"Health at School: A Hidden Health Care System Emerges from the Shadows." By Julia Graham Lear, George Washington University. IN: Health Affairs, vol. 26, no. 2 (March/April 2007) pp. 409-419.

["A vast array of child health professionals - 99,000 counselors; 56,000 nurses; 30,000 school psychologists; 15,000 social workers; and smaller numbers of dental hygienists, dentists, physicians, and substance abuse counselors - provide care to children and adolescents at school. However, most thought leaders in child health know little about this ‘hidden’ system of care or are skeptical about its capacity to contribute to children's well-being. Increased interest in prevention and chronic disease management, powered by escalating concern about childhood overweight, might end the isolation of school health programs and link them more effectively to community-based prevention programs and health care services." NOTE: Health Affairs is available for loan.]

[Request #S40702]

“Transforming the U. S. Child Health System.” By Neal Halfon, University of California, Los Angeles, and others. IN: Health Affairs, vol. 26, no. 2 (2007) pp. 315-330.

[“This paper presents a vision and rationale for reform of the U.S. child health system based on paradigmatic changes in the conceptualization of child health development. Reviewing well-known and well-documented accounts of how this system is under-performing, we suggest that a bold, well-defined, transformative, and long-term reform strategy is needed to address intractable problems in the underlying operating logic, organization, and financing of the current child health system. We conclude by considering an optimistic, long-term policy transformation agenda, building up emerging opportunities and changing realities in the United States and abroad.

There is an emerging scientific consensus that health is not endowed at birth but instead develops over time; this reality poses new challenges for the current and future performance and organization of the U.S. health system. Because the scaffolding for physical, cognitive, and socio-emotional health is built in the early years of life, early investments in prevention and health promotion can greatly improve long-term health, behavior, economic, and civic outcomes. An increasing body of literature also documents how many health disparities have their origins during childhood and compound over time, underscoring the potential significance of early investments and raising expectations for what the health care system can and should produce.” NOTE: Health Affairs is available for loan.]

[Request #S40703]

“The Need for a Paradigmatic in Juvenile Correctional Education.” By John S. Platt and others. IN: Preventing School Failure, vol. 51, no. 1 (Fall 2006) pp. 31-38.

[“No culture associates individual worth with a career like the United States. For juvenile offenders, in particular offenders with disabilities, this presents a significant challenge. In addition, the requirements that have been imposed on all education through the No Child Left Behind Act (NCLB; 2001) make programming that is consistent with the needs of the juveniles with disabilities population a major challenge. The authors propose the development of a career-based model that is consistent with best practice and in line with the requirements of NCLB. A comprehensive model based upon a vocational assessment designed to determine the aptitude and interest of each student is the basis for the development of a career pathway for each youth. Programming to provide the needed skill development in the areas of vocational, literacy, and adjustment skills, as well as transition or aftercare services that include advanced vocational preparation, health, welfare, and mental health services are all vital needs in the development of a successful program. The authors discuss the political, training, and financial realities associated with this needed paradigmatic change.”]

[Request #S40704]

“Identifying High-School Students ‘At Risk’ for Substance Use and Other Behavioral Problems: Implications for Prevention.” By Denise Hallfors, Pacific Institute for Research and Evaluation, and others. IN: Substance Use & Misuse, vol. 41, no. 1 (2006) pp. 1-15.

[“Attendance and grade point average (GPA) data are universally maintained in school records and can potentially aid in identifying students with concealed behavioral problems, such as substance use. Researchers evaluated attendance (truancy) and GPA as a means to identify high school students at risk for substance use, suicide behaviors, and delinquency in 10 high schools in San Antonio, Texas, and San Francisco, California, during the spring and fall of 2002. A screening protocol identified students as “high risk” if (1) in the top quartile for absences and below the median GPA or (2) teacher referred. Survey responses of 930 high-risk students were compared with those from a random sample of 393 ‘typical’ students not meeting the protocol. Bivariate and multivariate analyses assessed associations between the screening protocol variables and demographics, risk and protective factors, and problem outcomes.

The individual contribution of each of the variables was also assessed. Students identified as high risk were significantly more likely than typical students to use cigarettes, alcohol, and marijuana, evidence suicide risk factors, and engage in delinquent behavior. Norms varied between the two districts; nevertheless, high-risk students showed consistent differences in risk and protective factors, as well as problem behaviors, compared with typical students. Because of site differences in data collection and teacher participation, the comprehensive protocol is recommended, rather than individual indicators alone (e.g., truancy). Strengths of the screening protocol are the ready availability of school record data, the ease of use of the adapted protocol, and the option of including teacher referral. More research is recommended to test the generalizability of the protocol and to ensure that there are no unintended negative effects associated with identification of students as high risk.”]

[Request #S40705]

“Lessons Learned From the Design and Implementation of a Community-Based Developmental Surveillance Program.” By Kathleen McKay, Connecticut Children’s Medical Center, and others. IN: Infants & Young Children: An Interdisciplinary Journal of Special Care Practices, vol. 19, no. 4 (October-December 2006) pp. 371-377.

[“ChildServ, a coordinated, region-wide system of early detection and intervention for at-risk children, was implemented in Hartford, Connecticut in 1998. In this article, we report our experience with the design and implementation of the program, describe lessons learned, and implications for subsequent program expansion. From 1998 to 2001, 124 child health providers referred 358 children with 516 different needs. One third of referred children had multiple needs. Developmental assessment, speech and language services, parenting classes, and counseling were frequently recommended. Only 43% of referred children ultimately received services, despite an average of 6.9 contacts with the family following initial referral. Boys, Hispanic children, and children with private insurance were more likely to receive services.

It is believed that ChildServ helps to address a critical gap in service delivery to children at risk for poor developmental and behavioral outcomes. A system of triage, referral, and care coordination appears to facilitate access to program and services. However, additional strategies are necessary to more successfully reach and engage families. In our experience, outreach capacity and such financial barriers as lack of private insurance should be included in the design and implementation of early detection and intervention programs.”]

[Request #S40706]

“Nickel-And-Dimed in America: Underserved, Understudied, and Underestimated.” By Carolyn Sampselle, University of Michigan. IN: Family & Community Health, vol. 30 (January-March 2007) pp S4-S14.

[“The Institute of Medicine report Unequal Treatment outlines a disturbing picture of health disparities in contemporary United States. Persuasive evidence presented in that report and elsewhere links race/ethnicity to worse health outcomes for individuals who are members of historically underserved groups…Economic security, access to health insurance, and adequate resources for personal and family health are key factors in an individual’s health and well being. Even controlling for these factors, perceived discrimination adds a further component and has been associated with such negative health outcomes as hypertension, cardiac disease, major depression, early initiation of substance abuse, and low birth weight.

This article examines circumstances in the contemporary United States that increase health disparities. Minority women are particularly vulnerable because of environmental stress. Furthermore, absent or inadequate healthcare coverage deters the use of preventive healthcare practices. Organizing themes are as follows: underserved, which describes factors that contribute to health disparities and examines the consequences, particularly for underserved minority groups; understudied, which examines potential, fruitful, but as yet insufficiently investigated, avenues of research needed to better understand the basis for health disparities; and underestimated, which argues that without trusting researcher-community partnerships, interventions to address health disparities will be flawed and ineffective.”]

[Request #S40710]

“Cultural Responses to Health Among Mexican American Women and their Families.” By Yolanda C. Padilla, University of Texas, and Griselda Villalobos. IN: Family & Community Health, vol. 30 (January-March 2007) pp. S24-S33.

[“Based on an in-depth analysis of current empirical research, this article presents a framework for understanding the cultural experience of the Mexican American population and presents implications for innovative health promotion practices with women and their families. The framework sheds light on the complex ways in which individuals from this population integrate their cultural values in their everyday responses to health. Three patterns emerge: (a) cultural expectations and beliefs can be shared by and work complementarily in the family and the larger social context; (b) cultural beliefs can be a source of tension and stress as a result of pressures in the environment; and (c) cultural values can become less important than other concerns, such as problems related to access when dealing with the healthcare system.”]

[Request #S40711]

“The Mental Health Paradigm and the MacArthur Study: Emerging Issues Challenging the Competence of Juveniles in Delinquency Systems.” By David R. Kanter, Tulane Law School. IN: American Journal of Law & Medicine, vol. 32 (2006) pp. 503-583.

[“Understanding the factors that impact a juvenile’s adjudicative competence in delinquency and criminal proceedings today requires some familiarity with mental illness, mental retardation, and developmental immaturity. Current research and studies shed new light on these factors that juvenile advocates, prosecutors, judges, and policymakers must routinely confront. This article discusses some of the issues involved in competency determinations of juveniles awaiting trial; addressing both the more traditional factors, such as mental illness and mental retardation, and some of the more recent studies and literature identifying developmental immaturity as an emerging basis for challenging the competency of juveniles to stand trial.

Juvenile justice systems routinely presume that adolescents accused of delinquent or criminal misconduct are competent to stand trial. Adults charged with criminal misconduct are also presumed to be competent. Competency requires that citizens accused of criminal misconduct understand the charges against them, have rudimentary understanding of the court process, be able to understand and answer questions posed to them by their counsel, and be able to make decisions about their trial such as whether to testify, and whether to accept or reject plea bargains. Although juveniles must be competent to stand trial before their delinquency cases can go forward, recent studies of juvenile mental health issues and of developmental immaturity raise serious concerns for state delinquency systems.”]

[Request #S40712]

"Homelessness, Health Status, and Health Care Use." By Bella Schanzer, Columbia University, and others. IN: American Journal of Public Health, vol. 97, no. 3 (March 2007) pp. 464-469.

["Little is known about the health status of those who are newly homeless. We sought to describe the health status and health care use of new clients of homeless shelters and observe changes in these health indicators over the study period. We conducted a longitudinal study of 445 individuals from their entry into the homeless shelter system through the subsequent 18 months. Results were that disease was prevalent in the newly homeless. This population accessed health care services at high rates in the year before becoming homeless. Significant improvements in health status were seen over the study period as well as a significant increase in the number who were insured. Conclusion was that newly homeless persons struggle under the combined burdens of residential instability and significant levels of physical disease and mental illness but many experience some improvements in their health status and access to care during their time in the homeless shelter system.

Historically, policymakers have attempted to treat the medical or psychiatric problems of the homeless by bringing services to the shelters-whether in the form of primary care nurses on-site or tuberculosis treatment units or specialized mental health shelters for those with severe psychiatric illness. Clearly these services play an important role in improving the overall health status of individuals using the shelter system and may explain the results of this study. However, many individuals who are newly homeless and might have benefited equally from receiving attention for their health issues before they entered the shelter system. People should not have to enter a homeless shelter to experience an improvement in their health status and increased access to health insurance" NOTE: American Journal of Public Health is available for loan.]

[Request #S40713]

“The Structure of Thriving/Distress Among Low-Income Women at 3 Months after Giving Birth.” By Lorraine O. Walker and Bobbie Sue Sterling, University of Texas. IN: Family & Community Health, vol. 30 (January-March 2007) pp. S95-S103.

[“This article explores the dimensionality of thriving among low-income Anglo, African American, and Hispanic women using factor analysis of psychosocial, behavioral, and weight measures at 3 months postpartum. Three factors were extracted for each ethnic group. The first and most robust factor was psychosocial distress, which encompassed stress, depressive symptoms, (low) social support, (unhealthy) lifestyle, and (less favorable) body image. For Anglo and Hispanic women, self-regulation also loaded on the distress factor. The findings suggest that interventions to ameliorate psychosocial distress among low-income women, regardless of ethnicity, may need to consider a comprehensive range of intervention content.”]

[Request #S40714]

“The Construction of Fear: Americans' Preferences for Social Distance from Children and Adolescents with Mental Health Problems.” By Jack Martin and others. IN: Journal of Health and Social Behavior, vol. 48, no. 1 (March 2007) pp. 50-67.

[“Debates about children's mental health problems have raised questions about the reliability and validity of diagnosis and treatment. However, little research has focused on social reactions to children with mental health problems. This gap in research raises questions about competing theories of stigma, as well as specific factors shaping prejudice and discrimination toward those children. Here, we organize a general model of stigma that synthesizes previous research. We apply a reduced version of this model to data from a nationally representative sample responding to vignettes depicting several stigmatizing scenarios, including attention-deficit/hyperactivity disorder (ADHD), depression, asthma, or "normal troubles." Results from the National Stigma Study-Children suggest a gradient of rejection from highest to lowest, as follows: ADHD, depression, "normal troubles," and physical illness. Stigmatizing reactions are highest toward adolescents. Importantly, respondents who label the vignette child's situation as a mental illness compared to those who label the problem as a physical illness or a "normal" situation report greater preferences for social distance, a pattern that appears to result from perceptions that the child is dangerous.” NOTE: Journal of Health and Social Behavior will be available for loan.]

[Request #S40715]

“The ISTSS/RAND Guidelines on Mental Health Training of Primary Healthcare Providers for Trauma-Exposed Populations in Conflict-Affected Countries.” By David Eisenman, RAND Corporation, and others. IN: Journal of Traumatic Stress, vol. 19, no. 1 (February 2006) pp. 5-17.

[“Mental health care for trauma-exposed populations in conflict-affected developing countries often is provided by primary healthcare providers (PHPs), including doctors, nurses, and lay health workers. The Task Force on International Trauma Training, through an initiative sponsored by the International Society for Traumatic Stress Studies and the RAND Corporation, has developed evidence- and consensus-based guidelines for the mental health training of PHPs in conflict-affected developing countries. This article presents the Guidelines, which provide a conceptual framework and specific principles for improving the quality of mental health training for PHPs working with trauma-exposed populations.”]

[Request #S40716]