National Center for Education in Maternal and Child Health

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July 12, 2002

1. Report Emphasizes Need for a More Active Lifestyle

2. 2001 Data on Health-Risk Behaviors Among Youth Available

3. Supplement to Pediatrics Examines Treatment of Overweight Children and Adolescents

4. Study Links Language Spoken at Home with Health and School Issues Among Asian-American Adolescents

5. Program Seeks to Increase Use of Child Motor Vehicle Restraints in Hispanic Neighborhood

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1. REPORT EMPHASIZES NEED FOR A MORE ACTIVE LIFESTYLE

Physical Activity Fundamental to Preventing Disease, a June 2002 report released by the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, presents research demonstrating that virtually all individuals can benefit from regular physical activity and emphasizes the importance of physical activity for achieving and maintaining physical and mental health. The report includes information on the economic consequences of inactivity (e.g., the total cost incurred by the nation as a result of heart disease, cancer, diabetes, and arthritis). Information on the health risks associated with obesity and the importance of regular physical activity for maintaining a healthy weight are also included. The report is available at http://aspe.hhs.gov/health/reports/physicalactivity/physicalactivity.pdf.

Readers: More information about physical activity and children and adolescents is available on the Bright Futures Web site at http://www.brightfutures.org/physicalactivity/about.htm and in NCEMCH's knowledge path, Physical Activity and Children, at http://ncemch.org/RefDes/PhysActivity.html.

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2. 2001 DATA ON HEALTH-RISK BEHAVIORS AMONG YOUTH AVAILABLE

Youth Risk Behavior Surveillance -- United States, 2001 summarizes results from the national Youth Risk Behavior Survey, 34 state surveys, and 18 local surveys conducted among students in grades 9 through 12 during February through December 2001. These surveys comprise the Youth Risk Behavior Surveillance System (YRBSS). The YRBSS monitors six categories of priority health-risk behaviors among youth and young adults; these behaviors contribute to unintentional injuries and violence, tobacco use, alcohol and other drug use, sexual behaviors that can result in unintended pregnancy and STDs (including HIV infection), unhealthy dietary behaviors, and physical inactivity. The report includes a trend analysis of 1991-2001 data and information on how the data are being used by federal, state, and local agencies and nongovernmental organizations to analyze and improve policies and programs to reduce priority health-risk behaviors among youth. The report is available at http://www.cdc.gov/mmwr/PDF/ss/ss5104.pdf.

Readers: The increased accessibility of the Internet has encouraged several states and local agencies to post Youth Risk Behavior Survey (YRBS) data on their Web sites. The Council of Chief State School Officers' Web site (http://www.ccsso.org/yrbs.html) has links to several state YRBS reports.

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3. SUPPLEMENT TO PEDIATRICS EXAMINES TREATMENT OF OVERWEIGHT CHILDREN AND ADOLESCENTS

Treatment of Overweight Children and Adolescents: A Needs Assessment of Health Practitioners, is a compilation of six articles published as a supplement to the July 2002 issue of Pediatrics. This project was coordinated by the International Life Sciences Institute (ILSI) Center for Health Promotions in cooperation with the Maternal and Child Health Bureau and the National Center for Education in Maternal and Child Health. Publication of this supplement was made possible in part by a grant from the Robert Wood Johnson Foundation. The studies reported in these articles aimed to

• Examine the attitudes and practices of health professionals in the assessment and treatment of overweight children and adolescents;
• Evaluate health professionals' attitudes, perceived barriers, perceived skill levels, and training needs in the management of child and adolescent obesity;
• Describe the usual psychological, emotional, and behavioral evaluations of overweight children and adolescents to target education of pediatric health professionals;
• Determine how pediatric health professionals identify overweight in children and adolescents and how they evaluate obesity-related medical complications;
• Identify interventions used by pediatric health professionals in treatment of overweight children and adolescents to determine these health professionals' educational needs; and
• Identify the needs of pediatric clinicians (registered nurses, pediatric nurse practitioners, and pediatricians) when they care for overweight children.

Treatment of Overweight Children and Adolescents: A Needs Assessment of Health Practitioners. July 2002. Pediatrics 110(1;Part 2).

Subscribers to Pediatrics may access the full text of these articles at http://www.pediatrics.org/cgi/content/full/110/1/S1/236. For more information about nutrition in children and adolescents see NCEMCH's Childhood Nutrition knowledge path at http://www.ncemch.org/RefDes/kpchildnutr.html and the Bright Futures Web site at http://www.brightfutures.org/nutrition/about.html.

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4. STUDY LINKS LANGUAGE SPOKEN AT HOME WITH HEALTH AND SCHOOL ISSUES AMONG ASIAN-AMERICAN ADOLESCENTS

"These findings show evidence of increased risk for physical, psychosocial, and school health problems among Asian American immigrant adolescents, and the risks are greater for adolescents whose families are less acculturated to the United States, as measured by the language they speak at home," state the authors of an article published in the May 2002 issue of the Journal of School Health. The study described in this article examined the association between language spoken at home and school- and health-related outcomes among Asian Americans using data from the 1997-1998 World Health Organization Study of Health Behavior in School Children.

The U.S. data for this study were drawn from a school-based survey sample of 15,686 students in grades 6 through 10 from 386 schools in the United States. The 795 students who chose "Asian" as their race category or one of their race categories were divided into three groups depending on the language they reported speaking at home. They were grouped as follows: those who reported usually speaking English, those who reported usually speaking a language other than English, and those who reported speaking English and another language about equally. Outcome measures from the self-report survey included questions about health behavior, psychosocial and school risk factors, and parental influence.

The authors found that

• One-third of the students (32.8%) surveyed usually spoke English at home, 24% spoke a language other than English at home all or most of the time, and 42.9% spoke English and another language at home about equally;
• Students who usually spoke a language other than English at home were significantly more likely than those who usually spoke English at home to experience adverse health outcomes (frequent dizziness, headache, and stomachache) and were less likely to report themselves as being "very healthy";
• Students who usually spoke a language other than English at home were significantly more likely to report that they sometimes, often, or always feel helpless and were less likely to report that they feel confident in themselves, feel they belong in their schools, and feel that other students accept them as they are; and
• Students who usually spoke a language other than English at home were twice as likely to report that their parents were never or rarely ready to help with school problems or willing to come to school to talk with their teachers.

The authors conclude that "adolescent children of Asian immigrant families could benefit from early identification and outreach to their families, assessment of their needs, and counseling and support services," and they assert that "those in greatest need may be identified by a language the child speaks at home." They suggest that teachers and health professionals become aware of the health behaviors and risks experienced by this population and receive training in how to address these needs.

Yu SM, Huan ZJ, Schwalberg RH, et al. 2002. Association of language spoken at home with health and school issues among Asian American adolescents. Journal of School Health 72(5):192-198.

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5. PROGRAM SEEKS TO INCREASE USE OF CHILD MOTOR VEHICLE RESTRAINTS IN HISPANIC NEIGHBORHOOD

"We believe that the success of this program was the result of its ongoing nature, its integration of cultural and religious factors, the use of Hispanic teachers in child safety seat classes, the efforts of the community health center staff to integrate safety messages into the clinical routine, and the feedback that program staff received from surveillance data about progress in the program," state the authors of a field action report published in the July 2002 issue of the American Journal of Public Health. A preliminary survey of Hispanic children from birth through age 4 in West Dallas, TX, conducted in 1997 showed that the percentage using child motor vehicle restraints was much lower in this population (19%) than among children of all races in this age group throughout the rest of the city (62%). The authors sought to implement and evaluate interventions to increase child motor vehicle restraint use in this community.

Interventions were developed using standardized educational programs and community focus groups and were incorporated into various aspects of the culture. Child motor vehicle restraint use was evaluated through structured observational surveys conducted by trained observers as vehicles entered parking lots at (1) the community health center where the intervention was conducted, (2) child care centers that were intervention sites, and (3) the parking lots of eight grocery stores patronized predominantly by Hispanics. A total of 7,413 observations of the target population were made from 1997 through 2000. Additionally, 4,137 comparison observations of children from birth through age 4 of all races in other parts of the city were made.

The authors found that

• Child motor-vehicle restraint use among Hispanic children increased significantly in all three settings between 1997 and 2000;
• By 2000, restraint use among Hispanic children attending the health center was higher than use in the rest of the city (72% vs. 68%);
• Restraint use among children from birth through age 1 was substantially higher than use among children ages 2 through 4;
• Observed driver seatbelt use increased significantly in each of the three settings, whereas there was little change in driver seatbelt use in other parts of the city; and
• There was a strong association between child restraint use and driver seatbelt use at all the observation sites.

The authors conclude that "with a multifaceted program, child restraint use and driver seat belt use in the Hispanic population may reach levels that equal or exceed those of the general population."

Istre GR, McCoy MA, Womack KN, et al. 2002. Increasing the use of child restraints in motor vehicles in a Hispanic neighborhood. American Journal of Public Health 92(7):1096-1099.

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MCH Alert © 2002 by National Center for Education in Maternal and Child Health and Georgetown University. MCH Alert is produced by MCH Library Services at the National Center for Education in Maternal and Child Health under its cooperative agreement (U02 MC 0001-01) 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.

Permission is given to forward MCH Alert to individual colleagues. For all other uses, requests for permission to duplicate and use all or part of the information contained in this publication should be sent to MCH Alert Editor, National Center for Education in Maternal and Child Health, at mchalert@ncemch.org.

The editors welcome your submissions, suggestions, and questions. Please contact us at the address below.

EDITORS: Jolene Bertness, Tracy Lopez

COPYEDITOR: Ruth Barzel

National Center for Education in Maternal and Child Health
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E-mail: mchalert@ncemch.org
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