This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html
December 16, 2011
Readers: The next issue of MCH Alert will be published on January 6, 2011.
Multimedia Featured Resource: SmokefreeTXT is a free text message cessation service that provides 24/7 encouragement, advice, and tips to adolescents trying to quit smoking. The service is a component of the U.S. Department of Health and Human Services' efforts to develop mobile health programs and is one of the core features of the new Smokefree Teen Initiative, an extension of the National Cancer Institute's smoking-cessation website. Along with SmokefreeTXT, SmokefreeTeen offers several social media pages to connect adolescents with cessation tools. In January 2012, Smokefree Teen will launch a free smartphone application, QuitSTART -- an interactive guide to quitting smoking for adolescents that delivers cessation and mood-management tips, tracks cravings, and monitors quit attempts. More information about SmokefreeTXT and Smokefree Teen is available at http://www.teen.smokefree.gov
1. Chartbook Provides Unique View of CSHCN in the Context of Where They Live, Play, and Go to School
Children with Special Health Care Needs in Context: A Portrait of States and the Nation 2007 reports on the well-being of children as well as factors in the family environment and aspects of the neighborhood that may support or undermine the health of children and families. The chartbook, published by the Maternal and Child Health Bureau, is based on data from the 2007 National Survey of Children's Health (NSCH). The indicators present information on children's health status and risk as well as on protective factors for children nationally, within subpopulations at particular risk, and at the state level for each of the 50 states and the District of Columbia. Focus areas include health behaviors and risks; insurance, access, and quality of care; home and daily routines; family well-being; and school, friends, and community. The authors also explore how protective or risk factors combine and differ among children with and without special health care needs. The report is available at http://mchb.hrsa.gov/nsch/07cshcn
Readers: An interactive version of each state page is also available from the Data Resource Center for Child and Adolescent Health at http://www.childhealthdata.org/browse/snapshots/nsch-profiles/cshcn-in-context?geo=1. Other chartbooks in the NSCH series are available at http://mchb.hrsa.gov/nsch
2. Brief Focuses on How the Medical Home Model Has Benefitted Adolescents
Medical Home Innovations: Where Do Adolescents Fit? presents a picture of how the medical home model has addressed adolescents (ages 12 to 21) and how their unique health care needs are -- and are not -- being incorporated into transformation activities. The issue brief, published by the National Alliance to Advance Adolescent Health, is based on interviews with senior leaders from 12 medical home programs across the United States comprising public, private, and multi-stakeholder initiatives. Topics include efforts to enhance client-provider relationships and strengthen client engagement, the use of physician-led teams, the principle of whole-person orientation, care coordination or integration across the health care system and the client's community, evaluation to assess effectiveness, enhanced access to care, and payment for excellence. Progress and challenges are discussed. The report is available at http://www.thenationalalliance.org/pdfs/Report7.%20Medical%20Home%20Innovations.pdf
3. Article Examines Epidemic-Assistance Investigations Related to Maternal and Child Health Problems
Maternal and Child Health Epidemic-Assistance Investigations, 1946-2005, describes patterns of selected maternal, infant, or child health epidemic-assistance investigations (Epi-Aids) performed by the Centers for Disease Control and Prevention (CDC) staff and Epidemic Intelligence Service officers. The article, published in the supplement to the December 1, 2011, issue of the Journal of Epidemiology, draws from an analysis of 1,969 maternal, infant, or child health-related Epi-Aids (comprising 43.9 percent of all Epi-Aids for which investigations were initiated during 1946-2005). The analysis is organized into seven sections: (1) unintended pregnancy and pregnancy among adolescents, (2) reproductive health surveys, (3) elimination of maternal mortality from abortion in the United States, (4) pregnancy-associated morbidity and mortality, (5) unexpected increases or clusters of disease among infants, (6) Reye syndrome, and (7) child cancer and birth defects. The authors describe patterns of Epi-Aids, illustrative investigations, and, when possible, the public health impact of the Epi-Aids. The investigations selected for discussion highlight the importance of using surveillance and performing studies that use existing data sources, develop new data sources, and use epidemiologic tools to identify risk factors. The article is available (free full text) at http://aje.oxfordjournals.org/content/174/suppl_11/S80.full
Readers: The supplement to the December 1, 2011, issue of the Journal of Epidemiology focuses on the 58-year history of the Epidemic Intelligence Service. The papers in the supplement reflect the evolution of public health responsibilities and the growth and development of CDC in the areas of epidemiology and laboratory science, reproductive health, environmental health, chronic diseases, nutrition, injury control and prevention, and noncommunicable disease risk factors. The supplement (free full text) is available at http://aje.oxfordjournals.org/content/174/suppl_11
4. Authors Discuss the Use of the School Health Index in Building Collaboration
"By utilizing the SHI [School Health Index] and selected collaboration principles, we believe there are useful strategies and lessons learned that may benefit urban school districts, and outside organizations seeking to work together to potentially change student health behaviors, the school environment and policies," write the authors of an article published in the December 2011 issue of the Journal of School Health. The SHI is an adolescent- and school-health-assessment tool designed to help schools and school districts evaluate and improve their health policies and programs in the context of a coordinated school health program. Although research demonstrates the use of the SHI in the assessment of adolescent- and school-health promotion, there is a dearth of literature about the processes employed by external collaborators to engage teachers, parents, students, and the community in planning health-promotion initiatives. The article describes use of the SHI to promote collaboration between a major public university and an urban school district to develop an adolescent-health-promotion campaign.
From September to December 2002, the Pittsburgh, Pennsylvania, School District Superintendent held a series of meetings with district administrators, teachers, and principles to introduce the SHI in all 18 middle schools. University faculty were also invited and attended these meetings. During the earlier meetings, the focus was on engaging stakeholders in a collaborative process to create healthier students and schools by completing eight SHI self-assessment modules. Use of the SHI underscored the significant need for an adolescent-health-promotion campaign that specifically addressed physical activity and nutrition. From subsequent discussion, the concept of a campaign was born with the specific idea of following a cohort of students scheduled to graduate in 2010, using Healthy People 2010 as a beacon. The approach was inclusive of the entire school district and directly tied the campaign to the 2010 graduation.
The authors found that using the SHI as a planning instrument rather than an assessment tool facilitated the adoption of four collaboration principles: (1) partners' strengths and resources, (2) reciprocal learning, (3) cultural humility, and (4) long-term commitment. In addition, the SHI highlighted the importance of developing a carefully organized plan to build collaboration and solidify relationships that were necessary to effectively implement the school-based campaign across the entire school district. Furthermore, the SHI helped ensure that the health-promotion activities launched across the school district were not fragmented but became branded as a district-wide (i.e., across all 10 high schools in the system) campaign known as the Healthy Class of 2010.
To guide future university and school district collaborations, the authors recommend focusing on the following areas when developing and implementing school-based adolescent-health-promotion initiatives:
"Our work fills a gap in the literature by examining how to collaborate and form important partnerships. Futhermore, this work demonstrates how the SHI can be used both at the micro-level (students) with emphasis on the planning process and collaboration instead of just at the macro-level (schools)," conclude the authors.
Butler J, Fryer CS, Reed EA, et al. 2011. Utilizing the School Health Index to build collaboration between a university and an urban school district. Journal of School Health 81(12):774-782. Abstract available at http://onlinelibrary.wiley.com/doi/10.1111/j.1746-1561.2011.00657.x/abstract
Readers: More information is available from the following MCH Library resource:
- School Resources at
http://www.mchlibrary.info/schools/index.html
5. Study Addresses Necessity of CTs for Children with Blunt Head Trauma
"Children with blunt head trauma and isolated severe injury mechanisms are at very low risk for having clinically important TBIs [traumatic brain injuries]," write the authors of an article published in the Archives of Pediatrics and Adolescent Medicine online on December 5, 2011. Minor blunt head trauma in childhood is a common reason for emergency department (ED) evaluation, and cranial computer tomography (CT) is the reference standard for diagnosing children with TBI. ED use of CT has been increasing substantially over the past several decades. However, CTs expose children to an increased lifetime risk of lethal malignancy. Pediatric Emergency Care Applied Research Network (PECARN) head trauma clinical prediction rules were derived and validated using a prospective observational cohort of almost 45,000 children with minor blunt head trauma evaluated in 25 participating EDs. The study described in this article addresses the question of whether children with a severe injury mechanism (i.e., high-speed motor vehicle accident [for both a vehicular occupant or a pedestrian struck], bicycle-related injury, impact from high-speed projectile, and fall from a height or down stairs) but with no other PECARN TBI predictors always require emergent CTs.
Researchers performed a planned secondary analysis of a large prospective cohort study of children under age 18 with nontrivial head trauma. The study was conducted from 2004 through 2006. Children with blunt head trauma and Glasgow Coma Scale scores of 14 or 15 who presented to the ED within 24 hours of the traumatic event were eligible for enrollment. The primary outcome measure was clinically important TBI, which was defined as any of the following: intracranial injury resulting in death, neurosurgical intervention, intubation for more than 24 hours for management of TBI, or hospital admission for two or more nights due to the head trauma in association with TBI on CT scan. The authors performed all analyses for children under age 2 and age 2 or older separately. They calculated the rate of clinically important TBI in the following four injury mechanism groups: (1) all severe injury mechanisms, regardless of associated signs or symptoms of TBI; (2) isolated severe injury mechanism (i.e., a severe injury mechanism with no other age-specific PECARN TBI predictors); (3) severe injury mechanism plus one additional PECARN TBI predictor; and (4) isolated severe injury mechanism using an expanded definition of isolated (i.e., with no signs or symptoms of TBI extending beyond the clinical predictors in the PECARN TBI rules).
The authors found that
The authors conclude that "after careful evaluation and observation without development of signs or symptoms of TBI, many children with isolated severe injury mechanisms may not require emergent neuroimaging."
Nigrovic LE, Lee LK, Hoyle J, et al. 2011. Prevalence of clinically important traumatic brain injuries in children with minor blunt head trauma and isolated severe injury mechanisms. Archives of Pediatrics and Adolescent Medicine (published online on December 5, 2011). Abstract available at http://archpedi.ama-assn.org/cgi/content/short/archpediatrics.2011.1156.
To subscribe to MCH Alert, send an e-mail message to MCHAlert-request@lists.mchgroup.org with SUBSCRIBE in the subject line. You do not need to enter any text in the body of the message.
To unsubscribe from MCH Alert, send an e-mail message to MCHAlert-request@lists.mchgroup.org with UNSUBSCRIBE in the subject line. You do not need to enter any text in the body of the message.
MCH Library shares notices of new issues of MCH Alert on Twitter at http://bit.ly/OKv5Y
MCH Alert © 1998-2011 by National Center for Education in Maternal and Child Health and Georgetown University. MCH Alert is produced by Maternal and Child Health Library at the National Center for Education in Maternal and Child Health under its cooperative agreement (U02MC00001) 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.
Permission is given to forward MCH Alert, in its entirety, to others. For all other uses, requests for permission to duplicate and use all or part of the information contained in this publication should be sent to mchalert@ncemch.org.
We welcome your submissions, suggestions, and questions. Please contact us at the address below.
The Maternal and Child Health Library Team
Ruth Barzel, M.A., Senior Editor
Jolene Bertness, M.Ed., MCH Alert Editor
Beth DeFrancis, M.L.S., Associate Librarian
Tracy Lopez, M.S.L.S., Associate Librarian
Susan Lorenzo, M.L.S., Associate Librarian
Rochelle Mayer, Ed.D., NCEMCH Director
Melinda Nash, Web Developer
Olivia Pickett, M.A., M.L.S., Director of Library Services
John Richards, M.A. A.I.T.P., Director of Technology
Michael Wilkinson, Technology Developer
National Center
for Education in Maternal and Child Health
Georgetown
University
Box 571272
Washington, DC 20057-1272
Telephone: (202) 784-9770
Fax: (202) 784-9777
E-mail: mchalert@ncemch.org
Website: http://www.mchlibrary.info/alert
Twitter: http://www.twitter.com/mch_library