Nicole Catherine discusses early prevention of intimate partner violence on CBC Radio

Children’s Health Policy Centre Associate Director Nicole Catherine was recently featured on CBC Radio Saskatchewan’s The Morning Edition discussing new research on early prevention of intimate partner violence (IPV).

During the eight-minute segment, Catherine explained how a study led by the Children’s Health Policy Centre revealed promising signs that a nurse-home visiting program could help prevent IPV exposure for young first-time mothers and their children.

The study, published in January in BMJ Open, offers compelling evidence that policymakers across Canada should invest in research-backed approaches to early IPV prevention.

“Investing in prevention programs that commence as early in life as possible, especially for families experiencing disadvantage, that also have rigorous research evidence of effectiveness — that’s going to have the most benefits for children and mothers and society,” Catherine told host Adam Hunter.

The full interview is available on CBC Listen.

Why policymakers should invest in early prevention to reduce intimate partner violence exposure for mothers and children

An early prevention program shows promise for preventing exposure to intimate partner violence (IPV) for mothers and children, according to a recent article by the team from the Children’s Health Policy Centre.

Published in The Conversation, the article is based on new research examining the benefits of Nurse-Family Partnership (NFP), a nurse home-visiting program for expectant mothers and their children.

“These findings come at a crucial time,” the article said. “IPV is occurring at epidemic proportions. Yet, supports for children and mothers remain inadequate and early childhood prevention investments remain sparse.”

To understand the impact of NFP on intimate partner violence exposure, a team of researchers led by Nicole Catherine, Associate Director of the Children’s Health Policy Centre, examined data from the BC Healthy Connections Project, the Canadian randomized controlled trial of NFP. The program involved the provision of frequent support visits from public health nurses to expectant mothers and their children throughout pregnancy and early childhood.

Upon entering the study in early pregnancy, more than one-third (38 per cent) of the participating mothers-to-be reported IPV exposure within the past year. “By the end of the trial, when children were age two years, significantly fewer NFP mothers reported IPV exposure (since last interview) and psychological distress (in the previous month),” the article said.

These findings, while exploratory, offer compelling evidence that policymakers should invest in research-backed approaches to early IPV prevention.

According to a 2014 study cited in the article, the economic burden of childhood IPV exposure totaled over $7 billion in a 10-year period — roughly $9 billion in 2024 dollars.

“These costs could have been averted by early childhood prevention programming,” the article said. “Yet in 2024, only 6.1 per cent of Canada’s health spending was allotted to public health, including prevention.”

Effective primary prevention programs could not only save taxpayers billions of dollars — these programs are desperately needed to ensure children and mothers do not experience avoidable harms from IPV exposure.

Read the full article.

Children’s Mental Health Research Quarterly publishes last issue after 18-year run

The Children’s Health Policy Centre (CHPC) has released the final issue of the Children’s Mental Health Research Quarterly — for now.

For 18 years, the Quarterly summarized the best available research evidence on a wide range of children’s mental health topics. The publication was funded by the BC Ministry of Children and Family Development (MCFD). The final issue — on anxiety treatments — was released on April 2.

“When we started the Quarterly we hoped it would continue and have long-term impact,” said Charlotte Waddell, Director of the Children’s Health Policy Centre and Professor Emerita in the Faculty of Health Sciences at Simon Fraser University.

“Its duration speaks to our partnership with the Ministry, and to our shared commitment as researchers and policymakers to improving children’s mental health. We’ve had a fantastic run, and we’re proud of the impact the Quarterly has had.”

The CHPC released the first Quarterly issue in 2007. The vision for the publication was to highlight high-quality research on children’s mental health and to make it available to policymakers, practitioners and community members.

“We wanted to share research on children’s mental health in an accessible format,” said Waddell. “The Quarterly allowed us to make the research freely available — to policymakers and practitioners, yes, but also to parents and anyone else with an interest in children’s mental health.”

Over the years, the Quarterly covered many common childhood disorders like anxiety and ADHD. But it also looked at topics relevant to the national mental health conversation. For example, a recent issue on prevention of opioid use disorders formed the basis for an article published in The Conversation. This article led to further media coverage, reaching a national audience on the importance of early opioid use prevention.

Though Waddell and the CHPC team are sad to see the publication end, they are looking forward to continuing their research and engagements with policymakers. And they are leaving the door open for a possible return.

“MCFD wasn’t able to renew the Quarterly contract, but we intend to seek other funding. In the meantime, we have other initiatives underway to help encourage the best possible prevention and treatment programs for children in BC and beyond,” said Waddell.

For readers who may miss the Quarterly, Waddell points to the extensive archive of past issues, which will remain online indefinitely. The complete subject index will also remain available indefinitely.

“We are grateful to our readers for being there for children’s mental health,” said Waddell. “We hope the Quarterly library will continue to be a useful resource for many years to come, and we invite anyone who is interested in our work to stay connected with us. The Quarterly is on pause, but our team will continue sharing research and working to improve the lives of children and youth.”

You can view all past issues of the Children’s Mental Health Research Quarterly in the online Quarterly archive.

CHPC researchers to evaluate an adapted early prevention program for diverse families

A team of researchers from the Children’s Health Policy Centre (CHPC) have partnered with the Fraser Health Authority, Population and Public Health, to evaluate their new Enhanced Family Visiting (EFV) Program.

Led by Principal Investigator and CHPC Associate Director Nicole Catherine, the CHPC team aims to understand the experiences of those who took part in the EFV Program.

“The EFV Program was designed by Fraser Health to be more inclusive of diverse children and mothers,” said Catherine. “We now want to engage with mothers and nurses who participated in the program to learn about their experiences.”

EFV is an early prevention program designed to address avoidable childhood adversities. It is modelled on the Nurse-Family Partnership program (NFP), which involves intensive nurse-home visits starting in early pregnancy through to child age two years.

The CHPC team co-led the 10-year randomized controlled trial evaluation of NFP — the BC Healthy Connections Project — showing promising benefits for mothers and children by age two years. These benefits included reduced prenatal substance exposure; improved child mental health and language development, maternal mental health, and income; and reduced intimate partner violence exposure.

But while NFP is designed to reach young, English-speaking, first-time mothers experiencing disadvantage, the EFV Program serves a broader range of families. Those eligible for EFV also include Indigenous families, mothers with more than one child, older mothers, refugees and newcomers.

In collaboration with Fraser Health, the CHPC team will conduct research interviews with select EFV maternal clients to learn about their experiences with the program. The researchers will also survey EFV public health nurses to evaluate the delivery of the program. The survey questions will examine training, service implementation and additional resources needed.

The findings will help inform EFV program refinements to better reach and serve culturally diverse children and mothers who are experiencing disadvantage. Providing early prevention programs like EFV — for children experiencing disadvantage — is more cost-effective than later remediation. “It’s crucial that policymakers invest in effective early prevention programs to ensure that all young Canadians reach their potential,” said Catherine.

CBC Health highlights the CHPC’s call for investment in drug prevention programs

Funding effective prevention programs could significantly reduce youth drug use — that was the message shared by Adjunct Professor with the Children’s Health Policy Centre Christine Schwartz in an article published last week by CBC Health’s Second Opinion.

The article featured new research evidence showing that PreVenture, a school-based program developed by a researcher at the University of Montréal, produced a 35% reduction in the annual increase in the odds of teens developing substance use disorder, compared to a control group.

The piece also highlighted the need for sustained government funding to support and deliver programs such as PreVenture in schools across Canada.

Schwartz noted in her interview with CBC Health that policymakers are “increasingly turning to the research evidence” to evaluate drug prevention programs — and a growing body of evidence demonstrates the effectiveness of several prevention programs.

Second Opinion shared the link to a recent edition of The Children’s Mental Health Research Quarterly in which the CHPC presented findings from an evaluation of two such programs: Strengthening Families and Project PATHS. The CHPC team found that they were not only successful in reducing opioid misuse, but that they also reached large numbers of young people, highlighting the benefits of school delivery.

The missing piece, Schwartz told CBC Health, is funding to maintain these programs and put them in place more widely. But she is optimistic that the CHPC’s prevention-focused message will continue to reach policymakers and shape the national dialogue on youth substance use.

“It’s great to see this evidence on the effectiveness of school-based prevention programs being shared in national media,” she says. “These programs increase the likelihood that young people can lead happy, healthy lives and make it less likely they will suffer harms from substance use later on. This is a conversation we need to be having as a country, and one I’m sure policymakers will be paying close attention to.”

CHPC scholars receive funding to support evaluation of “upstream” public health initiatives

A team of researchers led by Children’s Health Policy Centre scholars Kimberly Thomson and Nicole Catherine has received a 2024 Convening and Collaborating (C2) Award from Michael Smith Health Research BC. The award funding will help the research team improve the evaluation of upstream public health interventions in British Columbia.

Public health interventions are more effective when they address the bigger picture of people’s lives — the social conditions in which they are born, live, and age. These “upstream” interventions aim to tackle the root causes of health problems, addressing systemic inequities that traditional healthcare approaches may overlook. But the impacts of these interventions can be difficult to measure.

Thomson and Catherine will address this challenge by facilitating a series of conversations between policymakers, researchers and health practitioners. Through online consultations and an in-person Thought Exchange event, they will bring together researchers and research users to discuss the evaluation of upstream public health projects in BC.

The goal of these conversations is to help participants:

  • better understand current evaluation methods
  • identify opportunities for coordination between public health researchers and institutions
  • improve innovation and evaluation capacity
  • set future research priorities

“We’re really excited to have these rich discussions with our public health partners,” said Thomson. “It’s a great opportunity to shape our collaborative research priorities, including for upcoming child health policy initiatives in BC that we’ll be measuring and monitoring.”

The C2 Award supports researchers in British Columbia who are working collaboratively to address public health challenges. More information about the project and the award can be found on the Michael Smith Health Research BC website.

Home visiting programs lead to positive outcomes for children and mothers

A recent report by the Children’s Health Policy Centre found that home visiting programs can have significant benefits for mothers and children facing adversity.

The report looked at randomized controlled trial evaluations of 13 home visiting programs across Canada, the U.S. and other high-income jurisdictions to investigate the effectiveness of these programs. Seven intensive programs based on the Nurse Family Partnership (NFP) model demonstrated particularly robust benefits.

The benefits for children included:

  • reduced prenatal substance exposure
  • improved language
  • improved cognitive development
  • better mental health
  • better school readiness and reading
  • fewer injuries or maltreatment concerns

Benefits for mothers included:

  • better social supports
  • greater self-efficacy
  • fewer subsequent pregnancies
  • increased breastfeeding duration
  • better mental health
  • improved parenting
  • improved socioeconomic status
  • reduced exposure to intimate partner violence

NFP is an early intervention where nurses visit girls and women through pregnancy and their child’s early years. Nurses explore topics such as healthy pregnancy, parenting skills, healthy relationships and child development.

The report also identified six other home visiting programs that benefitted children and mothers. However, these programs had fewer positive outcomes than the NFP-based programs due to shorter durations, later interventions and the varied skill levels of providers.

These findings provide critical evidence that policymakers in British Columbia can use to build on the success of existing programs, develop new intervention strategies and ensure that children and mothers flourish.

To learn more, read the full report.

Social support can promote young people’s emotional health

Social supports may be universally beneficial for adolescents, according to a paper recently published in the Journal of Adolescence.

Written by researchers including Kim Thomson, an assistant professor of Health Sciences at Simon Fraser University and a CHPC team member, the paper tracked the emotional health of immigrant, refugee and non-immigrant early adolescents in British Columbia.

The study found that immigrant and refugee adolescents across 10 school districts started Grade 4 with poorer emotional health than their peers, highlighting the need for culturally responsive supports for these students. From Grades 4 to 7, both immigrant and non-immigrant adolescents experienced a decline in their emotional health.

However, first-generation refugees were a notable exception — they reported feeling more satisfied with life over the same time.

Despite the differences in emotional health between the groups, Thomson and her co-authors “did not find differences in the associations between improvements in emotional health and improvements in social support by immigration group.” This indicates that social supports may benefit all adolescents regardless of their immigration backgrounds.

“These results highlight social support as a modifiable factor within schools that can promote young people’s emotional health,” the study concluded.

To learn more, read the full paper.

Why Canada needs to invest in opioid prevention for children

A prevention program for Grade 7 students could help end the opioid crisis, according to a recent article by the team from the Children’s Health Policy Centre.

Published in The Conversation, the article is based on research findings about school-based primary prevention interventions over the last 20 years.

“Many of Canada’s responses to the opioid crisis still focus downstream on adults, after problems have started or become entrenched,” the article said. “In contrast, primary prevention operates upstream in childhood — before most young people start engaging in substance use, misuse or experimentation.”

The two most promising school-based programs are: Strengthening Families and Project PATHS, and they have been tested in the US and Hong Kong. Both led to significant reductions in opioid use by young people, including over long-term follow-up.

The two programs have another feature adding to their appeal for delivery in Canada, according to the authors. Training for facilitators is very brief — only two days for Strengthening Families and three days for Project PATHS.

“The short training time also helps reduce delivery costs, further increasing the appeal for policy-makers and school administrators,” the article said.

In concluding, the authors noted that the federal government has committed more than a billion dollars since 2017 to address the toxic drug problem — paralleled by provincial and territorial funding. “But a policy shift towards meaningful prevention also requires tackling the realities of current Canadian health spending priorities,” they said.

“Only 6.1% of health spending in 2023 went towards public health including prevention, a longstanding pattern. So concerted, coordinated and collaborative efforts are needed within and across every policy level and jurisdiction.”

So new prevention efforts are badly needed to tackle the opioid crisis in Canada — thereby ensuring that many more children do not go on to experience avoidable harms.

Read the full article here.

Transgender youth face significant health concerns

Transgender and nonbinary children and youth often face significant challenges compared to their cisgender peers. Many experience peer victimization, and trans teens also face verbal harassment in many Canadian schools. These adverse experiences also extend into the home, where trans and nonbinary youth may face emotional neglect or abuse by a parent or other adult.

These experiences cause significant harm, and they also place trans and nonbinary youth at risk for secondary mental health disorders such as depression and anxiety.

Knowing how many transgender and nonbinary youth are dealing with these disorders is critical to inform prevention and treatment efforts. A recent report by the Children’s Health Policy Centre, funded by the BC Ministry of Health, investigated the prevalence of mental health concerns for trans and nonbinary young people.

The report identified:

  • The overall prevalence of mental disorders in transgender and nonbinary youth, which is 56.6% This makes it between 5.9 and 13 times higher than their cisgender counterparts.
  • Significant rates of self harm or suicidal ideation among transgender and nonbinary youth, with prevalence up to five times higher than in their cisgender peers.
  • A need for easily accessible and effective mental health treatments for these children and youth.
  • The importance of addressing the unacceptable and preventable adverse experiences that many transgender and nonbinary young people face and that can contribute to the development of mental health conditions.

These findings can inform efforts to improve mental health service planning, delivery and equity for transgender and nonbinary children and youth in British Columbia.

To learn more, read the report and review the findings.