Utility of Population Attributable Fraction Assessment in Guiding Interventions to Reduce Low Birthweight in the High-Altitude State of Colorado.

Objectives We evaluated the ability of population attributable fraction (PAF) assessments to alter significant modifiable risks for low birthweight (LBW) and the impact of high altitude as a risk for LBW in Colorado. Methods Logistic regression analysis of birth certificate parameters in 1995-1997 identified risk factors for PAF assessment. PAF for birth at high altitude, multiple births, and LBW in singleton births were determined.

Game change in Colorado: widespread use of long-acting reversible contraceptives and rapid decline in births among young, low-income women.

Context: Long-acting reversible contraceptive (LARC) methods are recommended for young women, but access is limited by cost and lack of knowledge among providers and consumers. The Colorado Family Planning Initiative (CFPI) sought to address these barriers by training providers, financing LARC method provision at Title X-funded clinics and increasing patient caseload.

Methods: Beginning in 2009, 28 Title X-funded agencies in Colorado received private funding to support CFPI.

Short-lived success: assessment of an intervention to improve pregnancy weight gain in Colorado.

Inadequate weight gain in pregnancy is a major contributor to low birth weight in Colorado, where the low birth weight rate is among the highest in the nation. In 2004, the Colorado Department of Public Health and Environment implemented a population-based intervention in 9 counties, including provider training and a public media campaign, to encourage pregnant women to gain an adequate amount of weight in pregnancy as defined by the 1990 Institute of Medicine guidelines. Pregnancy Risk Assessment Monitoring System survey data were used to track weight gain in pregnancy in 1997 through 2004 (baseline), 2005 (post-intervention), and 2006 and 2007 (after the intervention had concluded).

Evaluation of exercise on individuals with dementia and their carers: a randomised controlled trial.

Background: Almost all of the 820,000 people in the UK with dementia will experience Behavioural and Psychological Symptoms of Dementia (BPSD). However, research has traditionally focused on treating cognitive symptoms, thus neglecting core clinical symptoms that often have a more profound impact on living with dementia. Recent evidence (Kales et al, 2007; Ballard et al, 2009) indicates that the popular approach to managing BPSD - prescription of anti-psychotic medication - can increase mortality and the risk of stroke in people with dementia as well as impair quality of life and accelerate cognitive decline.

Hospital practices that increase breastfeeding duration: results from a population-based study.

Background: A high percentage (83%) of mothers in Colorado initiate breastfeeding; but in keeping with national breastfeeding trends, many of them discontinue breastfeeding within the first few months. The objective of this study was to determine the effects of hospital practices on breastfeeding duration and whether the effects differed based on maternal socioeconomic status.

Methods: Pregnancy Risk Assessment Monitoring System data were used to calculate breastfeeding duration rates for all Colorado mothers in 2002 to 2003.

School-based health centers and the decline in black teen fertility during the 1990s in Denver, Colorado.

Objectives: We examined the changes in Black adolescent fertility rates in high-school areas with school-based health centers and compared them over time with changes in rates in high-school areas without school-based health centers.

Methods: Fertility rates were estimated for high-school areas with and without school-based health centers with geocoded birth certificate and school enrollment data.

Results: A high adolescent fertility rate (165 births/1000) in 1992 among Black students in Denver high-school areas with school-based health centers declined to a low rate (38/1000) in 1997 that matched the rate of school areas that did not have school-based health centers.

Reducing low birthweight by resolving risks: results from Colorado's prenatal plus program.

Objectives: We examined low-birthweight (LBW) rates among participants in Colorado's Prenatal Plus program by prenatal risk factors (smoking, inadequate weight gain during pregnancy, and psychosocial problems) and the effect of successful resolution of these risks during pregnancy.

Methods: Data for 3569 Medicaid-eligible women who received care coordination, nutritional counseling, or psychosocial counseling through the Prenatal Plus Program in 2002 were analyzed to determine the prevalence of specific risks, the proportion of women who resolved each specific risk, and the low birthweight rates for births to women who did and did not resolve risk. LBW rates were analyzed with chi(2) tests of significance.