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Maternal Child Health Newsletter 10/22/04

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Maternal Child Health Newsletter 10/22/04

Post by laura » Fri Oct 22, 2004 12:37 am

MCH Alert
Tomorrow's Policy Today

National Center for Education in Maternal and Child Health
Search past issues of the MCH Alert and other MCH Library resources at

October 22, 2004

1. Chartbook Details Self-Reported Prevalence of Children and Adolescents
with Special Health Care Needs
2. Healthy People 2010 Companion Document Focuses on Critical Health
Objectives for Adolescents and Young Adults
3. Report Highlights Disparities in Maternal and Infant Health in California
4. Review Identifies High-Quality Research Findings in the Field of
Adolescent Violence
5. Article Examines Relationship Between Inhalant Abuse and Dependence
Among U.S. Adolescents



The National Survey of Children with Special Health Care Needs: Chartbook
2001 reports results of a survey on the prevalence of special health care
needs (SHCNs) among children and adolescents ages 17 and younger. The
survey, sponsored by the Maternal and Child Health Bureau and carried out
by the National Center for Health Statistics, represents the first source
of both national- and state-level data on the size and characteristics of
the population of children and adolescents with SHCNs. The chartbook
includes information on prevalence, health and functional status,
insurance coverage, health care needs and access to care, care
coordination, family-centered care, and impact on families. Tables and
graphs are also included. The chartbook is intended for use by health
professionals, program administrators, researchers, educators, and others
in monitoring and improving systems of care for children and adolescents
with SHCNs. It is available at



Improving the Health of Adolescents & Young Adults: A Guide for States and
Communities provides guidance and a framework for planning and
implementing programs for healthy adolescents and young adults. The guide
was developed by the Centers for Disease Control and Prevention's Division
of Adolescent and School Health and the Maternal and Child Health Bureau's
Office of Adolescent Health in collaboration with the National Adolescent
Health Information Center at the University of California, San Francisco.
It extracts Healthy People 2010 objectives that are key to the health of
adolescents and young adults. These Critical Health Objectives for
Adolescents and Young Adults are mortality, unintentional injury,
violence, substance use and mental health, reproductive health, and
prevention of chronic disease into adulthood. The guide provides a
framework for translating the objectives into a vision and plan for
improving the health, safety, and well-being of adolescents and young
adults in their communities. It is intended for use by agencies and
organizations in assessing needs and assets, establishing priorities,
taking collective action, measuring progress toward shared goals, and
taking advantage of the synergy that results when state- local-, and
community-level programs are in synchrony with national goals. The guide
is available at http://nahic.ucsf.edu/index.php/companion/index.



Disparities in Maternal and Infant Health: Are We Making Progress? Lessons
from California examines key indicators of maternal and infant health and
health care in California and documents findings on socioeconomic and
racial/ethnic disparities in unintended pregnancy, prenatal care, and
breastfeeding. The analysis, conducted by the Henry J. Kaiser Family
Foundation and the University of California at San Francisco, summarizes
data from two statewide-representative postpartum surveys linked with
birth certificates and examines changes in pregnancy intention, timing of
prenatal care initiation, and breastfeeding during 1994-1995 and
1999-2001. It also reviews the policy implications of the findings and
offers general recommendations for addressing maternal and infant health
disparities. The report is available at
http://www.kff.org/womenshealth/7157.cfm or



"The overarching goal of this review was to bring greater scientific rigor
to the evaluation process to identify the highest quality research
findings in the field of youth violence," state the authors of a report
published by the Agency for Healthcare Research and Quality. The report
presents findings from a review and analysis of longitudinal risk factor
research conducted in preparation for a National Institutes of
Health-sponsored consensus conference. The report summarizes what is
currently known about preventing adolescent violence and offers
recommendations for future research.

The review identified the roles of individual, family, school, community,
and peer-level influences as well as interventional research to evaluate
prevention-intervention effectiveness. The review was limited to
peer-reviewed articles published in 1990 or later and retrievable in
MEDLINE, PsychINFO, SocioAbstracts, and ERIC. It was also limited to
studies conducted in the United States and focused on violence perpetrated
by adolescents ages 12-17. Violence was defined as "threatened or actual
physical force or power initiated by an individual that results in, or has
a high likelihood of resulting in, physical or psychological injury or
death." The types of violent behavior assessed included murder or
homicide, aggravated assault, non-aggravated assault, rape or sexual
assault, robbery, gang fighting, physical aggression, psychological injury
or harm, and other serious injury or harm. Violence-prevention
interventions were defined as published in the Surgeon General's Report on
Youth Violence.

The authors offer the following recommendations for future research:

* Risk factors contributing to youth violence
Initiation of a national effort to develop comparable approaches to
defining, measuring, and analyzing research data related to youth
violence, as well as the funding of new initiatives, is needed to
facilitate the collection of comparable data across multiple sites and
with multiple youth populations.

* Interventions for the prevention of youth violence
Researchers should increase scientific rigor, including the use of control
populations and extended follow-up, to evaluate the sustained
effectiveness of youth-violence-prevention interventions.

* Rating of study quality
The need to develop valid instruments to evaluate the quality of studies
in the social sciences is apparent.

* Quality of publications
Special efforts are needed to improve the quality of publications,
including the consistency and adequacy with which the study
characteristics, such as research questions, conceptual framework, study
design, and description of the study population, are specified.

* Evidence assessment methods
Researchers should consider an "individual-level-data-meta-analysis"
method for future systematic reviews to identify both independent
predictors and clusters of predictors that lead to youth violence.

Chan LS, Kipke MD, Schneir A, et al. 2004. Preventing violence and related
health-risking social behaviors in adolescents. Evidence Report/Technology
Assessment No. 107. Rockville, MD: Agency for Healthcare Research and
Quality. Available at http://www.ahrq.gov/clinic/epcsums/adolvisum.htm.

Readers: The National Institutes of Health State-of-the-Science
Conference, titled Preventing Violence and Related Health-Risking Social
Behaviors in Adolescents, was held on October 13-15, 2004, in Rockville,
MD. The conference program and abstract book, the webcast archive, and the
panel's draft statement are available at
http://consensus.nih.gov/ta/023/023youthviolencepostconfintro.htm. The
full report (publication no. 04-E032-2) will be released in the next 3 to
4 weeks.

More information about adolescent violence prevention is available from
the MCH Library's knowledge path at
http://www.mchlibrary.info/KnowledgePaths/kp_adolvio.html and
organizations resource list at



"Adolescents who met criteria for inhalant abuse or dependence reported
coexisting delinquent behaviors, multiple drug abuse and dependence, and
utilizing mental health services for other emotional problems," state the
authors of an article published in the October 2004 issue of the Journal
of the American Academy of Child & Adolescent Psychiatry. National studies
of adolescents in the United States have found that, after marijuana,
inhalants were the second most widely used class of illicit drugs for 8th
and 10th graders and the third most widely used for 12th graders. Inhalant
use is defined as the deliberate inhalation of volatile substances to
induce a psychoactive or mind-altering effect. Inhalant use is a serious
public health problem; however, inhalant abuse and dependence among
adolescents remains a neglected area of research. The study described in
this article examined the prevalence and characteristics of inhalant use,
abuse, and dependence among adolescents ages 12 to 17 who participated in
the 2000-2001 National Household Surveys on Drug Abuse. The authors
investigated inhalant use patterns and characteristics associated with
progression to abuse and dependence.

The study sample consisted of 36,859 adolescents. The primary outcome was
inhalant abuse and dependence in the past year.

The authors found that

* Nine percent of the adolescents reported ever having used any inhalant
in their lifetime.

* Inhalant users were more likely than nonusers to be ages 14 or older; to
be American Indians, Alaska Natives, or of multiethnic origin; and to
reside in nonmetropolitan areas.

* Inhalant use was significantly associated with participation in mental
health treatment, a history of incarceration, a history of foster care
placement, delinquency, and the use of alcohol or other drugs.

* Among all the adolescents, 0.2% met the criteria for inhalant abuse and
0.2% for inhalant dependence.

* Adolescents who reported first use of inhalants at age 13 or 14 were six
times more likely to be dependent on inhalants than those who reported
first use at age 15 to 17.

* Using inhalants weekly, compared with less than weekly, was associated
with increased odds of dependence.

* Age group, gender, race/ethnicity, and family income were not
significantly associated with inhalant abuse or dependence.

* Receiving mental health treatment and the presence of other drug abuse
or dependence were associated with both inhalant abuse and inhalant

The authors conclude that "delaying the age at first inhalant use may help
reduce the risk of progressing to abuse or dependence."

Wu LT, Pilowsky DJ, Schlenger WE. 2004. Inhalant abuse and dependence
among adolescents in the United States. Journal of the American Academy of
Child & Adolescent Psychiatry 43(10):206-1214.


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MCH Alert © 2004 by National Center for Education in Maternal and Child
Health and Georgetown University. MCH Alert is produced by MCH Library
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National Center for Education in Maternal and Child Health
Georgetown University
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