Maternal Child Health Newsletter 8/12/04

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Maternal Child Health Newsletter 8/12/04

Postby laura » Thu Aug 12, 2004 12:53 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

August 13, 2004

1. MCH Library Releases New Knowledge Path on Mental Health In Children
and Adolescents
2. Directory Presents Information on Funding Opportunities for
Community-Based Participatory Research
3. Authors Investigate Risk Factors for Childhood Overweight
4. Analysis Assesses Insurance Coverage, Burden, and Adequacy for Children
with Special Health Care Needs
5. Article Explores Prevalence of and Risk Factors for Depressive Symptoms
Among Young Adolescents



Mental Health in Children and Adolescents is an electronic guide on
recent, high-quality resources for staying abreast of new developments in
child and adolescent mental health and for conducting further research.
Produced by the MCH Library, the knowledge path addresses the goals
outlined in Report of the Surgeon General's Conference on Children's
Mental Health: A National Action Agenda , and taps into the health,
education, social services, and juvenile justice literature. The knowledge
path includes information on (and links to) Web sites and electronic
publications, journal articles, databases, and electronic newsletters. It
is intended for use by health professionals, program administrators,
policymakers, educators, and families who are interested in tracking
timely information on this topic. The knowledge path is available at ... ealth.html.

MCH Library knowledge paths on other maternal and child health topics are
available at The MCH
Library welcomes feedback on the usefulness and value of these knowledge
paths. A feedback form is available at



Directory of Funding Sources for Community-Based Participatory Research
includes information on grants, training programs, and fellowships for
community-based participatory research (CBPR). Developed and published by
Community-Campus Partnerships for Health and the Northwest Health
Foundation, the directory provides information about public and private
funding agencies that have recently funded CBPR and about agencies that
have active "requests for proposals" and "program announcements" for
grants that either explicitly fund CBPR or could fund CBPR. The directory
includes descriptions, deadlines, contact information, examples of CBPR
projects, and an annotated list of funding resource Web sites. The
directory is intended for use by health professionals, program
administrators, educators, policymakers, and others in promoting health
through community-based research and other partnership strategies. It is
available at ... 62704f.pdf.



"Although the prevention of obesity may require alterations to an
environment that fosters inactivity and the consumption of calorie-dense
foods, the family is also a potential arena for prevention," write the
authors of an article published in the July 2004 issue of The Journal of
Pediatrics. The authors state that childhood overweight continues to
increase, and that because a considerable proportion of cases of adult
overweight begin in childhood, the development of effective prevention
programs in childhood is important. They add that this depends on the
identification of modifiable risk factors for childhood overweight. In the
exploratory study described in this article, the authors assessed many
established and hypothesized risk factors for the development of childhood

The study population consisted of 150 children (74 boys and 76 girls)
recruited in infancy from the well newborn nurseries of a university
hospital, a community hospital, and a health maintenance organization in
the San Francisco Bay Area. The children were followed to 9.5 years.

The authors found that

* Of the 150 children, 38 (25.3%) were above the 85th percentile of BMI at
9.5 years of age, including 14 (9.0%) above the 95th percentile.

* The strongest risk factor for childhood overweight was parental
overweight. This factor was correlated with highly emotional behavior on
the child's part.

* Other risk factors associated with childhood overweight included low
parental concern about their child's thinness, children with persistent
tantrums over food, and children's hours of sleep at ages 3 and 4
(children who were to become overweight were reported to sleep about 30
minutes less on average -- primarily during the day -- than those who
would remain normal weight).

The authors conclude that "the findings of this study suggest that at-risk
children and parents may be identifiable in the first few years of a
child's life, affording the opportunity for early preventive

Agrams WS, Hammer LD, McNicholas F. 2004. Risk factors for childhood
overweight: A prospective study from birth to 9.5 years. The Journal of
Pediatrics 145(1):20-25.

Readers: More information about child nutrition is available from the
Bright Futures Web site at, as well as from the
MCHLibrary's knowledge path at ... dnutr.html, bibliography
at ... tr&-search,
and organizations list at ... on&-search.



"Consistent with expectations, this analysis finds that CSHCN [children
with special health care needs] had different patterns of insurance
coverage than other children," states the author of an article published
in the August 2004 issue of Pediatrics. This article updates national
estimates of insurance coverage for CSHCN and provides information
concerning the burden on families to provide insurance and the adequacy of
existing coverage for CSHCN.

Data for the analysis were drawn from the 2000 and 2001 National Health
Interview Survey for children from birth to age 17. The unweighted sample
in the 2 years of pooled data included 2,879 CSHCN and 21,909 children
without special health care needs. Measures included the type of health
insurance coverage, the burden on the family to provide private insurance,
and the adequacy of insurance. The analyses tested whether there were
differences in characteristics and patterns of health insurance coverage
between CSHCN and other children and between children from families with
low incomes vs. those with higher income in both categories. For select
measures, models were used to test the effects of having special health
care needs while controlling for child and family characteristics (age,
gender, race, ethnicity, citizenship status, parent education, income).

The author found that

* Compared with other children, CSHCN had higher rates of public insurance
(29.8% vs. 18.5%), lower rates of private insurance (62.5% vs. 69.1%), and
lower rates of being without insurance (8.1% vs. 11.5%).

* There were few significant differences in the distribution of premium
sharing across the groups. Family premium contributions for
employer-sponsored plans covering CSHCN averaged $2,058, or 4.4% of total
family income; outlays for nongroup insurance were higher ($3,598, or 6.6%
of income).

* Almost 20% of CSHCN from families with low incomes experienced some
unmet need, compared with 9.1% of other children from families with low
incomes and 9.9% of CSHCN from families with higher incomes.

* Out-of-pocket spending was higher for CSHCN compared with other
children, both for families with low incomes and for those with higher

"The estimates presented in this article, as with all other estimates that
are sensitive to changing economic and policy environments, must be viewed
as snapshots in time," notes the author. Research in progress will assess
the effects of such changes (including SCHIP expansions) on insurance
coverage and access to care for CSHCN.

Davidoff AJ. 2004. Insurance for children with special health care needs.
Pediatrics 114(2, Part 1):394-403.

Readers: More information about insurance for children with special health
care needs is available from the MCH Library's knowledge path at ... #financing.



"This study indicates that the prevalence of depression among young
adolescents, particularly female adolescents, may be higher than previous
estimates," state the authors of an article published in the August 2004
issue of Archives of Pediatrics and Adolescent Medicine. The article
explores the prevalence of depressive symptoms in adolescents ages 11 to
15 and the extent to which involvement in bullying, substance use, and
somatic symptoms (headache, stomachache, backache) are associated with
depressive symptoms in this age group.

The study used data from a 1996 U.S. survey that was based on the Health
Behavior in School Children Study, a multinational, cross-sectional,
school-based survey. The weighted sample for the analysis included 9,863
students in grades 6, 8, and 10 who attended public and private schools in
the 50 states and the District of Columbia. The self-administered
questionnaire included items on health-related behaviors in the context of
students' families, schools, and peers. Variables of interest included
depressive symptoms, involvement in bullying, substance use, and somatic

The authors found that

* About 1 in 6 U.S. adolescents (18.2%) reported depressive symptoms.

* Prevalence of depressive symptoms was higher among females than males;
however, prevalence among both sexes increased with grade level.

* Prevalence of depressive symptoms varied by racial/ethnic group, and
prevalence among females in all racial/ethnic groups was consistently
higher than among males.

* The proportion of both males and females reporting depressive symptoms
increased with increased involvement in bullying, both as bullies and as

* Both males and females who reported using substances had significantly
higher proportions of depressive symptoms than those who did not report
using substances.

* Both males and females who reported having somatic symptoms one or more
times a week had a significantly greater prevalence of depressive symptoms
than those who did not report having these symptoms as often.

"Because depressive symptoms are likely to coexist with other adolescent
problem behaviors, such as bullying and substance use, young adolescents
who are involved in such behaviors might be depressed as well," state the
authors. They suggest that "practitioners who work with youths who have
such symptoms/behaviors should consider screening them for depression."

Saluja G, Iachan R, Scheidt PC, et al. 2004. Prevalence of and risk
factors for depressive symptoms among young adolescents. Archives of
Pediatrics and Adolescent Medicine 158(8):760-765.

Readers: More information about adolescent mental health is available from
the Bright Futures Web site at and from the MCH
Library's bibliography at ... th&-search.


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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
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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