Skip Navigation

Strengthening the evidence for maternal and child health programs

Search Results: MCHLine

Items in this list may be obtained from the sources cited. Contact information reflects the most current data about the source that has been provided to the MCH Digital Library.


Displaying records 1 through 20 (37 total).

Children's Health Alliance of Wisconsin. n.d.. Dental sealant permission slip—template. Milwaukee, WI: Children's Health Alliance of Wisconsin, 5 pp.

Annotation: This dental sealant permission slip template, for use by school-based dental sealant programs, can be used to obtain consent from parents or guardians for students to receive dental sealants as well as other related preventive oral health services. The template can be customized with the program name and other information. Space to provide additional information that parents or guardians would like the program to know is included. The form is written in Arabic, Burmese, English, Hmong, and Spanish.

Contact: Children's Health Alliance of Wisconsin, 620 South 76th Street, Suite 120, Milwaukee, WI 53214, Telephone: (414) 292-4000 Secondary Telephone: (414) 337-4561 Fax: (414) 231-4972 Web Site: http://www.chawisconsin.org/oral-health.php?pg=13

Keywords: Consent, Dental sealants, Fluoride, Non English language materials, Oral health, Prevention, School health services, Spanish language materials

School-Based Health Alliance and Oral Health 2020 Network. 2018. Confronting the consent conundrum: Lessons from a school oral health community. Washington DC: School-Based Health Alliance; Boston, MA: Oral Health 2020 Network, 6 pp. (OH2020 white paper)

Annotation: This document presents ideas that emerged from the School-Based Health Alliance initiative, Strengthening School Oral Health Services and Growing the School Oral Health Learning Community, and that resulted in an increase in the number of positive parental consents for school oral health services. The initiative encompassed the 10 largest U.S. school districts, which serve more than 4 million students, including a significant number of students with high needs. The document discusses school engagement, family engagement, community engagement, oral health education, and data collection and use.

Contact: School-Based Health Alliance, 1010 Vermont Avenue, N.W., Suite 600, Washington, DC 20005, Telephone: (202) 638-5872 Secondary Telephone: (888) 286-8727 Fax: (202) 638-5879 E-mail: info@nasbhc.org Web Site: http://www.sbh4all.org Available from the website.

Keywords: , Data collection, Health education, Informed consent, Initiatives, Low income groups, Oral health, School age children, School health services

Apple Tree Dental. [2017]. Consent for treatment of tooth decay (cavities) with silver diamine fluoride (SDF). [Rochester, MN]: Apple Tree Dental, 1 p.

Annotation: This form is designed for oral health professionals to give parents or guardians to obtain consent for treating a child's tooth decay with silver diamine fluoride (SDF). The form provides information about what SDF is and how it works, limitations and side effects of SDF treatment, reasons to avoid SDF treatment, and other options for treating tooth decay. Photographs showing teeth before and after SDF treatment are included. The form includes space for the child's name, tooth numbers to be treated, and the name and signature of the parent or guardian.

Contact: Apple Tree Dental, Web Site: https://www.appletreedental.org Available from the website.

Keywords: Fluoride, Oral health, Parental consent, Side effects, Treatment

San Francisco Department of Public Health, Dental Services. [2016]. Informed consent for silver diamine fluoride. San Francisco, CA: San Francisco Department of Public Health, Dental Services, 1 p.

Annotation: This form is designed to assist oral health professionals in obtaining patient consent for use of silver diamine fluoride (SDF) to arrest dental caries. Contents include facts about SDF, including potential risks, and alternatives to using SDF. A photo of how teeth may look after SDF treatment is included. The form is available in Chinese, English, and Spanish.

Contact: National Network for Oral Health Access, 181 East 56th Avenue, Suite 501, Denver, CO 80216, Telephone: (866) 316-4995 Fax: (866) 316-4995 E-mail: info@nnoha.org Web Site: http://www.nnoha.org Available from the website.

Keywords: Asian language materials, Dental care, Dental caries, Disease prevention, Informed consent, Non English language materials, Spanish language materials

National Cancer Institute. 2016. Research-tested intervention programs (RTIPs). Bethesda, MD: National Cancer Institute, multiple items.

Annotation: This fact sheet describes an online, searchable database designed to provide program planners and public health practitioners with easy and immediate access to evidence-based cancer control interventions and program materials. Contents include key features, criteria for inclusion, and program review process. Featured program areas include breast, cervical, and colorectal cancer screening; diet and nutrition; HPV vaccination; informed decision making; obesity; physical activity; sun safety; public health genomics; survivorship/supportive care; and tobacco control.

Contact: National Cancer Institute, 6116 Executive Boulevard, Suite 300, Bethesda, MD 20892-8322, Telephone: (800) 422-6237 Secondary Telephone: Fax: (301) 402-0555 E-mail: cancergovstaff@mail.nih.gov Web Site: http://www.cancer.gov Available from the website. Document Number: NIH Pub. No. 12-7617.

Keywords: Breast cancer, Cervical cancer, Colon cancer, Decision making, Disease prevention, Family support programs, Genomics, Human papillomavirus, Informed consent, Nutrition, Obesity, Online databases, Peer support programs, Physical activity, Prevention programs, Preventive health services, Risk factors, Screening, Smoking, Sun exposure, Survivors, Tobacco use, Vaccines

American Dental Association. 2016. Choosing Wisely®: Five things dentists and patients should question. [Philadelphia, PA]: ABIM Foundation, 3 pp.

Annotation: This list is intended to spur conversations between oral health professionals and their patients about how to choose the most appropriate care based on a patient’s specific situation. Contents include information about when procedures may be appropriate, as well as the methodology used to develop the list. Topics include the benefit of fluoride-containing toothpaste for infants and children, applying dental sealants to minimize the need for restorative care later, informed consent best practice, managing temporomandibular joint disorders, and criteria for replacing restorations.

Contact: ABIM Foundation, 510 Walnut Street, Suite 1700, Philadelphia, PA 19106, Web Site: http://www.abimfoundation.org Available from the website.

Keywords: Children, Communication, Decision making, Dental care, Dental caries, Dental sealants, Family centered care, Fluorides, Infants, Informed consent, Oral health, Preventive health services

Minnesota Department of Health, Child and Teen Checkups and Minnesota Department of Education, Early Learning Services. 2016. Sharing child information to coordinate early childhood special education (ECSE) referrals: Guidance for clinics and schools. St. Paul, MN: Minnesota Department of Health, Child and Teen Checkups; Roseville, MN: Minnesota Department of Education, Early Learning Services, 2 pp.

Annotation: This document provides guidance for clinics and schools on the roles and responsibilities of medical providers and educational professionals in identifying and treating developmental and social-emotional concerns in young children from birth to age 5. Topics include communicating with families; referring for educational and medical evaluation; sharing evaluation results, including information about confidentiality and consent; and shared care planning. A link to a map of trained mental health professionals and a graphic showing a communication feedback loop are included.

Contact: Minnesota Department of Health, Child and Teen Checkups Program, P.O. Box 64882, St. Paul, MN 55164-0882, Telephone: (651) 201-3760 E-mail: health.childandteencheckups@state.mn.us Web Site: http://www.health.state.mn.us/divs/cfh/program/ctc Available from the website.

Keywords: Child development, Clinics, Communication, Confidentiality, Early childhood, Early intervention, Emotional development, Family support, Legal issues, Mental health, Parent consent, Planning, Psychosocial development, Referrals, Role, School districts, Schools, Screening, Young children

Regional School Unit 40/Maine School Administrative District 40, School Health Services. 2014. [Fluoride varnish permission slip]. Union, ME: Regional School Unit 40/Maine School Administrative District 40, School Health Services, 1 p.

Annotation: This form describes a program to provide oral health screening and fluoride-varnish applications to students in kindergarten through grade 6. Topics include what fluoride varnish is, why it is recommended for children, safety, how it is applied to teeth, and how long it lasts. Space is provided for parents to write their child’s teacher's name; their child's name, address, age, grade, gender, home phone, and allergies; and whether they would like their child to participate in the program.

Keywords: Elementary schools, Fluorides, Low income groups, Oral health, Parental consent, Prevention programs, Preventive health services, School age children, School health services

Thomas SB, Quinn SC. 2013-. Building trust between minorities and researchers. College Park, MD: University of Maryland School of Public Health, Center for Health Equity, multiple items.

Annotation: These training and educational program resources are designed to increase the participation of minorities in public health and biomedical research and to strengthen the capacity of researchers and community members to work effectively with each other. Contents include a curriculum for community members and a curriculum for investigators, research staff, and institutional review board members. Topics include the importance of research, informed decision-making, and how research can improve the health and well-being of communities. Additional multimedia resources are also available.

Contact: University of Maryland School of Public Health, Center for Health Equity, 3302E SPH Building #255, College Park, MD 20742-2611, Telephone: (301) 405-8859 Fax: (301) 405-2542 Web Site: http://www.healthequity.umd.edu Available from the website.

Keywords: Barriers, Community participation, Curricula, Informed consent, Minority groups, Multimedia, Professional education, Public health education, Research, Training

Colman S, Dee TS, Joyce TJ. 2013. Do parental involvement laws deter risky teen sex?. Cambridge, MA: National Bureau of Economic Research, 43 pp. (NBER working paper series no. 18810)

Annotation: This paper addresses the question of whether laws requiring that physicians notify or obtain consent from a parent of a minor seeking an abortion before performing the procedure deter risky adolescent sexual behavior. Drawing on multiple data sources, the paper seeks to reconcile the disparate findings in the existing literature and to provide new and comprehensive evidence on the association between parental involvement (PI) laws and rates of sexually transmitted infections (STIs) in adolescents. Topics include abortion access and risky sexual activity among adolescents, data and samples, methods, and estimated impacts of PI laws on STIs.

Contact: National Bureau of Economic Research, 1050 Massachusetts Avenue, Cambridge, MA 02138-5398, Telephone: (617) 868-3900 Fax: (617) 868-2742 E-mail: info@nber.org Web Site: http://www.nber.org Available from the website.

Keywords: Abortion, Access to health care, Adolescent behavior, Adolescent sexuality, Consent, Health services, Parents, Legislation, Prevention, Risk taking, Sexually transmitted diseases, Statistical data

Childbirth Connection. 2012. What every pregnant woman needs to know about cesarean section (rev. ed.). New York, NY: Childbirth Connection, 12 pp.

Annotation: This booklet for pregnant women presents questions and answers on cesarean section (c-section). Questions include Which is safer, vaginal birth or c-section? What are the possible benefits and harms of vaginal birth and c-section? What is it like to have a c-section? If my doctor or midwife suggests a c-section, how should I decide if it is right for me? Is it possible to safely prevent a c-section? and What happens if I need a c-section?

Contact: National Partnership for Women and Families, Childbirth Connection Programs, 1875 Connecticut Avenue, N.W., Washington, DC 20009, E-mail: info@childbirthconnection.org Web Site: http://www.childbirthconnection.org Available from the website.

Keywords: Cesarean section, Childbirth, Informed consent, Patient rights, Pregnant women, Research, Safety, Vaginal birth

Guttmacher Institute. 2012. Minors' access to prenatal care. New York, NY: Guttmacher Institute, 3 pp. (State policies in brief)

Annotation: This brief summarizes policies on minors' access to prenatal care in states across the country. It describes how these policies have changed over the past 30 years and highlights the differences in state laws regarding a minor's ability to access prenatal care. A chart indicates which states have explicit policies; whether or not parental consent is required for treatment; and whether or not physicians are allowed to inform parents when providing prenatal care to minors.

Contact: Guttmacher Institute, 125 Maiden Lane, New York, NY 10038, Telephone: (212) 248-1111 Secondary Telephone: (800) 355-0244 Fax: (212) 248-1951; Washington, D.C. Office (202) 223-5756 E-mail: guttmacher@guttmacher.org Web Site: http://www.guttmacher.org Available from the website.

Keywords: Access to health care, Adolescent health, Confidentiality, Parental consent, Policy, Prenatal care, State legislation

Oregon Health Authority, Oral Health Program. 2012. School-based fluoride rinse program: Parent permission form. Portland, OR: Oregon Health Authority, Oral Health Program, 1 p.

Annotation: This form is designed to assist schools in raising awareness about and participation in a school fluoride rinse program for students in grades 1–6 who have other sources of fluoride but who may be at risk for tooth decay owing to other factors. The form includes information about fluoride and has space for parents to indicate whether they want their child to take part in the fluoride rinse program. The form is available in English, Russian, Spanish, Vietnamese, and Somali.

Contact: Oregon Health Authority, Oral Health Program, 800 N.E. Oregon Street, Suite 850, Portland, OR 97232, Telephone: (971) 673-0348 Secondary Telephone: (971) 673-0372 Fax: (971) 673-0240 E-mail: oral.health@state.or.us Web Site: https://public.health.oregon.gov/PreventionWellness/oralhealth/Pages/index.aspx Available from the website.

Keywords: Disease prevention, Fluorides, Non English language materials, Parental consent, Preventive health services, School age children

Edwards L. 2012. Louisiana Department of Health & Hospitals oral health program tool kit: Implementing school-based sealant programs in Louisiana. [Baton Rouge, LA]: Louisiana Department of Health and Hospitals, Center for Community and Preventive Health, 33 pp.

Annotation: This document is designed to help federally-qualified health centers in Louisiana implement school-based dental sealant programs. Topics include applying for a license to operate portable and mobile dental equipment, infection control recommendations and standards, and information required in the consent form for student participation in the program. Information about Medicaid reimbursement is also provided.

Contact: Louisiana Department of Health, Center for Community and Preventive Health, 628 North Fourth Street, P.O. Box 629, Baton Rouge, LA 70821-0629, Telephone: (225) 342-8093 Web Site: http://dhh.louisiana.gov/index.cfm/page/414 Available from the website.

Keywords: Community health centers, Dental care, Dental sealants, Infection control, Licensing, Louisiana, Mobile health units, Oral health, Parent consent, Preventive health services, Reimbursement, Resources for professionals, School age children, School based clinics, Screening, Standards, State programs

Sonoma County Department of Health Services, Maternal, Child, Adolescent Health. [2011]. Toothbrushing permission slip. Santa Rosa, CA: Sonoma County Department of Health Services, Maternal, Child, Adolescent Health, 1 p.

Annotation: This permission slip is designed for use in obtaining positive (active) parental consent for children to participate in a toothbrushing program—with or without fluoridated toothpaste—in child care centers or homes in Sonoma County, California. The content is available in English and Spanish.

Contact: Sonoma County Department of Health Services, Maternal, Child, Adolescent Health, 625 Fifth Street, Santa Rosa, CA 95404, Telephone: (707) 565-4552 Fax: (800) 427-8982 Web Site: http://www.sonoma-county.org/mcah Available from the website.

Keywords: California, Child care, Children, County agencies, Dental hygiene, Fluorides, Forms, Oral health, Parental consent, Parents, Spanish language materials

Washington School District. [2011]. Parent's consent form for child participation in tooth brushing. Washington, PA: Washington School District, 1 p.

Annotation: This form (letter) is designed for dental hygienists to use in obtaining positive (active) parental consent for toothbrushing among students participating in state-man- dated oral health screenings (grades 1, 3, and 7) and oral health education (grades K through 8) in Pennsylvania.

Contact: Washington School District, 311 Allison Avenue, Washington, PA 15301, Telephone: (724) 223-5112 Fax: (724) 223-5024 Web Site: http://www.washington.k12.pa.us Available from the website.

Keywords: Children, Dental hygiene, Forms, Health education, Oral health, Parental consent, Parents, Pennsylvania, School age children, School health programs, Screening, State initiatives

Colorado Association for School-Based Health Care. 2011. Understanding minor consent and confidentiality in Colorado: An adolescent provider toolkit. [Denver, CO]: Colorado Association for School-Based Health Care, 9 pp.

Annotation: This adolescent reproductive health toolkit includes Colorado-specific statutes and information related to minor consent and confidentiality. Adapted from a toolkit developed by the Adolescent Health Working Group and the Adolescent Health Collaborative, the tooklit includes legal information, charts on minor consent and confidentiality, practice tools, resource sheets, online resources and research, information addressing issue of Health Insurance Portability and Accountability Act (HIPAA) and Family Educational Rights and Privacy Act (FERPA), and health education handouts for adolescents and their parents or guardians. The information applies to teens who use school-based health centers, and to teens accessing services in a variety of medical settings.

Contact: Colorado Association of School-Based Health Centers, 1801 Wiliams Street, Suite 400, Denver, CO 80218, Telephone: (303) 399-6380 Fax: (303) 350-4296 E-mail: info@casbhc.org Web Site: http://www.casbhc.org Available from the website.

Keywords: Adolescent health, Colorado, Confidentiality, Consent, Parental consent, Patient consent, Reproductive health, State legislation

Oregon Health Authority, Oral Health Program. 2011. School-based fluoride tablet program: Parent permission form. Portland, OR: Oregon Health Authority, Oral Health Program, 1 p.

Annotation: This form is designed to assist schools in raising awareness about and participation in a school fluoride tablet program for students in grades K–6 who live in areas without optimum levels of fluoride in the water supply and who are not taking fluoride tablets at home. The form includes information about fluoride and has space for parents to indicate whether they want their child to take part in the fluoride tablet program. The form is available in English, Russian, Spanish, Vietnamese, and Somali.

Contact: Oregon Health Authority, Oral Health Program, 800 N.E. Oregon Street, Suite 850, Portland, OR 97232, Telephone: (971) 673-0348 Secondary Telephone: (971) 673-0372 Fax: (971) 673-0240 E-mail: oral.health@state.or.us Web Site: https://public.health.oregon.gov/PreventionWellness/oralhealth/Pages/index.aspx Available from the website.

Keywords: Disease prevention, Fluorides, Forms, Non English language materials, Oregon, Parental consent, Parents, Preventive health services, School age children, School health programs, Schools, State programs

Kansas Department of Health and Environment, Office of Oral Health. 2010. Kansas school oral health screening initiative. Topeka, KS: Kansas Department of Health and Environment, Office of Oral Health,

Annotation: These materials are designed for use by oral health professionals and school nurses in providing annual oral health screenings for students entering kindergarten through 12th grade in Kansas. Data collected from the screenings yield information on untreated oral health problems, urgent care needs, previous treatment received, and whether dental sealants have been placed on a child’s or an adolescent’s teeth. Contents include a program brochure, a toolkit, forms, reports, and instructions for submitting screening data. Information about the state statute mandating the program and a calibration-training course are also provided. Parental notification forms are available in English and Spanish.

Contact: Kansas Department of Health and Environment, Bureau of Oral Health, Curtis State Office Building, 1000 S.W. Jackson Street, Suite 200, Topeka, KS 66612-1274, Telephone: (785) 296-5116 Contact Phone: (785) 291-3683 Web Site: http://www.kdheks.gov/ohi Available from the website.

Keywords: Forms, Kansas, Oral health, Parental consent, Referrals, School age children, School health services, Screening, Spanish language materials, State programs

Guttmacher Institute. 2010. Minors' access to contraceptive services. New York, NY: Guttmacher Institute, 3 pp. (State policies in brief)

Annotation: This fact sheet provides information about minors' access to contraceptive services. The fact sheet offers background on the topic and includes highlights of how states differ in terms of their policies on minors access to contraceptive services.

Contact: Guttmacher Institute, 125 Maiden Lane, New York, NY 10038, Telephone: (212) 248-1111 Secondary Telephone: (800) 355-0244 Fax: (212) 248-1951; Washington, D.C. Office (202) 223-5756 E-mail: guttmacher@guttmacher.org Web Site: http://www.guttmacher.org Available from the website.

Keywords: Access to health care, Adolescent behavior, Adolescent sexuality, Consent, Contraception, Parents, State legislation

    Next Page »

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.