OBJECTIVE: The objective of the Children's Oral Health Initiative (COHI) is to increase access to preventive oral health services provided to First Nations and Inuit (FN/I) children living on federal reserves and in remote communities.PARTICIPANTS: COHI targets preschool children; 5-7-year-olds; pregnant women; and parents/caregivers in FN/I communities. SETTING:The program was piloted in 2004 by Health Canada and is potentially available to all FN/I communities. However, the community must consent to the program's implementation and agree to support a community member to be trained as a COHI aide. INTERVENTION:Dental therapists and hygienists screen eligible children, apply fluoride varnish and sealants to children's teeth, and stabilize active dental caries with glass ionomer. An innovation was the development of a community oral health worker, the COHI Aide. The COHI Aide is a community member who serves as an advocate for preventive oral health in the community and provides instruction to children, parent/caregivers and expectant mothers in preventing dental caries.RESULTS: COHI was piloted in 41 communities in 2004. By 2014, the program had expanded to 320 FN/I communities, which represents 55% of all eligible FN/I communities. In 2012, 23,085 children had received COHI preventive oral health services. CONCLUSION:The results demonstrate COHI's success as a preventive oral health care delivery model in remote communities. Implementation and delivery of preventive oral health services has been enhanced by the sustained presence of a community-based COHI Aide.KEY WORDS: Indigenous health services; pediatric dentistry; oral health; dental caries; community health worker La traduction du résumé se trouve à la fin de l'article.Can J Public Health 2016;107(2):e188-e193 doi: 10.17269/CJPH.107.5299A pproximately 4% (1.4 million people) of the Canadian population self-identify as being of Aboriginal descent. Of these individuals, over 314,000 live in 636 communities, also referred to as federal reserves, located on lands held in trust for bands by the Crown.
Dennis CL, Hodnett E, Gallop R, et al. The effect of peer support on breast-feeding duration among primiparous women: a randomized controlled trial. CMAJ 2002 Jan 8;166:21-8. QUESTION: Do primiparous, breastfeeding mothers who receive telephone based peer support continue breast feeding longer than women who receive conventional care? DesignRandomised (allocation concealed), blinded (outcome assessor), controlled trial with follow up at 4, 8, and 12 weeks post partum. Setting2 semi-urban community hospitals near Toronto, Ontario, Canada. Patients258 in hospital, primiparous, breastfeeding women who were >16 years of age, were able to speak English, had a singleton birth at >37 weeks gestation, and resided in the surrounding region accessible by a local telephone call. Exclusion criteria were factors that could seriously interfere with breast feeding (eg, serious maternal illness or infant congenital abnormality) or prenatal enrolment with the participating volunteer breastfeeding organisation. 256 women (99%) completed the trial and were included in the analysis. Most (75%) were between 25 and 34 years of age. Intervention132 women were allocated to the peer support group, which included telephone based peer support in addition to conventional in hospital and community postpartum services (eg, a hospital based breastfeeding clinic and support services by public health nurses). Each new mother was paired with a peer volunteer (ie, a mother who had >6 months of previous breastfeeding experience and a positive attitude towards breast feeding, and had completed a 2.5 h orientation session) on the basis of location of residence and availability. Peer volunteers were asked to contact the new mother within 48 hours after hospital discharge and as frequently thereafter as the mother deemed necessary. 126 women were allocated to conventional care only. Main outcome measureMain outcome was self reported breast feeding (receipt by the infant of any breast milk) in the 24 hours before the interview. Main resultsAnalysis was by intention to treat. Mothers who received peer support were more likely to be breastfeeding at 4, 8, and 12 weeks post partum than were mothers who received conventional care only (table). As well, mothers in the peer support group were more likely to be exclusively breast feeding at 12 weeks (table). ConclusionPrimiparous, breastfeeding mothers who received peer support by telephone were more likely to still be breast feeding at 12 weeks post partum than were mothers who received conventional care only. COMMENTARYMost mothers stop breast feeding before their infants are 6 months old, despite the well documented health benefits for both themselves and their infants. The study by Dennis et al focused on the effect of telephone based peer support on breastfeeding duration. This study was methodologically strong, with random assignment to groups, blinding of the outcome assessor, and follow up of all but 2 mothers. The findings show that telephone based peer support was effective in maintaining breast...
Early hospital discharge of newborn infants was not associated with feeding related hospital readmission during the first 28 days of life Edmonson MB, Stoddard JJ, Owens LM. Hospital readmission with feeding-related problems after early postpartum discharge of normal newborns. JAMA 1997 Jul 23/30;278:299-303. ObjectiveTo determine whether an association exists between early postpartum discharge of newborn infants and feeding related hospital readmission during the first 28 days of life.
Early hospital discharge of newborn infants was not associated with feeding related hospital readmission during the first 28 days of life Edmonson MB, Stoddard JJ, Owens LM. Hospital readmission with feeding-related problems after early postpartum discharge of normal newborns. JAMA 1997 Jul 23/30;278:299-303. ObjectiveTo determine whether an association exists between early postpartum discharge of newborn infants and feeding related hospital readmission during the first 28 days of life.
QUESTION: Is whey hydrolysate formula effective in the treatment of infantile colic in formula fed infants in a primary care setting? Design Randomised (allocation concealed), blinded (research nurses and parents), placebo controlled trial with follow up immediately after 1 week of intervention. Setting Community based, well baby clinics in 6 regions of the Netherlands.
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