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Maternal and Child Health
Section Newsletter
Spring 2005

Message from the Chair

Welcome to the latest issue of the MCH newsletter. It is filled with many exciting articles, but I just want to highlight two of them. At the Annual Meeting this fall, the MCH Section will be holding a special business meeting on Sunday, Nov. 6, to give all members of the Section an opportunity to meet the APHA leadership candidates and to comment on proposed policy. Please plan to come. See the article on this special session below.

We are also pleased to include in this issue of the newsletter the speech given by Bernard Guyer in 2003 when he received the Martha May Eliot Award. We thank the MCH Journal for permission to reprint Dr. Guyer's remarks, and we urge the membership to subscribe to this excellent journal.

The deadline for the fall newsletter is Aug. 15, so if reading all these exciting articles inspires you to write about your own activities, please make sure you get us the article by then. Send newsletter materials to our editor, Clare Feinson, at <cfeinson@erols.com>. Many thanks to everyone who contributed to this issue.

Jan Weingrad Smith

Special Session for Section to Meet Candidates, Shape Policy

The MCH Section Governing Councilors will host a two-part session during the Annual Meeting on Sunday Nov. 6, 2005 from 2 p.m. to 3:30 p.m. (room to be announced), entitled "Maternal and Child Health Section Special Meeting" (Business Meeting 119.1).

This session will provide the membership and the Governing Councilors the opportunity to meet and ask questions of all APHA Leadership Candidates except the Presidential Candidates, who will attend the regular membership meeting.

The session will also give MCH Section members the opportunity to discuss and comment on all pending policies prior to the Special Policy Review Sessions the Governing Councilors will be attending.

Please do not pass up this great opportunity to give your input about your future leaders and policies that will directly affect your organization.

If you have questions about this Special Meeting, feel free to contact Governing Councilor Whip Joseph Telfair at (205) 934-7161 or <jtelfair@uab.edu>.

Challenges Facing MCH Leadership: Martha May Eliot Award Commentary, 2003

by Bernard Guyer, MD, MPH

Receiving the Martha May Eliot Award from the American Public Health Association is meaningful because the award is named for one of the founding mothers of the field of maternal and child health (1) ; because it signifies the recognition and esteem of one’s colleagues; and because the previous recipients are the giants of the field and include some of my personal mentors. This is great company to be in. The only doubt attached to this award is that, as a career-achievement award, it may imply that one’s career is at its end! I console myself with the thought that this is still better than having peaked in high school!

I’ve organized these comments into three areas, each intended for a different MCH audience: the challenges facing academia, the challenges for public health practice, and the challenges of leadership.

First, for my academic colleagues, some thoughts about careers: Like Martha May Eliot, I’ve had the good fortune in my career to be a clinician, policymaker, researcher, and teacher. I teach students that careers are longitudinal, meaning that one can play all the important roles over time, but not necessarily all at once.

Ernest Boyer’s well-known book Scholarship Reconsidered provides a framework for thinking about career roles by identifying four kinds of scholarly pursuits: the scholarships of discovery, integration,application, and teaching (2).

By “scholarship of discovery,” Boyer meant the kind of research and scholarly writing that is expected of successful academics. In MCH such scholarship dates back to the founding of the Children’s Bureau, which was an investigative agency of government, publishing an immense number of influential research reports. Ironically, the amount of research carried out in MCH agencies declined over the course of the twentieth century. It is up to the academic community to be the strong constituency for excellence in research. Martha May Eliot would have been supportive of such an agenda. The “scholarship of integration” refers to the work of multidisciplinary teams on the important and difficult public health problems faced by women and children. This strong tradition goes back to the women of Hull House who founded the field of social work and worked in multidisciplinary teams. The “scholarship of application” is about using knowledge to make a difference! The history of MCH is one of activism on behalf of women and children. Recall that Martha May Eliot and her colleagues in the Children’s Bureau were instrumental in the implementation of both the Sheppard Towner Act and Title V of the Social Security Act. Finally, Boyer describes the “scholarship of teaching.” Dr. Eliot closed her career as the chair of MCH at the Harvard School of Public Health. The great strength of MCH as an academic field is that we encompass all of these forms of scholarship and must strive to achieve excellence in all of them.

Second for my colleagues practicing MCH in public health agencies some thoughts about directions for change: All fields, including MCH, change over time, despite resistance, struggle, and angst. Martha May Eliot participated in the evolution of the Children’s Bureau through the first half of the twentieth century. Where will MCH practice go in the twenty-first century?

This is the kind of question I pose to my students in the “Lifespan” course I teach at the Johns Hopkins Bloomberg School of Public Health. I begin the course with the following real phone call that I received in the late 1990s: "Dr. Guyer, I’m a graduate of Hopkins working on my first job. Our company has a contract with the Los Angeles County Health Department to prepare a report on the “forces” that will shape child health in L.A. County in the 21st century. I never took your course, but can you help me!"

In the ensuing classroom discussion the students themselves identify a long list of such “forces” that shape child health, including demographic, economic, environmental, biological, developmental, behavior, education, health systems, technology, discrimination, politics, and war, among others.

What are the implications of this broad set of forces for MCH practice? Traditionally, MCH agencies have focused their efforts on the delivery of a fairly narrow set of services to high-need populations of mothers and children. The analysis of the “forces” shows, however, that we can’t improve the health of populations unless we’re engaged with these broad issues. We are now witnessing the emergence of a body of thinking and research about multiple determinants of health and development across the lifespan. This is occurring in sociology, epidemiology, human development, and health care. MCH needs to embrace this evolution and build a new agenda for the importance of the early part of the life to the health of populations across the entire lifespan. I believe such an evolution will bring MCH practitioners into the society-wide discussions about health care for all that will take place in the next decade.

I believe Martha May Eliot would have supported this recommendation. She wrote in her final report for the Children’s Bureau (3): "Each new generation of children brings its own problems -— problems which require new approaches, new inventiveness, new counter measures -— and above all new knowledge and greater skill on the part of adults. All these things are of the future -— the children are the future."

Finally, some comments on leadership (and politics): Martha May Eliot was not an armchair spectator of the game of politics. She actively engaged in all the policy debates of her era. We are now challenged by a new era of threats to effective government, to independent scientific research, and to critical thinking in education. We can’t allow the public policy agenda to be undermined or academic enquiry to be stifled. Above all, we can’t allow the internal divisions in our own field to sidetrack us from the big picture. Like Martha May Eliot, we must be engaged and outspoken in our advocacy on behalf of all women and children. MCH is one area in which we have ample evidence for the effectiveness of excellent governmental programs to improve the health of the American population. Let’s make the case!!

I conclude with a quote about leadership from Yitzhak Rabin, made at his acceptance of the Nobel Prize (4) : "A child is born in an utterly undemocratic way. He cannot choose his father and mother. He cannot pick his sex or color, his religion, nationality or homeland. Whether he is born in a manor or manger . . .his fate to a large extent is decided by his nation’s leaders. It is they who decide whether he lives in comfort or despair, in security or in fear. His fate is given to us to resolve."

I hope we can all live up to this standard of leadership. Again, my deep thanks for this award.

Guyer can be reached at the Department of Population and Family Health Sciences, John Hopkins Bloomberg School of Public Health, Room E4146, 615 N.Wolfe Street, Baltimore, Maryland 21205, (443) 287-0088; e-mail: bguyer@jhsph.edu.

This article first appeared in the Maternal and Child Health Journal, the first exclusive forum to advance the scientific and professional knowledge base of the maternal and child health (MCH) field. You may visit the journal's homepage at: www.springeronline.com. For subscriptions and general inquiries in the US please contact the customer service department via e-mail at service-ny@springer-sbm.com or call toll free: 1-800-SPRINGER.


REFERENCES

1. Schmidt WM. Martha May Eliot: Social pediatrician, Children’s Bureau Chief. Address at the Harvard University Memorial Church, Cambridge, MA, 1977. (http://www.harvardsquarelibrary.org/unitarians/eliot m.html)
2. Boyer EL. Scholarship reconsidered: Priorities of the professoriate. Princeton, NJ: The Carnegie Foundation for the Advancement of Teaching, 1990.
3. Furman B. Dr. Eliot leaves US Child Bureau. New York Times, November 9, 1956.
4. Rabin Y. Remarks by Prime Minister Yitzhak Rabin on receiving the Nobel Prize for Peace. Oslo, December 10, 1994. (http://almaz.com/nobel/peace/1994c.html)

MCH Fellow Program Develops Association Leadership

Congratulations to the 10 outstanding women selected as 2005-06 MCH Fellows for the coming year: Caricia Catalania, Laura Chyu, Jennifer Erb-Downward, Janine Lewis, Ashley Murchison, Chinekwu Obidoa, Sharon Segev, Katie Sellers, Carrie Tatum, and Dolly Yang.

The purpose of the Fellows program is to promote student involvement in the Section, in Maternal and Child Health, and in public health generally. The Section provides an opportunity for the Fellow to take an active part in Section activities through attendance at the APHA Annual Meeting, participating in Section committee activities, serving as an assistant to the Governing Council representatives, and coordinating special sessions.

The qualification for becoming a Fellow include:
  • Currently enrolled in a graduate program in public health or related field.

  • Interest in becoming involved in APHA.

  • Outstanding student scholarship.

  • Outstanding student leadership.

  • Commitment to maternal and child health as demonstrated by MCH related interests.


This year’s Fellows more than met these criteria! They represent university programs around the country including Columbia University/Mailman School of Public Health, UCLA, New York University/The Steinhardt School of Education, University of Illinois at Chicago, Tulane University, Harvard, University of Connecticut, and USC. Six are completing their MPH, and four are doctoral students. Their interests include international reproductive health, women’s health, child care, adolescent health, epidemiology, children’s nutrition, community based services, MCH policy, community organizing, and domestic violence.

Over the next month, we will be placing these Fellows with mentors who are serving in leadership positions within APHA and the Section. If you are willing to be a mentor and/or have an interesting project or committee work that could use a little extra energy, contact Jane Pearson at <janepearson@cox.net>.

The Association of Teachers of Maternal and Child Health

What is ATMCH?
The Association of Teachers of Maternal and Child Health aims to provide leadership in education, research, and service in the field of maternal and child health. ATMCH offers an interdisciplinary forum through which MCH faculty from schools of public health and other institutions of higher learning can share the knowledge, ideas and skills essential to educating students, advancing MCH research, and applying research results to MCH policies, programs and services.

Who are ATMCH members?
Membership in ATMCH is open to all faculty teaching MCH or related subjects in schools of public health and other institutions of higher learning in the United States and other countries; faculty who formerly taught MCH or related subjects; staff of MCH teaching programs; and students of MCH or related subjects.

Benefits of membership include:
  • Collaboration and sharing of knowledge, teaching concepts, and skills through networking with academic MCH leaders.

  • Receiving the semi-annual electronic newsletter on items of importance to members.

  • Participation in the semi-annual meetings.

  • Listing and receiving the ATMCH membership directory.

  • Eligibility to vote in elections, hold an ATMCH office, and join an ATMCH committee.

  • Qualification for the annual Lacey Academic Leadership Award.

  • Free subscription to Public Health Reports.

  • Free online subscription to MCH Journal.

  • Discounted subscription for Journal of Obstetric, Gynecologic, & Neonatal Nursing (JOGNN).

  • Discounted AMCHP annual meeting registration.


For more information about ATMCH, please contact Kalpana Ramiah, MPH, MSc, CHES, Manager, Educational Programs at <kramiah@asph.org>. To join ATMCH, view our online application at <www.atmch.org/Application.pdf>. Or contact the ATMCH secretariat at:

ATMCH Secretariat
1101 15th Street, Suite 910
Washington, DC 20005
(202)296-1099

Breastfeeding Committee

Members of the Breastfeeding Committee have been working at the national and community level for the past year on the National Breastfeeding Awareness Campaign (NBAC), launched in June 2004 by the U.S. Department of Health and Human Services' Office on Women’s Health. This is the first national public health campaign on breastfeeding since 1911, and uses a risk-based approach to educating the public on health consequences of not breastfeeding.

The Ad Council created the Campaign’s public service announcements in English and Spanish, and the Campaign has received a total of $14,956,800 in donated media since June 2004, with PSAs appearing in the TV, radio, print, out-of-home, and interactive media. NBAC has rated highly compared with other Ad Council campaigns, placing fourth in public relations revenues out of all of the Ad Council's sponsored projects in the third quarter of 2004. The Campaign will continue through 2005.

ABC’s 20/20 ran a news story about the Campaign on the launch date, and the TV segment recently won a 2005 “Gracie Award” from the American Women in Radio & Television. The ‘Gracies’ recognize quality programming “created for women, by women and about women” in the electronic media. The award was presented on June 22, 2005.

In other news, the Breastfeeding Committee will have two sessions at this year’s APHA Annual Meeting: Session 3119.0, on Monday, Nov. 7, and Session 5057.0, on Wednesday, Nov. 9, as well as a poster session (4272.0: Tuesday, Nov. 8, 2005: 4:30 p.m.-5:30 p.m.). Breastfeeding related presentations will also appear in the following sessions: 4273.0: Improving Access to Maternity Health Services; 3053.1: Current issues in Health Education and Health Promotion; 3111.0: Emerging HIV/AIDS Issues for Discussion and Debate. Breastfeeding is one of six priority areas for the MCH Section. For more information, contact Committee co-chairs Lindsay MacAuley and Anne Merewood.

Innovations in Maternity Health Services

The Innovations in Maternity Health Services Committee has just finished putting together this year’s Annual Meeting program. While the program has been a worthwhile endeavor, we as individual providers have been dealing with massive cuts of public health programs. In Tennessee, where two of the co-chairs reside, the population of the state is facing the loss of publicly funded health insurance for more than 300,000 people. This will not directly affect pregnant women or children younger than 21, but has a serious impact on women’s health.

This year’s convention program is planned to highlight the issues in malpractice coverage. “Who’s Left to Deliver the Baby?” will be held on Monday, Nov. 7, 2005 from 4:30 – 6:30 p.m. Charles Mahan has agreed to be the moderator for this session. We have several presenters looking at the issues of who is delivering and what the barriers exist to receiving adequate maternity care. The business meeting for the committee will follow this session.

The mission of the Innovations 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 better outcomes? The continued growth of technology has caused loss of control by childbearing families of their birth options. At this time, however, the basic fabric of childbirth may be threatened as the number of actual providers shrinks in the face of staggering increases in malpractice insurance.

Beyond the topic for the Annual Meeting, issues regarding access to and quality of maternity services need to be addressed. The committee will be working with the overall section to plan a strategic approach to these overwhelming concerns. An online survey of access problems as well as malpractice insurance increases is being considered. The loss of federal Maternal and Child Health Funding will only make these problems more difficult in each state.

In other news, the CPM Statistics Project has written an article based on data from 5,000 labors which will be coming out in the British Medical Journal. We will publish the reference in the next newsletter.

Comments, questions, concerns? E-mail Barb Levin at <BarbL11@aol.com> or Carole Nelson at <cpmcnel@usit.net>. Thanks to committee members for their time and the effort.

Red Tape Doesn't Stop Family Violence Prevention Caucus

Three APHA members from the MCH and Injury Sections, Michael Durfee, MD, Peggy Goodman, MD, and Pat West, MSW, have applied to create a Family Violence Prevention Caucus. Informal announcements attracted an additional 100 professionals, from students to full professors, from other sections, including MCH, Injury, Community Health, Epidemiology, Environment, Medical, International, Population, Public Health Nursing, and Social Work, as well as the SPIG for Alternatative and Complementary Medicine, and the Caucuses for Blacks, Homeless, Women, and Students.

After several years of planning and a year of paperwork, our application was submitted to the Executive Board. However, the Executive Board tabled our request, asking us to wait until the work of the Task Force on Association Improvement and Organization (TFAIR) has been completed. The TFAIR, convened to evaluate the structure of APHA, is committed to preserving the diversity of the Association as much as possible, while working within limited resources. The TFAIR is planning to submit a proposal to the Governing Council in New Orleans in November, but beyond that, it is difficult to tell when their task will be complete. Meanwhile, the problem of family violence continues, and so do we.

Our initial project will be a directory of members, but in the meantime, members of the proposed Caucus will be identified by dots on their name tags. We have no assigned meeting room in New Orleans, but the proposed Caucus will meet at the MCH Family Violence Committee business meeting, Monday, Nov. 7, from 6:30 to 8. Everyone is welcome, and if you cannot attend, send comments and questions to Michael Durfee, MD, at <michaeld55@aol.com>.

Charles Feild Receives Faculty Honor

Charles R Feild, MD, MPH, FAAP, received the University of Arkansas College of Public Health 2005 Faculty Award for Excellence in Public Service. Feild is Professor of Pediatrics and Maternal Child Health, and is vice chair of Maternal Child Health. He is the Executive Director of the University of Arkansas for Medical Sciences (UAMS) Head Start Programs. UAMS Head Start serves 1100 low income children in Little Rock and the surrounding county. Congratulations to Charles Feild on receiving this recognition.

In Memoriam -- Doris Barnette

Doris Maria Barnette passed away in Jackson, Miss., on May 23 after a short illness.

She was born in Columbia, Louisiana, in 1945 and received her undergraduate degree and master’s degree in social work from the University of Southern Mississippi in Hattiesburg. Her first employment was with the United States Public Health Service in Philadelphia, working with the Mississippi Band of Choctaw Indians. In the late 1970s she assumed the position of director of the Mississippi Delta Child Health Improvement project in Clarksdale.

In 1980 Barnette was selected as statewide family planning director for the Mississippi Department of Public Health in Jackson. During that time she was selected as Social Worker of the Year by the National Association of Social Workers.

In 1986 she was appointed Assistant State Health Officer for the Alabama Department of Public Health in Montgomery. From 1992 to 1994 she did private consulting. In 1994 she joined the Florida Healthy Start coalition in Tampa, and in 1996 she moved to the U.S. Department of Health and Human Services in Washington, D.C. In 1997 she became Principal Advisor to the Administrator of the Health Resources and Services Administration (HRSA), a $6 billion agency assuring access to health care for over eight million Americans. Barnette moved to Jackson, Miss., in 2001 and was the administrator of a four-state disability business until her death.

Barnette was the daughter of the late Bythel Barnette and Cecil Ray Barnette. She is survived by two brothers, one sister, three nieces, one nephew, five great nieces, and six great nephews. A celebration of her life was held in Flowood, Miss., on Sunday, June 26. Donations can be made to the Doris Barnette Social Work Scholarship Fund by sending a check to Claude Earl Fox at 326 Suffolk Rd, Baltimore, MD 21218.

Childhood Cancer and Treatment Disparities

Two new publications have appeared that address critical policy issues concerning childhood cancer and treatment disparities in the United States and internationally.

The Institute of Medicine recently issued its report Making Better Drugs for Children with Cancer. It is available to read and purchase at <http://www.nap.edu/catalog/11259.html>. The report shows that market forces by themselves are not sufficient to ensure the research needed to produce new drugs for children with cancer. The report recommends forming new public/private partnerships to bring government, industry, researchers, and advocacy groups together to support research and development in this critical field.

The report analyzes childhood cancer treatment in the light of historic advances. "Over the past 40 years, researchers and clinicians have achieved long-term survival for most children and adolescents with cancer," said pediatric oncologist Peter C. Adamson, MD, chief of the Division of Clinical Pharmacology and Therapeutics at The Children's Hospital of Philadelphia, and an editor of the report. "However, our therapies are not curative for 30 percent of children, and for children who are cured, the short-term and long-term side effects of current treatments are often too high."

More than 250,000 children are diagnosed with cancer each year, worldwide. According the Children's Cancer Trust in the United Kingdom, the actual number of cases is unknown and thought to be significantly higher as few children in developing countries receive treatment and many die undiagnosed. Even with the present limitations of cancer treatments for children in the United States, the now-80 percent survival rate here is mirrored by a mortality rate in low- and medium-income countries of almost equal size, i.e. in those countries, only some 10-20 percent get treated and survive. The majority often also die in extreme anguish, with no access to pain relief either.

As infectious disease mortality decreases, childhood cancer has become a leading cause of death in many countries. For example, in Mexico, cancer is now the 2nd cause of death in children age 5-14, just as in the United States. In the United States, cancer is the single most fatal childhood disease. It is also not completely accurate to classify cancer as a noncommunicable disease, as there are known viral and infectious causes for some types such as Burkitt's lymphoma, common among children in Africa. And new research has identified viral causes of some leukemias and lymphomas. Access to affordable and appropriate medicines, of course, is an essential part of the strategy.

Also of note is an article recently publushed in the New England Journal of Medicine (NEJM)(352 (21) : 2158-2160 May 26, 2005), entitled Saving the Children: Improving Childhood (Cancer Treatment in Developing Countries, <http://content.nejm.org/cgi/content/full/352/21/2158>.

The authors, Raul C. Ribeiro, MD, and Ching-Hon Pui, MD, close with this message: "It has been said that if we are to preserve civilization, we must make certain its benefits are available to the many, not reserved for the few. The development of curative treatment for children with cancer is a benchmark for medical progress, and such treatment must not be sequestered within the borders of a few countries. The strategy we describe is only a start, but it could ignite a spirit of achievement that may ultimately reach even the least privileged nations."

The authors are also members of the International Society of Pediatric Oncology ( SIOP), which last year requested that the WHO put cancer treatment drugs in the priority group of the Essential Medicines List. To date, SIOP has had no response.

For more information, contact:
Joana Ramos, MSW
Cancer Resources & Advocacy
7303 23rd Ave. NE
Seattle, WA 98115
206) 229-2420
<http://ramoslink.info/>

'Children Now' Unveils New Web Site

Children Now is pleased to announce the launch of their redesigned Web site. The new site features improved navigation, bringing you the latest information about Children Now’s efforts to make children the top policy priority in the United States. You’ll find updated content about each of their program areas -- health, education and child care, media and investing in children -- and ways in which you can support their work. Take a moment to visit their new Web site to learn more at <www.childrennow.org>.

Children's Healthy Weight Program Posted by Health Egroup

We Can! (Ways to Enhance Children's Activity & Nutrition) is a national program designed as a one-stop resource for parents and caregivers interested in practical tools to help children 8-13 years old stay at a healthy weight. Tips and fun activities focus on three critical behaviors: improved food choices, increased physical activity and reduced screen time.

The program is a collaboration of four Institutes of the National Institutes of Health: the National Heart, Lung, and Blood Institute; the National Institute of Diabetes and Digestive and Kidney Diseases; the National Institute of Child Health and Human Development; and the National Cancer Institute. For more information, see <www.nhlbi.nih.gov/health/public/heart/obesity/wecan/>.

Information about this program was posted by Bringing Health Information to the Community (BHIC), an egroup hosted by the Mid Continental Region of the National Network of Libraries of Medicine. BHIC is an excellent source of information about programs, grant opportunities, and other items of interest in health. For more information, or to subscribe, contact Community Outreach Liaison Siobhan Champ-Blackwell at <siobhan@creighton.edu>.

Community Baby Showers: An Outreach Event Targeting Low-Income Pregnant Women

In 2004, the Alameda County Public Health Department’s Improving Pregnancy Outcomes Program (IPOP), a grantee of the federal Healthy Start program, began implementing an effective approach to reaching pregnant women by hosting community baby showers. In 2004, IPOP hosted four pilot community baby showers in targeted areas. As they became more popular through increased program visibility and word-of-mouth, attendance increased from four to 26 pregnant women, and from no fathers to six fathers.

Community baby showers are intimate, fun celebrations with three purposes: case finding of target area pregnant women for case management services; recruitment of perinatal health workshop participants; and linkage of pregnant women with maternal and child health services and resources. Additionally, a free nutritious lunch, cake, gifts and child care are provided at each baby shower. Evaluations show that the attendees: 1) appreciated knowing that there are people who care about them; 2) had “a lot of fun;” 3) appreciated the gifts and prizes; 4) learned “a lot;” and 5) want the baby showers to continue. As their popularity continues to grow in 2005, an average of 35 pregnant women participate in each quarterly baby shower.

The baby showers provide targeted women an opportunity to self-identify as pregnant without the stigma of being labeled “at-risk” for a poor birth outcome. In fact, the opposite is true — the women feel happy, uplifted and excited because their pregnancy is being supported with referrals to services, contacts with professionals who can answer questions, exposure to education and information, gifts, food and fun.

The showers also offer participants an interactive, group-based, pregnancy basics class in a pleasant and welcoming environment. Selected content of the IPOP Pregnancy Basics curriculum is highlighted, including: stages of pregnancy; risks of smoking and using drugs during pregnancy; signs of preterm labor; importance of good nutrition, exercise and rest; and referrals to resources. In addition, the showers provide pregnant women with: 1) opportunities to talk with a pubic health nurse and/or community health outreach worker; 2) referrals to case management care, perinatal education workshops, and resources they need; and 3) the opportunity to attend an event honoring and supporting them.

"It makes me feel happy because I am giving the mom an opportunity to celebrate the upcoming birth of her baby. Many times with the community we serve, a baby's birth is viewed as more of a burden than a joy. When women are able to show up at the baby shower, they are standing by their decision to have their baby despite all the obstacles.” said Yokia Mason, IPOP community education staff who facilitates the Pregnancy Basics portion of the agenda.

Throughout the event, the attendees enter raffles of baby gifts such as a bed/playpen, stroller, breastfeeding boppy, bouncer, baby bathtub and supplies, clothes hamper, diapers, diaper bag, baby clothing, books etc. In addition, each woman receives a gift bag filled with incentive items such as a Back-to-Sleep baby t-shirt, pedometer, water bottle, a booklet on fetal development during each month of pregnancy, and baby safety gadgets such as cabinet locks, electric socket plugs, etc. Shower game prizes also include gifts for the expecting mother such as a bathrobe and slippers, a grocery or department store gift card, spa bag, and manicure-pedicure gift certificate to
name a few.

Written materials are provided in a participant packet of information covering secondhand smoke and tobacco cessation, preterm labor, maternal depression, kick counts, alcohol and other drugs, a self-referral form to case management programs, a copy of the Alameda County Resource Guide, and an announcement of the upcoming perinatal education workshop series on Pregnancy Basics and Healthy Eating & Living for Mom and Baby.

According to IPOP health educator Dana Cruz Santana, MSW, MPH, some of the women who participate in the community baby showers have never had a baby shower during previous pregnancies or will not have one otherwise if they are expecting their first child. Either their families and friends lack the resources to have a baby shower, or the women have very little social support.

The community baby showers have attracted wide community support through monetary donations, as well as baby clothes and items, and volunteers who assist with the publicity and hands-on coordination of the event.

For questions or further information, contact:
Kay Adams, MPH
MPCAH/IPOP Health Promotion & Community Education Coordinator
Alameda County Public Health Department
1000 San Leandro Blvd., Suite 100
San Leandro, CA 94577
Kay.Adams@acgov.org

Conference Looks at How Environment Affects Children

A conference entitled Promoting Healthy Communities for Children: The Physical and Social Environments will be held Sept. 26-27, 2005, at the University of Minnesota, Earle Brown Center, St. Paul Campus.

What is the purpose of the conference? To examine critical aspects of the environment as they affect the health and well-being of children and adolescents, organized around three broad themes:
  • the natural environment

  • the built environment

  • the social environment


Given its ecodevelopmental perspective, the conference will be organized to examine the diverse social contexts in which children live, work, and play during different stages of life: preconception, fetal development, first year of life; preschool period - ages 1 - 5; and school age.

Who should attend? This conference is intended for a multidisciplinary audience, including public health and clinical researchers and MCH professionals, community organizers/program developers, and graduate students.

Primary sponsor: Maternal and Child Health Program, Division of Epidemiology and Community Health, School of Public Health, University of Minnesota.

Co-sponsors: UM College of Architecture and Landscape Architecture, UM Medical School, UM School of Nursing, UM School of Social Work, Sustainable Resources, and the Institute for Trade and Agriculture.

For further information: Registration information will be available in July on the Maternal and Child Health Program Web site: <www.epi.umn.edu/mch>. Registration fees will be minimal, and continuing education credits will be available.

Foundation Center Examines Funding Trends for Children

To measure the involvement of foundations in supporting children's health, the Foundation Center has prepared Foundation Funding for Children's Health, the first detailed examination of US foundation health giving that specifically benefits children and youth, defined as newborns through 19-year-olds. The report examines funding trends and the future outlook fo rsupport in the field. In addition, Lauren LeRoy and Anne Schwartz of Grantmakers In Health have provided commentary on the critical role of foundations in funding children's health.

The mission of the Foundation Center is to strengthen the nonprofit sector by advancing knowledge about US philanthropy. For more information about the report, contact Steven Lawrence at 212-620-4230, or email, sal@fdncenter.org. Download Foundation Funding for Children's Health at www.fdncenter.org/research.

The report was sponsored by the Lucile Packard Foundation for Children's Health (www.lpfch.org), whose mission is to promote, protect, and sustain the physical, mental, emotional, and behavioral health of children. Grantmakers in Health (GIH) (www.gih.org) is a nonprofit, educational organization dedicated to helping foundations and corporate giving programs improve the nation's health.

Healthy Tomorrows Funds Community-Based Initiatives Focusing on Children’s Health

The Healthy Tomorrows Partnership for Children Program is a collaborative effort between the Maternal and Child Health Bureau and the American Academy of Pediatrics. HTPCP is a grant making and technical assistance program that aims to stimulate the development of health programs in areas where identified child health needs are not being met. This program promotes community planning and problem solving at the local level through pediatrician involvement, and advisory board development, evaluation planning, and matching funds to ensure project sustainability.

Since its inception in 1989, a total of 188 HTPCP grants have been awarded; 126 of the 188 projects have been completed. To be eligible for funding, projects must represent a new initiative within the community or an innovative component that builds upon existing community resources. Healthy Tomorrows grant awards are for approximately $50,000 per year for a five-year project period.

Healthy Tomorrows projects focus on a variety of service populations and health topics. Past projects have addressed the needs of infants, pregnant mothers, children with special health care needs, and low income or uninsured families. Projects focus on a variety of topical areas including access to care, oral health, home visiting, mental health, obesity, and school health.

Ten new grants began on March 1, 2005, and include:
  • Creating Opportunities for Physical Activity (COPA) in Torrance, Calif.

  • The Village Fit Kids Project in Miami, Fla.

  • Family Center for Health Futures in Lexington, Ky.

  • Treasure Valley Children’s Mental Health Project in Boise, Idaho

  • Pontotoc CATCH Kids Expansion Project in Tupelo, Miss.

  • Connecting the Dots in Chapel Hill, N.C.

  • Good Beginnings Home Visiting Network Expansion Project in Claremont, N.H.

  • Behavioral Developmental Primary Care Program in Austin, Texas

  • Boys Health Advocacy Program in Rapid City, S.D.

  • Pre-Emptive Behavioral Health Team Intervention for At-Risk Children and Families in Centralia, Wash.



The funding cycle for HTPCP is usually announced by MCHB in August. Please check the HTPCP Web site at <www.aap.org/commpeds/htpcp/index.html> in August for more information, and click on “Grant Cycle Information.” The HRSA Preview will also provide information on how to apply for the grant in August at <www.hrsa.gov/grants/preview/default.htm>. If you would like more information on HTPCP, please contact Nicole Miller at <nmiller@aap.org> or (847) 434-7082 or Anne Gramiak at <agramiak@aap.org> or (847) 434-4279.

Interconceptional Care and Counseling

Recent data from Pregnancy Associated Mortality Reviews, Perinatal Periods of Risks analyses, and Fetal Infant Mortality Review teams have highlighted the strong association between a mother's health both before and during pregnancy and birth outcomes. Data has also shown that 50 percent of all pregnancies among adult women are unplanned. Based on these factors, Florida identified the pre/interconceptional period as one untapped area of opportunity to positively influence birth outcomes in Florida. In the fall of 2004, the Department of Health and Healthy Start Coalitions initiated a campaign to address infant mortality and improve pregnancy outcomes through education and counseling aimed at improving a women’s health status before she becomes pregnant.

Florida’s Healthy Start Interconceptional Care and Counseling component was developed in collaboration with the Florida Department of Health, Healthy Start Coalitions, and Healthy Start providers, and subsequently integrated into existing Healthy Start programs without additional funding. Healthy Start Programs are able to develop their own curriculum, but individual Interconceptional Care curricula must be approved by the local coalition and adhere to the minimum standards outlined in the Healthy Start Standards and Guidelines. Providers, including nurses, social workers, health educators, and paraprofessionals in Healthy Start programs throughout the state, are being trained to provide interconceptional education in a culturally sensitive manner that is applicable to the participant and their assessed risk factors. Technical assistance guidelines were also developed for use in Florida’s county health departments as a guide for programs like Family Planning and prenatal care clinics to provide pre/interconceptional care to women of childbearing age. Educational components of both these initiatives include access to health care; management of maternal infections and chronic health conditions; weight, physical activity and nutritional counseling; appropriate baby spacing; substance abuse and smoking; mental health issues; and environmental risk factors.

For more information, contact Terrye Bradley, MSW, Chief, Bureau of Family and Community Health, Florida Department of Health, <Terrye_Bradley@doh.state.fl.us>.

Resources Help School Nurses Care for Chronic Conditions

The Florida School Health Services Program office proudly offers several documents and tools to assist the professional school nurse in providing safe care for children with chronic conditions while in the school setting. These include the following:



The Nursing Guidelines for the Delegation of Care for Students with Asthma in Florida and the associated model training will be released soon. Both the diabetes and asthma guidelines and training tools were developed by the Florida Department of Health in cooperation with the Florida Department of Education, local school health providers, and community stakeholders. This guidance to the field responds to the growing numbers of children with diabetes and asthma in schools, and numerous requests from parents, school staff, and administrators. The goal is to ensure that children with diabetes and asthma have full and safe access to school programs regardless of their disease.

For more information, contact Terrye Bradley, MSW, Chief, Bureau of Family and Community Health, Florida Department of Health, <Terrye_Bradley@doh.state.fl.us>.

TA Project Tracks Infant Mortality Trends in Florida

Like many states, Florida has found that the ability to collect, track, and analyze health outcome data at the local level is becoming more critical to addressing the challenge of an increasing infant mortality rate. The state continues to experience increases in both low birth weight rates and infant mortality rates, and the most recent data (2003) show that the infant mortality rate remained at 7.5 per 1,000.

Local level analysis is key to understanding the root causes of these trends. But there continues to be vast differences in the local level capacity for data analysis. While some counties have epidemiologists with time dedicated specifically to maternal and child health, others have insufficient resources to obtain even the most basic data support.

To address this problem, staff members from the infant, maternal, and reproductive health unit of the Florida Department of Health worked in collaboration over the past year with three state and local collaborative teams focused on increasing local data and analytical capacity to address infant mortality and the related contributing risk factors. Each team covers five Florida communities that were selected on criteria developed to identify target areas based on rising trends in infant mortality. The membership on each team includes:

  • A representative of the local Healthy Start Coalition from each county.

  • A representative from the local county health department in each county.

  • The state health office Healthy Start contract manager for each county

  • The state health office maternal and child health quality improvement liaison for each county.

  • A staff member of the state health office data and evaluation team.

  • A CDC-assigned MCH medical epidemiologist.


Although the work of the teams was interrupted by hurricane activity in Florida during the Fall of 2004, many communities were able to complete local level analysis to help identify trends in infant mortality. The teams just completed a training focused on cause of death trend analysis and the use of Geographic Information System (GIS) mapping in analysis of maternal and child health outcomes.

For more information, contact Terrye Bradley, MSW, Chief, Bureau of Family and Community Health, Florida Department of Health, <Terrye_Bradley@doh.state.fl.us>.

The Children's Partnership Releases New Research About Impact of Technology on Children

The Children's Partnership released a report on a year-long study that examines if and how computers and Internet tools help children increase educational achievement, lead healthier lives, prepare for the workforce, and become engaged in their communities. Measuring Digital Opportunity for America's Children: Where We Stand And Where We Go From Here includes an analysis of how low-income, minority, and disabled children disproportionately lack such access. In addition, the report introduces The Digital Opportunity Measuring Stick (DOMS), an index of 40 indicators that provides a snapshot of how the Internet and other information and communications technology benefits children.

This year-long study is the first-ever look across four key areas to see whether information and communications technology is helping children improve educational achievement, lead healthier lives, increase economic opportunity, and participate in their communities.

The report reveals that the Internet and other digital tools are beginning to increase success-related outcomes for millions of America's children. However, disparities have resulted in an "opportunity gap" for millions of other low-income and ethnic minority children. The report includes impacts of technology on children, introduces the Digital Opportunity Measuring Stick, illustrates the disparities, and offers an action agenda and additional resources.

For more information and access to full report, please visit <http://www.contentbank.org/DOMS>, or contact <DOMS@childrenspartnership.org>.

Web-Based Course on Advocating For Folic Acid

Advocating For Folic Acid: A Guide For Health Professionals at <www.folicacid.net> is a free, Web-based course designed for current and emerging health professionals.

The course provides information about the benefits of folic acid and strategies for counseling individuals regarding folic acid intake. Users are presented with interactive elements that allow them to learn and test their knowledge, including a case study and a virtual kitchen. The module also includes a section that contains detailed information for specific health professionals (allied health, dentistry, dietetics, medicine, nursing, optometry, pharmacy and public health), and guidance for counseling individuals. A number of health professional schools are currently using this education tool, and special features are available for educators to view student performance. A special section of the Web site describes relevance of folic acid to public health professionals.

This project was made possible through funding from the March of Dimes. The course was developed with the assistance of subject matter experts and professionals in maternal and child health. For more information about the Web site and how you can use it in your classes, contact Kalpana Ramiah at <kramiah@asph.org>.