Maternal Child Health Newsletter 7/9/04

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Maternal Child Health Newsletter 7/9/04

Postby laura » Sat Jul 10, 2004 00:45 am

MCH Alert
Tomorrow's Policy Today

National Center for Education in Maternal and Child Health
Search past issues of the MCH Alert and other MCH Library resources at

July 9, 2004

1. Fact Sheet Presents Updates on Early Childhood Caries
2. New Web Site Addresses the Health Concerns of American Indians and
Alaska Natives
3. Fact Sheet Examines Extent of State Medicaid Policy Changes Affecting
4. Report Presents Recommendations to Support States' Role in Eliminating
Disparities in Health and Health Care
5. Article Assesses the Impact of a Preventive Medicine and Nutrition
Curriculum for Medical Students



Promoting Awareness, Preventing Pain: Facts on Early Childhood Caries
(ECC), a fact sheet published by the National Maternal and Child Oral
Health Resource Center (OHRC), presents information on dental caries in
the primary teeth of children from birth through age 5. The fact sheet
defines ECC, describes who is at risk, and presents information on both
the financial and the human costs of ECC. It also suggests ways in which
health professionals can reduce a child's risk for ECC. The fact sheet is
intended for use by health professionals, program administrators,
policymakers, and others working to improve the oral health status of
infants, children, and their families. It is available on the OHRC Web
site at



American Indian Health, a new National Library of Medicine Web site,
presents information on issues affecting the health and well-being of
American Indians and Alaska Natives. The Web site is designed to bring
together health and medical resources, including policies, consumer health
information, and research. Information on traditional healing resources
and links to an assortment of documents, Web sites, databases, and other
resources is also provided. The Web site is available at



Children Not the Target of Major Medicaid Cuts But Still Affected by
States' Fiscal Decisions, a new fact sheet produced by the Maternal and
Child Health Policy Research Center, provides information on the extent of
state Medicaid policy changes affecting children in states' fiscal years
2003 and 2004. The fact sheet is part of the Center's Program Impact
Series and includes information on changes affecting Medicaid (as opposed
to those affecting Medicaid State Children's Health Insurance Programs
exclusively). The authors obtained current information by examining
managed care contracts, provider bulletins, and Medicaid state plan
amendments submitted to the Center for Medicaid and Medicare Services. In
addition, they conducted extensive telephone interviews with senior
Medicaid staff. The authors discuss eligibility, managed care, enrollment,
benefits, authorization, cost sharing, fee-for-service provider payments,
and home- and community-based waivers. The fact sheet is available at ... ne2004.pdf.



"A national strategy to achieve a public health goal most often requires
the involvement of the states," according to the authors of A State Policy
Agenda to Eliminate Racial and Ethnic Health Disparities, a June 2004
Commonwealth Fund report. The authors argue that although a goal of
eliminating disparities in six health categories by 2010 was first
articulated in 1998, this goal has not yet attained the status and
priority necessary to improve the health and well-being of many Americans.
The report focuses on states' role in advancing the
disparities-elimination policy agenda by providing a menu of policy
interventions that have been implemented at the state level to address
disparities in minority health and health care.

The disparities-elimination policy agenda was developed by a team of
health services researchers during 2003. Drafts of each agenda category
were shared with specialists; drafts of the entire agenda were shared with
state minority health directors. The agenda is organized into two
principal sections: issues related to state infrastructure and capacity
and issues related to health conditions. Each category in the agenda
includes a description of research defining the problem, examples of
promising practices currently in operation in states and localities, and
policy recommendations for state policymakers.

Based on their review, the authors identified eight key policy
recommendations for each category of the agenda:

* Consistent racial/ethnic data collection

* Effective evaluation of disparities-reduction programs

* Minimum standards for culturally and linguistically competent health

* Greater minority representation within the health care work force

* Expanded health screening and access to services

* Establishment or enhancement of state offices of minority health

* Involvement of all health system stakeholders in minority-health
improvement efforts

* Creation of a national coordinating body to promote continuing
state-based activities to eliminate racial and ethnic health disparities

The authors conclude that "state governments have an opportunity to play a
vital role and there is much more that states can do. There are many ways
that national governments committed to disparities elimination can support

McDonough JE, Gibbs BK, Scott-Harris JL, et al. 2004. A State Policy
Agenda to Eliminate Racial and Ethnic Health Disparities. New York, NY:
Commonwealth Fund. Available at ... da_746.pdf.

Readers: More information on racial and ethnic disparities in health is
available from the MCH Library's knowledge path at and from the
bibliography at



"This study demonstrates that an innovative preventive medicine and
nutrition course improved second-year medical students' confidence in
their ability to assess and change patients' diet and exercise," state the
authors of an article published in the July 2004 issue of the American
Journal of Preventive Medicine. According to the authors, medical school
curricula have been found deficient in content relating to nutrition and
exercise. To improve the preventive medicine and nutrition (PMN) teaching
at Harvard Medical School (HMS), the authors implemented and evaluated an
innovative course for second-year students. The study described in this
article evaluates the impact of the course on students' diet and exercise
patterns and on their self-efficacy for addressing these topics with

Students enrolled in HMS's PMN course (N=137) completed surveys before and
after taking the course. The surveys assessed their demographics, dietary
patterns, exercise patterns, other health behaviors, and confidence in
their ability to address diet and exercise with patients and family
members. Pre- and post-course surveys were administered concurrently to a
naturally occurring comparison group of 30 second-year HMS students
enrolled in a separate program.

The authors found that

* After completing the PMN course, students improved significantly in all
six of the measures considered (advise family and friends about diet,
assess patient diet, change patient diet, advise family and friends about
exercise, assess patient exercise, change patient exercise).

* PMN students perceived having made changes over time in their own
dietary patterns but not in their exercise patterns.

* Control students showed no significant change over time in any of the
six measures considered.

* Control students did not perceive having made changes over time in their
own dietary or exercise patterns.

* For four of the six measures considered, the change in the PMN students
was significantly greater than the change in the control students.

The authors conclude that "[a PMN] course may help medical schools to meet
the public health goal of training physicians to routinely counsel
patients about diet and physical activity."

Conroy MB, Delichatsios KH, Hafler JP. 2004. Impact of a preventive
medicine and nutrition curriculum for medical students. American Journal
of Preventive Medicine. 27(1):77-80.


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MCH Alert © 2004 by National Center for Education in Maternal and Child
Health and Georgetown University. MCH Alert is produced by MCH Library
Services at the National Center for Education in Maternal and Child Health
under its cooperative agreement (6U02 MC 00001) 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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