From: mchalert-bounces@list.ncemch.org on behalf of MCH Alert [mchalert@ncemch.org] Sent: Friday, December 15, 2006 2:26 PM To: MCHAlert@list.ncemch.org Subject: MCH Alert ************************************************************ MCH Alert Tomorrow's Policy Today ************************************************************ Maternal and Child Health Library This and past issues of the MCH Alert are available at http://www.mchlibrary.info/alert/archives.html. December 15, 2006 1. Policy Center Releases Second Report on Innovative Approaches for Improving Pediatric Subspecialty Care 2. Fact Sheets on Suicide and Mortality Among Adolescents and Young Adults Updated 3. Mental Health National Anti-Stigma Campaign Launches New Web Site 4. Authors Review School-Based Obesity-Prevention Research, Challenges, and Recommendations 5. Article Assesses Trends in Physical Activity and Sedentary Behavior During Adolescence ************************************************************ 1. POLICY CENTER RELEASES SECOND REPORT ON INNOVATIVE APPROACHES FOR IMPROVING PEDIATRIC SUBSPECIALTY CARE Promising State and Regional Approaches for Extending Access to Pediatric Subspecialty Care and Coordination with Primary Care presents 13 examples of exemplary efforts to extend the geographic reach of pediatric subspecialty care and to enhance the capacity of pediatric health professionals to identify and manage chronic conditions. The report is the second in a series of promising practices reports prepared by the Federal Expert Work Group on Pediatric Subspecialty Capacity, convened by the Maternal and Child Health Policy Resource Center with support from the Maternal and Child Health Bureau. The report is divided into three sections. The first section describes the rationale for strengthening state and regional networks of pediatric subspecialty care within the context of the medical home and the major barriers affecting the expansion of state and regional pediatric specialty systems linked with primary care. The second section contains descriptions of 13 promising state and regional pediatric delivery networks. The third section identifies promising features of state and regional pediatric subspecialty arrangements. The report is available at http://www.mchpolicy.org/practice/documents/StateandRegionalPromisingPractices.pdf. ************************************************************ 2. FACT SHEETS ON SUICIDE AND MORTALITY AMONG ADOLESCENTS AND YOUNG ADULTS UPDATED The National Adolescent Health Information Center has released two updated fact sheets containing the most recent available data on suicide and mortality among adolescents and young adults (ages 10-24). The 2006 fact sheets, produced with support from the Maternal and Child Health Bureau, highlight key findings and present data on mortality and suicide rates (in color-coded figures and text) by age, gender, cause, and race and ethnicity. Information about the data sources and other notes are also included. The 2006 Fact Sheet on Suicide: Adolescents & Young Adults is available at http://nahic.ucsf.edu/download.php?f=/downloads/Suicide.pdf; the 2006 Fact Sheet on Mortality: Adolescents & Young Adults is available at http://nahic.ucsf.edu/download.php?f=/downloads/Mortality.pdf. A list of other NAHIC-produced briefs and fact sheets is available at http://nahic.ucsf.edu/index.php/data/article/briefs_fact_sheets. ************************************************************ 3. MENTAL HEALTH NATIONAL ANTI-STIGMA CAMPAIGN LAUNCHES NEW WEB SITE What a Difference a Friend Makes is designed to decrease the negative attitudes that surround mental illness and encourage young adults (ages 18-25) to support their friends who are living with mental illness. The Web site was launched by the Ad Council and the Substance Abuse and Mental Health Services Administration in partnership with other federal agencies, state mental health agencies, leading researchers on stigma, and a broad coalition of stakeholders. Content is based on research demonstrating that the prevalence of serious mental illness among young adults (ages 18-25) is almost double that of the general population, and that this age group shows the lowest rate of help-seeking behaviors. The site includes tools to help in the recovery process, information about different kinds of mental illnesses, true stories about support and recovery, and an interactive video about how friends can make a difference. A search tool is provided to help locate mental health services by state and territory. The Web site also contains public service announcements for television and radio that illustrate how friendship may be the key to recovery. The resources are intended for use by health professionals and others working to minimize future disability by broadening social acceptance and ensuring that young adults with mental illness receive the early support and services they need. The Web site is available at http://www.whatadifference.samhsa.gov. ************************************************************ 4. AUTHORS REVIEW SCHOOL-BASED OBESITY-PREVENTION RESEARCH, CHALLENGES, AND RECOMMENDATIONS "Choosing which obesity prevention components to include in a curriculum should be based on the evidence," state the authors of an article published in the December 2006 issue of the Journal of School Health. Schools are an important venue for primary prevention, and evaluation of the prevention research conducted in school-based populations can provide school health officials and others with useful information. The article presents a review of school-based randomized controlled trials (RCTs) aimed at reducing body weight or preventing weight gain. The authors review basic childhood obesity assessment, present an overview of successful school-based RCTs, and discuss challenges and future recommendations. A literature search was conducted for the years 1985-2004 in MEDLINE, CINAHL, PsycINFO, and the Cochrane Database of Systematic Reviews. Bibliographies of identified papers and review articles, recent book chapters on obesity prevention in children and adolescents, and Web sites of professional organizations and government agencies were also reviewed. Selection criteria included the following: (1) RCTs; (2) studies including BMI for age and gender as an outcome; (3) studies conducted in U.S. schools during the school day; (4) studies with students in elementary, middle, or high school; and (5) publication in a peer-reviewed journal. The literature search yielded 23 research studies addressing childhood-obesity prevention, 12 of which met the inclusion criteria. The authors found that two types of programs have potential for reducing childhood obesity: * For older students, classroom instruction and physical education can promote moderate to vigorous physical activity both in and out of school, especially for adolescent girls. * Younger students benefit from behavior-change programs that reduce sedentary behavior. Based on the findings, the authors offer the following conclusions: * Classroom programming should provide behavior-modification strategies to help students and their families reduce the amount of fast food, high-sugar drinks, and high-fat foods they consume and increase fruit and vegetable consumption. In addition, food service must be involved in obesity-prevention initiatives, and sales of unhealthy foods for fundraising purposes should be restricted. * Physical education that promotes at least 30 minutes of vigorous activity three to five times a week is the goal. Achieving this with a cumulative approach through physical education classes, intramural sports, and before- and after-school programs is recommended. * Schools must consider the reduction of sedentary behavior as a separate issue from increasing physical activity. Classroom programs for reducing sedentary behavior should use a behavior-change approach, start in the early grades, and be repeated every few years. Budd GM, Volpe SL. 2006. School-based obesity prevention: Research, challenges, and recommendations. Journal of School Health 76(10):485-495. Abstract available at http://www.blackwell-synergy.com/doi/abs/10.1111/j.1746-1561.2006.00149.x. Readers: More information is available from Bright Futures Web in Practice: Physical Activity at http://www.brightfutures.org/physicalactivity/about.htm and Bright Futures in Practice: Nutrition at http://www.brightfutures.org/inpractice.html; and from the MCH Library's knowledge paths, Child and Adolescent Nutrition, at http://www.mchlibrary.info/KnowledgePaths/kp_childnutr.html, Overweight in Children and Adolescents, at http://www.mchlibrary.info/KnowledgePaths/kp_overweight.html, and Physical Activity and Children and Adolescents at http://www.mchlibrary.info/KnowledgePaths/kp_phys_activity.html, from the bibliographies, Childhood Nutrition, at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_chldnutr.html&-MaxRecords=all&-DoScript=auto_search_chldnutr&-search, School Health Education, at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_schlthed.html&-MaxRecords=all&-DoScript=auto_search_schlthed&-search and School Health Services at http://www.mchlibrary.info/action.lasso?-database=Biblio&-layout=Web&-response=/databases/BibLists/bib_schlthserv.html&-MaxRecords=all&-DoScript=auto_search_schlthserv&-search; and from the organizations resource list, Nutrition, at http://www.mchlibrary.info/action.lasso?-database=Organizations&-layout=Web&-response=/databases/OrgLists/orgs_nutrition.html&-MaxRecords=all&-DoScript=auto_search_nutrition&-search. ************************************************************ 5. ARTICLE ASSESSES TRENDS IN PHYSICAL ACTIVITY AND SEDENTARY BEHAVIOR DURING ADOLESCENCE "Our findings indicate that adolescents are experiencing unfavorable shifts in activity patterns, such as longitudinal decreases in MVPA [moderate to vigorous physical activity], coupled with longitudinal and secular increases in sedentary behaviors that are attributable specifically to computer use," state the authors of an article published in the December 2006 issue of Pediatrics Electronic Pages. Low levels of MVPA and high levels of sedentary behavior have been shown to be associated with obesity. Project EAT-1 (Eating Among Teens) and Project Eat II (a follow-up study) follow a large cohort of individuals longitudinally through various stages of the adolescent transition to young adulthood. These studies have provided the unique opportunity to examine important health behavior trends that are occurring concurrently as a result of age (longitudinal trends from early to mid-adolescence and from mid-adolescence to late adolescence) and time (secular trends in mid-adolescence, from 1999 to 2004). The objective of the study described in this article was to evaluate these 5-year longitudinal and secular trends in MVPA, television viewing, and leisure-time computer use in a large, diverse cohort of adolescents. Project Eat-II (N=2,516) is a follow-up study of Project EAT-1, a study of the socioenvironmental, personal, and behavioral determinants of dietary intake and weight status among a large and ethnically diverse adolescent population. The main outcomes measures of the mixed-model regression analyses used in this research were self-reported weekly hours of MVPA, television or videotape viewing, and leisure-time computer use. The authors found that * The mean age of project EAT-1 participants was 12.8 and of EAT-II participants was 17.2. * MVPA among female adolescents declined dramatically from 5.9 to 3.9 hours per week during the transition from early to mid-adolescence and from 5.1 to 3.5 hours per week during the transition from mid- to late adolescence. * Among female adolescents making the transition from early to mid-adolescence, television and videotape viewing time decreased significantly, by 2.2 hours per week, and leisure-time computer use showed a nonsignificant trend toward increasing. * Computer use significantly increased among older female adolescents during the transition from mid- to late adolescence. * MVPA among male adolescents did not decline during the transition from early to mid-adolescence but did decline significantly from mid- to late adolescence (from 6.5 to 5.1 hours per week). Leisure-time computer use increased substantially from both early to mid-adolescence (from 11.4 to 14.2 hours per week) and from mid- to late adolescence (from 10.4 to 14.2 hours per week). * Television viewing time did not change among adolescent males across the adolescent transition period. * Between 1999 and 2004, secular trends during mid-adolescence indicate further striking increases in computer use. Mid-adolescent males engaged in 10.4 hours of use in 1999, compared with 15.2 hours in 2004. Mid-adolescent females engaged in 2.3 more hours of use per week in 2004 than in 1999. * There was no evidence of a secular decline in MVPA between 1999 and 2004 for either female or males adolescents. The authors conclude that "as the prevalence of obesity continues to rise in this and other age groups, we need to continue to advance our understanding of dynamic population-wide trends in behavior patterns, so as to inform effectively a broad array of health promotion strategies and public policies that aim to prevent obesity." Nelson MC, Neumark-Stzainer D, Hannan PJ, et al. 2006. Longitudinal and secular trends in physical activity and sedentary behavior during adolescence. Pediatrics Electronic Pages 118:1627-1634. Abstract available at http://pediatrics.aappublications.org/cgi/content/abstract/118/6/e1627. Readers: More information about physical activity and adolescents is available from the Bright Futures and MCH Library Web sites (see note in item #4 above). ************************************************************ To subscribe to MCH Alert, send an e-mail message to MCHAlert-request@list.ncemch.org with SUBSCRIBE in the subject line. 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