Author Archives: Daphne Gray-Grant

Study shows drop in cannabis and cigarette use during pregnancy for young, first-time mothers

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Findings from a scientific study by Simon Fraser University give encouraging clues on how to reduce cannabis and cigarette use during pregnancy for young, first-time mothers -to-be.

The BC Healthy Connections Project, which is being led by SFU’s Children’s Health Policy Centre, in collaboration with researchers at McMaster University, is a randomized controlled trial examining an intensive nurse-home visiting program, called Nurse-Family Partnership (NFP). Findings suggest that NFP may help in reducing some types of prenatal substance use in girls and young women experiencing socioeconomic disadvantage.

Findings were recently published in a peer-reviewed academic journal, Canadian Medical Association Journal Open. The paper may be seen here.

Prenatal exposure to alcohol, cigarettes/nicotine, cannabis, and street drugs all place children at risk for poor health outcomes including being born too early, having a low birth weight, and having later learning and behaviour problems.

Girls and young women who received NFP (compared with regular prenatal services) showed a statistically-significant drop in prenatal cannabis use. As well, those who were smokers and received NFP showed a statistically significant drop in daily number of cigarettes smoked — which is important, given that even low-level cigarette smoking is harmful to a fetus.

Prevention is by far the best approach to such issues, according to Children’s Health Policy Centre director Charlotte Waddell. “These findings are good news in that they show we can prevent or reduce substance use during pregnancy,” she says. Study scientific director Nicole Catherine agrees. “It’s exciting to see these positive results during pregnancy, which is a crucial window for promoting children’s health and wellbeing.” 

NFP is a prevention program involving public health nursing home visits starting early in pregnancy and continuing until children reach age two years. It aims to improve child and maternal wellbeing, focusing on young, first-time parents facing socioeconomic disadvantage. While NFP trials in the United States have shown many short- and long-term benefits for both children and mothers—including the program more than paying for itself—NFP has never before been tested in Canada.

For this study, the team is following 739 mothers and 737 children across BC. The BC Ministry of Health is sponsoring the trial, with support from the BC Ministries of Children and Family Development and Mental Health and Addictions—in collaboration with Fraser, Interior, Island and Vancouver Coastal Health Authorities.

Nurse home visiting and prenatal substance use in a socioeconomically disadvantaged population in BC

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  • Catherine, N.L.A., Boyle, M., Zheng, Y., McCandless, L., Xie, H., Lever, R., Sheehan, D., Gonzalez, A., Jack, S.M., Gafni, A., Tonmyr, L., Marcellus, L., Varcoe, C., Cullen, A., Hjertaas, K., Riebe, C., Rikert, N., Sunthoram, A., Barr, R.G., MacMillan, H., Waddell, C. (2020). Nurse home visiting and prenatal substance use in a socioeconomically disadvantaged population in British Columbia: Analysis of a prenatal secondary outcomes in an ongoing randomized controlled trial. Canadian Medical Association Journal Open, 8, E667–E675. https://doi.org/10.9778/cmajo.20200063

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Report highlights effective interventions for anxiety

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The COVID-19 public health crisis has introduced new and urgent mental health challenges for children across British Columbia.

As a result, the BC Representative for Children and Youth, Jennifer Charlesworth,  asked the Children’s Health Policy Centre (CHPC) to prepare a “Rapid Response” report on effective approaches for reducing childhood anxiety.

Published today, the report identifies two interventions that can be delivered by practitioners virtually and three that can be self-administered by children and families themselves.

“We know it is crucial to address anxiety symptoms and disorders early to ensure they don’t persist into adulthood,” Charlesworth said. “Help cannot wait until the pandemic is over.”

Nearly 45,000 children in B.C. were estimated to have anxiety disorders, before COVID-19, according to Charlotte Waddell, director of the CHPC. “Our new report confirms there are many effective ways for practitioners, caregivers and families to prevent and reduce anxiety during these challenging times,” she said.

Read the entire report here.

Scientific team update on BC Healthy Connections Project now available

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The scientific team guiding the BC Healthy Connections Project has published an update. The project is a randomized controlled trial evaluating the Nurse-Family Partnership program, involving 739 BC-based girls and young women — and their 744 children. The update may be viewed here.

Following last year’s publication of data describing maternal participants and the life conditions they were coping with in early pregnancy, the team is now analyzing initial data on the effectiveness of the nurse-visitation program. A first findings report will soon be released — examining the program’s impact on prenatal substance use. Further findings reports will follow in 2020-2022.

As well, some 27% of project participants identified as Indigenous (including First Nations, Métis or Inuit). The scientific team is collaborating with the First Nations Health Authority to produce publications telling their stories.

The scientific team expects to provide an additional update every quarter until March 2022.

 

Coping with COVID-19

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The Faculty of Health Sciences at Simon Fraser University has created a brief video offering parents advice on how to help children cope with COVID-19.

The video features Charlotte Waddell, director of the Children’s Health Policy Centre, who says that physical distancing doesn’t have to mean loss of connections.

She suggests that parents help children by:

• Getting help themselves when needed to manage stress and to help kids maintain healthy routines
• Encouraging kids to stay connected with friends and family using social networks and the phone
• Remembering how COVID19 affects some children and families more than others
• Thinking of ways to be helping others, which in turn contributes to resilience

“Social connections are crucial for children, as they are for adults,” Waddell says. For more information on specific steps parents and caregivers can take to support kids in the time of COVID-19, go here.

New prevalence study will address children’s mental health needs in BC

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The Children’s Health Policy Centre has taken on a new research project to comprehensively estimate children’s mental health needs in BC and recommend how they can be met. The BC Ministry of Children and Family Development (MCFD) has requested this effort, to inform new services for children’s mental health.

This project will inform needs-based planning by:

• Reviewing the latest epidemiological data on the prevalence of the 10 most common childhood mental disorders
• Summarizing the best evidence on exemplary prevention and treatment interventions for young people
• Examining public datasets that can be used to track children’s mental health outcomes going forward, and
• Synthesizing prevalence, intervention and public data evidence to suggest a comprehensive plan for BC

Led by BC MCFD’s Child and Youth Mental Health Policy Branch, a cross-governmental policy advisory group for the project includes senior representatives from the:
• BC Ministry of Mental Health and Addictions (co-sponsor)
• BC Ministry of Health
• BC Ministry of Education
• First Nations Health Authority, and
• Métis Nation of BC
Other policy collaborators are also being consulted as needed.

The CHPC team is being led by Charlotte Waddell, Christine Schwartz and Nicole Catherine — together with Jen Barican, Donna Yung and Yufei Zheng. Additional scientific collaborators include Kathy Georgiades from McMaster University and Bohdan Nosyk and Emanuel Krebs from Simon Fraser University.

This project is being conducted from 2019 through 2021.

Supporting kids in the time of COVID-19

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The COVID-19 public health emergency is putting a lot of pressure on parents, caregivers and others who work with children. They must explain challenging concepts to help children manage their fears and keep routines as stable as possible.

To assist with these challenges, we offer the following suggestions:

  • Create situations for children to comfortably ask questions at their own pace. Answer questions honestly using concepts that children can easily understand. For example, explain that the new coronavirus is one of many different types of viruses, like the ones that cause colds. And be ready to repeat your answers as children may re-ask the same questions as a way to gain reassurance.
  • Help children manage their fears by modelling calmness and by providing accurate information. This can include explaining the steps you are taking to keep them healthy and safe. (See sidebar, below.) It may also involve highlighting the many actions that community members are taking to protect everyone. And avoid letting children be exposed to media sources that could unnecessarily increase their anxiety.
  • Maintain children’s regular routines as much as possible. Fun activities, like playing outdoors and bike riding, are still possible even with physical distancing. Similarly, technology can help with other important activities like play dates and connecting with grandparents.
  • Encourage children to think about ways they can help others. This could include, for example, helping neighbours who may need things delivered to their doors, sending positive messages to loved ones who may not be near, or communicating with other children about doing schoolwork together, remotely.

Our sidebar, below, gives helpful resources for parents and families. For children who are experiencing more severe anxiety, the book Helping Your Anxious Child may be particularly useful. (Many local bookstores are offering free shipping for online and phone orders.) The book provides guidance to parents of school-age children on ways to teach cognitive-behavioural strategies to reduce anxiety, including recognizing worries and changing the thinking that encourages them.

Collectively, we have faced serious challenges in the past — including wars, 9/11 and wildfires. We will weather this latest crisis as well, with strong public health leadership and with the support of everyone who cares for and works with children.

Resources for parents and families

New resources to help children — and their parents or caregivers — cope with COVID are being developed rapidly. These include:

Research making a difference for children

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A significant percentage of very young mothers in BC are coping with low income, poor education and mental health challenges. These were the issues highlighted by Katie Hjertaas, Ange Cullen and Charlotte Waddell speaking at SFU Vancouver’s inaugural Lunch ‘n’ Learn event, Feb. 6,  on the topic Improving Children’s Lives Through Research.

This new series of lunch hour sessions showcases how SFU’s Vancouver research is making a positive difference in society.

Hjertaas, Cullen and Waddell came to their understanding of the challenges facing very young mothers in part through working on the BC Healthy Connections Project (BCHCP). This randomized controlled trial aims to assess Nurse-Family Partnership (NFP), an intensive, home-based nursing program for very young mothers and their children. NFP runs throughout pregnancy and the child’s first two years of life.

The talk showed that the 739 girls and young women in the study were coping with daunting challenges when they first enrolled:

  • 83% were living on less than $20,000 per year
  • Half were coping with not having grade 12 or equivalent, and those still in school had their education interrupted by pregnancy
  • Many experienced housing instability
  • 74% were coping with mental or physical health problems that affected their daily activities
  • 56% reported experiencing maltreatment when they were children themselves.

Findings from this study are already informing public health policy locally, nationally and beyond — with more reports to come, particularly on how NFP can benefit children.