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Am Fam Physician. 2005;71(11):2037-2038

AAFP Joins National Call to Action on Adult Immunizations

The American Academy of Family Physicians (AAFP) has joined immunization experts and other groups in asking Congress to narrow the gap between national adult immunization goals and actual vaccination rates. The AAFP has signed a proposal from the Partnership for Prevention, a national nonprofit, nonpartisan organization, for a six-step plan to increase adult immunization rates. The partnership is asking the federal government to establish a multiyear pilot in at least four states to purchase and distribute flu vaccine to adults who meet high-risk criteria; to require the Federal Employees Health Benefits Program to mandate that participating health insurers provide first-dollar coverage of flu and pneumococcal vaccines for high-risk adults; to earmark additional funds to support adult immunization activities; to launch a national campaign to educate adults about the value of these immunizations; to direct the Centers for Medicare and Medicaid Services (CMS) to expand its quality initiatives to include adult immunization, and commit funding for the Agency for Healthcare Research and Quality (AHRQ) to assess CMS’s efforts to identify best practices and reward quality; and to require CMS to reach an agreement with the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) on making immunization of health care workers one of the criteria JCAHO considers when accrediting hospitals, nursing homes, home health agencies, and other facilities. Additional information is available online at

Depression in Pregnant Women Is Common But Often Untreated

Depression is as common in women during pregnancy as it is after giving birth, according to a new evidence report by the AHRQ. However, physicians and patients may not recognize depression during pregnancy because signs of depression such as tiredness, trouble sleeping, emotional changes, and weight gain also may occur with pregnancy, the AHRQ says. According to the report, about one in 20 American women who are pregnant or have given birth in the past 12 months have major depression. When episodes of major and minor depression are combined, as many as 13 percent of women experience depression. Factors contributing to depression during or after pregnancy may include a personal or family history of depression or substance abuse, anxiety about the unborn child, problems with a previous pregnancy or birth, and marital or financial problems. Factors that contribute to depression after childbirth may include a sharp change in hormone levels, feeling tired and not getting enough sleep, doubts about being a good parent, and changes in work and home routines. The report is available online at

CDC Adopts New Mosquito Repellent Guidelines

The Centers for Disease Control and Prevention (CDC) has released updated guidelines about effective mosquito repellents. The recommendations include the addition of two active ingredients, picaridin and oil of lemon eucalyptus, which have been shown to offer longlasting protection against mosquito bites. Repellents containing DEET also are highly effective and continue to be recommended by the CDC. Picaridin, also known as KBR 3023, has been used in mosquito repellents in Europe, Australia, Latin America, and Asia for some time, and evidence indicates that it is comparable to DEET products of similar concentrations. Oil of lemon eucalyptus, also known as p-menthane 3,8-diol or PMD, is a plant-based repellent that provides protection time similar to low-concentration DEET products. It is available in a variety of formulations throughout the United States. More information is available online at

HHS Launches Campaign to Reduce Infant Mortality Rates in Blacks

The U.S. Department of Health and Human Services (HHS) has started a public education campaign to increase awareness about the risk factors associated with infant mortality among blacks. Black infants are more than twice as likely to die before their first birthday than white infants. Preterm delivery is the leading cause of death and developmental disability in black infants, and the number of deaths resulting from low birth weight and premature birth is nearly four times that for white infants. The campaign uses preventive messages aimed at expectant mothers and fathers, and caretakers. It encourages pregnant women to begin seeing a health care professional as soon as they think they may be pregnant; to go to all of their prenatal care appointments; to avoid drinking alcohol, smoking, and using other drugs before or during pregnancy and after giving birth; and to get help for chronic illnesses and other medical problems.

AAFP Updates Recommendations on Screening for Colorectal Cancer

The AAFP recently streamlined its stance on colorectal cancer screening. The new policy continues to strongly recommend screening men and women 50 years of age or older for the disease but gives no specifics on how often screening should be performed or what methods should be used. The changes were based on recommendations from the U.S. Preventive Services Task Force (USPSTF), which found good evidence that periodic at-home fecal occult blood testing (FOBT) reduced mortality rates from colorectal cancer and fair evidence that sigmoidoscopy alone or in combination with FOBT did so. Although the USPSTF found no direct evidence that screening colonoscopy reduced mortality rates, the overall efficacy of colonoscopy was supported by other data and evidence of benefit. Double-contrast barium enema offered an alternative means of whole-bowel examination but was less sensitive than colonoscopy and also showed no direct evidence of effectiveness in reducing mortality. Data were insufficient to indicate whether newer technologies such as computed tomographic colography improved outcomes. The new AAFP policy is available online at

HHS Announces $95 Million in Grants to Improve Health in Minorities

The HHS has earmarked $95 million in grants to develop a program to reduce the number of cancer deaths in minority and poor populations. The new initiative, called the Community Networks Program, aims to reduce cancer disparities through community participation in education, research, and training. Up to 25 grantees will develop programs to increase the use of cancer interventions in underserved communities. Interventions will include proven approaches such as smoking cessation, increasing healthy eating and physical activity, and early detection and treatment of breast, cervical, and colorectal cancers. Programs will be designed to reach communities with a disproportionate share of the cancer burden. The grants will be used to train investigators, identify potential research opportunities, and ensure that best practice models are widely disseminated. Additional information is available online at

New AHRQ Guide Helps Nurses Encourage Patients to Stop Smoking

A new tool that gives nurses evidence-based information that they can use to help patients quit smoking is available from the AHRQ. The free pocket guide “Helping Smokers Quit: A Guide for Nurses,” gives nurses easy access to information based on the “5 As” approach to cessation intervention: Ask, Advise, Assess, Assist, and Arrange. It also includes a list of approved smoking cessation medications and a referral to HHS’s National Quitline, 1-800-QUIT NOW (1-800-784-8669). According to HHS, approximately 70 percent of adult smokers report that they would like to quit, but only one half of smokers who see a health care professional have ever been urged to quit. The pocket guide, was developed by the AHRQ in collaboration with Tobacco Free Nurses, a national initiative funded by the Robert Wood Johnson Foundation to increase nurses’ participation in tobacco control. The guide is available online at

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