Nat'l Ctr for Educ in Maternal & Child Health

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Nat'l Ctr for Educ in Maternal & Child Health

Postby annegarrett » Fri Dec 19, 2003 11:23 am

Alert
Tomorrow's Policy Today
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National Center for Education in Maternal and Child Health
Search past issues of the MCH Alert, and other MCH Library resources, at http://www.mchlibrary.info/databases/search.lasso

December 19, 2003

1. New Web Site Offers One-Stop Shopping for Information About Federal Grants
2. Data About Children's and Adolescents' Unmet Dental Needs Released
3. Policy Brief Highlights Issues Related to Cost Estimates for Adolescent Pregnancy and Adolescent Pregnancy Prevention
4. Article Assesses Validity of Self-Reported Health-Risk Behavior Among Adolescents
5. Study Determines Characteristics of Infant Pertussis Cases in the 1990s

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Readers: MCH Alert will not be published for the next 2 weeks. The next issue is scheduled for January 9, 2004. Happy holidays!

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1. NEW WEB SITE OFFERS ONE-STOP SHOPPING FOR INFORMATION ABOUT FEDERAL GRANTS

Grants.gov is a single source for information about finding and applying for grants across the federal government. Development of the cross-agency Web site was led by the U.S. Department of Health and Human Services (HHS) in collaboration with other federal agencies and the National Science Foundation, and with input from organizations that apply for and receive federal grants. To date, application packages have been posted to the Web site by five agencies including the Departments of Commerce, Education, Energy, Justice, and HHS. The Web site provides information in a standardized format across agencies and includes features to (1) help applicants find potential funding opportunities and (2) download, complete, and submit applications for specific grant opportunities from any federal grant-making agency. The site is intended to help organizations learn about and apply for federal grants . The Web site is available at http://www.grants.gov.

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2. DATA ABOUT CHILDREN'S AND ADOLESCENTS' UNMET DENTAL NEEDS RELEASED

The Child Trends DataBank has released a new key indicator about children's and adolescents' unmet dental needs. The indicator, one of over 80 key indicators of child and adolescent well-being in the databank, provides information on how unmet dental needs affect child and adolescent well-being; trends in unmet dental needs among children and adolescents ages 2 to 17; and differences in unmet dental needs among children and adolescents by race/ethnicity, health insurance coverage, poverty status, and age. International estimates, national goals, definitions, and data sources are also provided. The information is intended for use by policymakers, health professionals, researchers, and others interested in improving child and adolescent health. Information about unmet dental needs is available at http://childtrendsdatabank.org/indicators/82UnmetDentalNeeds.cfm.

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3. POLICY BRIEF HIGHLIGHTS ISSUES RELATED TO COST ESTIMATES FOR ADOLESCENT PREGNANCY AND ADOLESCENT PREGNANCY PREVENTION

"The many different assumptions and methodologies underlying the . . . range of cost estimates [for adolescent pregnancy and adolescent pregnancy prevention] are a testament to how difficult it is to determine the associated expenditures," states the author of State/Local Costs of Teen Pregnancy and Teen Pregnancy Prevention: What We Know. The policy brief, published by the Joint Center for Political and Economic Studies, examines studies that have estimated adolescent-pregnancy-related costs incurred at state and local levels.

Analyses were drawn from research reports and other public documents published between the late 1970s and the early 2000s and include findings from studies conducted for the public and private sectors at the state, county, and metropolitan area/city levels. The brief features state and local estimates of amounts spent to address the consequences of adolescent pregnancy (mainly government expenditures for assistance to families begun by adolescents), prevent adolescent pregnancy, and cover the medical costs associated with adolescent pregnancy and prevention. The brief also addresses issues related to assumptions that underlie the cost estimates.

Measuring Public-Sector Costs of Adolescent Pregnancy
* The welfare program (Aid to Families with Dependent Children or Temporary Assistance to Needy Families, depending on the date of the study) and its expenditures were the single most commonly used constituent of estimates of state and local expenditures associated with adolescent pregnancy.
* Additional programs included in the estimates, and the ways these programs' expenditures are measured, vary considerably.
* Estimates of single-year and single-cohort costs vary considerably among state and local jurisdictions, while single-birth cost estimates vary much less, reflecting differences in not only the sizes of states but also in the incidences of adolescent pregnancy.

Measuring Public-Sector Costs of Adolescent Pregnancy Prevention
* There are two general difficulties in estimating state expenditures to prevent adolescent pregnancy: (1) identifying the programs whose funds are used to prevent adolescent pregnancy and (2) determining how states have actually used federal block grant funds.
* More programs may use their funds to prevent adolescent pregnancy than may be readily identified. In addition, unless the programs offer an adolescent pregnancy prevention module that has a separate budget line item, determining the amount of money spent to prevent adolescent pregnancy might not be straightforward.
* Estimates of the amount of federal money used to cover state expenditures to prevent adolescent pregnancy reflect the amount that could potentially be spent rather than the amount actually spent or the amount spent that prevented pregnancies.
* Recent increased state flexibility in the use of federal block grant dollars has made it harder to determine how federal dollars that could be used to prevent adolescent pregnancy are actually spent.

Other Costs Associated with Adolescent Pregnancy and Adolescent Pregnancy Prevention
* Studies that estimate the opportunity costs of adolescent pregnancy (e.g., lost earnings, unpaid sales and income taxes) encounter arithmetic and data-collection challenges. Too often, state or local data are simply not available.

This review, the author suggests, helps to "encourage future interest in refining this knowledge and ultimately improving the accuracy of these cost estimates."

Leigh W. 2003. State/local costs of teen pregnancy and teen pregnancy prevention. Washington, DC: Joint Center for Political and Economic Studies.

Readers: A related policy brief, National Costs of Teen Pregnancy and Teen Pregnancy Prevention: What We Know, and report, Estimating the Cost of Effective Teen Pregnancy Prevention Programs, are also available from the Joint Center at http://www.jointcenter.org/publications/details/health/TPP.html. The report features a costing worksheet that can be used to calculate per-client cost for a program, as well as examples of cost estimates for selected programs. More information about adolescent pregnancy prevention is available from the MCH Library knowledge path at http://www.mchlibrary.info/KnowledgePaths/kp_adolpreg.html.

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4. ARTICLE ASSESSES VALIDITY OF SELF-REPORTED HEALTH-RISK BEHAVIOR AMONG ADOLESCENTS

"This review has demonstrated that self-reports of . . . [adolescent health-risk behaviors] are indeed affected by both cognitive and situational factors in varying degrees," state the authors of a review article published in the December 2003 issue of the Journal of Adolescent Health. The authors of this article point out that the truthfulness and accuracy of adolescents' self-reported health-risk behaviors may be compromised for several reasons, and that determining the accuracy of such reports, as well as the magnitude of any inaccuracies and their likely source, is important. The goal of this article was to review the existing empirical literature to assess factors that may affect the validity of adolescents' self-reports of several health-risk behaviors.

To find relevant articles, the authors searched Medline, ERIC, Sociological Abstracts, and PsycINFO. The six types of health-risk behaviors identified were alcohol and other drug use, tobacco use, behaviors related to unintentional injuries and violence, dietary behaviors, physical activity, and sexual behaviors. For each of these behaviors, the authors searched for information on possible validity problems viewed from two major theoretical perspectives: (1) the cognitive perspective, which focuses on the mental processes underlying self-reported data and attributes validity problems to inaccuracies arising from comprehension, recall, and other cognitive operations and (2) the situational perspective, which focuses on validity problems that arise from factors related to social desirability and interviewing conditions.

The authors found that

* Self-reports of each of the six types of health-risk behaviors are affected by both cognitive and situational factors.
* These factors do not threaten the validity of self-reports of each type of behavior equally.
* Each type of behavior differs in terms of the extent to which it can be validated by an objective measure.

The authors conclude that "the importance of assessing the prevalence of health-risk behaviors as part of research activities involving adolescents often necessitates the use of self-reports measures." They continue, "researchers should familiarize themselves with . . . threats to validity and design studies that minimize these threats as much as possible."

Brener ND, Billy JO, Grady WR. 2003. Assessment of factors affecting the validity of self-reported health-risk behavior among adolescents: evidence from the scientific literature. Journal of Adolescent Health 33(6) 436-457.

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5. STUDY DETERMINES CHARACTERISTICS OF INFANT PERTUSSIS CASES IN THE 1990S

"National surveillance data show a progressive increase in reports of pertussis among infants in the United States from the end of the 1970s through the 1990s," state the authors of an article published in the December 10, 2003, issue of JAMA, The Journal of the American Medical Association. The article describes trends and characteristics of reported infant (under age 12 months) pertussis cases in the United States in the 1990s.

Researchers analyzed data from the National Notifiable Disease Surveillance System for the period 1980-1999 to determine the total number of infant cases and deaths by year. Data from the Supplementary Pertussis Surveillance System since 1984 were used to calculate incidences. Reporting of race and ethnicity was restricted to cases reported in 1997-1999. Population demographic data were obtained from the U.S. Census Bureau.

The authors found that

* The annual number of reported cases of pertussis among infants has increased progressively during the last 2 decades, with peaks every 3 to 4 years.
* The mean annual incidence rate among infants ages 4 months or younger increased from 63.4 cases per 100,000 population in the 1980s to 88.7 cases per 100,000 in the 1990s; the mean annual incidence rate among infants ages 2 months or younger increased from 72.1 cases per 1,000 in the 1980s to 107.3 cases per 100,000 in the 1990s. The mean annual incidence rate among infants ages 5 to 11 months changed little (20.2 cases per 100,000 in the 1980s, and 18.6 cases per 100,000 in the 1990s).
* The proportion of cases that were age-appropriately vaccinated was higher in the 1990s than in the 1980s.
* Classic symptoms of pertussis (cough and paroxysm) were common among infant cases irrespective of age.
* Irrespective of age, infants with pertussis who received fewer diphtheria-tetanus-pertussis vaccinations were significantly more likely to be hospitalized.
* During the 1990s, 46% of reported infant pertussis cases had an onset of cough between June and September.

The authors conclude that "further improvements in the surveillance of pertussis among young infants and additional data on both transmission sources and risk factors for pertussis in this age group are needed to guide the development of new pertussis control strategies and to monitor their success."

Tanaka M, Vitek CR, Pascual FB, et al. 2003. Trends in pertussis in the United States, 1980-1999. JAMA, The Journal of the American Medical Association 290(22):2968-2975.

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MCH Alert © 2003 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 (6U02 MC 00001) 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.

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EDITORS: Jolene Bertness, Tracy Lopez
COPYEDITOR: Ruth Barzel

National Center for Education in Maternal and Child Health
Georgetown University
Mailing address: Box 571272, Washington, DC 20057-1272
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Anne Garrett
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Preeclampsia Foundation
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