Maternal Child Health Newsletter 6/18/04

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Maternal Child Health Newsletter 6/18/04

Postby laura » Fri Jun 18, 2004 01:21 pm

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

June 18, 2004

1. Partnership Organized to Encourage Breastfeeding
2. Results of the National Survey of Early Childhood Health Released
3. USDA Reports on Initiatives to Address Information Needs of Federal
Food Assistance and Nutrition Programs
4. Authors Assess Clinicians' Perceptions of the Healthy Steps for Young
Children Program
5. Article Assesses Screening Measure for Depression in Young Children


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The National Breastfeeding Campaign -- Babies Were Born to Be Breastfed
aims to promote breastfeeding among first-time parents (mothers and
fathers) who would not typically breastfeed their infants. The campaign
represents an effort to carry out the recommendations of the U.S.
Department of Health and Human Services' (DHHS') Blueprint for Action on
Breastfeeding. As part of this effort, the DHHS' Office on Women's Health
(OWH) recently partnered with the Advertising Council to launch a 3-year
media campaign to include public service announcements, bus stop posters,
articles in community newspapers, and educational pamphlets. OWH and the
Advertising Council will also work with 18 community-based demonstration
projects in 22 sites throughout the United States to implement the
campaign at the local level. The overall goal is to increase the
proportion of mothers who breastfeed their babies in the early postpartum
period to 75% and during the 6-month period following delivery to 50% by
the year 2010. More information about the National Breastfeeding Campaign,
as well as breastfeeding information specifically designed for parents, is
available at



The June 2004 Pediatrics supplement reports results of The National Survey
of Early Childhood Health (NSECH), a survey of parents of infants and
toddlers. The NSECH was developed by the American Academy of Pediatrics
and the UCLA Center for Healthier Children, Families and Communities to
address gaps in information about the content, process, and quality of
health supervision for young children, particularly from the perspective
of parents. The Pediatrics supplement, titled Content and Quality of
Health Care for Young Children: Results From the 2000 National Survey of
Early Childhood Health, was published with major funding from the Gerber
Foundation, with additional support from the American Academy of
Pediatrics Friends of Children Fund; The Commonwealth Fund; and the Health
Resources and Services Administration, Maternal and Child Health Bureau.
The articles in the supplement represent the first wave of analyses. The
information is intended for use by parents, pediatricians, policymakers,
and other stakeholders as they seek to improve early childhood health care
services. The supplement is available to subscribers at http://www. ... ml#SUPPLS1.

American Academy of Pediatrics. 2004. Content and quality of health care
for young children: Results from the 2000 National Survey of Early
Childhood Health. Pediatrics 113(6, Suppl.):1895-1990.



The Data Development Initiatives for Research on Food Assistance and
Nutrition Programs Web page presents a series of reports on data resources
that have the potential to improve the usefulness and cost-effectiveness
of research on federal food assistance and nutrition programs. The
reports, published by the U.S. Department of Agriculture's Economic
Research Service, include information on data development initiatives to
address research and program information needs for the Food Stamp Program;
the Special Supplemental Nutrition Program for Women, Infants and Children
(WIC); and the National School Lunch and School Breakfast Program. The
reports provide specific implementation plans for the initiatives and
discuss potential costs, benefits, and alternatives. The reports are
available at



The findings of this study suggest that the Healthy Steps for Young
Children Program (HS) "was successful in universally increasing
developmentally oriented services across all income levels, as reported by
clinicians, in a variety of settings," state the authors of an article
published in the June 2004 issue of the Journal of Urban Health. The study
described in the article examined whether HS changed clinicians'
perceptions over time about the preventive primary care they provided. The
article compares the change in perceptions of clinicians working in
practice settings serving low-income families with young children to
clinicians who served higher-income families with young children.

The study was based on analyses of clinician surveys collected as part of
the ongoing evaluation of HS in 13 states across the country. Overall, the
sites served an economically, geographically, and ethnically diverse
population and represented a range of organizational practice settings
(group practices, hospital-based clinics, and pediatric practices in
health maintenance organizations).

The sample for this study consisted of physicians and nurse practitioners
at 20 HS practice sites that implemented the HS program between 1996 and
2001. All HS clinicians were asked to complete a self-administered
questionnaire at the initiation of the program and again approximately 30
months later. The sample was divided into three groups of clinicians based
on the median income of the patient population at the site in which they
practiced. Comparisons were made for clinicians at the three groups of HS
practices between baseline and 30 months on variables measuring the
practice environment and clinicians' perceptions of care.

The authors found that

* Across all income groups and over time, clinicians were more likely to
report the provision of preventive developmental health services.

* Over time, clinicians in low-income practices reported increased
problems with both reimbursement and time barriers; clinicians in
higher-income practices reported increased problems with reimbursement.

* At 30 months, clinicians in low-income practices reported the greatest
positive changes in their perceptions about the quality of care provided
by their practices. They also were more likely than clinicians in
higher-income practices to strongly agree that they gave support to
families and to be very satisfied with the ability of their clinical staff
to meet children's developmental needs.

"That the practices serving low-income families were comparatively as
successful in providing child development services as practices serving
higher income families is noteworthy," the authors conclude. They suggest
that "the incorporation of developmental services and the HS Specialist
into routine pediatric primary care appears to assist clinicians and
clinical staff in their efforts to provide more comprehensive health care
to low-income children and their families."

McLearn KT, Strobino DM, Hughart N, et al. 2004. Developmental services in
primary care for low-income children: Clinicians' perceptions of the
Healthy Steps for Young Children Program. Journal of Urban Health



"The findings support the validity of the PFC [Preschool Feelings
Checklist] as a screening measure for the identification of young children
in need of clinical assessment for depression," state the authors of an
article published in the June 2004 issue of the Journal of the American
Academy of Child and Adolescent Psychiatry. The authors point out that
evidence is now available demonstrating that children as young as age 3
can experience a clinically significant episode of major depressive
disorder (MDD) and that this highlights the need for a validated brief and
feasible screening tool to capture young children from the general
population who are in need of a clinical evaluation. Currently, such a
tool is not available. In the study described in this article, the authors
sought to develop and test the criterion validity (i.e., ability to
discriminate between young children with and without a disorder) of a very
brief checklist specifically designed to identify MDD in young children in
community settings.

Study participants included 174 preschool-age children. The children's
parents completed the PFC, a 20-item checklist designed to identify
children ages 3.0 through 5.6 with symptoms of depression. Children who
met inclusion and exclusion criteria received a comprehensive 2- to 3-hour
assessment. The authors investigated the differential frequencies of
individual symptoms on the PFC in four comparison groups: (1) MDD/any
comorbid disorder, (2) MDD/only anxious comorbid, (3) "psychiatric"
comparison group composed of children with attention deficit hyperactivity
disorder and/or oppositional defiant disorder, and (4) a no disorder
comparison group.

After analysis, four items were dropped from the PFC in an effort to make
the scale as simple and short as possible, without sacrificing predictive
power. Thus, the final version of the PFC contains 16 items and takes 1 to
3 minutes to complete.

The authors found that

* There were significant correlations between the PFC and the diagnosis of

* The PFC demonstrated excellent internal consistency.

* Summary scores on the PFC significantly differentiated depressed young
children from those with other nonaffective psychiatric disorders.

* The PFC was characterized by a cutoff point that maintained a high level
of sensitivity and specificity for the diagnosis of MDD.

* The sensitivity and specificity characteristics of the 16-item PFC for
the identification of young children at high risk for diagnosis of MDD
were superior to these characteristics of the Child Behavior Checklist, a
well-validated and widely used dimensional measure designed to capture a
wide range of childhood psychopathology.

The authors conclude that the checklist "appears to have unique utility as
a measure to capture preschoolers in need of clinical evaluation for
depression from large primary care and/or community samples."

Luby JL, Heffelfinger A, Koenig-McNaught AL, et al. 2004. The Preschool
Feelings Checklist: A brief and sensitive screening measure for depression
in young children. Journal of the American Academy of Child and Adolescent
Psychiatry 43(6):708-717.


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