Maternal and Child Health Library
This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html
November 12, 2010
1. Fact Sheets Focus on Health Reform Implementation
Within the Context of State MCH Programs
2. Centers for Medicare and Medicaid Services Develops
New Health Literacy Resource
3. Survey Lists State and National Home Visiting
Investments and Program Strategies
4. Authors Provide an Overview of Childhood Poverty and
the Social Safety Net
5. Article Explores Women's Attitudes About Influenza
Vaccination and Educational Text Messages
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1. FACT SHEETS FOCUS ON HEALTH REFORM IMPLEMENTATION WITHIN THE
CONTEXT OF STATE MCH PROGRAMS
The Association of Maternal & Child Health Programs (AMCHP) has
released three new fact sheets to help state maternal and child health
(MCH) programs understand and implement key provisions of the Patient
Protection and Affordable Care Act (ACA). The resources focus on
provisions related to promoting medical homes, adolescent health, and
children and adolescents with special health care needs. Each document
provides an overview of the legislation, opportunities and issues for
state programs, and links to additional resources. The fact sheets are
available as follows:
The fact sheets are part of a series of AMCHP tools, documents, and
resources on ACA implementation and its impact on MCH populations. More
information is available from AMCHP's National Center for Health Reform
Implementation at http://www.amchp.org/Advocacy/health-reform/Pages/default.aspx
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2. CENTERS FOR MEDICARE AND MEDICAID SERVICES DEVELOPS NEW HEALTH
LITERACY RESOURCE
Toolkit for Making Written Material Clear and Effective provides a set
of tools to help make written materials in printed formats easier for
people to read, understand, and use. The toolkit, published by the
Centers for Medicare and Medicaid Services, focuses on creating written
material intended for use by people eligible for or enrolled in
Medicare, Medicaid, or the Children's Health Insurance Program and by
the people who serve or assist them, such as family members and
friends, outreach workers, agency staff, community organizations, and
care providers. Topics include using a reader-centered approach to
develop and test written material, guidelines for writing and design,
methods for testing material with readers, using readability formulas,
writing materials for older adults, and guidelines for translation. The
toolkit is available at http://www.cms.gov/WrittenMaterialsToolkit
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3. SURVEY LISTS STATE AND NATIONAL HOME VISITING INVESTMENTS AND
PROGRAM STRATEGIES
Pew Inventory of State Home Visiting Programs provides state leaders,
agency administrators, and program directors with a state-by-state and
national snapshot of home visiting programs, models, funding, and
policies for fiscal year 2009-2010. The inventory is drawn from a
survey of state agency leaders in all 50 states and the District of
Columbia conducted by the Pew Center on the States. Topics include how
much states are investing in home visiting; the scale, breadth, and
range of state-directed funds; the strategies states are using to fund
programs; the empirical standards or evidence for program effectiveness
that drive funding allocation decisions and to what extent they drive
them; and how states hold local programs accountable for meeting
performance measures. The state-by-state inventory, national overview,
definitions, and survey methodology are available at http://www.pewcenteronthestates.org/initiatives_detail.aspx?initiativeID=61051
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4. ARTICLE PROVIDES AN OVERVIEW OF CHILDHOOD POVERTY AND THE SOCIAL
SAFETY NET
"To assist in a successful transition from childhood to adulthood for
children living in poverty, it is essential that we provide assistance
to those who are most in need," write the authors of an article
published in the November 2010 issue of Current Problems in Pediatric
and Adolescent Health Care. The "safety net" is a metaphor for external
supports that minimize risk to children and also protect them as their
families cope with risk factors associated with poverty. This article
examines the broader social safety net (vs. the narrower health care
safety net). The article also discusses the historical origins of the
safety net in the United States, describes the present-day impact of
poverty on the economic security of families and its repercussions for
inadequate nutrition and housing instability, and examines the topics
of early childhood education and school readiness, educational
achievement, adolescent incarceration, and neighborhood safety. Current
programs in place to deal with these problems as well as resources for
pediatricians are provided. The article concludes with a discussion of
the frequent debate over the roles of the public vs. private sectors
and why the Social Safety Net must incorporate both to minimize the
limitations of each and maximize the opportunities of a combined effort
to assist vulnerable families with children.
Birth of the Safety Net
This section of the article examines the origins of charitable care and
then explores its transition from a private-sector endeavor to a
broader public societal obligation.
Childhood Vulnerability and the Safety Net Response
This section of the article discusses poverty and income-support
programs, food insecurity and family and child nutrition programs,
homelessness and public housing support programs, uninsured children
and health care access programs, early childhood education and school
readiness, education and schooling, juvenile justice and vulnerable
adolescents, and neighborhood safety.
Conclusions
The authors conclude that "by expanding the breadth and scope of a new
Social Safety Net that is available from birth through adolescence and
designed to meet not only basic human needs but also the more complex
needs of school readiness and educational achievement, we have a
greater chance of witnessing safe and sustainable communities for
future generations."
Oberg CN, Aga A. 2010. Childhood poverty and the social safety net.
Current Problems in Pediatric and Adolescent Health Care
40(10):237-262. Abstract available at http://www.cppah.com/article/S1538-5442%2810%2900136-7/abstract
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5. ARTICLE EXPLORES WOMEN'S ATTITUDES ABOUT INFLUENZA VACCINATION AND
EDUCATIONAL TEXT MESSAGES
"Our study highlights the need for continued outreach and education
regarding vaccine
safety and efficacy, with both patients and providers," write the
authors of an article published in Preventive medicine online (ahead of
print) on November 1, 2010. Pregnant women and their newborns are at
increased risk for influenza-related morbidity and mortality. The
influenza vaccine is a safe and effective intervention for preventing
illness among pregnant women and their newborns and thus is universally
recommended during pregnancy. However, many pregnant women remain
unvaccinated. While text messaging has been used to increase vaccine
coverage in travelers, its use to promote vaccination in pregnant
populations has not been reported. Text messages may provide
information needed to help pregnant women make informed vaccine
decisions. In addition, text messages may serve as cues to action,
reminding women to be vaccinated. Goals of the current study were to
explore attitudes toward influenza vaccination and interest in
educational text messages about influenza among urban pregnant women.
In April 2010, a convenience sample of pregnant women was recruited
from two
community health centers in New York City. Women were invited to
participate in focus groups if they had a cell phone and spoke English
or Spanish. After providing informed consent, all women completed a
brief survey covering demographics and text message utilization. Focus
groups, lasting 1 hour, were moderated by native speakers experienced
in this methodology. The two English- and two Spanish-language focus
groups were attended by 40 women; participants ranged in age from 19 to
35, and their gestational age range was 8-40 weeks.
The authors found that
- Participants had generally positive views about immunization.
- Many participants had concerns about the influenza vaccine, even
those who ultimately chose to be vaccinated. Most expressed fears about
vaccine safety, including fears that the vaccine caused fever. For
some, lack of provider recommendation was an additional barrier to
immunization.
- Participants' primary and most trusted source for information on
influenza and vaccination was their health professional.
- Participants reported that they would welcome receiving text
messages about the influenza vaccine. They preferred messages to be
concise, personalized, and to come from their health professional. Most
reported that messages about vaccine safety or vaccine benefit would
not directly change their beliefs, but they thought that the messages
would encourage them to discuss the vaccine with their health
professionals.
- Nearly all participants were able to open, read, and respond to
English- or Spanish-language text messages.
The authors conclude that "given the risks of influenza during
pregnancy and low vaccine coverage among pregnant women, interventions
are needed to increase uptake in this population." They continue, "Our
study proposes educational text messages as an innovative strategy to
increase influenza vaccine uptake."
Kharbanda EO, Vargas CY, Castano PM, et al. 2010. Exploring pregnant
women’s views on influenza vaccination and educational text messages.
Preventive Medicine [published online ahead of print on November 1,
2010]. Abstract available at http://dx.doi.org/10.1016/j.ypmed.2010.10.009.
Readers: More information is available from the following MCH Library
resource:
- Immunizations: Resource Brief at
http://www.mchlibrary.info/guides/immunization.html
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and
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