Child Health Outcomes Research Articles

From Striving to Thriving: Mitigating Anti-Black Family Racism to Maximize Health Outcomes in Black Children

Certain inequities and injustices represent long-standing, recurring challenges that disproportionately affect many Black communities in the United States. Despite decades of efforts to eliminate these problems and improve outcomes in health, housing, education, and employment, a significant number of Black families are still “surviving” and not “thriving.” The effects of historical and ongoing discriminatory policies continue to increase risk for adverse outcomes among Black people and their families. These systemic conditions also help perpetuate negative myths and stereotypes associated with the Black family unit, and particularly, Black fathers. In striving to achieve equitable child health outcomes, it is vital for health care professionals to comprehend the tangible traumas that result from experiencing racism. This specific type of harm also acts as a driver for manifestation of developmental, physical, behavioral, and mental health issues in Black children. This review highlights the intersecting dynamics of structural racism, Black family units, and adverse outcomes on child health, development, and behavior. Health care professionals seeking to provide culturally attuned and appropriate anticipatory guidance need to address the effects of racism on social-emotional, language, and cognitive development in children. This includes centering Black family perspectives and advocating for antiracist programs and policies that protect Black children, such as increased support of Black children with special education needs, more equitable funding for neighborhoods where Black families reside, and meaningful efforts to reform criminal justice system practices that unfairly target Black men. By actively mitigating anti-Black racism, Black children and families can shift from surviving to thriving.

Socioeconomic Factors and Its Correlation with Nutritional Status in Toddlers: A Study in Papua

Nutritional status in toddlers is a critical indicator of overall well-being and long-term health outcomes. Malnutrition among children is persistent and continues to be an alarming burden, often linked to socioeconomic factors in Papua. This study aims to analyze the relationship between socioeconomics and the nutritional health of toddlers. This cross-sectional study involved 300 toddlers aged 1–5 years from working areas at the Primary Health Center (PHC) Remu, Sorong City, Papua. We collected data by conducting structured interviews with the mothers and measuring the anthropometric traits of the toddlers. Socioeconomics was assessed through family income, maternal education, and access to healthcare. We measured nutritional status using WHO standards for weight-for-age (underweight), height-for-age (stunting), and weight-for-height (wasting). We implemented the Pearson and Spearman correlation tests for data analysis. The results indicated family income (p < 0.05), maternal education (p < 0.05), and access to healthcare (p < 0.05) were significantly correlated with nutritional status. This study highlights the significant influence of socioeconomic status on the nutritional status of toddlers in Papua. Toddlers from families with higher income, better maternal education, and enhanced accessibility to healthcare had better nutritional outcomes, with lower rates of stunting, wasting, and underweight. These findings suggest the need for targeted interventions aimed at improving socioeconomic conditions and enhancing access to nutritional and healthcare services in Papua, particularly in rural and remote areas, to reduce malnutrition and promote better health outcomes for children.

Peculiarities of arterial hypertension in pregnancy from the point of view of evidence-based medicine

Background: Arterial hypertension during pregnancy is a significant public health issue, affecting 10-15% of pregnancies globally. It encompasses gestational hypertension, preeclampsia, and chronic hypertension, which are leading causes of maternal and fetal morbidity and mortality. Understanding and managing these hypertensive disorders is crucial due to their impact on maternal and child health outcomes. Recent advancements in screening, diagnostic criteria, and treatment options have significantly improved clinical practices, emphasizing the importance of evidence-based management. Methods and Materials: This study adopts an evidence-based methodology, combining qualitative and quantitative research to investigate arterial hypertension in pregnancy. A systematic literature review was conducted using databases such as PubMed, Cochrane Library, and ScienceDirect. Comparative and statistical analyses were performed to evaluate diagnostic and treatment efficiencies across various studies. The study aims to synthesize current data on epidemiology, risk factors, and management outcomes to enhance clinical guidelines and improve maternal-fetal health. Results: The findings highlight the significant global burden of hypertensive disorders in pregnancy, with varying prevalence across different regions influenced by genetic, healthcare access, and socioeconomic factors. Effective management strategies include both pharmacological interventions, such as the use of labetalol, methyldopa, and nifedipine, and non-pharmacological approaches, including dietary modifications and lifestyle changes. The study also underscores the importance of early detection and personalized treatment plans to mitigate adverse outcomes. Conclusion: The study concludes that hypertensive disorders in pregnancy pose substantial risks to maternal and fetal health, necessitating precise diagnostic protocols and evidence-based therapeutic interventions. Public health strategies, including educational programs and community-based interventions, are essential in raising awareness and preventing these conditions. Continued research and clinical practice improvements are vital to better understanding and managing hypertension in pregnancy, ultimately improving health outcomes for mothers and future generations.

Multifaceted Determinants of Breastfeeding Practices in Udaipur, Rajasthan

Background: Breastfeeding is crucial for child health and development, yet its practices and their implications on children's nutritional status vary. Aim & Objectives: This study aimed to explore the determinants of breastfeeding practices and their effects on the nutritional status of children in an Indian population. Methodology: This study is conducted in four villages of Udaipur district, Rajasthan, among 120 mother-child pairs. The data is collected on anthropometric measurements, socio-economic factors, and child health parameters. Results: We found that only 37.5% of children were exclusively breastfed. Significant associations were observed with birth month (P=<0.001) and nearly significant associations with mode of delivery (P=0.06) and undernutrition (P=0.07). Conclusion: These findings highlight the need for larger-scale research to further investigate these associations and enhance breastfeeding practices to improve child health outcomes.

Determinants of Risk Factors Associated with Low Birth Weight in Nigeria

Low birth weight (LBW) remains a significant public health challenge with profound implications for neonatal and child health, particularly in low-income countries. Defined by the World Health Organization as a birth weight of less than 2.5 kilograms, LBW contributes to increased neonatal mortality and long-term developmental issues. This study examines the prevalence and determinants of LBW in Nigeria, leveraging data from the 2018 Nigeria Demographic and Health Survey (NDHS). The study employs a cross-sectional design and a stratified two-stage sampling technique, analyzing 7,728 recorded birth weights. Key findings indicate that maternal age, education, and socio-economic status significantly influence birth weight. Optimal reproductive ages (25-34 years) and higher educational attainment are associated with healthier birth weights, whereas younger (below 20 years) and older mothers (above 40 years), and those with lower education levels, face higher LBW risks. Employment and wealth are positively correlated with better birth outcomes, underscoring the importance of financial stability. Environmental factors such as urban residence, access to improved water sources, and sanitation facilities also play crucial roles in determining birth weight. The study compares frequentist logistic regression and Bayesian structured additive logistic regression models to identify and predict LBW risk factors, highlighting regional disparities within Nigeria. The findings emphasize the need for targeted interventions addressing socio-demographic, socio-economic, and environmental determinants to reduce the prevalence of LBW and improve maternal and child health outcomes. Enhanced understanding of these factors through advanced statistical modeling can inform policy and health interventions, ultimately contributing to achieving global health targets and improving neonatal health in Nigeria.

Impacts of women's work and childcare on child illness among Bangladeshi Shodagor communities

For decades, women's employment has been seen as crucial for achieving greater autonomy and empowerment for women, and for promoting better health and nutrition outcomes for children, particularly in low- and middle-income countries (LMIC). However, numerous empirical studies of the relationship between women's work and child outcomes have shown mixed results. Our study tests the assumptions of a model that suggests loss of maternal care during working hours may produce negative health outcomes for children. We use longitudinal data collected from traditionally semi-nomadic, boat-dwelling Shodagor families in Matlab, Bangladesh to determine the importance of maternal care as a mechanism influencing the relationship between women's work and child illness. We use Bayesian linear mixed models to assess the influence of occupation and amount of care on average days of child illness per month, and also to examine the role that allomothers play in buffering against potential negative impacts of lost maternal care on child illness. Results show that children who receive more care from mothers experience fewer days of illness, and that availability of high-quality alloparents mediates the relationship between maternal work and child health. These results indicate that both the care and resources provided by mothers influence children's biological outcomes. This has important implications for policy and aid interventions in LMIC, which have been developed to capitalize on an assumed positive relationship between maternal work and child health and nutrition.

Exploring User Experiences with a Persuasive mHealth App for Breastfeeding: An Empirical Investigation

Women are increasingly turning to mHealth apps as primary sources for breastfeeding education and support. The rising prevalence of mHealth apps presents a unique opportunity to explore their impact on women’s breastfeeding experiences. Understanding user perspectives of these apps, especially focusing on their persuasive design aspects, can offer valuable insights for enhancing maternal and child health outcomes. These insights can optimize these technologies to align with user values and promote sustained healthy behaviors. This study aimed to undertake an empirical exploration of users’ experiences with the persuasive design features employed in the Milky Way mHealth app and align the findings with human values within the value-sensitive design (VSD) framework. Semi-structured interviews were conducted with a group of women who had used the Milky Way app. Interview data were analyzed using an inductive thematic approach. To provide insight into users’ values mediated by the app, a deductive analysis complemented by a data-driven inductive approach was performed. Data analysis was supported by NVivo data-management software. Findings from the study demonstrate that the persuasive design elements in the Milky Way app significantly influence users’ experiences. The analysis provided four primary themes: Informative, Easy to use, Credible, and Social connection. Overall, participants praised the app’s trustworthy educational content and support features as valuable resources for addressing breastfeeding challenges and obtaining reliable support. Participants expressed concerns about information overload and emphasized the importance of personalized support and evidence-based tailored recommendations. The results demonstrated that users’ values were expressed and embedded within the app. The analysis indicated an alignment between the app design features and the values and opinions of the users within the VSD framework. This study interprets women’s perspectives utilizing the Milky Way app and highlights the significance of its evidenced-based educational and support features. Further investigation into potential user values like privacy, remains crucial for a comprehensive user-centered app design. The empirical insights gained from this study contribute to future research, informing the development and design of ethically considerate persuasive mHealth apps to maintain their relevance in promoting positive user experiences and facilitating meaningful behavior change.

Effects of Air Pollution on Respiratory Events and Pain Crises among Children with Sickle Cell Disease in New York City.

The disease burden of sickle cell disease (SCD) is highest among U.S. Black and Hispanic populations, who are often disproportionately represented in communities with poor air quality. There is limited data on the effects of air pollution exposure and social environmental factors on health outcomes in children with SCD. The objective of our study was to examine the associations between air pollution exposure and acute respiratory and vaso-occlusive pain crises (VOCs), and further study the associations stratifying by asthma status and neighborhood disadvantages. We conducted a retrospective study collecting data on outpatient sick and ED visits, and hospital admissions for respiratory events (i.e., respiratory tract infections, asthma exacerbation, acute chest syndrome), and hospitalizations for VOCs among children with SCD in a tertiary care center in New York City (NYC) from 2015-2018. Modeled data from the NYC Community Air Survey data using home addresses estimated street-level, annual-average exposure to air pollution (i.e., black carbon (BC), fine particulate matter (PM2.5), and nitrogen dioxide (NO2)). The area deprivation index (ADI): continuous national ranking percentile (1-100) was used, representing a composite index for neighborhood-level social disadvantage. We further dichotomized study participants at the upper tertile (high vs. low ADI). Multivariable Poisson regression in generalized estimating equation (GEE) models were used to estimate relative risks (RR), after adjusting for potential covariates. A total of 114 children with SCD were included in this study and had between 1-4 annual repeated measures of annual average air pollutants over a total of 425 visits. Overall, there were no significant associations between air pollution levels and acute respiratory and VOCs among children with SCD and when stratified by asthma status. We found significant interactions between air pollution levels and the continuous ADI variable on respiratory outpatient and frequent respiratory outpatient/ED visits (p<0.1). When stratified by high ADI, increased exposure to PM2.5 was significantly associated with more frequent respiratory outpatient/ED visits among children residing in higher ADI neighborhoods (RR (95% CI)= 1.13 (1.01, 1.27), p<0.05), but not among those in lower ADI neighborhoods. Increased exposure to NO2 was associated with more outpatient respiratory events for children in high ADI neighborhoods (RR (95%CI= 2.74 (1.24, 6.08), p<0.05), compared with low ADI neighborhoods. Air pollution exposures increased respiratory complications among children with SCD living in deprived neighborhoods.

Unveiling the effects of energy poverty on mental health of children in energy-poor countries

While existing literature extensively investigates the adverse effects of energy poverty on physical health, exploring its impacts on the mental well-being of school-aged children (5–14 years old) remain underexplored, particularly in the energy-deprived regions of South Asia and Sub-Saharan Africa. This research aims to bridge this gap by delving into the indirect pathways through which energy poverty influences the mental health of these children, explicitly examining anxiety and depression, with a particular focus on child abuse as a potential mediating factor. This study employs comprehensive data at both the country level, covering 52 energy-poor nations from 2000 to 2019, and the household level, covering 18 energy-poor nations. This study utilizes a two-step system generalized method of moment approach to unveil the significant relationships between energy poverty and heightened levels of anxiety and depression. Furthermore, the study employs advanced statistical methods to analyze household-level data, including multilevel logistic regression, Probit instrumental regression models, and mediation analysis. These analyses confirm a robust association between energy poverty and an increased likelihood of anxiety and depression among school-aged children. The study also uncovers a concerning link between energy poverty and child abuse, emphasizing its role as a contributing factor to adverse mental health outcomes in children. The findings of this study offer critical insights for policymakers, highlighting the urgent need for targeted interventions and policies aimed at alleviating the adverse mental health effects of energy poverty on children. By addressing this issue, policymakers can contribute to fostering children's overall well-being and development in energy-poor regions.

Health insurance, social safety net and maternal health service utilisation in Pakistan: a population based cross-sectional study

ObjectiveThe objective of the study is to examine the impact of health insurance and social safety net programmes on maternal health service utilisation (MHSU) in Pakistan.DesignCross-sectional.SettingsData were obtained from Pakistan...

Machine learning approach to investigate pregnancy and childbirth risk factors of sleep problems in early adolescence: Evidence from two cohort studies

BackgroundThis study aimed to predict early adolescent sleep problems using pregnancy and childbirth risk factors through machine learning algorithms, and to evaluate model performance internally and externally. MethodsData from the China Jintan Child Cohort study (CJCC; n=848) for model development and the US Healthy Brain and Behavior Study (HBBS; n=454) for external validation were employed. Maternal pregnancy histories, obstetric data, and adolescent sleep problems were collected. Several machine learning techniques were employed, including least absolute shrinkage and selection operator, logistic regression, random forest, naïve bayes, extreme gradient boosting, decision tree, and neural network. The area under the receiver operating characteristic curve, sensitivity, specificity, accuracy, and root mean square of residuals were used to evaluate model performance. ResultsKey predictors for CJCC adolescents’ sleep problems include gestational age, birthweight, duration of delivery, and maternal happiness during pregnancy. In HBBS adolescents, the duration of postnatal depressive emotions was the primary perinatal predictor. The prediction models developed in the CJCC had good-to-excellent internal validation performance but poor performance in predicting the sleep problems in HBBS adolescents. ConclusionThe identification of specific perinatal risk factors associated with adolescent sleep problems can inform targeted interventions during and after pregnancy to mitigate these risks. Health providers should consider integrating these predictive factors into routine pre- and postnatal assessments to identify at-risk populations. The variability in model performance across different cohorts highlights the need for context-specific models and the cautious application of predictive analytics across diverse populations. Future research should focus on refining predictive models to account for such variations, potentially through the incorporation of additional socio-cultural factors and genetic markers. This study emphasizes the importance of personalized and culturally sensitive approaches in the prediction and management of adolescent sleep problems, leveraging advanced computational methods to enhance maternal and child health outcomes.

Enhancing maternal health service utilization among highly vulnerable pregnant women through a human-centered design process: Study protocol for a quasi-experimental study in Oromia, Ethiopia

Background Disproportionate uptake of and access to maternal and child health services remain significant challenges across and within countries. Differing geographic, economic, environmental, and social factors contribute to varying degrees of vulnerabilities among individuals, which manifest as disparities in maternal and newborn health outcomes. Designing solutions according to need is vital to improve maternal and child health outcomes. In this paper, we describe our study protocol on evaluating the effectiveness of an intervention package developed through a human-centered design (HCD) process in improving maternal health service uptake among vulnerable pregnant women in rural areas of Ethiopia. Methods The study has two distinct phases. For both phases, solutions will be developed leveraging HCD approaches to improve institutional delivery and antenatal care uptake among vulnerable pregnant women. Final solutions will be implemented in collaboration with community health workers and health officers. A community-based, quasi-experimental, mixed-method study design is used to assess differences between intervention and control arms. A panel sample will be enrolled after screening for pregnancy and vulnerability level and surveyed at baseline and midline in Phase 1. In Phase 2, a post-only study will be conducted in the same intervention and control sites. Pregnant women will receive refined solutions for six months, which will be evaluated using end-line assessment. Qualitative interviews will be conducted among vulnerable pregnant women and healthcare providers. Conclusions and Implications Our sequential approach to evaluating initial solutions, which in turn will be used to inform the enhancement of solutions, will provide practical insights into how solutions are accepted among vulnerable women and how they can be better integrated into women’s lives and health systems. Our findings on program effectiveness and implementation research will be disseminated to the Ethiopian Ministry of Health and its partners to inform large-scale implementation at the national level.

Assessing the implementation of healthy eating and physical activity policies and practices in Early Childhood Education and Care in New South Wales, Australia: A cross-sectional study.

Australian children are not meeting the recommended physical activity (PA) and healthy eating (HE) guidelines. Health behaviour practices implemented in community settings such as early education services can improve child's health outcomes and are therefore key to help meet guidelines. This study aimed to measure the implementation of HE and PA policies and practices in Early Childhood Education and Care (ECEC) services in New South Wales (NSW), Australia, and to examine their association with service characteristics. A random sample of 1122 centre-based ECEC services were invited to a cross-sectional survey measuring HE and PA policy and practice implementation. Regression analyses were conducted to assess the relationship between the service characteristics and implementation of policies/practices. In total, 565 ECEC services completed the survey. Results show that while some practices are implemented, the implementation of practices promoting HE and PA education is low. Practices related to educator training for HE (18%) and PA (13%) were poorly implemented. The implementation of practices such as 'providing educator training around child PA', 'engaging families in activities to increase child PA' and 'encouraging supportive feeding practices' were significantly higher in services located in major cities than regional/remote services. 'Having a PA policy' and the practice of 'limiting the use of screen time' was significantly higher in long day care services than in preschools. The implementation of 'providing educator-led PA', 'providing free play opportunities' and 'having a PA policy' was significantly lower in private not-for-profit community managed services than in private for-profit services. Implementation of various HE and PA policies and practices in regional/remote services, private not-for-profit services and preschools across NSW could be improved. SO WHAT?: Future research should be prioritised towards identifying factors influencing the implementation of these policies and practices to best tailor implementation support efforts for those who need it the most.

Diverging destinies: How children are faring under demographic transition

India reached the replacement level of fertility in 2020. However, the journey of fertility transition is unconventional and heterogeneous within the country and across the different socio-economic groups. The fertility transition is considered to be faster than its socio-economic and health transition in several states. Thus, it has been presumed that the returns to fertility decline are heterogeneous across the states and population sub-groups. Our specific hypothesis is that although rich and poor, and educated and un-educated, everyone had significantly contributed to the fertility decline in response to family planning policies, only those socio-economically better-off have been investing relatively more in their children compared to the poor, and this has led to diverging destinies for children. We tested this supposition using a macro-level panel dataset (1992–2021), fixed and random effects, and IV regression models. The results confirm that child health care and outcomes have diverged while fertility declined from 1992 to 2021. These results are sustained in multiple robustness checks. While fertility is declining with highly state-sponsored family planning programmes, the persistent socio-economic inequalities are leading to unequal progress in health outcomes for children in India.

O PAPEL DA ENFERMAGEM NA PREVENÇÃO, EDUCAÇÃO, ASSISTÊNCIA E COMO LIDAR COM A DEPRESSÃO PÓS-PARTO

Postpartum depression (PPD) is a mental health condition that affects many women after the birth of their children, with significant consequences for the mother’s health and the baby’s development. This article addresses the fundamental role of nurses in the prevention and treatment of PPD within primary health care. It is widely recognized that nurses are in a strategic position to identify risk factors associated with PPD early, such as a history of depression, high levels of stress, and lack of adequate social support. In addition to early identification, nurses are essential in screening, monitoring and intervening with women who are at risk or already have symptoms of PPD. The assistance offered by nurses includes emotional support and education about PPD, helping to reduce the stigma surrounding the condition and promoting the mental well-being of mothers. Collaboration between nurses and other healthcare professionals is crucial to ensure comprehensive, patient-centered care, from the prenatal to postpartum period. Strengthening these practices in primary care is vital to improving maternal and child health outcomes, ensuring that women receive the support they need to cope with and overcome PPD.

Promoting gender equity in a home visits programme: a qualitative study in Northern Nigeria

BackgroundGender inequities remain critical determinants influencing maternal health. Harmful gender norms and gender-based violence adversely affect maternal health. Gendered division of labour, lack of access to and control of resources, and limited women’s decision-making autonomy impede women’s access to maternal healthcare services. We undertook a cluster randomized controlled trial of universal home visits to pregnant women and their spouses in one local government area in Bauchi State, North-Eastern Nigeria. The trial demonstrated a significant improvement in maternal and child health outcomes and male knowledge, attitudes and behaviours. This paper qualitatively evaluates gender equity in the home visits programme.MethodsThe research team explored participants’ views about gender equity in the home visits programme. We conducted nine key informant interviews with policymakers and 14 gender and age-stratified focus group discussions with men and women from visited households, with women and men home visitors and supervisors, and with men and women community leaders. Analysis used an adapted conceptual framework exploring gender equity in mainstream health. A deductive thematic analysis of interviews and focus group reports looked for patterns and meanings.ResultsAll respondents considered the home visits programme to have a positive impact on gender equity, as they perceived gender equity. Visited women and men and home visitors reported increased male support for household chores, with men doing heavy work traditionally pre-assigned to women. Men increased their support for women’s maternal health by paying for healthcare and providing nutritious food. Households and community members confirmed that women no longer needed their spouses’ permission to use health services for their own healthcare. Households and home visitors reported an improvement in spousal communication. They perceived a significant reduction in domestic violence, which they attributed to the changing attitudes of both women and men due to the home visits. All stakeholder groups stressed the importance of engaging male spouses in the home visits programme.ConclusionThe home visits programme, as implemented, contributed to gender equity.

Professional perspectives on facilitators and barriers for high quality provision of health, education and social care services to disabled children in England during the COVID-19 pandemic: a qualitative study

ObjectivesTo understand how health, education and social care services for disabled children changed during the COVID-19 pandemic, what did or did not work well and what the impacts of service...

Nutritional status of HIV-infected children at Federal University Teaching Hospital, Owerri, Nigeria: A prospective analysis of rural and urban dwellers.

Malnutrition is a critical concern among children living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), particularly in regions heavily affected by the HIV epidemic, such as sub-Saharan Africa. In 2019, nearly 2.84 million children under 19 years of age were living with HIV globally, with over 90% residing in sub-Saharan Africa. Concurrently, malnutrition remains prevalent in the region, with approximately 49 million children under the age of 5 experiencing stunting and 149 million suffering from wasting in 2018. This burden of malnutrition is exacerbated by factors such as poverty, food insecurity, and HIV/AIDS, which collectively contribute to adverse health outcomes among affected children. The bidirectional relationship between HIV/AIDS and malnutrition is well-established, with HIV infection increasing the risk of malnutrition and malnutrition worsening the progression of HIV/AIDS. Studies have consistently demonstrated higher rates of stunting, underweight, and wasting among HIV-infected children compared to their uninfected counterparts. Moreover, malnutrition significantly impacts the disease progression, morbidity, and mortality of HIV-infected individuals, further underscoring the importance of addressing this issue in pediatric HIV care. A total of 99 HIV-infected children, aged 2 to 16 years, were consecutively recruited from the pediatric infectious disease clinic of the Federal University Teaching Hospital Owerri. Anthropometric measurements, including weight and height, were obtained using a stadiometer (RGZ-160 England). Weight status was categorized as normal, underweight, overweight, or obese, while height status was classified as stunted, normal, or tall stature. The study participants ranged in age from 2 to 16 years. Approximately 20.2% of the children were underweight, and 6.1% were classified as obese. Stunting was observed in 29.3% of the participants. Notably, all forms of malnutrition, including underweight and overweight, were more prevalent among children residing in rural areas. In addition, stunting was more common among rural dwellers. This study highlights the high prevalence of malnutrition among HIV-infected children attending the pediatric infectious disease clinic at the Federal University Teaching Hospital Owerri. The findings underscore the urgent need for targeted nutritional interventions, particularly in rural areas, to improve the health outcomes of HIV-infected children.

Answering a Call to Action: Reducing Fetal Alcohol Spectrum Disorders Using a Healthcare Champion Model.

Prenatal alcohol exposure and fetal alcohol spectrum disorders (FASDs) remain critical public health issues. Alcohol use in pregnancy is a leading preventable cause of birth defects, developmental disabilities, and learning disabilities. Alcohol screening and brief intervention (SBI) is effective at reducing excessive alcohol use. However, this clinical preventive service remains critically underutilized in primary care. In 2014, the Centers for Disease Control and Prevention called for the creation of FASD Champion programs to promote clinician education about FASDs. Six professional health organizations and groups providing reproductive and child health services set out to create FASD Champion programs. The American College of Obstetricians and Gynecologists FASDs Prevention Program was created to focus on reducing alcohol-exposed pregnancies. The American Academy of Pediatrics' Champion program maintains the goal of improving health outcomes for children with FASDs by improving pediatricians' diagnostic capacity. The American Academy of Family Physicians has prioritized training family physician champions to improve the delivery of alcohol SBI among adult patients. The University of Alaska Anchorage has partnered with the National Association of Nurse Practitioners in Women's Health, the American College of Nurse-Midwives, and the Association of Women's Health, Obstetric, and Neonatal Nurses to assure advanced practice registered nurses and midwives have the knowledge and skills to prevent alcohol-exposed pregnancies and FASDs. The American Association of Medical Assistants has prioritized expanding the knowledge and skills of medical assistants related to promoting alcohol-free pregnancies. Finally, the Champions program at the University of Texas at Austin was established to train health social workers in alcohol SBI. Through the advocacy, education, and mission of these 6 health sectors in collaboration with national organizations and educational institutions, the evidence-based approach of alcohol SBI is being disseminated throughout the United States to reduce the harmful effects of prenatal alcohol exposure.

Expanding Child Health Screenings Through School-Community Partnerships.

Child health screenings are a critical, but often overlooked, aspect of children's medical care. School-community partnerships to conduct screenings and ensure that diagnostic follow-up and treatment occur can help achieve optimal child health outcomes. Such partnerships also serve to mitigate the impact of social determinants of health on children's well-being, address health disparities, and promote health equity. This article reviews four essential childhood health screenings-vision, hearing, dental, and mental health-and discusses how schools and community partners can collaborate to offer these screenings.