and Families Board on Children, Youth – författare

Influence of Pregnancy Weight on Maternal and Child Health: Workshop Report summarizes a one and a half day workshop convened in May 2006 that reviewed U.S. trends in maternal weight (prior to, during, and after pregnancy) among different populations of women; examined the emerging research findings related to the complex relationship of the biological, behavioral, psychological, and social interactions that affect maternal and pregnancy weight on maternal and child health outcomes; and discussed interventions that use this complex relationship to promote appropriate weight during pregnancy and postpartum.

Given the unprecedented environment in the United States in which two-thirds of the adult population meets the criteria for being overweight or obese, the implications for women in the reproductive age period are unique in the history of the country. The concerns for maternal and infant health are real. The questions and answers tackled by committee members and workshop participants were not easy. Nevertheless, having an opportunity to explore what is known, examine the gaps in knowledge, and explore what to do now and in the future build a pathway for further inquiry and action. This report summarizes the workshop proceedings and highlights key themes that deserve further attention.

The participants in this workshop describe what is known about recent trends in maternal weight gain and the impact of maternal weight during pregnancy on the health of mothers and their children. The workshop provided a valuable opportunity to assess trends that have occurred since the publication of an earlier study by the Institute of Medicine (IOM), which included guidelines for recommended weight gain during pregnancy.

Several positive and negative lifelong behaviors are established during adolescence including diet and exercise, sexual conduct, practices related to oral health, smoking, drinking, and the use if legal and illegal substances. The complex issues that adolescents deal with on a daily basis can turn into health problems that persist throughout adulthood. Unfortunately the adolescents who are frequently the most disconnected from routine health care services - those who lack insurance and family support - are often those at greatest risk for multiple and chronic health problems. Therefore, those that are responsible for delivering health care services to adolescents must address the health conditions that require immediate attention while preparing young people to adopt practices that can help improve their future health status and prevent unhealthy behaviors.

Challenges in Adolescent Health Care studies adolescent health care in the United States, highlights critical health care needs, and identifies service models and components of care that may strengthen and improve health care services, settings, and systems for adolescents. The book explores the nature of adolescent challenges and how they reflect larger societal issues such as poverty, crime and the prevalence of violence. These issues, in addition to lack of comprehensive health coverage, dysfunctional families and the lack of support systems, make providing adequate health care incredibly challenging.

Challenges in Adolescent Health Care defines high-quality health care, identifies the strengths and weaknesses of various service models and explores various training programs. The book recommends that health care providers must be sensitive to socioeconomic factors and incorporate health care in a broad array of settings including schools, neighborhoods and community centers.

Recognizing that health care providers play an important role in fostering healthy behaviors among adolescents, Adolescent Health Services examines the health status of adolescents and reviews the separate and uncoordinated programs and services delivered in multiple public and private health care settings. The book provides guidance to administrators in public and private health care agencies, health care workers, guidance counselors, parents, school administrators, and policy makers on investing in, strengthening, and improving an integrated health system for adolescents.

This book evaluates the research plan for the NCS, by assessing the scientific rigor of the study and the extent to which it is being carried out with methods, measures, and collection of data and specimens to maximize the scientific yield of the study.

The book concludes that if the NCS is conducted as proposed, the database derived from the study should be valuable for investigating hypotheses described in the research plan as well as additional hypotheses that will evolve. Nevertheless, there are important weaknesses and shortcomings in the research plan that diminish the study’s expected value below what it might be.

Depression is a widespread condition affecting approximately 7.5 million parents in the U.S. each year and may be putting at least 15 million children at risk for adverse health outcomes. Based on evidentiary studies, major depression in either parent can interfere with parenting quality and increase the risk of children developing mental, behavioral and social problems. Depression in Parents, Parenting, and Children highlights disparities in the prevalence, identification, treatment, and prevention of parental depression among different sociodemographic populations. It also outlines strategies for effective intervention and identifies the need for a more interdisciplinary approach that takes biological, psychological, behavioral, interpersonal, and social contexts into consideration.

A major challenge to the effective management of parental depression is developing a treatment and prevention strategy that can be introduced within a two-generation framework, conducive for parents and their children. Thus far, both the federal and state response to the problem has been fragmented, poorly funded, and lacking proper oversight. This study examines options for widespread implementation of best practices as well as strategies that can be effective in diverse service settings for diverse populations of children and their families.

The delivery of adequate screening and successful detection and treatment of a depressive illness and prevention of its effects on parenting and the health of children is a formidable challenge to modern health care systems. This study offers seven solid recommendations designed to increase awareness about and remove barriers to care for both the depressed adult and prevention of effects in the child. The report will be of particular interest to federal health officers, mental and behavioral health providers in diverse parts of health care delivery systems, health policy staff, state legislators, and the general public.

Well-planned and effective assessment can inform teaching and program improvement, and contribute to better outcomes for children. This book affirms that assessments can make crucial contributions to the improvement of children’s well-being, but only if they are well designed, implemented effectively, developed in the context of systematic planning, and are interpreted and used appropriately. Otherwise, assessment of children and programs can have negative consequences for both. The value of assessments therefore requires fundamental attention to their purpose and the design of the larger systems in which they are used.

Early Childhood Assessment addresses these issues by identifying the important outcomes for children from birth to age 5 and the quality and purposes of different techniques and instruments for developmental assessments.

Mental health and substance use disorders among children, youth, and young adults are major threats to the health and well-being of younger populations which often carryover into adulthood. The costs of treatment for mental health and addictive disorders, which create an enormous burden on the affected individuals, their families, and society, have stimulated increasing interest in prevention practices that can impede the onset or reduce the severity of the disorders.

Prevention practices have emerged in a variety of settings, including programs for selected at-risk populations (such as children and youth in the child welfare system), school-based interventions, interventions in primary care settings, and community services designed to address a broad array of mental health needs and populations.

Preventing Mental, Emotional, and Behavioral Disorders Among Young People updates a 1994 Institute of Medicine book, Reducing Risks for Mental Disorders, focusing special attention on the research base and program experience with younger populations that have emerged since that time.

Researchers, such as those involved in prevention science, mental health, education, substance abuse, juvenile justice, health, child and youth development, as well as policy makers involved in state and local mental health, substance abuse, welfare, education, and justice will depend on this updated information on the status of research and suggested directions for the field of mental health and prevention of disorders.

As women of childbearing age have become heavier, the trade-off between maternal and child health created by variation in gestational weight gain has become more difficult to reconcile. Weight Gain During Pregnancy responds to the need for a reexamination of the 1990 Institute of Medicine guidelines for weight gain during pregnancy. It builds on the conceptual framework that underscored the 1990 weight gain guidelines and addresses the need to update them through a comprehensive review of the literature and independent analyses of existing databases. The book explores relationships between weight gain during pregnancy and a variety of factors (e.g., the mother''s weight and height before pregnancy) and places this in the context of the health of the infant and the mother, presenting specific, updated target ranges for weight gain during pregnancy and guidelines for proper measurement. New features of this book include a specific range of recommended gain for obese women.Weight Gain During Pregnancy is intended to assist practitioners who care for women of childbearing age, policy makers, educators, researchers, and the pregnant women themselves to understand the role of gestational weight gain and to provide them with the tools needed to promote optimal pregnancy outcomes.

A Review of the HHS Family Planning Program provides a broad evaluation of the Title X family planning program since its establishment in 1970. The program successfully provides family planning services to its target audience of low-income individuals, but there is room for improvement. While the program''s core goals are apparent, a secondary set of changing priorities has emerged without a clear, evidence-based strategic process. Also, funding for the program has increased in actual dollars, but has not kept pace with inflation or increased costs. Several aspects of the program''s structure could be improved to increase the ability of Title X to meet the needs of its target population. At the same time, the extent to which the program meets those needs cannot be assessed without a greater capacity for long-term data collection.A Review of the HHS Family Planning Program recommends several specific steps to enhance the management and improve the quality of the program, as well as to demonstrate its direct contribution to important end results, such as reducing rates of unintended pregnancy, cervical cancer, and infertility. The book will guide the Office of Family Planning toward improving the effectiveness of the program. Other parties who will find the research and recommendations valuable include programs receiving Title X funding from the Office of Family Planning, policy makers, researchers, and professional organizations.

After-school programs, scout groups, community service activities, religious youth groups, and other community-based activities have long been thought to play a key role in the lives of adolescents. But what do we know about the role of such programs for today''s adolescents? How can we ensure that programs are designed to successfully meet young people''s developmental needs and help them become healthy, happy, and productive adults?

Community Programs to Promote Youth Development explores these questions, focusing on essential elements of adolescent well-being and healthy development. It offers recommendations for policy, practice, and research to ensure that programs are well designed to meet young people''s developmental needs.

The book also discusses the features of programs that can contribute to a successful transition from adolescence to adulthood. It examines what we know about the current landscape of youth development programs for America''s youth, as well as how these programs are meeting their diverse needs.

Recognizing the importance of adolescence as a period of transition to adulthood, Community Programs to Promote Youth Development offers authoritative guidance to policy makers, practitioners, researchers, and other key stakeholders on the role of youth development programs to promote the healthy development and well-being of the nation''s youth.

In 2003, Congress passed the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act, which established a 5-year, $15 billion initiative to help countries around the world respond to their AIDS epidemics. The initiative is generally referred to by the title of the 5-year strategy required by the act—PEPFAR, or the President''s Emergency Plan for AIDS Relief.

PEPFAR Implementation evaluates this initiative''s progress and concludes that although PEPFAR has made a promising start, U.S. leadership is still needed in the effort to respond to the HIV/AIDS pandemic. The book recommends that the program transition from its focus on emergency relief to an emphasis on the long-term strategic planning and capacity building necessary for a sustainable response. PEPFAR Implementation will be of interest to policy makers, health care professionals, special interest groups, and others interested in global AIDS relief.

Socioeconomic conditions are known to be major determinants of health at all stages of life, from pregnancy through childhood and adulthood. "Life-course epidemiology" has added a further dimension to the understanding of the social determinants of health by showing an association between early-life socioeconomic conditions and adult health-related behaviors, morbidity, and mortality. Sensitive and critical periods of development, such as the prenatal period and early childhood, present significant opportunities to influence lifelong health. Yet simply intervening in the health system is insufficient to influence health early in the life course. Community-level approaches to affect key determinants of health are also critical. Many of these issues were raised in the 1995 National Academies book, Children''s Health, the Nation''s Wealth. The present volume builds upon this earlier book with presentations and examples from the field. Focusing on Children''s Health describes the evidence linking early childhood life conditions and adult health; discusses the contribution of the early life course to observed racial and ethnic disparities in health; and highlights successful models that engage both community factors and health care to affect life course development.

A Review of the HHS Family Planning Program provides a broad evaluation of the Title X family planning program since its establishment in 1970. The program successfully provides family planning services to its target audience of low-income individuals, but there is room for improvement. While the program''s core goals are apparent, a secondary set of changing priorities has emerged without a clear, evidence-based strategic process. Also, funding for the program has increased in actual dollars, but has not kept pace with inflation or increased costs. Several aspects of the program''s structure could be improved to increase the ability of Title X to meet the needs of its target population. At the same time, the extent to which the program meets those needs cannot be assessed without a greater capacity for long-term data collection.A Review of the HHS Family Planning Program recommends several specific steps to enhance the management and improve the quality of the program, as well as to demonstrate its direct contribution to important end results, such as reducing rates of unintended pregnancy, cervical cancer, and infertility. The book will guide the Office of Family Planning toward improving the effectiveness of the program. Other parties who will find the research and recommendations valuable include programs receiving Title X funding from the Office of Family Planning, policy makers, researchers, and professional organizations.

Socioeconomic conditions are known to be major determinants of health at all stages of life, from pregnancy through childhood and adulthood. "Life-course epidemiology" has added a further dimension to the understanding of the social determinants of health by showing an association between early-life socioeconomic conditions and adult health-related behaviors, morbidity, and mortality. Sensitive and critical periods of development, such as the prenatal period and early childhood, present significant opportunities to influence lifelong health. Yet simply intervening in the health system is insufficient to influence health early in the life course. Community-level approaches to affect key determinants of health are also critical. Many of these issues were raised in the 1995 National Academies book, Children''s Health, the Nation''s Wealth. The present volume builds upon this earlier book with presentations and examples from the field. Focusing on Children''s Health describes the evidence linking early childhood life conditions and adult health; discusses the contribution of the early life course to observed racial and ethnic disparities in health; and highlights successful models that engage both community factors and health care to affect life course development.

Mental health and substance use disorders among children, youth, and young adults are major threats to the health and well-being of younger populations which often carryover into adulthood. The costs of treatment for mental health and addictive disorders, which create an enormous burden on the affected individuals, their families, and society, have stimulated increasing interest in prevention practices that can impede the onset or reduce the severity of the disorders.

Prevention practices have emerged in a variety of settings, including programs for selected at-risk populations (such as children and youth in the child welfare system), school-based interventions, interventions in primary care settings, and community services designed to address a broad array of mental health needs and populations.

Preventing Mental, Emotional, and Behavioral Disorders Among Young People updates a 1994 Institute of Medicine book, Reducing Risks for Mental Disorders, focusing special attention on the research base and program experience with younger populations that have emerged since that time.

Researchers, such as those involved in prevention science, mental health, education, substance abuse, juvenile justice, health, child and youth development, as well as policy makers involved in state and local mental health, substance abuse, welfare, education, and justice will depend on this updated information on the status of research and suggested directions for the field of mental health and prevention of disorders.

The deficiencies that many children experience from birth to school age—in health care, nutrition, emotional support, and intellectual stimulation, for example—play a major role in academic achievement gaps that persist for years, as well as in behavior and other problems. There are many intervention programs designed to strengthen families, provide disadvantaged children with the critical elements of healthy development, and prevent adverse experiences that can have lasting negative effects. In a climate of economic uncertainty and tight budgets, hard evidence not only that such interventions provide lasting benefits for children, their families, and society, but also that the benefits translate into savings that outweigh the costs is an extremely important asset in policy discussions. Convincing analysis of benefits and costs would provide a guide to the best ways to spend scarce resources for early childhood programs. Benefit-Cost Analysis for Early Childhood Interventions summarizes a workshop that was held to explore ways to strengthen benefit-cost analysis so it can be used to support effective policy decisions. This book describes the information and analysis that were presented at the workshop and the discussions that ensued.

Depression is a widespread condition affecting approximately 7.5 million parents in the U.S. each year and may be putting at least 15 million children at risk for adverse health outcomes. Based on evidentiary studies, major depression in either parent can interfere with parenting quality and increase the risk of children developing mental, behavioral and social problems. Depression in Parents, Parenting, and Children highlights disparities in the prevalence, identification, treatment, and prevention of parental depression among different sociodemographic populations. It also outlines strategies for effective intervention and identifies the need for a more interdisciplinary approach that takes biological, psychological, behavioral, interpersonal, and social contexts into consideration.

A major challenge to the effective management of parental depression is developing a treatment and prevention strategy that can be introduced within a two-generation framework, conducive for parents and their children. Thus far, both the federal and state response to the problem has been fragmented, poorly funded, and lacking proper oversight. This study examines options for widespread implementation of best practices as well as strategies that can be effective in diverse service settings for diverse populations of children and their families.

The delivery of adequate screening and successful detection and treatment of a depressive illness and prevention of its effects on parenting and the health of children is a formidable challenge to modern health care systems. This study offers seven solid recommendations designed to increase awareness about and remove barriers to care for both the depressed adult and prevention of effects in the child. The report will be of particular interest to federal health officers, mental and behavioral health providers in diverse parts of health care delivery systems, health policy staff, state legislators, and the general public.

The deficiencies that many children experience from birth to school age—in health care, nutrition, emotional support, and intellectual stimulation, for example—play a major role in academic achievement gaps that persist for years, as well as in behavior and other problems. There are many intervention programs designed to strengthen families, provide disadvantaged children with the critical elements of healthy development, and prevent adverse experiences that can have lasting negative effects. In a climate of economic uncertainty and tight budgets, hard evidence not only that such interventions provide lasting benefits for children, their families, and society, but also that the benefits translate into savings that outweigh the costs is an extremely important asset in policy discussions. Convincing analysis of benefits and costs would provide a guide to the best ways to spend scarce resources for early childhood programs. Benefit-Cost Analysis for Early Childhood Interventions summarizes a workshop that was held to explore ways to strengthen benefit-cost analysis so it can be used to support effective policy decisions. This book describes the information and analysis that were presented at the workshop and the discussions that ensued.

As women of childbearing age have become heavier, the trade-off between maternal and child health created by variation in gestational weight gain has become more difficult to reconcile. Weight Gain During Pregnancy responds to the need for a reexamination of the 1990 Institute of Medicine guidelines for weight gain during pregnancy. It builds on the conceptual framework that underscored the 1990 weight gain guidelines and addresses the need to update them through a comprehensive review of the literature and independent analyses of existing databases. The book explores relationships between weight gain during pregnancy and a variety of factors (e.g., the mother''s weight and height before pregnancy) and places this in the context of the health of the infant and the mother, presenting specific, updated target ranges for weight gain during pregnancy and guidelines for proper measurement. New features of this book include a specific range of recommended gain for obese women.Weight Gain During Pregnancy is intended to assist practitioners who care for women of childbearing age, policy makers, educators, researchers, and the pregnant women themselves to understand the role of gestational weight gain and to provide them with the tools needed to promote optimal pregnancy outcomes.

Many low-income families struggle with stable housing and frequently have to move due to foreclosures, rent increases, or other financial setbacks. Children in these families can experience lasting negative effects, especially those who are young and still developing basic learning and social skills. A joint NRC-IOM committee held a workshop in June 2009 to examine these issues, highlight patterns in current research, and discuss how to develop a support system for at-risk children.