Join us in confronting disinformation….

You are invited to attend the Innovations in Research event hosted by SFU Public Square on April 10.

Innovations in Research is an evening event showcasing SFU researchers and innovators who are designing solutions to confront the disinformation age.

There will be a presentation showing how the Children’s Health Policy Centre prepares its Quarterly publication using systematic review and synthesis methods. This publication, which is produced in partnership with policy-makers from the BC Ministry of Children and Family Development, confronts disinformation to improve children’s mental health.

Innovations in Research will take place on Wednesday, April 10 from 7 to 9 pm at SFU Segal Graduate School of Business, 500 Granville Street, Vancouver, B.C.

Anyone wanting more information, is invited to visit the event website.

Preparing to parent — while coping with multiple adversities

Life has been challenging for many of the girls and young women participating in BC’s randomized controlled trial that is evaluating the Nurse-Family Partnership (NFP) program for the first time in Canada.

The first data report on participants’ profiles when they entered the trial in early pregnancy has just been released. This report reveals a group of 739 girls and young women who were pregnant and preparing to parent for the first time and selected based on socioeconomic disadvantage. They were age 24 or younger and experiencing low income, low education and/or being single.

The data show that some 83% of these girls and young women were earning less than $20,000 annually, while 53% of them had not completed high school. Most were also single. As well, almost half had experienced homelessness in their lifetime and a third had recently experienced housing insecurity (having to move more than three times within the past year).

Most participants — some 74% — also reported having coped with serious long-term mental and physical health conditions. Nearly half reported coping with severe anxiety or depression and 22% reported they had diagnosed mental disorders.

More than half reported having experienced moderate-to-severe child maltreatment when they were younger. Half also report experiencing intimate partner violence more recently.

While 77% had recently visited primary healthcare providers for physical health concerns, only 28% had received prenatal classes. Perhaps most surprising, only 29% had recently received important BC benefits for people living on low income such as Income and Disability Assistance.

Overall, 89% of these girls and young women were experiencing three or more forms of disadvantage, with 77% experiencing four or more and 56% experiencing five or more.

“Our data show there are unacceptable pockets of deep socioeconomic disadvantage for BC girls and young women who are preparing to parent for the first time,” said lead principal investigator Charlotte Waddell. “This finding has important policy implications,” she added.

An intensive home-visiting program provided by public health nurses, NFP starts early in pregnancy and continues until children reach their second birthday. First developed more than 40 years ago in the United States, NFP has shown many benefits in that country including:

  • reducing prenatal substance use
  • reducing childhood injuries
  • improving children’s mental health and cognitive development, and
  • helping lift young mothers out of poverty

Through the BC trial, we may discover similar benefits for young mothers and their children here. Trial recruitment began in October 2013 and closed in December 2016. The study team is now following the 739 families, who are participating in research interviews until children reach their second birthday (the duration of the NFP program). Study results will be available later in 2020.

Participating regional Health Authorities are also offering NFP to all eligible girls and young women and their children as an enhanced public health service. Trial results will help strengthen the program across BC.

Based in the Faculty of Health Sciences at SFU, the trial is funded by the BC Ministry of Health with support from the BC Ministry of Children and Family Development and from four Health Authorities (Fraser Health, Interior Health, Island Health and Vancouver Coastal Health). Funding is also being provided by the Mowafaghian and R. and J. Stern Family Foundations.

Charlotte Waddell and Harriet MacMillan are the Nominated Co-Principal Investigators. Nicole Catherine is the Scientific Director and Co-Principal Investigator. Susan Jack and Debbie Sheehan are also Co-Principal Investigators. A larger Scientific Team provides guidance, including from collaborators at McMaster University, UBC, the University of Victoria and the Public Health Agency of Canada.

Anyone in BC who wishes to be referred to the Nurse-Family Partnership program should contact their primary care practitioner or their local Health Authority. For more information about Nurse-Family Partnership, see here. The BC Healthy Connections Project Study Team can be reached by email at: bchcp@nullsfu.ca.

 

 

Preparing to Parent in British Columbia: A Profile of Participants in the BC Healthy Connections Project

Charlotte Waddell, Nicole Catherine, Harriet MacMillan, Rosemary Lever, Patricia Wallis, Debbie Sheehan, Michael Boyle, Amiram Gafni, Lawrence McCandless, Lil Tonmyr, Andrea Gonzalez, Susan Jack, Ron Barr, Colleen Varcoe and Lenora Marcellus for the BC Healthy Connections Project Scientific Team. Preparing to Parent in British Columbia: A Profile of Participants in the BC Healthy Connections Project. Vancouver, BC: Children’s Health Policy Centre, Simon Fraser University, 2018.

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Helping policy makers respond to the needs of kids

A recent video conference, focusing on an academic publication by the Children’s Health Policy Centre, ended up highlighting a unique partnership in B.C.

“I think it’s remarkable that you have such an integrated group of people who implement policy, who advocate for policy and who research policy,” said moderator Michael Ostacher, associate professor of psychiatry and behavioural sciences at Stanford University and digital content editor for the journal Evidence-Based Mental Health.

The one-hour discussion brought together the BC Ministry of Children and Family Development, represented by Rob Lampard, the BC division of the Canadian Mental Health Association, represented by Bev Gutray and the CHPC research team, led by Charlotte Waddell. She was joined by Christine Schwartz and Jen Barican from the CHPC.

Although the impetus for the event was publication of a systematic review of prevention and treatment of childhood behaviour disorders, the wide-ranging discussion touched on much broader issues and concerns.

Highlighted was the unique relationship between the CHPC research group and the BC government. “There’s been a relationship between [the CHPC and] the policy branch that goes way back to the early 2000s,” said BC Child and Youth Mental Health Policy Executive Director Rob Lampard. “The team has had a big influence on the public policy landscape. Their excellent work is part of a large fabric that’s been woven over many years.”

His positive views were echoed by BC division Canadian Mental Health Association CEO Bev Gutray. “It’s a great privilege to be part of this team,” she said, noting that she was particularly happy with her own group’s ability to launch an intervention called Confident Parents/Thriving Kids. An adaptation of evidence-based parent training developed in Oregon, the built-in-BC program is able to provide support to parents via the phone in evenings and on weekends. “We couldn’t have done this without the CHPC team,” Gutray said. “And the Ministry has been alongside us every step of the way,” she adds.

While emphasizing the value of systematic review work, CHPC director Charlotte Waddell also stressed the importance of being pragmatic. “It’s really important to avoid what some people have called systemic review nihilism,” she said. “We need to give policy makers something practical that will allow them to respond to kids’ needs.”

Anyone wishing to view the video conference can see it here.

Hangout addresses childhood behaviour disorders

You are invited to attend a Google Hangout on preventing and treating childhood behaviour disorders, Sept. 5 at 8 am Pacific time.

Attending the event will be a team of people from the Children’s Health Policy Centre, including the director and child psychiatrist, Charlotte Waddell, clinical psychologist and scientific writer Christine Schwartz and research manager Jen Barican. The CHPC has authored a publication for the journal Evidence-Based Mental Health, which is the organizer of the hangout.

Also attending the event will be representatives of the Canadian Mental Health Association, the BC government, Oxford University and Stanford University.

Oppositional defiant and conduct disorders start early and persist, incurring high individual and collective costs. The panel of experts will discuss the best available research evidence on preventing and treating these disorders, following their recent systematic review. The review will provide a starting point for wide ranging discussion and debate, including consideration of the implications of the evidence for policy and practice.

To join the event go to YouTube at https://bit.ly/2wmos51.

Children’s Health Policy Centre team takes children’s mental health messages to Banff

Representatives from the Children’s Health Policy Centre were proud to address the 50th Annual Banff International Conference on Behavioural Science, March 18 to 21, 2018. The theme was, “What are Ideal Children’s Mental Health Services?”

CHPC director Charlotte Waddell (adjacent), delivered the closing plenary address on the topic, “Improving Children’s Mental Health: The Policy Opportunities in Canada.” In her 50-minute presentation, Waddell covered a host of topics for the broad-ranging audience that included everyone from well-known academics to graduate students.

Waddell’s key messages included five points:

• It’s important not to focus on one age group at the expense of others. The responsibility facing children’s mental health policymakers encompasses all young people from before birth to early adulthood.

• There are considerable challenges in providing services for all ages and all disorders. “We are currently reaching only 30% of children with mental health disorders,” Waddell said, citing a recent systematic review the CHPC prepared.

• We shouldn’t fall for the argument that there’s not enough money. “Canada spends a lot on healthcare, but if we look at current Canadian spending, most of it is going towards older Canadians,” Waddell said. “We need to have a public conversation about that.”

• It is possible to change spending patterns. This has been demonstrated by spending on autism where funding has increased tenfold over the last 10 years. “It’s a terrific success story for one mental disorder,” Waddell says, adding, “We can learn from that.”

• We need to triple spending on children’s mental health. “That goal is entirely reasonable,” according to Waddell. She adds that new spending should cover both prevention and treatment, and should go towards effective or proven interventions.

Earlier in the conference, the CHPC team also delivered a three-hour workshop titled, “Research-policy partnerships in children’s mental health: Lessons from British Columbia.” In it, Nicole Catherine spoke about her experience as Scientific Director and Co-Principal Investigator of the BC Healthy Connections Project, the first Canadian randomized controlled trial evaluating the Nurse-Family Partnership (NFP) program.

Developed nearly 40 years ago by David Olds and colleagues in the US, NFP starts in early pregnancy, before children are born, and involves intensive home visits continuing until children reach their second birthday. The program particularly focuses on girls and young women and their children who are facing disadvantages such as low income.

The BC Healthy Connections Project trial involves close collaborations with BC policymakers in the Ministries of Health and Children and Family Development and in four participating regional Health Authorities. Some 744 children are being reached through the trial, with final results expected in 2020–2021.

In the same workshop, Christine Schwartz spoke about the Children’s Mental Health Research Quarterly, describing a longstanding research-policy-practice partnership with BC’s Ministry of Children and Family Development. She highlighted the methods used to convey research evidence to policymakers, as well as to practitioners and families.

These methods include preparing systematic reviews of evidence on prevention and treatment interventions across a wide array of childhood mental health problems. Evidence is then prepared in user-friendly formats, published free on line, in the Quarterly. Topics are chosen in consultation with policy partners and each issue is accompanied by talks.

BC children need more funding for mental health

The BC child and youth mental health budget should be tripled to ensure help for the estimated 70 per cent of young people with mental disorders who currently receive no effective treatment, according to Charlotte Waddell, director of SFU’s Children’s Health Policy Centre.

Waddell shared her views in an article published recently in the Vancouver Sun.

The system needs more interdisciplinary teams, including psychologists, nurses and social workers, to be available in communities where children live, according to Waddell. But instead, budgets for these services, which are provided for all BC children through the Ministry of Children and Family Development’s Child and Youth Mental Health Branch, have been steadily eroded over the years.

Waddell also said that some common childhood disorders — such as anxiety, behaviour problems, substance misuse and depression — could be avoided if society invested in more preventive programs. There are many such programs that are effective and that can be delivered, in family homes and in schools. (For examples, please see the Centre’s recent publication on preventing childhood depression as well as one on preventing anxiety in children.)

Waddell noted that budgets for autism in both B.C. and Ontario have increased 10-fold over the last decade, mostly due to effective lobbying by parents of autistic children. The same has not been true for budgets for other childhood mental disorders, she said. But these increases for children with autism show that increases are possible.

The story, which ran under the headline “Not enough services for mentally ill kids, says family of struggling boy,” was published in the Dec. 1/17 issue of the Vancouver Sun. A follow-up story appeared on Dec. 4/17 under the headline, ” A mother’s plea: Save unique Richmond school that helped her 7-year-old mentally ill son.”

Many happy returns: All babies are delivered

Consider this an unusually weighty birth announcement.

All the babies have now been born to the young mothers enrolled in the BC Healthy Connections Project (BCHCP). There are 744 young ones, including 11 sets of twins.

“People are usually happy to hear birth announcements, but this one is particularly exciting,” says Charlotte Waddell, one of the project leads. “We believe this project will give these mothers and these children a stronger voice.”

The BCHCP is the first Canadian scientific evaluation of the Nurse-Family Partnership (NFP) program. NFP aims to help young first-time mothers and their children by providing intensive visits by specially-trained public health nurses. The goals are to improve children’s health and development, while also improving the mothers’ lives.

The success of the program has been widely documented in the US, most recently in a study released July 24/17 by James Heckman, a Nobel laureate economist at the University of Chicago. By ages six and 12, children whose mothers received the home visits were healthier and had better cognitive and social and emotional skills, he found. And mothers had better mental health and parenting skills, he added. A US National Public Radio interview with Heckman spells out why he believes NFP has been so successful in the US.

The BC evaluation is using randomized controlled trial methods to investigate how NFP compares with the province’s existing health and social services. Preliminary profiles of the participants will be released later in 2017 with main study results to follow after all the families have graduated in late 2020. An outline of the project may be seen here, along with a journal article on the study protocol.

There are also two adjunctive studies associated with the BCHCP. The first is a Process Evaluation, determining how well the intervention is being implemented and what factors may be influencing its outcomes. The second is the Healthy Foundations Study, examining biological markers of health outcomes for children over the first two years of life.

BC leads the country by being the first province to now offer Nurse-Family Partnership to all eligible women who are interested. Five regional Health Authorities — Fraser, Interior, Island, Northern Health and Vancouver Coastal Health — have opened the program with no need for randomization to control and intervention groups.

To enquire about Nurse-Family Partnership or to enroll in the program, please contact:

  1. Your nurse practitioner, family doctor or midwife, or
  2. Your local Health Authority: