MCH Alert


Maternal and Child Health Library

This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html


November 5, 2010

Multimedia Featured Resource: Investing in Early Childhood: Partnerships to Implement Home Visiting Programs brought together public- and private-sector stakeholders to explore how partnering to invest in early childhood results in benefits for children and families and ultimately benefits all of society. The Webinar was convened by the NIHCM Foundation on October 26, 2010, and was sponsored by the Health Resources and Services Administration's Maternal and Child Health Bureau (MCHB). Presenters included Dr. Audrey Yowell, MCHB; Veronica Creech and Peggy Hill, Nurse-Family Partnership; and Katie Eyes, Blue Cross and Blue Shield of North Carolina Foundation. The agenda, speaker biographies, presentations, evaluation, Webinar archive, and additional resources are available at
http://nihcm.org/page/webinar_home_visiting

1. Report Examines Policies on Conditions of Confinement for Pregnant and Parenting Women
2. Independent Panel Discourages Routine Use of Treatment Regimen for Premature Infants
3. Article Presents Adolescents' Views on Health
4. Authors Describe Design to Evaluate a Web-Based Intervention to Increase Vision Screening at Well Child Visits

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1. REPORT EXAMINES POLICIES ON CONDITIONS OF CONFINEMENT FOR PREGNANT AND PARENTING WOMEN

Mothers Behind Bars examines federal and state policies on the conditions of confinement for women who are pregnant or parenting and identifies steps that can be taken by policymakers and advocates to improve conditions for women and their children. The report card, published by the Rebecca Project for Human Rights and the National Women's Law Center, looks at how women are treated in federal and state correctional facilities during pregnancy, labor and delivery, and parenting. The authors analyze policies on prenatal care, shackling, and alternative sentencing programs and grade states on whether their policies help or harm women. Additionally, they analyze related federal laws and policies on conditions of confinement for women in federal prisons and immigration detention facilities, assess how the federal government funds state programs that serve incarcerated women who are pregnant or parenting, identify areas where the federal government is making gains in the treatment of incarcerated women who are pregnant or parenting, and provide recommendations for areas that need improvement. The report card is available at http://www.nwlc.org/sites/default/files/pdfs/mothersbehindbars2010.pdf

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2. INDEPENDENT PANEL DISCOURAGES ROUTINE USE OF TREATMENT REGIMEN FOR PREMATURE INFANTS

Inhaled Nitric Oxide in Preterm Infants summarizes the evidence on the use of inhaled nitric oxide (iNO) in preterm infants born at or before 34 weeks' gestation who receive respiratory support. The evidence report and technology assessment is based on research conducted by the Johns Hopkins University Evidence-Based Practice Center under contract to the Agency for Healthcare Research and Quality. The authors address the following questions: (1) Does iNO therapy increase survival and/or reduce the occurrence or severity of bronchopulmonary dysplasia (BPD) among premature infants who receive respiratory support? (2) Are there short-term risks of iNO therapy among premature infants who receive respiratory support? (3) Are there effects of iNO therapy on long-term pulmonary and/or neurodevelopmental outcomes among premature infants who receive respiratory support? (4) Does the effect of iNO therapy on BPD and/or death or neurodevelopmental impairment vary across subpopulations of premature infants? (5) Does the effect of iNO therapy on BPD and/or death or neurodevelopmental impairment vary by timing of initiation, mode of delivery, dose and duration, or concurrent therapies? The information is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. The report is available at http://www.ahrq.gov/downloads/pub/evidence/pdf/inoinfants/inoinfants.pdf

Readers: Readers: On October, 27-29, 2010, the National Institutes of Health convened a consensus-development conference during which invited experts presented scientific evidence pertinent to the posed questions, summarized the systematic literature review, and prepared and presented a draft consensus statement. The draft panel statement, program and abstracts, agenda, and media and other resources are available at http://consensus.nih.gov/2010/ino.htm

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3. ARTICLE PRESENTS ADOLESCENTS' VIEWS ON HEALTH

"These data demonstrate how understanding adolescents' own views of health can inform policies and programs," write the authors of an article published in the Journal of Adolescent Health online (ahead of print) on October 21, 2010. Health disparities between adolescents and other pediatric groups related to unmet health care needs, access to care, and health insurance demonstrate that adolescents are poorly served by existing national and state health policies. Adolescent health programs and practices that focus solely on the individual's responsibility for behavior change (e.g., obesity treatment, suicide prevention, sex education) have had limited success. Adolescents themselves are rarely consulted in policy formation. In an effort to inform the Indiana Coalition to Improve Adolescent Health's (ICIAH's) policy recommendations, the study described in this article presented Indiana adolescents' views on health and provided implications for state policy.

For the study, eight focus groups, each consisting of 6 to 12 adolescents, were recruited from community organizations across the state of Indiana. A purposive sampling approach was used to recruit culturally, geographically, and sociodemographically diverse adolescents.

The authors found that
The authors conclude that "these adolescents' lived experiences provided the perspective needed for health providers and policy makers to create an environment in which adolescents can thrive."

Ott MA, Rosenberger JG, McBride KR, Woodcox SG. 2010. How do adolescents view health? Implications for state health policy. Journal of Adolescent Health [published online ahead of print on October 21, 2010]. Abstract available at http://www.jahonline.org/article/S1054-139X%2810%2900369-1/abstract

Readers: More information is available from the following MCH Library resource:

- Adolescent Health: Resource Brief at
http://mchlibrary.info/guides/adolescent.html

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4. AUTHORS DESCRIBE DESIGN TO EVALUATE A WEB-BASED INTERVENTION TO INCREASE VISION SCREENING AT WELL CHILD VISITS

"In this study, we used Medicaid claims data, as well as providers' self-reported data from web-based modules, to assess frequency of vision screening in the primary care setting," state the authors of an article published in Contemporary Clinical Trials online (ahead of print) on October 23, 2010. Preschool vision screening has been targeted for improvement by Healthy People 2010 and 2020 and by a recent report from the Office of the Inspector General, which suggests its importance as well as the continued need for innovative methods to overcome barriers and improve screening rates. Primary care providers (PCPs) can play a pivotal role in translating vision screening into practice, yet PCPs receive very little training about amblyopia and its risk factors. In addition, studies targeting primary care practices reveal little uniformity in the implementation of vision screening among PCPs. The article describes the design of a randomized clinical trial  to change practice behavior and make vision screening a priority at well child visits (WCVs), particularly for children ages 3 or 4.

The researchers used current literature and professional guidelines on vision screening to develop an Internet-based, provider-targeted, multi-faceted intervention designed to improve knowledge and rates of vision screening by PCPs. Eligible PCPs were defined as Medicaid Early and Periodic Screening Detection and Treatment providers in Alabama, South Carolina, and Illinois who filed claims (in their own names) for at least eight children ages 3 or 4 during the 12 months preceding the first study month. Participants were enrolled and randomized at login according to cluster assignment (defined as the individual or practice, along with the children seen for WCVs by that individual or practice). Enrolled participants included 65 intervention and 71 control providers from 58 and 59 clusters, respectively.

The ultimate goal was to increase rates of detection of amblyopia and strabismus during preschool years by eye specialists. Baseline rates showed a need to improve both primary outcome measures. The authors found that
"Our project will show whether the web-based materials we developed can improve knowledge, vision screening behavior of practicing PCPs, and/or diagnosis of amblyopia and strabismus by eye care specialists serving Medicaid eligible preschool children," they conclude.

Wall TC, Marsh-Tootle WL, Crenshaw K, et al. 2010. Design of a randomized clinical trial to improve rates of amblyopia detection in preschool aged children in primary care settings. Contemporary Clinical Trials [published online ahead of print (uncorrected proof) on October 23, 2010]. Abstract available at

Readers: More information is available from the following MCH Library resources:

- Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services in Medicaid: Knowledge Path at
http://mchlibrary.info/KnowledgePaths/kp_EPSDT.html

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MCH Alert © 1998-2010 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.
 
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EDITOR/ADMINISTRATOR: Jolene Bertness, M.Ed.
CO-EDITOR: Tracy Lopez, M.S.L.S.
COPYEDITOR/WRITER: Ruth Barzel, M.A.
WRITER: Beth DeFrancis, M.L.S.

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