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Bureau of Women's and Children's Health

News and Views – May 2012

Bureau of Women's and Children's Health - News and Views

Want to read this publication offline? You can print a hard copy of this issue. To find previous issues, visit our newsletter archive.

Maternal Child Health Navigator Portal

MCH navigator
The MCH Navigator portal links individuals seeking to advance their learning and skills mastery to existing open-access trainings.

The Maternal and Child Health Bureau, Health Resources and Services Administration (HRSA), is excited to announce the availability of a new resource for MCH professionals working in state agencies and at the community level who seek to advance their learning and skills mastery. The MCH Navigator is a learning portal that links individuals to existing open-access training, organized in areas consistent with nationally endorsed public health and MCH leadership competencies. Online training resources—like archived webcasts and webinars, instructional modules and self-guided short courses—have undergone academic review and have been handpicked for, and vetted by, MCH audiences.

This website is being made widely available now, while still in development, in response to requests from state and local stakeholder collaborators. We believe that, in addition to meeting what have been described as urgent needs in the field, our release of this early product will enable input and feedback from the widest of array of target audiences. We encourage you, therefore, to share this notice broadly and to use the “Comment” feature of the MCH Navigator website to help us fine tune the learning portal.

For those wishing to “jump in” and explore the learning resources linked in the MCH Navigator system, there is a MCH Navigator Web Tour. Those seeking more complete information about the overall MCH Navigator project can find a short video presentation.

Thank you so much to the diverse academic and practice partners who developed materials, reviewed existing resources, and helped design the web site to best suit the needs of busy professionals.

Enjoy this new resource and please provide your feedback so that we can continue to improve the product.

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Oral Health of Arizona Preschool Children Remains Below National Recommendations

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The American Academy of Pediatrics recommends children be seen by a dentist within 6 months of the first tooth erupting or by 1 year of age, whichever comes first.

Summary of Findings

The Arizona Department of Health Services, Office of Oral Health’s (OOH) survey of preschool children shows that the oral health of Arizona preschoolers is well below national recommendations. Oral disease is nearly 100 percent preventable and this new information will help determine what resources are needed and where best to place them to improve the oral health of children statewide.

Arizona preschool children have a significant burden of oral disease and it starts early with 7% of children ages birth through age one having the first signs of tooth decay. By the time children reach the ages of 2 through 4, 37% have had tooth decay and 30% have untreated tooth decay. These levels are far beyond the U.S. Department of Health and Human Services’ Healthy People 2010 targets of 11% having ever had tooth decay and 9% having untreated tooth decay.

Data further show that race, ethnicity and socioeconomic status may be factors in oral health. Over 43% of Asian/Pacific Islander children ages 2-4 have untreated tooth decay. Thirty-four percent of Hispanic children have untreated tooth decay with similar rates found in Black (32%) and Native American (31%) children. Children who come from families where parents/guardians have a high school education or less are much more likely to have untreated tooth decay (42%) than children who come from families with parents/guardians who have more than a high school education (24%).

Dental insurance status was not significantly related to whether a child had untreated tooth decay. Twenty-seven percent of children who have private dental insurance have untreated tooth decay; similar rates are found among children with public dental insurance (32%) and children who have no dental insurance (30%).

The American Academy of Pediatrics (AAP) recommends that children be seen by a dentist within 6 months of the first tooth erupting or by 1 year of age, whichever comes first. Only 6% of children ages birth to one had seen a dentist, according to parents’ reports. In addition, older children are not getting needed dental care; more than half (54%) of parents/guardians responded that their preschool children age 3 had never visited a dentist.

These results indicate that tooth decay clearly remains a problem for young children in Arizona. Although preventive measures, such as fluorides have been widely available for years, efforts need to focus on reaching underserved children who stand to benefit the most. These findings challenge us to strengthen disease prevention programs and to implement strategies that lead to treatment access for specific populations. The direction of OOH is to address this and other oral health issues by setting goals and providing specific, measurable and time-phased objectives and activities for accomplishing them.

Methods

Preschool children received oral health screenings at 100 randomly selected licensed child care centers with classroom sizes of ten pupils or more. The screenings of 989 children were completed during the fall of 2008 through the spring of 2009. The survey involved a standardized cross-sectional, open-mouth screening developed by the Association of State and Territorial Dental Directors and conducted by trained dental staff.

Key Findings

  • Tooth decay starts early in childhood; 7% of children ages birth through age have the first signs of tooth decay.
  • Children ages 2 through 4 have tooth decay rates far beyond national recommendations; 37% have tooth decay experience and 30% have untreated tooth decay.
  • Disparities exist for children who come from families where parents/guardians have a high school education or less. They are significantly more likely to have untreated tooth decay (42%) than children who come from families with parents/guardians who have more than a high school education (24%).
  • Children are not getting needed dental visits; 54% of children age 3 had never visited a dentist.

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Important Message from the Office of Newborn Screening

newborn screening
Every year, approximately 700 newborns are identified as carrier of hemoglobin traits. It will be the role of the PCP to inform parents about the results.

The Newborn Screening Case Management Program implemented a new protocol for tracking and management of abnormal results for hemoglobinopathies detected by the newborn screen starting February 13, 2012.

The Case Management program will continue to coordinate appropriate follow up with primary care providers, hematologists and families for infants with abnormal results for hemoglobin disorders. However, follow up with families for hemoglobin traits is discontinued. It will be the role of the primary care physician to inform parents about the results. Advice and special considerations for infants with hemoglobin traits are available from the Office of Newborn Screening.

Educational materials in English and Spanish for Sickle Cell Trait are available. If you would like to order the brochures or would like to schedule an educational workshop for your clinic, please contact Sondi Aponte, Quality Improvement and Outreach Manager, at 602-364-1642.

The State Public Health laboratory anticipates no impact on the Program’s ability to detect and coordinate confirmatory diagnostic testing and treatment for affected infants.

If you have any questions please do not hesitate to contact Ward Jacox, Chief of the Office of Newborn Screening at Ward.Jacox@azdhs.gov or (602) 364-1410.

Understanding the New Protocol for Hemoglobinopathies

The Newborn Screening Case Management Program implemented a new protocol for tracking and management of abnormal results for hemoglobinopathies detected by the newborn screen on February 13, 2012. The new follow up protocol for abnormal results for hemoglobinopathies will be handled as follows:

  • Primary Hemoglobin Disorders: FS, FSA, FSC
    • NO CHANGE in follow up. This means that the follow up program will continue to notify and work with the Primary Care Physician (PCP), family and contracted hematologists until a final diagnosis is obtained.
  • Other hemoglobin disorders: FC, FE, FU, Hemoglobin H Disease, or others
    • NEW! Notification of results by fax to the ADHS contracted hematologist. Laboratory results will be mailed to the submitting agency and the PCP. No further follow up with PCP or family. It will be the role of the PCP to inform parents about the results and consult with a pediatric hematologist.
  • Hemoglobin Traits: FAS, FAC, FAE/O, FAD/G, FAU, Barts and other traits
    • NEW! The Office of Newborn Screening will discontinue follow up for hemoglobin traits with the family. Laboratory results will still be released to the PCP. Every year, about 700 newborns are identified as carrier of hemoglobin traits. It will be the role of the PCP to inform parents about the results. Advice and special considerations for infants with hemoglobin traits are available from the Office of Newborn Screening.

As a Healthcare Provider, you should take the following actions:

  • Contact the family to inform them of the screening result and to offer education and counseling;
  • Reassure the family that the infant does not have clinical problems related to the carrier state; and
  • Encourage parents to seek genetic counseling and offer family members referral for hemoglobinopathy testing.

The Office of Newborn Screening will conduct outreach activities with community health clinics, parent support groups, and providers on available resources. In collaboration with the Office for Children with Special Health Care Needs, we will also be providing educational materials in English and Spanish for Sickle Cell Trait. If you would like to order brochures or would like to schedule an educational workshop in your community, please contact Sondi Aponte, Quality Improvement and Outreach Manager, at 602-364-1642.

The State Public Health laboratory anticipates no impact on the Program’s ability to detect and coordinate confirmatory diagnostic testing and treatment for affected infants.

If you have questions or concerns regarding this information, please do not hesitate to contact Ward Jacox, Chief of the Office of Newborn Screening at Ward.Jacox@azdhs.gov or (602) 364-1410.

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Can You Hear Me? Are Children Not Listening or Can They Not Hear?

babies
Early identification of hearing loss improves lifetime learning potential and quality of life as well as significant cost saving in special education services.

Hearing loss is invisible and without early and regular screening often will go undetected until a child has serious speech and language delays identified. A child’s age at identification of hearing loss is the single most telling factor for speech and language development regardless of degree of loss. Early identification provides significant cost savings in special education services as well as improvement in lifetime learning potential and quality of life.

Because the rate of hearing loss doubles between the birth screening and school age, the EAR Foundation of Arizona in partnership with the Office for Children with Special Health Care Needs within the Bureau of Women's and Children's Health at the Arizona Department of Health Services is working to ensure that hearing screening and follow-up remains a priority beyond the newborn period and through early childhood. The goal is to increase the number of children who receive needed evaluation after a failed newborn screening; and increasing screening opportunities for young children beyond the newborn period to identify and treat children with late onset and progressive hearing loss as early as possible and long before starting school. For more information, please call Melissa 602-685-1050 or Melissa@earfoundationaz.com.

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Being Aware of Heart Disease

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Heart Disease is the number one killer of women. The Heart Truth Professional Education Program provides evidence based prevention strategies and tools for heart disease prevention.

Awareness of heart disease among women has nearly doubled in the last 12 years, but it remains the #1 killer of women. More than 60% of women ages 20-39 and more than 80% of women ages 40-60 have one or more modifiable risk factors for heart disease.

Through our partnership with the National Heart, Lung, and Blood Institute, the Office on Women's Health is pleased to invite you to browse new Heart Truth Professional Education Program materials on women's heart disease prevention. We also invite you to earn free CME credits through new Medscape modules on women's heart disease (free registration required). Learn about motivational interviewing to support heart healthy behaviors and evidence-based prevention strategies and tools. These new resources have been updated to reflect the American Heart Association's newest cardiovascular disease guidelines for women.

The Office on Women's Health encourages health care professionals to use these resources and stay up-to-date on women's heart disease risk and prevention. Join the Million Hearts movement with us, the National Heart, Lung, and Blood Institute’s The Heart Truth campaign, and our Make the Call. Don’t Miss a Beat. campaign. Help prevent 1 million heart attacks and strokes over the next five years!

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Arizona's Bar Bystander Project

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Based on findings from a comprehensive state-wide survey, efforts are underway to decrease factors contributing to alcohol-related sexual violence by involving alcohol serving establishment staff and patrons.

In 2008, the Arizona Department of Health Services (ADHS), Sexual Violence Prevention and Education Program (SVPEP) conducted a comprehensive statewide sexual violence prevention needs assessment to identify the need for sexual violence prevention education around the state. Based on these findings, the Arizona’s Sexual Violence Primary Prevention Eight Year Program Plan was created. The SVPEP Planning Committee identified the need to involve alcohol serving establishments’ staff and patrons in efforts to decrease factors contributing to alcohol-related sexual violence/assault.

Throughout 2011, we continued to gather data to determine the core components of bystander intervention training. Focus groups were conducted for both bar staff and patrons. We found that alcohol/drug facilitated sexual aggression/ rape should be a core component in staff and patron training. The following 11 topics were identified by all focus groups:

  1. Bar Policies: Create zero tolerance of sexual aggression.
  2. Bar's Role: Create a safe environment. Let patrons know that they have a safe environment and that "we want them to have a good time."
  3. Tell patrons to go to bar staff if they need help.
  4. Teach patrons intervention strategies. If you see something, say something/assertive confrontation.
  5. Teach patrons gender-specific intervention (women to women, men to women, women to men).
  6. Provide resource tools for patrons and patron education.
  7. Design and display posters that explain the accepted bar environment. Create a poster that defines sexual assault and sexual harassment.
  8. Place posters in the men's and women's restrooms.
  9. Create a SAFE ZONE sticker/sign/logo for display for participating bars that have had staff members take the sexual violence prevention classes.
  10. Get the public's attention. Use media to focus attention on sexual assault and prevention.
  11. State and Local Roles: Create bar cooperatives/coalitions against sexual violence.

Local programs are flexible and can easily adapt to a changing environment, but the focus groups also envisioned the creation of a statewide standardized model as the most effective strategy to reducing sexual aggression in alcohol serving establishments. Learn more about the Arizona Bar Bystander Project Report.PDF

For more information about the Sexual Violence Prevention and Education Program (SVPEP) needs assessment and the Arizona Bar Bystander Project, please visit the SVPEP website.

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New Additions to the Bureau

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New additions to the Bureau of Women's and Children's Health (from L to R): Christopher Wells, Virginia "Jenny" Vick, and Sandy Hunter.

Christopher Wells, MPH
Chris is the assessment and evaluation epidemiologist for the Bureau of Women’s and Children’s Health and the Office for Children with Special Health Care Needs. He supports the office by conducting state/community-wide needs assessments, program evaluations, and statistical analysis to monitor children’s health status indicators that guide funding decisions. Christopher will provide technical assistance to meet grant requirements and educate public/health care professionals to improve the quality of life for children and families across the state.

Virginia "Jenny" Vick
Virginia joined the Bureau of Women’s and Children’s Health in March as the receptionist. Jenny is the first contact constituents have when calling the Bureau and the first person to greet visitors. She works with the Sensory Unit as the staff person responsible for checking in and out sensory equipment. Jenny works with various programs assisting whenever and wherever needed. She has an Associate’s Degree in Applied Science from Bryman College in Washington State. Before moving to Arizona she worked for UPS in Tacoma, Washington.

Sandy Hunter
Sandy is a Kelly Temp for the Office of Assessment and Evaluation Data Unit. As a member of the Data Unit, she assists with data entry for the Sensory, Nursing, CHN and NICP programs.

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