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.


March 20, 2009

Reminder: Applications for the Training Course in Maternal and Child Health Epidemiology are due April 3, 2009. This national program is designed to build conceptual, technical, and analytic skills among professionals who have significant responsibility for collecting, processing, analyzing, and reporting maternal and child health data. The course will be held on May 17-21, 2009, in Tampa, Florida, and is sponsored by the Health Resources and Services Administration's Maternal and Child Health Bureau (MCHB) and the Centers for Disease Control and Prevention as part of their ongoing effort to enhance the analytic capacity of state and local health agencies. The application form is available at http://www.positiveoutcomes.net/mchb_epi/MCHB_Epidemiology_Training_Course.doc.

1. Workshop Summary Explores How to Achieve More Equitable Health Care Outcomes
2. Report Card Offers Policy and Program Solutions to Child Homelessness
3. Journal Focuses on Benefits and Challenges of Using Information Technology in Health Care
4. Study Examines How Beliefs About the Causes of Obesity Affect Support for Public Policy
5. Article Assesses Trends in Fast Food Intake Among Adolescents

************************************************************

1. WORKSHOP SUMMARY EXPLORES HOW TO ACHIEVE MORE EQUITABLE HEALTH CARE OUTCOMES

Toward Health Equity and Patient-Centeredness: Integrating Health Literacy, Disparities Reduction, and Quality Improvement summarizes presentations and discussion of a workshop held on May 12, 2008, to examine the role of quality improvement in improving health literacy and reducing racial and ethnic disparities, as well as geographic disparities. The report, published by the National Academy of Sciences, presents a vision for integrating disparities reduction, health literacy, and quality improvement to achieve better outcomes and the foundation for integration of these three areas. Other topics include integration at the practitioner level; policy issues of integration; types of measures that could be developed to understand the contributions of health literacy and disparities reduction to improved quality; how efforts at integration could be evaluated; and issues of financing, education, and training. The workshop agenda and participant list are included as appendices. The report is available at http://www.nap.edu/catalog.php?record_id=12502 (download requires sign-in).

************************************************************

2. REPORT CARD OFFERS POLICY AND PROGRAM SOLUTIONS TO CHILD HOMELESSNESS

America's Youngest Outcasts: State Report on Child Homelessness provides a snapshot of child homelessness in America today. The report card, published by the National Center on Family Homelessness, describes homeless children (from birth to age 18) who are accompanied by one or more parent(s) or caregivers. Brief reports on each state include the state's overall rank and information about four domains that comprise the score: the extent of child homelessness; child well-being; structural risk factors; and policy and planning efforts. Selected sub-domains also received individual scores and ranks, which contributed to the overall score. Topics include housing and income, child care, food security, homelessness and children's health, and educational achievement. Ways that communities are addressing particular aspects of child and family homelessness are highlighted throughout the report card. Appendices include information on systems that identify homeless children, the study methodology and limitations, a review of selected report cards, ranks, a glossary, and references. An executive summary, the full report, state rankings, and state-by-state report cards are available at http://www.homelesschildrenamerica.org/about.php.

************************************************************

3. JOURNAL FOCUSES ON BENEFITS AND CHALLENGES OF USING INFORMATION TECHNOLOGY IN HEALTH CARE

The March-April 2009 issue of Health Affairs examines the impact of information technology (IT) on health care and the challenges of implementation and adoption. The issue was produced with support from the Markle Foundation, the California HealthCare Foundation, and the federal Agency for Healthcare Research and Quality. Two of the articles in the supplement document Kaiser Permanente's electronic health record (EHR) system and model of online health care. Other articles in the supplement address EHR's impact on patient safety, state-backed efforts to implement health IT among independent physician practices, the use of social media tools in health care, the potential of personal health records (PHRs) to promote better self-management for chronic conditions and how health insurers are developing and promoting PHRs, e-prescribing and computerized physician order entry, privacy, health IT systems, and state health information exchange. The issue is available at http://content.healthaffairs.org/content/vol28/issue2.

************************************************************

4. STUDY EXAMINES HOW BELIEFS ABOUT THE CAUSES OF OBESITY AFFECT SUPPORT FOR PUBLIC POLICY

"Our findings indicate that the metaphors that people use to understand why obesity rates in the United States are rising are powerful predictors of support for public policies aimed at curbing obesity," state the authors of an article published in the March 2009 issue of Milbank Quarterly. Little is known about the factors that shape public attitudes toward obesity as a social concern. The study described in this article applied a general theory of metaphor-based reasoning to the newly emerging policy concern: the "obesity epidemic" in America. The authors posit that people think about the causes of obesity using metaphors (understanding and experiencing one kind of thing in terms of another). They examine whether individuals' beliefs about the causes of obesity have affected their support for specific policies aimed at stemming obesity rates.

Data for the study were drawn from the Yale Rudd Center Opinion on Obesity Survey, a nationally representative Web sample (N=1,009) surveyed in late 2006 through early 2007, to examine Americans' beliefs about obesity. The survey examined the role of seven specific metaphors related to the causes of obesity: (1) obesity as sinful behavior, (2) obesity as a disability, (3) obesity as a form of eating disorder, (4) obesity as a food addiction, (5) obesity as a reflection of time crunch, (6) obesity as a consequence of manipulation by commercial interest, and (7) obesity as a result of a toxic food environment. The researchers also examined 16 policies chosen from a comprehensive list of obesity-related policies introduced as federal legislation between 2003 and 2005 and supplemented with policies introduced in two or more states. Respondents were asked to identify, on an ordinal scale, their level of support or opposition for each policy. Three separate outcome variables (redistributive policies, compensatory policies, price-raising policies) were created by averaging respondents' support for all the policies. The authors report how respondents' demographic and health characteristics, political attitudes, and agreement with the seven metaphors explained their support for obesity policies.

The authors found that
"Study findings provide clues to a potential framework for policymakers and interest groups to influence support for obesity policies by framing the causes of obesity through metaphor," conclude the authors.

Barry CL, Brescoll VL, Brownell KD, et al. 2009. Obesity metaphors: How beliefs about the causes of obesity affect support for public policy. The Milbank Quarterly 87(1):7-47. Available at http://www.milbank.org/quarterly/8701feat.html.

Readers: The March 2009 issue of The Milbank Quarterly is devoted to obesity as a public policy issue. The 11 articles in this issue focus on both public and private policy options for addressing the high rates of obesity. They present new empirical studies; policy history; overviews of developments in particular arenas such as schools, workplaces, and the built environment; and analyses of different legal strategies and public policies. The issue is available at http://www.milbank.org/8701.html.

************************************************************

5. ARTICLE ASSESSES TRENDS IN FAST FOOD INTAKE AMONG ADOLESCENTS

"A secular increase in the percent of middle adolescents (high school-aged) who were frequent fast food consumers was observed between 1999 and 2004," write the authors of an article published in the March 2009 issue of Preventive Medicine. Among adolescents, fast food consumption has been found to be associated with poor dietary intake and weight gain over time. The study described in this article used data from Project EAT (Eating Among Teens), a 5-year longitudinal study of two cohorts of adolescents, to simultaneously examine (1) the secular (i.e., time-dependent) change in fast food consumption among middle adolescents between 1999 and 2004 and (2) longitudinal trends in fast food intake among adolescents as they move from early to middle adolescence and from middle to late adolescence.

In 1999, Project Eat collected data from 4,746 participants in two cohorts, early adolescents (mean age = 12.8) and middle adolescents (mean age = 15.8) in Minnesota. Five years later, follow-up data were collected for 68 percent of the baseline participants for whom contact information was available. The analysis assessed differences in fast food consumption across time, both within and across cohorts.

The authors found that
The authors conclude that "efforts to reduce adolescents' fast food consumption are essential."

Bauer KW, Larson NI, Nelson MC, et al. 2009. Fast food intake among adolescents: Secular and longitudinal trends from 1999 to 2004. Preventive Medicine 48(3):284-287. Abstract available at http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WPG-4VB01PX-2&_user=655954&_coverDate=03%2F31%2F2009&_rdoc=17&_fmt=high&_orig=browse&_srch=doc-info(%23toc%236990%232009%23999519996%23968059%23FLA%23display%23Volume)&_cdi=6990&_sort=d&_docanchor=&_ct=21&_acct=C000035538&_version=1&_urlVersion=0&_userid=655954&md5=7ca5c7e2acdd23c99dfe03d7affab521.

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

- Nutrition in Children and Adolescents: Knowledge Path at
http://www.mchlibrary.info/KnowledgePaths/kp_childnutr.html

More information about fast food intake among adolescents and young adults, and other Project EAT publications, are available at
http://www.epi.umn.edu/research/eat/publications.shtm.

************************************************************

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 Alert © 1998-2009 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.

The editors welcome your submissions, suggestions, and questions. Please contact us at the address below.

MANAGING EDITOR: Jolene Bertness
CO-EDITOR: Tracy Lopez
COPYEDITOR/WRITER: Ruth Barzel
LIST ADMINISTRATOR: Beth DeFrancis Sun

MCH Alert
Maternal and Child Health Library
Georgetown University
Box 571272
Washington, DC 20057-1272
Phone: (202) 784-9770
Fax: (202) 784-9777
E-mail: mchalert@ncemch.org
Web site: http://www.mchlibrary.info/alert/index.html

************************************************************