Maternal and Child Health Journal最新文献

{"title":"Improving Access to Mental Health Care among Children who Receive Subspecialist Care.","authors":"Kristin Hittle Gigli, Genevieve Graaf","doi":"10.1007/s10995-025-04116-4","DOIUrl":"10.1007/s10995-025-04116-4","url":null,"abstract":"<p><strong>Objectives: </strong>Children and Youth with Special Healthcare Needs (CYSHCN) have high rates of unmet health care need, particularly mental health. To increase access to mental health care, policymakers support pediatric subspecialists providing mental health care. Yet it is unclear how great the need for this role might be. This study described mental health care needs among CYSHCN who needed pediatric subspeciality care, and rates at which needs go unmet.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 20,335 CYSHCN who needed subspecialist care from 2016 to 2021 using pooled National Survey of Children's Health data. Analysis described rates of mental health care need and unmet need.</p><p><strong>Results: </strong>40% (N = 8,538) of CYSHCN who needed subspecialist care had mental health care needs. CYSHCN receiving care from a specialist had a significantly lower unmet need for mental health care, compared to those who did not receive specialist care (12.5% vs. 43.5%). Receiving subspecialist care was associated with a 24-percentage point decrease in unmet mental health need.</p><p><strong>Conclusions for practice: </strong>CYSHCN who receive subspecialist care have high rates of mental health care need, most need is met. Future work should explore strategies to support subspecialists in the provision of holistic, physical, and mental, health care without assuming roles as mental health care providers.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"879-886"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Chronic Diabetes with 42-Day Readmission after Delivery Hospitalization.","authors":"Melanie Boyd, Dominique DuBois, J Mick Tilford, Mandana Rezaeiahari, Anthony Goudie, Clare C Brown","doi":"10.1007/s10995-025-04122-6","DOIUrl":"10.1007/s10995-025-04122-6","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the impact of chronic diabetes on 42-day hospital readmission rates and hospitalization costs following hospital delivery discharge.</p><p><strong>Methods: </strong>Using 2016-2019 data from the Hospital Cost and Utilization Project Nationwide Readmissions Database, we conducted a propensity score matched analysis comparing individuals with and without chronic diabetes. Given the strong relationship between severe maternal morbidity and readmission, we used an exact match for severe maternal morbidity during the delivery hospitalization. The study evaluated three outcomes: (1) readmission rates within 42 days of discharge from the delivery hospitalization, (2) total hospitalization costs during the delivery and readmissions within 42 days, and (3) total hospitalization costs for readmission hospitalizations.</p><p><strong>Results: </strong>Adjusted analyses showed 61% [adjusted Odds Ratio: 1.61; Confidence Interval: (1.52, 1.71)] higher rates of postpartum hospital readmission within 42 days (4.49% vs. 2.85%; p < 0.001) and 24% higher total delivery hospitalization costs plus the cost of readmission among individuals with chronic diabetes relative to individuals without diabetes ($9,047 vs. $7,296; p < 0.001). Hospital readmissions costs were higher for individuals with diabetes compared with individuals without diabetes at the time of delivery ($9,136 vs. $8,363; p  = 0.03).</p><p><strong>Conclusions for practice: </strong>Continued efforts to prevent and control chronic diabetes may be important for prevention of postpartum hospital readmissions and increased associated costs.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"911-918"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intimate Partner Violence Against Indigenous Women and Association with Stunting and Anemia in Children: A Mixed Approach in Chimborazo-Ecuador.","authors":"María F Rivadeneira, María D Naranjo, María F Barrera, Patricio Trujillo, María A Montaluisa, Ana L Moncayo, David Grijalva, Ana L Torres","doi":"10.1007/s10995-025-04117-3","DOIUrl":"10.1007/s10995-025-04117-3","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to describe intimate partner violence in Indigenous women and assess its association with stunting and anemia among children less than five years of age in Chimborazo, Ecuador.</p><p><strong>Methods: </strong>This study used a mixed-methods research design with two components: A cross-sectional study was conducted among 317 children under 5 years of age and their mothers. Structured questionnaires were used to collect data on Spousal Index Abuse, family socioeconomic characteristics, and alcohol consumption. Data on children's anthropometric measurements and hemoglobin were quantified. Bivariate and multivariate Poisson regressions were performed to determine the association of stunting and anemia with intimate partner violence. Additionally, a qualitative study was conducted with focus groups in 28 indigenous women from rural communities in Chimborazo.</p><p><strong>Results: </strong>31.5% (n = 100) of women were exposed to nonphysical IPV and 18% (n = 57) to physical IPV. Spousal alcohol consumption frequency of twice a month or more was associated with a probability 4.2 times greater of being a victim of IPV (95% CI 1.14-12.6). Physical and non-physical IPV was 2.71 (95% CI 1.36-5.39) and 3.48 times (95% CI 1.4-8.6) more prevalent in households without drinking water supply or sewerage network, respectively. There was not a statistically significant association between IPV and stunting in children. Maternal physical and nonphysical IPV was associated with a higher prevalence of anemia, 2.1 times higher for physical (95% CI 1.8-5.0) and 2.6 for nonphysical IPV (95% CI 1.1-5.8). The focus group discussions revealed a relationship between violence, age, religion, poverty, lack of education, and limited access to public services. For mothers, violence is related to sadness, which affects the health and nutrition of their children.</p><p><strong>Conclusions: </strong>This study suggests that children of women exposed to IPV are at greater probability of suffering from anemia. Therefore, an integral approach to IPV prevention is required, through social protection and healthcare policies for mothers and children, considering the intercultural context.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"932-947"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Origins and Evolution of the Maternal and Child Health Journal, 1991-2025.","authors":"Milton Kotelchuck, Donna J Petersen, Timothy De Ver Dye","doi":"10.1007/s10995-025-04124-4","DOIUrl":"https://doi.org/10.1007/s10995-025-04124-4","url":null,"abstract":"<p><p>The Maternal and Child Health Journal, a preeminent peer-reviewed scientific and practice journal of the MCH field, was established 25 years ago to showcase research and practice in MCH and to provide a forum that enhances and reflects our ever-expanding field. The three surviving editors reflect on the history, evolution, and future of the MCH Journal-with special emphasis on the MCH Journal's origins, and on the lived experience of the editors. APHA's MCH section formed a committee in Nov 1991 to explore creation of a journal. This effort culminated in March 1997 with the publication of the first issue of the MCH Journal, which has since published over 240 subsequent issues. The MCH Journal evolved from a small quarterly print journal to a large monthly, abstracted, print and digital Journal that publishes over 200 + articles and receives almost 1,000,000 downloads annually. Milt Kotelchuck (1997-2003) helped create and sustain the culture of the Journal in its earliest most precarious stage of development, secured Medline abstraction and digital publication, and fostered MCH Epidemiology and Social Determinants of Health (SDOH) initiatives. Greg Alexander and Donna Petersen (2004-2012) expanded the frequency and size of the Journal, implemented its Editorial Manager System, expanded author and reviewer writing capacity and quality, strengthened ties with MCH practitioners, and increased the MCH Journal's use as a pedagogic tool. Tim Dye (2013-present) continued expanding and globalizing the Journal introducing a monthly format; broadened the scope of disciplines and types of articles published; and-through aligning publication policies-uplifted voices of communities traditionally marginalized by academic presses. The MCH Journal continues to provide a critical platform for the publication of MCH research, practice, policy, and professional development, helping to define, strengthen, and forcefully advocate for our MCH field and advance MCH population health, social justice, and equity.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Maternal Child Health Initiatives and Programs 1974 to 2023.","authors":"Debra Jackson","doi":"10.1007/s10995-025-04121-7","DOIUrl":"https://doi.org/10.1007/s10995-025-04121-7","url":null,"abstract":"<p><strong>Aim: </strong>This review paper aims to review Global MCH initiatives and note trends across the last five decades (1974-2023).</p><p><strong>Methods: </strong>As an organizing framework, MCH initiatives and programs have been classified into five categories: Global Health Conferences, Declarations or Strategies; Global Health Surveys; Global MCH Programs; Global MCH related Data Initiatives or Working/Advisory Groups; and Global MCH Partnerships or Networks.</p><p><strong>Results: </strong>Over 50 Global MCH initiatives and programs have been implemented during this period. The first International Conference on Primary Health Care and the Alma Ata Declaration in 1978 initiated a new era of global public health. International conferences building on Alma Ata with a focus on population health and MCH, along with global surveys to measure the health status of populations across countries and global working groups to analyze these data, emerged over the next decades. Global MCH partnerships also emerged for advocacy and coordination of an increasing number of efforts to improve maternal, newborn, child and adolescent health and well-being-towards achieving the Millennium (2000-2015) and Sustainable (2016-2030) Development Goals.</p><p><strong>Conclusion: </strong>Four trends were noted across these five decades: (1) MCH Mortality decreased but unacceptable inequities persist with COVID-19, ongoing conflicts and climate change threatening these gains. (2) Implementation of primary health care (PHC) as envisioned by Alma Ata in 1974 continues to see a debate about selective versus comprehensive programs. (3) As mortality declined (Survive), the field expanded focus to child well-being (Thrive) and across preconception through adolescents (Transform). (4) Global MCH issues are relevant across high-income (HIC) and low-middle income (LMIC) settings to achieve health and well-being of all women and children everywhere.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of the Use of Doulas to Support Rural Perinatal People in the United States.","authors":"Jessica L Liddell, Al Garnsey, Annie Glover, Emma Piskolich","doi":"10.1007/s10995-025-04106-6","DOIUrl":"10.1007/s10995-025-04106-6","url":null,"abstract":"<p><strong>Introduction: </strong>Maternal health outcomes are frequently worse for individuals living in rural and remote communities due to the distance people must travel for healthcare, higher rates of poverty, and higher risk factors for related health conditions, such as mental illness and substance use. Doulas, non-medical childbirth companions, provide emotional, informational, physical, and advocacy support to people during pregnancy, birth, and postpartum. Research has documented doulas' positive impact on birth outcomes, including lower rates of induction and cesarean birth. The benefits of doulas may be especially important for marginalized and underserved populations who experience disparate health outcomes, including rural residents. This scoping review was conducted to describe and assess the landscape of doula-focused research that focuses on the unique contextual challenges faced by rural communities.</p><p><strong>Methods: </strong>We conducted a scoping review of research exploring the use of doulas in rural contexts. Peer-reviewed articles presenting original research using both quantitative and qualitative methods were included. Target populations for the included studies were rural perinatal people receiving doula support or doulas in rural contexts. All definitions of rurality were included. Database index terms were searched as well as keyword search terms: \"rural\" AND \"doula\" OR \"labor coach\" OR \"birthing coach\" OR \"childbirth coach\" OR \"birth attendant\" AND \"United States\" OR \"U.S.A.\"12 peer-reviewed journal databases and Google Scholar were searched May 2022- September 2023. Data was synthesized using tabular and narrative methods to capture (a) study design and type, b) study purpose, c) population, d) study location, e) analysis, d) definition of rurality, and e) reported results and gaps in the literature.</p><p><strong>Results: </strong>2,195 articles were identified. After removing duplicates and ineligible studies, 3 articles were included in the final results. These articles included quantitative (1), qualitative (1), and mixed methods (1) studies exploring access to and perceptions of doulas in rural areas.</p><p><strong>Conclusion: </strong>Findings demonstrate limited scholarship on the use of doulas in rural settings. This area of research warrants further attention.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"733-740"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Knowledge, Practices and the Associated Factors Among Postpartum Mothers Concerning Neonatal Umbilical Cord Care in Pakistan: A Cross-Sectional Study.","authors":"Mahnoor Atta, Yan Xie, Hong Qin","doi":"10.1007/s10995-025-04103-9","DOIUrl":"10.1007/s10995-025-04103-9","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to estimate the maternal knowledge and practice levels regarding neonatal umbilical cord care and their associated factors in different provinces of Pakistan.</p><p><strong>Methods: </strong>A descriptive cross-sectional study design was used to collect data from the respondents. Multistage sampling techniques were carried out for this study. Semi-structured questionnaire was designed for collection of data after acquiring ethical approval and informed consent. Descriptive statistics were carried out by taking frequencies and percentages of the collected data and associated factors were analyzed by applying chi-square test at the p value of < 0.05.</p><p><strong>Results: </strong>245 (65.3%) of the respondents had poor knowledge levels about umbilical cord care and 220 (58.7%) respondents practiced poor cord care. More than half of the respondents had poor knowledge. 285 (76%) about the usage of chlorhexidine (CHX) on the cord for seven consecutive days. Some conventional and unhygienic practices were also recorded in this study. More than half of the mothers used cord clamps for tying the cord 245 (65.3%) followed by tailor's threads 77 (20.5%). The associated factors including parity, occupation and income were not showing statistically significant results at the p value of < 0.05 except for place of delivery (*p = 0.01), (*p = 0.005) and educational status (*p = 0.04), (*p = 0.03), which are showing statistically significant results.</p><p><strong>Conclusion: </strong>Paucity in both knowledge and practices of umbilical cord care were observed among mothers attending postnatal care in the hospitals. Programs need to be initiated for the improvement of knowledge of UCC and discouragement of unhygienic practices.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"808-817"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Positive Toxicology at Delivery: Insights From the University of Maryland Medical System.","authors":"Leah L Habersham, Candice L Woolfolk, Kima J Taylor, Mishka Terplan, Katrina Mark","doi":"10.1007/s10995-025-04107-5","DOIUrl":"10.1007/s10995-025-04107-5","url":null,"abstract":"<p><strong>Objective: </strong>To explore factors associated with positive toxicology tests during birthing admissions within a hospital system employing universal toxicology testing.</p><p><strong>Methods: </strong>A retrospective cross-sectional study from 2019 to 2022, within a health system where toxicology tests are performed routinely during the birth admission. Substance use was defined as a positive toxicology test and race was self-reported. The association between substance use with race and insurance was analyzed. Assessments were made using descriptive statistics, chi-squared tests, and logistic regression models, controlling for maternal age, gestational age, birth year, insurance, and birth hospital. Separate analyses were conducted excluding cannabis from the toxicology evaluations.</p><p><strong>Results: </strong>Of 37,438 deliveries, 97% (36,323) underwent toxicology testing. Unadjusted odds for positive toxicology tests (including amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, fentanyl, methadone, opioids (all), phencyclidine) were: Black (OR 1.91), Hispanic (OR 0.36), and Other (OR 0.56), compared with White. After adjusting for confounders, all groups showed decreased odds: Black (aOR 0.75), Hispanic (aOR 0.15), and Other (aOR 0.36). For insurance, the unadjusted odds were compared to private insurance: Public (OR 4.18) and Other (OR 1.81). When excluding cannabis, unadjusted odds for Black individuals increased (OR 1.21) while adjusted odds for Black, Hispanic, and 'Other' groups decreased relative to White individuals.</p><p><strong>Conclusion: </strong>Substance use during pregnancy exhibits sociodemographic variations. Initial unadjusted findings indicated racial disparities in substance use. However, adjusted models shifted these initial observations. Findings highlight the intertwined nature of sociodemographic factors in toxicology test results. Study findings underscore the need for comprehensive research to inform interventions, focusing on racial and socioeconomic inequities.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"783-790"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Interaction Between Caregivers and Children with Chronic Diseases in Oral Medication-Taking Situations: A Validation Study of the Interaction Rating Scale.","authors":"Takuya Yasumoto, Tomoka Yamamoto, Atsuko Ishii, Hiroko Okuno, Haruo Fujino","doi":"10.1007/s10995-025-04099-2","DOIUrl":"10.1007/s10995-025-04099-2","url":null,"abstract":"<p><strong>Introduction: </strong>Caregiver-child interaction is essential for maintaining adaptive oral medication-taking behavior in children. To evaluate interactive behavior between children and caregivers, the Interaction Rating Scale (IRS), an observation-based instrument for evaluating the quality of caregiver-child interaction, can be applied via observation of interactions. This study examined the applicability of the IRS in oral medication-taking situations.</p><p><strong>Methods: </strong>Sixty-six caregiver-child dyads were evaluated using the IRS. The reliability of the measure was evaluated using Cronbach's alpha for internal consistency and intra-class coefficient (ICC) for inter-rater reliability and test-retest reliability. The concurrent validity was evaluated using the Positive and Negative Parenting Scale and the Social Skills Scale for Preschool Children.</p><p><strong>Results: </strong>The IRS total, caregiver, and child scores showed high internal consistency (α = 0.86-0.92), test-retest reliability (ICC = 0.76-0.80) and inter-rater reliability (ICC = 0.86-0.91). The IRS indices were partially associated with the Positive and Negative Parenting Scale and Social Skills Scale scores in the hypothesized directions.</p><p><strong>Discussion: </strong>The results indicated the IRS is a reliable and validated instrument for measuring characteristics of caregiver-child interactions in medication-taking situations. Further studies may be helpful for validating the measure in wider patient groups and investigating the medication behavior of children.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"835-844"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Logos on Intrastate Variation of Response Rates for the Pregnancy Risk Assessment Monitoring System in Nevada.","authors":"Randall J Owen, Lex Owen, Rishab Karki","doi":"10.1007/s10995-025-04100-y","DOIUrl":"10.1007/s10995-025-04100-y","url":null,"abstract":"<p><strong>Introduction: </strong>Survey response rates have varied for Nevada's administration of the Pregnancy Risk Assessment Monitoring System (PRAMS) across the state. The authors evaluated whether using different logos for survey distribution would impact response rates.</p><p><strong>Methods: </strong>Using focus groups and an online survey, we asked how participants perceived three logos (which was the most likely to be opened, most trustworthy, and must credible).</p><p><strong>Results: </strong>Results showed that the State seal would be the mostly likely opened, but they were likely to discard it if the envelope's contents were not official business. The University's logo was polarizing in some areas.</p><p><strong>Conclusions: </strong>A PRAMS-specific logo survey may be more effective, as it was seen as \"inviting\" and adequately described the contents of the envelope. Further research is needed to better explore the impact of logos on mail distributions for public health surveillance surveys.</p>","PeriodicalId":48367,"journal":{"name":"Maternal and Child Health Journal","volume":" ","pages":"777-782"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}