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.

CHPC plays a role in Science Meets Parliament

In the historic halls of the BC provincial legislature, Kimberly Thomson discovered how much government runs on relationships.

The Assistant Professor in the Faculty of Health Sciences at Simon Fraser University and member of the Children’s Health Policy Centre was attending a two-day session at the legislature as part of a Science Meets Parliament event in April.

With the goal of improving conversation between policymakers and scientists, the Science Meets Parliament organizers had arranged for Thomson and the other delegates, including several members of SFU’s Faculty of Health Sciences, to meet with MLAs and government staff.

As part of the experience, all delegates met with Raj Chouhan, the Speaker of the Legislative Assembly, and with Lieutenant Governor Janet Austin. Thomson also met with BC Green Party representatives, including Party Leader Sonia Furstenau, and with NDP MLA Dan Coulter, the Minister of State for Infrastructure and Transit. Despite working in different fields, Thomson and the MLAs she met with discovered several points of connection, including shared interests in child rights, diversity and inclusion, and youth justice. These conversations helped Thomson better understand how policymakers set their agendas.

“It was really beneficial to spend the day immersed in their world and understand what their priorities are, the considerations that they are juggling when making different policies,” Thomson said.

“Research is important for policy making, but it’s only one part. Your researcher brain says that if you just construct the best possible evidence and present it to them, they’ll make the decision based on that. But that’s not entirely how it works. At the end of the day, policymakers want to make the best decisions for people living in BC and there are a number of factors to consider.”

For Thomson, this experience also highlighted the importance of the work the Children’s Health Policy Centre does to share its research with policymakers.

“Building connections with policymakers allows you to be part of their process so they might call on you for advice,” she said. “This experience made me respect and appreciate the time and effort that goes into building these relationships and how special it is that the Centre has these relationships.”

Thomson spent the rest of the program attending Question Period, listening to panel discussions with legislators, and networking with the 30 other Science Meets Parliament delegates from universities across BC. She left the legislature with several new connections and a stronger sense of how she could support policy decisions through her work.

“I would absolutely recommend it [Science Meets Parliament] to other researchers,” Thomson said. “This was an invaluable experience to better understand the roles and responsibilities of policy makers, their priorities, and how science can best support decision-making.”

Science Meets Parliament is hosted by the Canadian Science Policy Centre, a non-profit organization dedicated to building a strong and inclusive science policy community in Canada. Since 2018, the annual event has brought emerging science leaders to Parliament Hill in an effort to strengthen the connection between Canada’s scientific and political communities. The Science Meets Parliament BC program was the event’s first expansion into a provincial legislature.

Showcasing Indigenous-led-research

Centre Director Charlotte Waddell gave a virtual talk about a Nuu-chah-nulth-led study on healthy child development to the child health advisory board at the Canadian Institutes of Health Research on April 10.

The talk was titled, “Everything is One, Everything is Connected.”

Waddell presented together with SFU scholar Pablo Nepomnaschy, on behalf of Lynnette Lucas and the Nuu-chah-nulth Tribal Council team, the study leads.

The presentation described a multi-generational study being conducted by and within the 14 Nuu-chah-nulth Nations, whose ancestral lands are located on the west coast of Vancouver Island.

“As non-Indigenous research allies,” Waddell said, “team members from SFU are helping to merge the best of Indigenous and ‘Western’ science while upholding high ethical standards including ensuring Indigenous data sovereignty.”

“This study will be ‘the Framingham’ of Indigenous Peoples,” Waddell added, quoting Indigenous scholar Jeff Reading, who is co-leading the Nuu-chah-nulth project. Framingham refers to a famous long-term cardiovascular health study that began in 1948 and is now on its third generation of participants, helping to improve population wellbeing.

Funding and community consultations for the Nuu-chah-nulth project began in 2017 and continued in 2022 with a grant of $15 million over six years from the Canadian Institutes of Health Research, in partnership with Alberta First Nations.

“Everything we do,” Waddell said, “involves constant reciprocity and respect for Indigenous Knowledge and wishes.

“We are working to overcome some of the harmful legacies of colonialism by supporting Indigenous leadership of research that is by and about them, as one step towards truth and reconciliation.”

Why we need to do a better job of serving children who are neurodiverse

Centre Director Charlotte Waddell gave a Zoom talk to close to 300 parents, practitioners and policy makers on Dec. 2. The talk was titled, “Neurodiversity and mental health: Serving children better.”

The presentation covered the following themes:

  • The need to create communities where all children are welcomed and celebrated, and where services are delivered according to needs so that all children can flourish and meet their potential.
  • The prevalence of anxiety, ADHD, behaviour disorders and depression, which are higher for children experiencing three particular forms of neurodiversity (autism spectrum disorder, fetal alcohol syndrome disorder and intellectual disability).
  • The research evidence for effective treatments for these four conditions for children with the three forms of neurodiversity.
  • The effective treatments for other common childhood mental disorders that can also be offered, with adaptations when needed

“We need to ensure that timely and effective treatments are offered to all children, particularly if they are neurodiverse, given higher prevalence rates,” Waddell told the group.

The talk ended with celebrating people who are neurodiverse, and the communities that support them over the lifespan.

Waddell then stayed on the Zoom call to respond to questions and comments. She also joined a small breakout group discussion to learn more about parent’s perspectives.

A recording of the talk can be seen here.

 

Two new studies on Covid-19 published by CHPC scholar

A new study on the Covid-19 pandemic by SFU Assistant Professor and CHPC team member Kim Thomson, has just been published in Plos One.

The study found that parents with children at home reported nearly double pre-pandemic population estimates of moderate to severe psychological distress.

Psychological distress was more frequently reported among parents with pre-existing mental health conditions, disabilities and financial stressors. As well, parents with greater psychological distress reported an increase in negative interactions with their children as a result of the pandemic, and perceived higher anxiety in their children.

“These results highlight that meaningful responses to promote mental health among parents and families must address social and structural inequalities,” the report concluded.

In the same timeframe, Thomson was also co-author of another paper on the Covid-19 pandemic, this one published in the Journal of Adolescence. It profiled the social connectedness among early adolescents in Grade 7 before the pandemic was declared (Winter 2020) and in Grade 8 during the second wave of the pandemic (Winter 2021).

The paper concluded that connectedness with peers and adults in Grade 7 was significantly related to higher levels of mental wellbeing in Grade 8 even during the Covid-19 pandemic, highlighting the protective role of social connection.

 

 

 

Child and youth mental health practitioners and policymakers urged to address service gaps

Charlotte Waddell, Centre Director, gave a Sept. 14 talk with the Doctors of BC, Community of Practice on Child and Youth Mental Health. The talk was titled, “Children’s mental health: Research for informing practice and policy.”

Waddell covered crucial messages including the high prevalence of childhood mental disorders and the severe service shortages — with fewer than half of children with these disorders getting any kind of help.

For this talk, which took place in Vancouver with an audience of approximately 100 family physicians, child and youth psychiatrists and policymakers, among others, she urged strong advocacy — to not only address the service gaps, but also ensure that BC invests in effective prevention programs to reduce needs in the population. Waddell noted: “Your advocacy can and will be very powerful in making a difference for children.”