Maternal and Child Health
Section Newsletter
Fall 2003

FROM THE CHAIR

Howard Spivak-MCH Section Chair 
Howard Spivak-MCH Section Chair
As this is the last section newsletter before the APHA Annual Meeting, I want to start by stating that on behalf of the section leadership, we look forward to seeing many of you at the MCH Section meeting at the APHA Annual Meeting, as well as the scientific presentation sessions and the Martha Elliot Forum. I'd like to thank the section leaders, councilors and members for all the hard work that each of you has done in behalf of mothers and children.

This year, the Forum will focus on youth violence prevention, a topic of great importance to many of us. Youth violence continues to be a serious concern for most communities around the country. The Forum will take a look at the science, community practice, and public policy issues related to youth violence and will use several of the outstanding programs in the San Francisco area as illustrations of current practice as well as program evaluation. Please try to attend this meeting, as I believe it will be an outstanding program.

We also hope that many of you will be able to come to the business meeting on Sunday (with my promise that irrespective of whether the meeting will start on time, it will certainly end on schedule) and the leadership meeting on Monday morning—which is at some ridiculously early time in the morning. Check the program book for details on time and location. There is also a section banquet on Saturday evening that will be a Chinese banquet at Far East Café on Saturday, Nov. 15, 2003, at 7:00 p.m. Please see below for additional information about this wonderful event!

One of the key topics that we will address at both of the section meetings will be advancing the formulation of an advocacy agenda and plan for the section. The section councilors have been talking with various committees and section members about priority areas, and we want to move the discussion along to the point where we have a clear agenda with specific action plans. The direction of public policy, especially related to children and families at both national and state levels, requires that we not sit back but identify ways for our voices to be heard loudly and effectively. Our section has several thousand members across the country, and we can be heard if we are smart and strategic. I very much want my tenure as chair to help move the section to as visible a role as possible as a voice for women, children and families. So, please come prepared with ideas and possible action steps for us to consider and move along. Among the possibilities are: ddressing the impact of budget cuts at the state and national level; the issues related to the cost of the Iraq War; the extensive attention towards homeland security at a huge cost to programs affecting children and families; issues of childhood nutrition (including obesity-related issues); and possibly other children's programs that are being cut such as Head Start, etc. We have a solid base of public health knowledge and expertise in our section and should use this strength to help build an effective strategic plan for any of these issues.

I always find the interactions with section members and MCH colleagues extremely invigorating and feel renewed and refreshed. Please join me in San Francisco. We have much to do.

Howard

A QUICK GLANCE AT SPECIAL MCH SECTION EVENTS @ THE ANNUAL MEETING

APHA 2003 
APHA 2003
All MCH Sessions and Business meetings will be held at the San Francisco Marriott. Check the APHA Program for room assignments.

SECTION CHINESE DINNER SOCIAL
Join us for the MCH Section Dinner (Peaking Duck Feast)!
Saturday, Nov. 15, 2003
7:00 p.m.
Far East Café
631 Grant Avenue
Cost $30 (inclusive of tax and tip)

Send reservations and checks for Social payable to:
Albert Chang, MD
3625 Shoreheights Drive
Malibu, CA 90265
Deadline: Nov. 8, 2003
Limited Seating!
Reserve Early!
Phone: 310-454-3621
Fax: 310-454-3621
E-mail: albertchang@charter.net
Questions: Call 310-994-9974

SECTION BUSINESS MEETING
Sunday, Nov. 16, 2003
6:00 p.m.-9:00 p.m.

SECTION LEADERSHIP MEETING
Monday, Nov. 17, 2003
6:30 a.m.-8:00 a.m.

STUDENT PAPER PRESENTATIONS
Oral Presentation (#3139)
Monday, Nov. 17, 2003
10:30 a.m.

Poster Presentation(#4285)
Tuesday, Nov. 18
4:30 p.m.

MARTHA MAY ELIOT LUNCHEON AND FORUM
Tuesday, Nov.18, 2003
12:30 p.m.-2:00 p.m.

APHA ANNUAL MEETING

Dr. Bernard Guyer-Martha May Eliot honoree 
Dr. Bernard Guyer
APHA’s 131st Annual Meeting will be held Nov. 15-19 in San Francisco. The MCH Section has planned a program that includes a combination of contributed and invited sessions as well as business meetings and social events.

Highlights of the program include:

The Martha May Eliot Luncheon and Forum
This is the Section's premier event. It includes a Luncheon (ticket required) to honor the Martha May Eliot honoree and the MCH Young Professional awardee. This year's MCH Young Professional is Dr. Bao-Ping Zhu. He is with the Michigan Department of Community Health, Division of Epidemiology Services.

Dr. Bernard Guyer, Zanvyl Kreiger Professor in Children's Health and Chair of the Department of Population and Family Health Sciences at the John's Hopkins School of Public Health, is this year's Martha May Eliot awardee. Dr. Guyer's research focuses on improving the health of children, their mothers, and their families -- in this country and in the developing world --using the tools of public health. His specific areas of research include, immunization against vaccine-preventable diseases, childhood injury and injury prevention, the causes and strategies to reduce infant mortality, and interventions to strengthen human development during the early portion of the lifespan. Dr. Guyer is currently the chairperson of the Institute of Medciine's Committee on the Poison Control system and has served as president and chairperson of several national committees related to maternal and child health. Among his many honors, Dr. Guyer was given the "Award for Outstanding Contributions to the Advancement of Maternal and Child Health" in Massachusetts in 1996. In addition, in 2003, students at John's Hopkins University awarded him the "Golden Apple Award" for his outstanding teaching. Finally, Dr. Guyer has been principal investigator on numerous maternal and child health publications and authored many publications in this field.

The Forum will focus on violence prevention as a priority and concern for youth and will highlight San Francisco Bay area programs and strategies. The session will discuss a model for dealing with the complexity of violence through a comprehensive approach (Larry Cohen) and will describe research, practice, and advocacy and the interplay between them. Mayor Anna Caballero of Salinas will describe their community-wide cultivating peace approach. Dr. Howard Pinderhughes will delineate how strategies can be based on youth input and perspectives, and Donna Garske will describe how youth can focus on the vital goal of ending gender violence.

Challenges Determinants of Preterm Birth
This session will describe trends in preterm birth and associated factors and how these factors contribute to the preterm birth rate, the role of medical intervention on the preterm birth rate from an obstetrician's and neonatologist's perspective and a programmatic response.

Cuts and Bruises or Major Trauma: Impact of Federal and State Medicaid Changes on Women, Children and Youth
Speakers at this session will describe the changes from a national, state and population perspective. They will identify advocacy strategies, including strategies which focus on: documentation of outcomes; education of the public; the media or policy makers; mobilization of constituencies; and legal or legislative challenges to specific program cuts.

The National Birth Defects Prevention Study
The purpose of the National Birth Defects Prevention Study (NBDPS) is to evaluate genetic and environmental factors associated with the occurrence of birth defects. The NBDPS, which began in October 1997, is an ongoing case-control study that records case-infants identified by existing birth defects surveillance registries in eight states. The session will include papers describing various ways the Study has been used to increase understanding of birth defects and other contributing factors to poor birth outcomes.

Walk in My Shoes: A Health Access Simulation
Walk in My Shoes is an in-depth participatory learning experience that focuses on health access issues affecting low-income women and children. Following the simulation, participants will discuss its impact in a "debriefing’." They will leave with ideas of how this or similar experiential activities can be used in educational or community settings to promote and preserve vital health services and programs, bring together community partners, or introduce students to the barriers faced by those with limited access to health services.

In addition to these invited sessions, there will be 21 presented sessions and 13 poster sessions. This includes presented and poster sessions contributed by students.

APHA, ADVOCACY AND THE MCH SECTION

APHA's E-Advocacy Tool
In January, APHA purchased its first e-advocacy tool to help mobilize its members to send letters to their members of Congress electronically. In the last six months APHA has organized several advocacy efforts through the system. In June APHA used its e-advocacy tool to rally more than 1,500 public health professionals to send electronic letters to their members of Congress. As members become comfortable with this tool, APHA anticipates that these numbers will dramatically increase as our members become more familiar with the system. APHA's new advocacy tool has many great features that we encourage all members and public health professionals to use when advocating on behalf of a public health issue.

These resources include:

Mega Vote: Sign up to receive a weekly e-mail on how your senators and representative voted during the week on important issues. APHA provides this resource through our e-advocacy site. <www.capwiz.com/apha/megavote/>

Elected Official Finder: Find biographical information on elected officials including the president, members of congress and agency heads.
<www.capwiz.com/apha/dbq/officials/>

Issues and Legislation: In this section you will find Capitol Hill Basics, pending public health legislation and key public health votes.
<www.capwiz.com/apha/issues/>

Media Guide: Send electronic letters to the editor on issues important to public health directly to your local media outlets with APHA's media advocacy tool.
<www.capwiz.com/apha/dbq/media/>

Legislative Action Center: See the latest APHA Action Alerts. Send e-mails to your members of Congress on legislation important to APHA. This tool also allows members to customize our list.
<www.capwiz.com/apha/home/>

Join APHA's Legislative Network,
APHA staff works hard to ensure that public health is being fairly represented on Capitol Hill. More than ever, this is a critical time for public health, and as public health professionals, APHA needs your help to ensure that our needs and accomplishments are being recognized on Capitol Hill. The most powerful message a member of Congress receives comes from a constituent in his/her home district. That is why it is essential that APHA have a legislative advocacy network. APHA has a strong membership base and it is paramount to show our association's power by intensifying our advocacy efforts. Having a network of public health professionals willing to take action is essential to ensuring that the legislative priorities of APHA are addressed. While APHA will continue to request that its membership as a whole take action on issues effecting public health, the legislative network will serve as the "grasstops" of APHA entire Advocacy network. <www.apha.org/legislative/eform.cfm> Join Now!

APHA appreciates the advocacy efforts of its members and the entire public health community on issues that ultimately affect all of America. Members of APHA can view a more in-depth <www.apha.org/private/legislative/update.htm> legislative update on APHA's Web site. This legislative information is updated weekly.

Action Board
APHA's Government Relations staff works very closely with the <www.apha.org/private/action/2003_roster.htm> Action Board on advocacy efforts within Sections. The Action Board is made up of a representative from each Section, a member at large and three Affiliate members. This year the Action Board divided up into three work groups that addressed APHA's three priority areas: health disparities, access to health care and infrastructure. The health disparities workgroup contributed a lot of their expertise to staff from Senators Frist and Kennedy's offices. If you are interested in getting more involved in APHA advocacy efforts through your Section, please contact your Action Board Member.

Hill Visits or Section Legislative Efforts
If members of the MCH section participated in Hill Visits or other legislative activities, that might also be beneficial to highlight. For example Dr. Steven Wallace, Chair-Elect of the Gerontological Health Section, was one of three speakers at Congressman Watson's Town Hall Meeting on Medicare Prescription Drug Coverage on July 19.

Adding Advocacy Web Sticker to MCH Section Site
Also remember you can add the "Write Your Member of Congress" icon directly to the MCH Section Web site. This will allow our section members to take action directly form our Web site. You can download a web sticker at <www.capwiz.com/apha/remotecontent/>.

If you would like additional information about APHA's advocacy efforts, please don't hesitate to contact Lakitia:

Lakitia Mayo
Director of Grassroots Advocacy and Affiliate Affairs
American Public Health Association
800 I Street, NW
Washington, DC 20001
(202) 777-2515 Phone
(202) 777-2532 Fax
lakitia.mayo@apha.org
www.apha.org

Join APHA's Legislative Action <www.apha.org/legislative/eform.cfm> Network and sign up for APHA's Mega Vote <www.capwiz.com/apha/megavote/>!

NEW STUDENT FELLOWS

Congratulations to the new student fellows for 2003!

Ms. Alyssa Wigton-John's Hopkins University
Ms.Mary Maher-U Rochester School of Nursing & School of Community Preventive Medicine
Ms.Deborah Dee-UNC
Ms. Anne Marie Zaura Jukic-Rollins SPH (Emory)
Ms. Georgana Hanson-Boston Univ
Ms. E. Lanette Milligan-UAB
Ms. Anna Zakos-Feliberti-U Texas
Ms. Chevis Shannon-UAB
Ms. Keri Norris-Morehouse (Medicine)
Ms. Karen Ertel-UC Berkeley

FOLICACID.NET

FolicAcid.net, <www.folicacid.net> a free, Web-based course designed for current and emerging health professionals, provides education about folic acid, including the benefits and strategies for counseling individuals regarding folic acid intake. This project was made possible through funding from the March of Dimes and was developed with the assistance of numerous subject matter experts and professionals in maternal and child health.

In this course, users are presented with numerous interactive elements that allow them to learn and test their knowledge, including a case study and a virtual kitchen. Also included is a section with detailed information for health professionals (allied health, dentistry, dietetics, medicine, nursing, optometry, pharmacy and public health), about the importance of initiating counseling about folic acid use with individuals. Finally, student progress in the course is measured with a pre and post test. The module was pilot-tested last fall with approximately 500 students across the major health professions.

Please let your colleagues know about this great resource. For more information and for access to this resource, please contact Kalpana Ramiah at <Kramiah@asph.org>.

NATIONAL BREASTFEEDING AWARENESS CAMPAIGN LAUNCHED

During World Breastfeeding Week (1-7 August), the U.S. Department of Health and Human Services Office on Women's Health (OWH) in partnership with the Advertising Council of New York and the United States Breastfeeding Committee (USBC) launched a comprehensive 3-year media campaign to promote breastfeeding and implement the recommendations of the Surgeon General in the HHS Blueprint for Action on Breastfeeding (2000). Healthy People 2010 goals of increasing the proportion of mothers who breastfeed their babies in the early postpartum period to 75 percent and 6 months postpartum to 50 percent and eliminating disparities will be the overall goals of the campaign.

In addition to trying to raise initiation rates, the campaign will also stress the importance of exclusive breastfeeding for at least six months as recommended recently by the WHO and UNICEF:
"Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants; it is also an integral part of the reproductive process with important implications for the health of mothers. A review of the literature has shown that, on a population basis, exclusive breastfeeding for 6 months is the optimal way of feeding infants.

To enable mothers to establish and sustain exclusive breastfeeding for 6 months, WHO and UNICEF recommend:


  • Initiation of breastfeeding within the first hour of life

  • Exclusive breastfeeding - that is the infant only receives breast milk without any additional food or drink, not even water

  • Breastfeeding on demand - that is as often as the child wants, day and night

  • No use of bottles, teats or pacifiers.


Further information may be obtained from:


The National Breastfeeding Awareness Campaign will include the creation and dissemination of public service announcements (PSAs) for TV and radio. The Ad Council will distribute the PSAs to TV and radio stations in the top 210 media markets in the United States. Partners will include community-based demonstration projects and media trained community action volunteers. Eighteen community-based demonstration projects (CDPs) throughout the United States will work in coordination with the Office on Women's Health and the Advertising Council to implement the National Breastfeeding Awareness Campaign at the local level. The CDPs, which include breastfeeding coalitions, hospitals, universities, and other organizations, have been funded to offer breastfeeding services, provide outreach to their communities, train health care providers on breastfeeding, implement the media aspects of the campaign, and track breastfeeding rates in their communities.

BOARD AND COMMITTEE UPDATES

SIDS AND INFANT MORTALITY COMMITTEE
Co-Chair: Marian MacDorman <mmacdorman@cdc.gov>
Co-Chair: Howard Hoffman <hoffmanh@nidcd.nih.gov>

Monday, Nov. 17, is a busy day for the SIDS and Infant Mortality Committee, as we are sponsoring three back-to-back sessions at the APHA Annual Meeting. Oral session #3138: Research on High Risk Birth Outcomes and SIDS/Infant Mortality, will be held from 10:30 a.m.-12:00 p.m., and will present a compendium of recent research on SIDS, infant mortality, and related risk factors. Poster session #3214: Sudden Infant Death and Infant Mortality will be from 12:30-2:00 p.m., and will present a mix of research-oriented and program-oriented posters on SIDS and infant mortality interventions and risk reduction strategies. Oral session #3294:Challenging Determinants of Preterm Birth will be held from 2:30-4:00 p.m. This session will bring together clinicians, epidemiologists and public health professionals to discuss the challenging issue of preterm birth. Highlights will include presentations by clinicians on medical management of preterm pregnancies and its effect on the preterm birth rate and also a presentation on the March of Dimes National Prematurity Campaign. A lively discussion is anticipated.

An additional SIDS and Infant Mortality Committee-sponsored session will be held on Wednesday, Nov. 19 from 12:30-2:00 p.m., and is #5115: Programs to Reduce Health Disparities and Infant Mortality. This session will focus on public health intervention programs instituted by state and local health departments to reduce infant mortality, including several employing the Perinatal Periods of Risk Approach.

We hope that you will all be able to attend some or all of our sessions. We will also be holding our annual business meeting at the 2003 APHA meeting – to discuss emerging trends in SIDS and infant mortality research, to set priorities for research to be solicited through the APHA Call for Abstracts, and to plan future activities. The business meeting will be held on Sunday, Nov. 16 from 4:00-5:30 p.m. We invite all interested parties to attend. Information on the locations of the various sessions will be available in the program for the 2003 APHA Annual Meeting. For further information about the committee and our activities, please contact Marian MacDorman, <mmacdorman@cdc.gov>.


IMPROVING PREGNANCY OUTCOMES(IPO)COMMITTEE UPDATE
Co-Chair: Catherine Rohweder <rohweder@mail.schsr.unc.edu>
Co-Chair: Susan McLaughlin <Susan.McLaughlin@hhs.co.santa-clara.ca.us>

For the APHA Annual Meeting in November, the IPO Committee has organized six abstracts submissions into a session titled "Interventions that Make a Difference: Innovative Programs to Improve Pregnancy Outcomes." The authors will present lessons learned and evaluations from innovative MCH programs across the country.

This past spring, we wrote letters to both the March of Dimes and Dr. Benjamin, which resulted in APHA's official support of the March of Dimes Prematurity Campaign as an Alliance Member. The IPO committee has volunteered to coordinate a position paper with others in the MCH Section, which will encompass the many contributory factors to the rising rate of prematurity.

We are pleased to welcome our student representative, Anna Zakos-Feliberti from the University of Texas School of Public Health.

Finally, the IPO Meeting will be held on Sunday, Nov. 16, 2003, from 10:00 a.m.-11:30 a.m.

Catherine L. Rohweder, MPH
Research Associate
Smoke-Free Families National Dissemination Office
Cecil G. Sheps Center for Health Services Research
CB# 7590, 725 Airport Rd.
UNC-Chapel Hill
Chapel Hill, NC 27599-7590
Phone: 919-966-6879
FAX: 919-966-5764
E-mail: <rohweder@mail.schsr.unc.edu>

Susan McLaughlin, MPH, RN
Breastfeeding Coordinator
Nutrition and Wellness
Santa Clara County Public Health Department
976 Lenzen Ave.
San Jose, CA 95126
(408) 792-5121
<susan.mclaughlin@hhs.co.scl.ca.us>


ADOLESCENT HEALTH
Co-Chair: Joyce Eatmon <jeatmon@healthyarkansas.com>
Co-Chair: Lynn Roberts <lroberts@hunter.cuny.edu>

Are you concerned about the welfare of today's youth? Do you have a burning desire to reach out and help those youth who are headed down the wrong path? The Adolescent Health Committee is just the place for you. We in adolescent health promote programs and research with the goal of improving the health status of adolescents. In keeping with the changing needs and concerns of the adolescent population, our current focus is on wellness, risk behaviors (including sexual behavior and substance use), interpersonal violence, intentional and unintentional injury, teen parenting and school health.

Priorities for the Coming Year
1. Increase membership involvement through
-Regular contact with members via e-mail or regular mail
-Posting info on committee to Web Board
-Maintain contact with State Adolescent Health Coordinators Network

2.Active involvement in legislative issues related to adolescents

3.Promote adolescent health issues, i.e., wellness, risk behaviors, violence, unintentional & intentional injury, teen parenting, school health.

4.Create list serve of committee membership and other interested parties

The Adolescent Health Committee is still looking for members and other interested parties to join our listserv. If you are interested in being a part of the listserv, please send an e-mail with your name, organization, address, phone, fax, and email address to Joyce Eatmon at <jeatmon@healthyarkansas.com>.

We also are looking for volunteers to help in drafting a resolution on the provision of comprehensive sex education for adolescents. If you are interested in helping us draft this resolution, please contact Lynn Roberts by e-mail at <lroberts@hunter.cuny.edu>.

APHA Annual Meeting Highlights
The Adolescent Health Committee is sponsoring two (one oral and one poster) very informative sessions at this year's APHA Annual Meeting. The first session is scheduled for Monday, Nov. 17 from 8:30 a.m.-10:00 a.m., entitled “Adolescent Health: Behavior Change, Health Risk Attitudes and Risky Behavior .” In this session, presentations will be made on concerning behavioral interventions and the characteristics that influence adolescent attitudes and behavior. The second session is a compendium of issues related to adolescent health. These issues will be presented in a poster session on Tuesday, Nov. 18 from 4:30 p.m.-6:00 p.m.

The Adolescent Health Committee Business Meeting will be held Sunday, Nov. 16 from 4:00 p.m.-5:30 p.m. Please plan to join us as we make plans for the coming year, set goal and priorities and finalize plans for the resolution on comprehensive sex education for adolescents. We also will be making plans for the 2004 APHA Annual Meeting in Washington, DC.


INNOVATIONS IN MATERNITY HEALTH SERVICES
Co-Chair: Carol Nelson <cpmcnel@usit.net>
Co-Chair: Barb Levin <BarbL11@aol.com>

The mission of the Innovations in Maternity Health Services Committee is to raise the “hard” questions in childbirth: Why do we do this? Is it necessary? Is it mother and child friendly? Does it help have better outcomes? At this time in health care, with a continued growth of technology and further loss of control by childbearing families of their birth options, the committee feels that the underlying structure of maternal health care delivery should be evaluated.

This year our committee has focused on several crucial issues: What do pregnant women want and need? How do they make their decisions? Where do they get their information about birth options? How can health professionals facilitate their patients getting the most up to date evidence based information to facilitate decision making. We would like to continue to stress “partnering” of practitioner and patient.

To this end, the committee has planned a scientific sessions which confronts some of these issues. The session is entitled Evidence Based Practices in Maternity Care That Foster Patient-Provider Communication and Trust. The focus of the session is to explore the barriers to implementation of evidence based practice. We will be looking into areas such as: social determinants of birth culture; why medical practice does not follow the evidence, such as outcomes when Electronic Fetal Monitoring is used; and Caesarean Section. The session, # 4052.0 is the scheduled on Tuesday Nov. 18, at 8:30 a.m. at the 131st Annual Meeting in San Francisco.

Innovations in Maternity Health Services Business meeting will be held on Monday, Nov. 17, at 6:30-8:00 p.m. The location for the scientific session and business meeting will be announced in the final program.

Our committee is very excited to announce that the resolution, "Safe Motherhood in the United States: Reducing Maternal Mortality and Morbidity" was passed by the APHA Joint Policy Committee and will be considered by the full Governing Council. Thanks to the authors, Ina May Gaskin, Carol Nelson, and Anne Richter for their excellent work in getting this resolution on the docket for the fall meeting. The statement is in Section D-3 listed under Social and Other Issues on the APHA's policy Web page, for your review.

The co-chairs of our committee have continued to work with the Maternal Child Section (MCH) to define the role of the committee. It is an ongoing process. We hope to see many of you at our scientific session and business meeting.