National Center for Education in Maternal and Child Health
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May 31, 2002
1. 2002 KIDS COUNT Data Book Released
2. Brief Highlights Managed Care Best Practices for Improving Preventive Care Services for Children
3. Guidebook Provides Methods and Handouts for Perinatal Patient Education
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1. 2002 KIDS COUNT DATA BOOK RELEASED
The 2002 KIDS COUNT Data Book, an annual analysis of child well-being in America published by the Annie E. Casey Foundation, features 10 measures of child well-being and supplemental data on education, health, and economic conditions of families. States can use KIDS COUNT to assess their progress in meeting ongoing benchmarks of child well-being as well as to compare the status of children in their state with that of children in other states across several dimensions of well-being. Seven of the indicators of child well-being showed that conditions improved between 1990 and 1999, while two indicators (the percentage of low-birthweight babies and the percentage of families with children headed by a single parent) showed that conditions worsened. One indicator showed that conditions remained unchanged. All 2002 KIDS COUNT data are available from an online database that allows users to generate custom graphs, maps, ranked lists, and state-by-state profiles, as well as to download the entire KIDS COUNT data set as delimited text files. The 2002 KIDS COUNT Data Book online is available at http://www.aecf.org/kidscount/kc2002/.
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2. BRIEF HIGHLIGHTS MANAGED CARE BEST PRACTICES FOR IMPROVING PREVENTIVE CARE SERVICES FOR CHILDREN
Working with Medicaid Plans to Improve Preventive Care Services for Children describes the quality-improvement typology followed by the medical directors of eight health plans convened in a work group to improve the delivery of preventive care services for children within their own health plans. The brief also outlines pilot projects of three of the eight participating plans. Produced by the Center for Health Care Strategies Best Clinical and Administrative Practices initiative, the brief reports on the health plans' strategies for identifying children in need of preventive care services, stratifying their risks, conducting outreach, and, finally, following through with the appropriate health interventions. The brief is available at http://www.chcs.org/publications/pdf/mcbps/preventivecarebrief.pdf. More information is available in the Improving Preventive Care Services Toolkit at http://www.chcs.org/ManagedCare/preventivecaretoolkit.html.
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3. GUIDEBOOK PROVIDES METHODS AND HANDOUTS FOR PERINATAL PATIENT EDUCATION
Perinatal Patient Education: A Practical Guide with Education Handouts for Patients was designed to provide institutions and nurses with information about what constitutes patient education and about how to educate their perinatal patients. The guidebook is divided into two parts; Part 1 includes information on patient-education methodology, behavior change, cultural competence, readability, literacy, materials development, and documentation, and Part 2 includes handouts on prenatal, intrapartum, postpartum, and interconceptional topics. The handouts are written in both English and Spanish at a sixth- to eighth-grade reading level. A CD-ROM is included to enable readers to print and distribute the handouts.
Freda MC. 2002. Perinatal Patient Education: A Practical Guide with Education Handouts for Patients. New York, NY: Lippincott Williams & Wilkins.
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4. ARTICLE ASSESSES RELATIONSHIP BETWEEN AVAILABILITY OF NEONATAL INTENSIVE CARE AND NEONATAL MORTALITY
"The supply of neonatologists . . . seems to have grown beyond that needed for the care of ill newborns," state the authors of an article published in the May 16, 2002, issue of the New England Journal of Medicine. In this article, the authors examine the relationship between the availability of resources for neonatal intensive care and neonatal mortality.
The study included the 1995 U.S. birth cohort as reflected by the linked birth and death data set of the National Center for Health Statistics. Infants with a birthweight of less than 500 g were excluded. The primary outcome was neonatal mortality, defined as death within the first 27 days of life. The authors examined the relationship between death within the first 27 days of life and the numbers of neonatologists and neonatal intensive care beds per 10,000 births.
The authors found that
"These findings suggest that, in the case of infants with extremely low birth weights, some neonatal intensive care units may have an inadequate supply of neonatologists, whereas most other regions have an adequate supply or a surplus," state the authors. They point out that they did not have data on health status in infancy, other than mortality, or on long-term outcomes, and they conclude that "information on the effect of the availability of medical resources on outcomes could help us identify areas where we should increase the numbers of clinical units and physicians and areas where we should use alternative approaches to improve public health."
Goodman DC, Elliott SF, Little GA. 2002. The relationship between the availability of neonatal intensive care and neonatal mortality. The New England Journal of Medicine 346(20):1538-1544.
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5. STUDY FINDS ASSOCIATION BETWEEN WOMAN'S OWN BIRTHWEIGHT AND SUBSEQUENT RISK FOR GESTATIONAL DIABETES
"This study is among the first to demonstrate a clear, dose-response relationship between relative fetal growth and adult risk for [gestational diabetes mellitus], an important complication of pregnancy and a strong predictor of diabetes and other insulin resistance conditions," state the authors of an article published in the May 15, 2002, issue of JAMA, The Journal of the American Medical Association. This article describes findings from a large, population-based study to investigate the relationship between markers of a woman's own growth in utero and her subsequent risk for gestational diabetes mellitus (GDM) among young New York women.
Data for this case-control study were drawn from the linked pregnancy and birth records of women who had completed a first pregnancy in Upstate New York between 1994 and 1998, and who were also born in New York State in 1970 or later. Researchers identified a total of 440 GDM cases among 23,395 eligible women. Controls were all remaining eligible subjects whose first pregnancies were uncomplicated by GDM (N=22,995). Growth in utero was measured as the subject's own birthweight and gestational age as recorded on her birth certificate. The independent effects of a woman's own birthweight, gestational age, and other factors on the development of GDM, as well as the influence of potential confounders, were evaluated.
The authors found that
The authors conclude that these findings support the hypothesis that susceptibility to diabetes and related insulin resistance conditions may be programmed in utero, and that early life factors, and, in particular, fetal growth, may be important in the etiology of GDM.
Innes KE, Byers TE, Marshall JA, et al. 2002. Association of a woman's own birth weight with subsequent risk for gestational diabetes. JAMA, The Journal of the American Medical Association 287(19):2534-2541.
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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.
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EDITORS: Jolene Bertness, Tracy Lopez
COPYEDITOR: Ruth Barzel
National Center for Education in Maternal and Child Health
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