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California Department of Healthcare Services

Pediatric Nutrition Surveillance System (PedNSS)

The Children's Medical Services (CMS) Branch just released the 2010 PedNSS Annual Prevalence Reports. An upcoming information notice will provide a description and update of PedNSS prevalence reports.

Overview

2010 Data Tables

Sample Format for Sharing PedNSS (California and county samples)

PowerPoint Presentations

Prior PedNSS Reports

 

Overview

Purpose

PedNSS is a child based public health surveillance system that provides national, state and county level prevalence reports which are produced by the Centers for Disease Control and Prevention (CDC).  This surveillance system primarily monitors indicators of nutrition status: short stature, underweight, overweight, obesity, anemia (low hemoglobin/hematocrit) and low and high birthweight. Body Mass Index (BMI)-for-age percentile for children over 2 years of age is used to identify prevalence of overweight, obesity and underweight prevalence.  Additionally, the prevalence of “smoking in household” is a health indicator that is reported in PedNSS.  Breastfeeding prevalence is not collected in California but national prevalence reports are available at the CDC website.  Prevalence reports for nutrition/health indicators are reported by age and race/ethnicity and county jurisdiction among low income, at-risk infants, children and adolescents who participate in publicly funded health programs.  In California, data is collected from individuals who participate in the Child Health and Disability Prevention (CHDP) Program and used to develop annual prevalence reports.

 

Conducted

Nationwide, pediatric nutrition surveillance has been conducted continuously since 1973. California has continuously participated in PedNSS since 1988.

 

Target Population

Low-income, at-risk children, birth through 19 years of age, with an emphasis on birth to 5 years of age.

 

Design and Methods

Primary indicators of nutrition status (hematology, BMI-for-age percentile, height-for-age, and weight-for-height) are monitored in California using clinic data from CHDP health assessments. Data are collected in medical offices/clinics and recorded on the CHDP Confidential Screening/Billing Report form (PM 160). The CHDP Confidential Screening/Billing Report form is submitted for payment and program reporting and serves as California’s PedNSS data source. The CMS Branch transmits the data to CDC for inclusion in the national surveillance system. Annual reports are produced by CDC and made available on the CHDP webpage.

 

Technical Assistance

CMS Branch staff provides technical assistance in interpretation of data for local CHDP Programs. For additional technical information/explanations about PedNSS methodology, go to CDC’s website and click on "How to."

 

Users

A variety of entities use child based public health surveillance reports.  Local CHDP programs use PedNSS to identify at-risk groups; determine local program priorities; monitor population trends; disseminate prevalence reports to providers and community groups; complete performance measures and evaluate program interventions.  CHDP providers may use county prevalence reports to identify at-risk patients, common nutrition risks and to prioritize patient intervention.  Other public programs such as, WIC, maternal and child health programs and schools may use state and county prevalence reports to supplement community assessments, identify at-risk groups, identify significant nutrition indicators, program planning, development of policies, monitor population trends, evaluate program interventions and to obtain funding.

 

Descriptive Variables

State, Los Angeles metro area, county, age, year, and race/ethnicity

 

Outcome Variables of Interest

Low hematology, low or high birthweight, short stature, underweight, overweight, obesity and smoking in household

 

MMWR Surveillance References

Updated Guidelines for Evaluating Public Health Surveillance Systems (MMWR, 2001; 50 (RR 13); 1-35)

Obesity Prevalence Among Low-Income, Preschool-Aged Children (MMWR, 2009; 56 (28); 769-773)

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CDC Growth Charts Overview

The CDC Growth Charts were developed for use by health care professionals using the pediatric growth charts in clinical and public health settings to assess growth of infants, children, and adolescents. Using these charts, health care providers can compare growth in infants, children, and adolescents with a nationally representative reference based on children of all ages and racial or ethnic groups. Comparing body measurements with the appropriate age- and gender-specific growth chart enables health care providers to monitor growth and identify potential health- or nutrition-related problems.

During routine screening, health care providers assess physical growth using the child’s weight, stature, length, and head circumference. Although one measurement plotted on a growth chart can be used to screen children for nutritional risk, it does not provide adequate information to determine the child’s growth pattern. When plotted correctly, a series of accurate weights and measurements of stature or length offer important information about a child’s growth pattern, which may be influenced by such factors as gestational age, birth weight, and parental stature. Parental stature, for example, is considered before assuming there is a health or nutrition concern. Other factors, such as the presence of a chronic illness or special health care need, must be considered, and further evaluation may be necessary.

The training module provides rationale for their use, describes differences in the CDC and WHO growth charts, and reviews how to use and interpret the charts. The “How to” section on the use of the growth charts will emphasize how to access the charts online, how to assess growth  and interpret the growth charts, how to transition from the WHO to the CDC charts at age 2 years, and how to monitor growth over time.

The CDC Growth Chart training can be accessed at: http://www.cdc.gov/nccdphp/dnpao/growthcharts/

The CHDP Nutrition Subcommittee will be posting its CHDP website Growth Chart training by the end of 2012.

 

Sharing PedNSS Example

To obtain a Microsoft Publisher version for editing these documents, contact Judy Sundquist.

 

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PowerPoint Presentations

National

California

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Prior PedNSS Reports

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