalled in the past decade," state the authors of a report published in Morbidity and Mortality Weekly Report (published online on July 24, 2012). The report describes changes over time in the prevalence of HIV-related risk behaviors among students in grades 9-12 in all 50 states and the District of Columbia.
The Centers for Disease Control and Prevention analyzed data from the biennial national Youth Risk Behavior Survey for the period 1991-2011. For each survey, students completed anonymous, self-administered questionnaires that included identically worded questions about their sexual experience, number of sexual intercourse partners, current sexual experience, condom use, and injection drug use. Analyses controlled for sex, race and ethnicity, and grade.
The authors found that
* During 1991-2011, a significant linear decrease occurred in the prevalence of sexual experience overall and among male, female, black, and white high school students (overall: 54.1 to 47.4 percent; male: 57.4 percent to 49.2 percent; female: 50.8 percent to 45.6 percent; black: 81.5 percent to 60.0 percent; and white: 50.0 percent to 44.3 percent).
* Overall, the prevalence of sexual experience decreased during 1991-2001 and then did not change significantly during 2001-2011 (54.1 percent to 45.6 percent, and then 47.4 percent).
* A significant linear decrease occurred during 1991-2011 in the prevalence of having four or more sex partners overall and among male, female, black, and white students (overall: 18.7 percent to 15.3 percent; male: 23.4 percent to 17.8 percent; female: 13.8 percent to 12.6 percent; black: 43.1 percent to 24.8 percent; and white: 14.7 percent to 13.1 percent).
* Overall, the prevalence of having four or more sex partners decreased during 1991-2001 and then did not change significantly during 2001-2011 (18.7 to 14.2 percent and then 15.3 percent).
* A significant linear increase occurred during 1991-2011 in the prevalence of condom use among currently sexually active students overall and among both sexes and all three racial and ethnic populations (overall: 46.2 percent to 60.2 percent; male: 54.5 percent to 67.0 percent; female: 38.0 percent to 53.6 percent; 48.0 percent to 65.3 percent; Hispanic: 37.4 percent to 58.4 percent; and white: 46.5 percent to 59.5 percent).
* Overall and among female and white students, condom use increased during 1991-2003 and then did not change significantly during 2003-2011 (overall: 46.2 percent to 63.0 percent and then 60.2 percent; female: 38.0 percent to 57.4 percent and then 53.6 percent; and white: 46.5 percent to 62.5 percent and then 59.5 percent).
* During 1995-2011, a significant linear increase occurred in the prevalence of injection drug use among black and Hispanic students (black: 1.1 percent to 2.4 percent; Hispanic: 2.2 percent to 2.9 percent). Overall and among male, female, and white students, no significant change was detected.
"To reduce the number of young persons who become infected with HIV, renewed educational efforts and other risk factors reduction interventions are warranted," conclude the authors.
Centers for Disease Control and Prevention. 2012. Trends in HIV-related risk behaviors among high school students -- United States, 1991-2001. Morbidity and Mortality Weekly Report [published online on July 24, 2012]. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6129a4.htm?s_cid=mm6129a4_w.
Readers: More information is available from the following MCH Library resources:
- Adolescent Health: Resource Brief at
- Sexuality Education: Resource Brief at
5. Article Assesses Effectiveness of Interventions on Oral Contraceptive and Condom Use
"In this study, we observed that women who received additional education on how to use OC [oral contraception] were no more likely than those randomized to standard care to remain on this method or to do so correctly," write the authors of an article published in Contraception online on July 27, 2012. Many young women have difficulty using OC consistently or correctly. Moreover, almost half of young users discontinue using OC within 6 months of obtaining a prescription. The study described in this article tested two comprehensive educational and behavioral interventions designed to increase OC adherence among young women with low incomes. Researchers also assessed the efficacy of these interventions in increasing dual-method use (joint use of a condom for protection from sexually transmitted infections [STIs] and a highly effective contraceptive method) and in decreasing rates of STIs and unintended pregnancy.
A randomized, controlled trial was conducted to examine the effect of a clinic-based intervention (C) and a clinic-based plus telephone intervention (C+P) on OC adherence among young women initiating use of OC at one of five publicly funded reproductive health clinics in Southeast Texas. Sexually active, non-pregnant females ages 16-24 who requested initiation of OC between July 2006 and January 2010 were invited to participate (20,263 females). Exclusion criteria included a desire to become pregnant in the next year, a medical contraindication to OC, and current or prior OC use. The final sample consisted of 1,155 participants. These were randomized into three groups to receive standard clinical care (S) alone or one of the two interventions. Outcomes were assessed at 3, 6, and 12 months. Dual-method use, as well as pregnancy and STI rates, were also assessed at 3, 6, and 12 months.
The authors found that
* Neither of the interventions had a significant effect on OC continuation after 12 months.
* No significant differences were seen in dual-method use or in condom use at last sexual intercourse at any point of follow-up.
* Pregnancy and STI rates did not differ between study groups.
* Neither intervention significantly increased the duration of correct OC use over standard care. Correct use of each individual contraceptive pill pack also did not differ between groups.
* Women in the C and C+P groups did not differ from those in the S group after 12 months in almost all contraceptive-adherence variables. However, those in the C+P group were more likely to report condom use at last sexual intercourse than those in the S group. Furthermore, those in the C and C+P groups were more likely than those in the S group to identify a cue to help them remember to take their pills.
The authors conclude that "data from this large randomized study may be useful in
developing more sophisticated interventions to increase OC compliance, such as those using text messaging."
Berenson A, Rahman M. 2012. A randomized controlled study of two educational interventions on adherence with oral contraceptives and condoms. Contraception (published online on July 27, 2012). Abstract available at http://www.contraceptionjournal.org/article/S0010-7824(12)00639-7/abstract.
Readers: More information is available from the following MCH Library resources:
- Adolescent Pregnancy Prevention: Knowledge Path at
- Preconception and Pregnancy: Knowledge Path at
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