Did You Know?

Intimate relationships should be meaningful and enjoyable, not dangerous. Yet about one in 10 young people experience violence in their dating relationships. This form of violence can be prevented, however, setting the stage for healthy and respectful relationships in early adulthood and beyond. Two programs stand out — Fourth R and Youth Relationships — for having proven success in teaching positive relationship skills to Canadian teens.  For more information, see Vol. 7, No 1 of the Children’s Mental Health Research Quarterly.

In conducting a scientific evaluation of a program designed to help young first-time mothers, a research team from the BC Healthy Connections Project went to extra effort to make connections. The team was prepared to contact each participant five or more times to schedule interviews. This ‘extra effort’ was deemed important in reaching participants who were often struggling with issues such as insecure housing and mental or physical health challenges. The scientific evaluation, which started in 2011, looked at the Nurse-Family Partnership, a landmark US program focusing on children born to girls and young women who are facing disadvantages such as low income. The program starts early — in pregnancy, before children are even born — and involves intensive home visits from public health nurses. In Canada and elsewhere, policy-makers and practitioners have traditionally struggled to reach, engage and maintain connections with populations who are facing socioeconomic disadvantage. The BC Healthy Connections Project team has provided a detailed case example, offering strategies for how to make better connections, that last. The team hopes that their paper, which can be seen in the journal, Trials, will inform a shift for researchers, policy-makers and practitioners alike—from seeing disadvantaged populations as “hard-to-reach” to viewing them as “need-to-reach.”

Parents are crucial in promoting children’s positive behaviours. Parents can do this by interacting in ways that are sensitive and warm, being highly connected to children and setting effective limits. For more information, see Vol. 9, No. 4 of the Children’s Mental Health Research Quarterly.

Positive relationships can protect children from problematic anxiety. For example, young people who feel accepted and respected by their parents and cared for by their friends are less likely to develop anxiety problems.For more information, see Vol. 10, No. 2 of the Children’s Mental Health Research Quarterly.

The Nurse-Family Partnership (NFP) program is a leading example of how intervening very early in life can bring many long-term benefits. This intensive home-visiting program focuses on young first-time mothers-to-be who are coping with socio-economic disadvantage. It begins in early pregnancy and continues until children reach age two, and can produce life-changing benefits. A recent paper — by researchers from the Children’s Health Policy Centre and published in the Canadian Medical Association Journal OPEN — suggests some encouraging results. In a randomized controlled trial in BC, NFP led to reduced prenatal cannabis use, and in smokers it led to modest reductions in cigarette use. As a result, it is thought that NFP may hold promise for reducing some types of prenatal substance use in disadvantaged populations.

This is a good time to remember that reducing inequality in society has been shown to reduce maltreatment of children. In particular, policies that redistribute wealth to ensure that more children have their basic needs met can contribute to reducing important problems such as child maltreatment. For more information on preventing and treating child maltreatment, see Vol. 3, No. 2 of the Children’s Mental Health Research Quarterly.

When a child has depression, families should have easy access to effective psychosocial treatments such as Cognitive-Behavioural Therapy. Interpersonal Therapy can also be effective. Then, if medication is needed, fluoxetine is the first choice, given robust research evidence supporting its use. For more information, see Vol. 11, No. 4 of the Children’s Mental Health Research Quarterly.

Spanking can harm children, for example, leading to physical injuries as well as emotional and behavioural problems. Spanking is also ineffective at changing children’s behaviour. Spanking and other forms of physical punishment should therefore not be used. For more information, see Vol. 9, No. 1 of the Children’s Mental Health Research Quarterly.

How do you persuade busy young mothers to participate in a scientific trial that’s going to last more than two years? The BC Healthy Connections Project achieved this goal by using a number of strategies. These included:

• Offering to perform research interviews on weekends and evenings.
• Changing the type of contact to suit the needs of participants who were aged 14–24 years.
• Making texting the preferred style of contact.
• Personalizing the connection by showing appreciation and conveying genuine interest.

Many of the 739 participants said they enjoyed contributing to research and having their voices heard, through the survey data. They especially appreciated being able to feel that someone was listening and was interested in their lives.

The trial, which started in 2011, was designed as a scientific evaluation of the Nurse-Family Partnership, a landmark US program focusing on children born to girls and young women who are facing disadvantages such as low income. The program starts early — in pregnancy, before children are even born — and involves intensive home visits from public health nurses.

For more information on how the BC Healthy Connections Project maintained its impressive participation rates, see the team’s paper recently published in Trials.

In October, which is ADHD Awareness Month in Canada and around the world, it’s worth remembering the many young people who are frequently labeled as “problem children” rather than children with a medical problem. Research evidence supports the use of three medications — methylphenidate, dextroamphetamine and atomoxetine — for children with ADHD. Careful use of these medications can reduce children’s symptoms and improve their quality of life. For more information, see Vol. 11, No. 1 of the Children’s Mental Health Research Quarterly.