News Archive: Maternal, Child, and Adolescent Health
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2004 and Prior
Language barriers and perceptions about care.
Among members of a Medicaid managed-care plan, Spanish-speaking parents who requested interpretive assistance were more likely to report that providers spent too little time with their children than were English-speaking parents or Spanish speaking parents who did not request interpreters. (Posted 12/04.)Predicting who is likely to start smoking marijuana.
Adolescents who begin smoking marijuana in their early teen years are more likely to be using hard drugs and a number of different drugs, to have poor grades and low academic goals, to have been offered marijuana by friends, and to report smoking in order to cope with problems than those who start smoking later. These differences suggest a range of potentially modifiable risk factors. More on adolescent risk for substance abuse... (Posted 10/04.)"Voltage drops" in children's health care.
Some children drop out of the health care system. This study identified critical needs for expanded insurance, coordination of care, and better ways to measure quality. (Posted 9/04.)Caring for very-low-birthweight infants.
Referring very-low-birthweight infants to hospitals with the best outcomes is one way to improve care for these high-risk infants . More about caring for very-low-birthweight infants...(Posted 9/04.)Adolescents who watch large amounts of television
containing sexual content are twice as likely to begin engaging in sexual intercourse in the following year as their peers who watch little such TV. Research brief; more on adolescent health...(Posted 9/04.)Phys ed cuts number of overweight young girls.
Increasing physical education instruction in kindergarten and first grade by as little as one hour per week could reduce the number of overweight 5- and 6-year-old girls nationally by as much as 10 percent. More on obesity...(Posted 8/04.)Community drug programs curb teen substance abuse — Sep. 2004
Community-based drug treatment programs can help troubled teens reduce substance abuse and improve psychological health, according to an exhaustive study of a common treatment approach.
News release
More on substance abuse research
Being overweight in childhood.
Being overweight is already associated with behavior problems for girls, but not boys, in the first two years of school. But being overweight doesn't predict behavior problems later on. More on obesity... (Posted 8/04.)Asking parents about their children's traumatic symptoms.
Parents are wiling to answer questions about their children's traumatic experiences. More on treating trauma in children... (Posted 8/04.)Barriers to care for children with special health care needs.
The Barriers-to-Care Questionnaire is a reliable and valid survey for measuring barriers to care for children with special health care needs. The survey could help improve care for this vulnerable group. More on RAND Health surveys. (Posted 7/04.)Measuring the health of U.S. children.
Accurately measuring the health of the increasingly diverse population of U.S. children requires instruments that are comparable and valid across cultures, economic background, and language. This review of common measures identified the influence of race, ethnicity, and income on health and health reports as the next generation of issues to be addressed. (Posted 7/04.)Continuity of care for children.
Nearly all young children aged 4 to 35 months in the United States have a regular setting in which they get well-child care, but less than half have a specific clinician. More on children's health. (Posted 6/04.)Giving parents the advice they want.
Most parents believe that their children's doctors should discuss smoking at home, financial difficulties, and emotional support that's available to parents. But except for smoking, fewer than half of parents have been asked about these topics by their child's clinician. (Posted 6/04.)What parents and pediatricians talk about.
Parents and pediatricians often talk about preventive care such as immunization, feeding issues, and sleep patterns. But parents wish pediatricians would talk more about children's developmental needs. (Posted 6/04.)Measuring quality of hospitals for very low birthweight infants.
The number of very low birthweight infants that a hospital admits is not a good measure of the care the infants will receive. More about very low birthweight infants. (Posted 6/04.)The time to prevent smoking.
Children typically start to smoke in adolescence but that's also the time when prevention efforts can pay off. More on children and smoking. (Posted 6/04.)The course of marijuana use in young adults can follow several different patterns — May 2004
Not surprisingly, those who begin to use it heavily in the early teen years suffer the worst behavioral, physical, and socioeconomic consequences later on, even if the initial heavy use subsides somewhat.
A drug prevention program proves its effectiveness in a variety of settings — May 2004
Project ALERT, RAND's school-based drug-prevention program for middle-school students lowered the risk factors for drug use in young adolescents in South Dakota.
Benefits of athletic activities — March 2004
In a group of about 5500 public high school students, more than 40% were obese or overweight. But students who participated in athletic activities were more likely to have a lower body mass index, the usual measure of obesity.
Challenges facing the American middle school.
Middle school students in the U.S. feel less positive about learning conditions and report more physical and emotional problems at their schools than peers in 11 other nations. The study was conducted in RAND Education. (Posted 3/04.)African American teens less likely to become regular smokers — Feb. 2004
Most African American teenagers try smoking, but they are less likely than whites and Hispanics to become regular smokers during adolescence and young adulthood. Reasons include parental disapproval of smoking, having fewer friends who smoke, receiving fewer offers of cigarettes from peers, and not developing strong intentions to smoke in the future.
Substance abuse and teen marriage.
Teen marriage has been linked to substance abuse, but a new study finds that only early smoking is associated with the likelihood of getting married before the age of 20, suggesting that the link reflects a tendency toward risk taking, rather than the effect of drug or alcohol abuse on judgement. More on adolescent smoking... (Posted 1/04.)Childhood obesity and early school achievement.
Lower test scores among overweight kindergarteners and first-graders compared with their classmates who are not overweight can be explained by differences in parents' education and socioeconomic status. However this association between lower achievement and overweight may have the unfortunate consequence of contributing to the negative stigma of overweight at a very early age. (Posted 1/04.)Busiest hospitals may not offer best care.
Referring infants with very low birth weights to hospitals that treat a large number of similar cases is an unreliable way to direct patients to the highest quality medical providers. News release; Abstract (Posted 1/04.)Schools and bioterrorism. (PDF)
Schools will likely play a critical role in helping communities recover from a bioterrorist attack. Almost all schools have natural disaster recovery plans. But bioterrorism is different: the attack may be prolonged, and the psychological effects on children and the community may be more severe. This study describes how schools can improve preparedness. (Posted 1/04.)Helping kids cope with violence.
A simple school-based program can help children exposed to violence recover from the emotional and behavioral problems it causes. The manual describing the program is now available directly from the publisher. Prevalence of children's exposure to violence... (Posted 12/03.)Bullying among young adolescents.
Bullying and being bullied are health problems for adolescents because they affect adolescents' well-being and functioning. This study looked at the unique problems of bullies, victims, and bully-victims and suggests some school-wide approaches that can change the peer dynamics supporting bullying. (Posted 11/03.)Using health-related quality of life to measure pediatric health.
A test of the 23-item Pediatric Quality of Life Inventory found that it is a feasible, reliable and valid measure of pediatric health and could be used to evaluate the health outcomes of programs such as the Children's Health Insurance Program in California. Surveys available on this site... (Posted 11/03.)Teen Suicide Prevention Programs May Under-serve Latino Teens.
Assessment of a school-based suicide prevention program sponsored by the Los Angeles public school system suggests that Latino teens in L.A., whose suicide rate is higher than that of Caucasian teens, are under-identified by the intervention program. Research is needed to identify the barriers to identifying Latino youth at risk for suicide. (Posted 11/03.)TV Can Be a Sex-education Tool for Teens
A new RAND study finds that teens who viewed an episode of "Friends" that dealt with pregnancy resulting from condom failure tended to retain the message, particularly if they discussed the show's content with a parent or another adult. (Posted 11/03.)Help for High-Risk Teens with Drug Abuse Problems
A new study finds that Project ALERT, the widely used substance abuse prevention program, is effective in preventing teens from starting to use marijuana or tobacco, misusing alcohol, and continuing to smoke regularly. The program even proved to be effective among high-risk middle-school age teens—those who have already started smoking and drinking by 7th grade. (Posted 10/03.)Disparities among states in mental health care for children.
Mental health programs serve a far larger share of children in some states than in others, but states with higher use of mental health services don't necessarily have a greater need for them. Complete article | More on mental health care for children (Posted 10/03.)Managing policy responses to prenatal substance exposure.
This article presents a new way to view the reciprocal obligations of the state and the pregnant woman to a fetus exposed to substance abuse. (Posted 9/03.)Women receive poorer care for cardiovascular disease.
Monitoring quality of care for women with cardiovasclar disease could reduce the disparity between the care they receive and care given to men. More on quality of care for women. (Posted 9/03.)Health insurance for low-income children.
Subsidized group insurance provides more stable insurance coverage for low-income children than public insurance does. But other programs will be needed to reach the majority of uninsured children. More on providing health insurance for children. Assessment of state efforts to insure the uninsured. (Posted 9/03.)Does using marijuana interfere with learning?
A new study examined whether high school students that used marijuana had poorer scores on standardized tests. The study found that other characteristics of students—for example, risk of dropping out of school, using cigarettes, and binge drinking accounted for much of the negative association between marijuana use and test scores. However, when researchers compared changes in test scores across 10th and 12th grades, they found that marijuana use is associated with a 15% reduction in performance on math—but not reading— tests. Researchers suggest that marijuana may affect specific cognitive skills differently. Does using marijuana raise the risk of using harder drugs? (Posted 9/03.)Talking to your child about Kobe.
This op-ed suggests how parents can have a useful conversation with their children about sex. More RAND research on the sexual behavior of adolescents. (Posted 9/03.)Helping kids cope with violence.
Children exposed to violence, either as victims or witnesses, frequently develop serious emotional and behavioral problems. A simple school-based program can help them recover. And the program is well-accepted by teachers, parents, and the kids themselves. Summary» | News release» | Time Magazine coverage» | More on RAND's work with children. (Posted 9/03.)Parents' perceptions of pediatric primary care experiences.
High-quality primary care underpins efforts to reduce health care disparities. This study found that increasing access to care (in terms of insurance and a regular provider) and providing linguistically appropriate services can play a major role in improving parents' perceptions of the quality of primary care that their children receive. More research on quality of care for children. (Posted 8/03.)More teens in drug treatment may need psychological counseling. Preliminary findings of a new study on the mental health needs of teens entering drug treatment programs suggest that many of these teens have mental health problems, and few are receiving care for those problems. Linking referral for mental health treatment with admission to substance abuse treatment programs would help address these unmet needs. (Posted 6/03.)
RAND Health experts comment on the role of after-school supervision. RAND Health research on adolescents' sexual behavior is cited in an NPR feature on the role of after-school supervision in the sex lives of young teenagers. Summary of RAND's work on the sexual behavior of adolescents. (Posted 6/03.)
Early alcohol use is associated with multiple problems, including substance abuse, in later adolescence... Young people who report drinking or experimenting with alcohol as early as 7th grade are more likely than nondrinkers to experience multiple behavioral and social problems in late adolescence, according to a 10-year longitudinal study just released by RAND. These findings support the need for early intervention with these high-risk youth to address their drinking as well as their tendencies to smoke and use other drugs. More... (Posted 5/03.)
Tools to assess the quality of health care for women... Researchers at RAND have released a new set of Quality Assessment tools to evaluate the performance of health care systems that provide women's health care. Quality measures include preventive care as well as care for chronic and acute conditions. The performance information that this system will provide will be invaluable to consumers, purchasers, and those involved in quality improvement efforts. (Posted 4/03.)
Explaining racial/ethnic differences in smoking among young adults. Using data gathered to test Project ALERT, this study examined whether social bonds and influences could account for race and ethnicity as predictors of smoking at age 23. Social influences during high school account for the differences. More research on adolescent smoking... (Posted 5/03.)
Why do some adolescents transition from experimentation to regular smoking? More than 6,000 adolescents reported on their smoking behavior. Prosmoking attitudes and social influence are important influences on those who become regular smokers. (Posted 4/03.)
Using costs to assess the performance of Neonatal Intensive Care Units. Treatment costs are high for very low birthweight infants, and quality improvement efforts can move costs in either direction. Information about costs can be used to understand the economic performance of a Neonatal Intensive Care Unit and to assess the effects of quality improvement efforts. Read this article (PDF). (Posted 4/03.)
Longer postpartum hospital stays are cost-effective. Lengthening hospital stays after birth is more cost-effective than a medication routinely given to premature newborns to protect them against a common respiratory virus and is as cost-effective as a pneumonia vaccine recommended for all infants. Read the press release. Read the article (PDF). (Posted 3/03.)
Helping kids exposed to violence—and their parents and teachers. RAND researchers have been working closely with the Los Angeles Unified School District to help recent Latino immigrant children traumatized by violence. The kids in the program received structured group therapy; their parents and teachers received education and support. A recent RAND study reports the results: the kids experienced significant improvement. (Posted 3/03.)What should you tell your kids about sex? An authoritative and extremely readable new volume presents the latest research on parenting techniques and childhood sexuality and includes helpful stories from real parents about what worked (and what didn't) with their kids. The book draws in part on work conducted in the UCLA/RAND Center for Adolescent Health Promotion. (Posted 2/03.)
How many kids in the U.S. use tobacco in some form other than cigarettes? A new study answers this question, drawing on data from the Youth Tobacco Survey, the only national youth survey to monitor use of a wide variety of tobacco products such as smokeless tobacco, cigars, bidis, kreteks, and pipes. (Posted 2/03.)
Progression in the development of binge-drinking during adolescence. A new study shows that the development of binge-drinking behavior as well as resistance to binge-drinking from early adolescence to young adulthood can follow a variety of pathways that are associated with other risk factors. (Posted 2/03.)
How pediatricians talk to children and their parents during exams influences whether parents ask for antibiotic. Public health and medical communities are committed to reducing the prescription of antibiotics to treat conditions for which they are ineffective. RAND researchers looked at how doctors talk to children with respiratory symptoms and their parents. When doctors minimize the exam findings to parents of children with probable colds, rather than emphasizing their seriousness, far fewer prescriptions for antibiotics are written. (Posted 1/03.)
When and where do youth have sex? More than half of the students in six urban high schools report being home without an adult present 4 or more hours per day after school. More than half of sexually active youths reported that they had sex at home after school. Particularly for boys, sexual-and drug-related risks increased as the amount of unsupervised time increased. (Posted 12/02.)
Many studies have been designed to examine inappropriate prescribing of antibiotics for children—for example, when they have a viral, rather than a bacterial, infection. However, the process of observing physicians as they make diagnoses and prescribe antibiotics changes physicians' behavior. Thus results of these observational studies probably underestimate the real extent of the problem. (Posted 12/02.)
Study questions marijuana "gateway" effect A new study casts doubt on claims that marijuana acts as a "gateway" to the use of cocaine and heroin, challenging an assumption that has guided U.S. drug policies since the 1950s. More... (Posted 12/02.)
Many U.S. children don't get preventive pediatric and dental care. A study of nearly 36,000 children under 18 reveals substantial gaps between the care they receive and recommended care. Nearly 25% don't get recommended preventive pediatric visits, and nearly 50% don't receive the recommended number of dental visits. Children who are uninsured, have a parent who is less than college educated, or are in poor health are most at risk for not receiving care. (Posted 12/02.)
One in three children is exposed to secondhand smoke at home. Exposure to secondhand tobacco smoke has been linked with an increased risk for many childhood illnesses: One goal of the Healthy People 2010 Initiative is to reduce the rates of exposure to just 10% of children. Yet, a study just released by the RAND-UCLA Center for Adolescent Health shows that 35% of children 17 years of age and younger are exposed to secondhand tobacco smoke at home.
View Press Release.
Highlights of other RAND studies on smoking and youth... (Posted 11/02)Insurance improves access to prenatal services, but the health care delivery system is also critical to improving birth outcomes. A recently completed study by RAND researchers compared birth outcomes among women who receive Medicaid benefits and those with no health insurance. The study found that women on Medicaid have greater access to prenatal health care than do uninsured women, but that for both groups, birth outcomes are better if they receive care from the public health care system than if they receive care from the private health care system. (Posted 10/02)
The economic impetus for obesity in the United States. A recently completed analysis of labor statistics by two RAND researchers shows that the health of young Americans is deteriorating as the elderly are becoming healthier. This deterioration in health and increase in disability among the young is due to the rise in overweight and obesity, particularly over the past 10 years. The researchers go on to show that the rise in overweight can be attributed at least in part to economic factors: the rise in incomes, the increased availability of inexpensive food, and the increasingly sedentary nature of work. (Posted 10/02.)
Peers strongly influence teens' decisions to quit smoking. Peer pressure is among the factors that are well known to influence teens' decisions to smoke. Now, a recently released study shows that peer influence is also a strong factor in teens' decisions to quite smoking. These findings suggest that smoking cessation programs aimed at teens should continue to target both peer and parental influences. More... (Posted 10/02)
Prenatal substance exposure guidelines should be tightened. A new study by RAND researchers finds that hospital prenatal substance exposure guidelines tend to be incomplete and poorly written, often lacking basic information such as whether specific maternal consent is required for a maternal or a newborn toxicology screen. The development of such guidelines requires greater attention, because it is these guidelines that form the basis of treatment protocols. (Posted 10/02)
Philadelphia schools consider adopting Project ALERT as replacement for DARE. More on Project ALERT. (Posted 9/02)
Programs to help adolescents quite smoking should continue to target the influences of parents and peers. The research team that evaluated Project ALERT has continued to study the children, now adolescents, who participated in the original program. Their findings suggest that Project ALERT's focus on social influences is appropriate for smoking cessation programs through late adolescence. (Posted 9/02)
Helping traumatized kids. Many recent immigrant children have violence-related mental health problems. RAND Health staff have been collaborating with the Los Angeles Unified School District and UCLA to design and evaluate the Mental Health for Immigrants Program, a school-based mental health intervention. The program recently received an award from the Carter Center. (Posted 8/02)
RAND Health study on psychological consequences of terrorism featured in assessment of the national psyche. Results of a RAND survey conducted immediately after the 9/11 attacks are cited in a Newsweek article that asks "How Are We Doing?" The study is part of ongoing research in the RAND Center for Domestic and International Health Security. (Posted 8/02)
Project ALERT—Exemplary in all respects. The Department of Education has just published its description of the 9 exemplary programs selected by the Safe, Disciplined, and Drug-Free Schools Expert Panel. One of these programs is Project ALERT, a school-based drug prevention program developed, implemented and evaluated at RAND. (Posted 8/02)
The reviewers called the evaluation "exemplary in all respects." The description of all the exemplary programs is available without charge from the Department of Education—see http://www.ed.gov/about/ordering.jsp.
Does early drug use signal later problems? Smoking and using other drugs in early adolescence has long-term social consequences: Adolescents who use alcohol, cigarettes, and marijuana in the 7th grade are much more likely to commit frequent acts of predatory violence (muggings, robberies, gang assaults) 5 years later. Thus school-based drug prevention programs may provide an additional violence-prevention bonus.
Read more: Does Early Smoking Signal Later Problems?; Stopping Violence Before It Starts. (Posted 8/02)
American Academy of Pediatrics Consortium identifies health care priorities and needs for Latino youth. Latinos have become the largest racial/ethnic minority group of US children. The Latino Consortium of the American Academy of Pediatrics Center for Child Health Research has identified the most urgent health care priorities in Latino child health as well as areas where further research is needed. (Posted 7/03)
Asthma is reaching epidemic proportions among America's children. More than 5 million children suffer from asthma, and the number of cases is increasing rapidly. For some, the disease is fatal. Because asthma risk factors are complex, successful asthma policies must push the limits of the traditional healthcare system. A panel of asthma experts and leaders convened by RAND has developed specific policy recommendations to improve asthma outcomes. Read the press release. (Posted 5/02)
For adolescents, virginity does not necessarily mean not sexually active. Clinicians should not rely on an inquiry about virginity as their only screening question when deciding whether to test an adolescent for STDs. The beginning of adolescents' engaging in sexual experience with partners is not marked by a single act; rather, it involves a range of activities. More information about RAND research on HIV and STDs. (Posted 4/02)
Does emotional distress increase the chance that teens will smoke cigarettes? A recent study suggests that the relationship between teen cigarette smoking and emotional distress changes with time: emotional distress initially leads to smoking, but over time, smoking actually worsens distress. (Posted 1/02)
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