MCH Alert

Maternal and Child Health Library

This and past issues of the MCH Alert are available at

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



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



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



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



"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.

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



"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
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

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

- Immunizations: Resource Brief at


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CO-EDITOR: Tracy Lopez, M.S.L.S.
WRITER: Beth DeFrancis, M.L.S.

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