Academic Publications

Academic Publications

Catherine, N.L.A., MacMillan, H., Jack, S., Zheng, Y., Xie, H., Boyle, M., Sheehan, D., Gonzalez, A., Gafni, A., Tonmyr, L., Barr, R., Marcellus, L., Varcoe, C., & Waddell, C. (2025). Effects of nurse-home visiting on intimate partner violence and maternal income, mental health and self-efficacy by 24 months postpartum: a randomised controlled trial (British Columbia Healthy Connections Project). BMJ Open. https://doi.org/10.1136/bmjopen-2023-083147

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Catherine N, Barican J, White O, Tang J, Thomson K, & Waddell C (2024). Effective Home Visiting Programs for Children and Mothers Experiencing Adversities. Vancouver, British Columbia: Children’s Health Policy Centre, Faculty of Health Sciences, Simon Fraser University.

Executive Summary

This report aimed to identify research evidence for British Columbia (BC) policymakers on the best options for home visiting with children and mothers experiencing adversity. We first used systematic review methods to identify randomized controlled trial (RCT) evaluations. This approach almost exclusively uncovered intensive nurse home visiting programs similar to or based on Nurse-Family Partnership (NFP). We therefore supplemented our methods by scanning RCT-backed home visiting interventions recommended by the United States (US) Department of Health and Human Services through its Maternal, Infant and Early Childhood Home Visiting (MIECHV) program. The systematic review identified seven NFP-informed programs, some with important variations. The supplemental scan identified six additional programs that varied by provider, intensity and duration. We identified 13 relevant programs in total.

The NFP-based home visiting programs included: Family Nurse Partnership (England); Minding the Baby (US); NFP (US); NFP (BC); and VoorZorg (Netherlands). Two other programs entailed adaptations.

ProKind (Germany) involved delivery solely by midwives and social workers, while right@home (Australia) included multiparous mothers. Minding the Baby and right@home were also delivered by social workers in addition to nurses. All seven programs started in pregnancy and continued until children were age two — approximately 2.5 years duration.

The US MIECHV scan included NFP-based programs as well as other kinds of home visiting including: Child First; Family Check-Up; Healthy Families America; Play and Learning Strategies; Promoting First Relationships; and Video-feedback Intervention to promote Positive Parenting. Providers ranged from community workers to master’s-trained clinicians. Start times also varied — ranging from prenatally to anytime from birth to age seven years. Program duration ranged from only six visits to three to five years.

The seven intensive NFP-related programs led to a comprehensive array of positive outcomes for both children and mothers — including many benefits that emerged later, across childhood and adolescence. The six other programs also led to benefits.

Evaluation is critical to ensure that new and ongoing public investments make a positive difference in the lives of children and mothers — particularly for those who are facing more adversities than others. BC has an opportunity to build on its extensive leadership and experience with delivering NFP and other prevention programs for children — to adapt existing research-informed programs to local needs and to conduct innovative evaluations to ensure effectiveness. The 13 programs we have outlined here all show benefits for children and mothers — some more robust and enduring than others. In choosing among the trade-offs, the main goal must be to ensure the flourishing of all children in this province, and therefore to choose programs that will meet this goal.

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Schwartz C, Barican J, White O, Tang J, Catherine N, Thomson K, & Waddell C. (2024). Mental Health of Transgender and Nonbinary Children and Youth: Informing Service Needs. Vancouver, BC: Children’s Health Policy Centre, Faculty of Health Sciences, Simon Fraser University.

Executive Summary

Many transgender and nonbinary children and youth face added challenges compared with their cisgender counterparts, including more frequent adverse experiences, peer victimization and harassment. These avoidable hardships cause harm in and of themselves and also raise risks for secondary mental health problems. Knowing the prevalence of mental health concerns for transgender and nonbinary young people is therefore crucial as the numbers of those in need can and should inform service planning to ensure both adequate mental healthcare and greater equity. 

To provide the most accurate estimate, we conducted a systematic review of studies on the prevalence of mental disorders in transgender and nonbinary young people. The two studies that met inclusion criteria, were both conducted in the United States (US). The first study assessed overall prevalence, finding that 56.6% of transgender young people had experienced at least one mental disorder in the previous six months — a proportion between 5.9 and 13.0 times higher than cisgender counterparts. As well, for individual disorders as well as disorder groups, prevalence was higher for transgender children and youth compared with cisgender counterparts. The second study focused exclusively on eating disorders, finding that 4.2% of transgender youth had this diagnosis — a proportion approximately 200% higher than expected according to studies in general populations of young people.

We also identified two studies that assessed suicidal ideation and self-harm including one of the previously cited American studies. This US study found that 3.2% of transgender youth experienced a self-inflicted injury in the previous six months according to health records — a rate at least 17 times higher than cisgender counterparts. As well, health records noted suicidal ideation for 6.3% of transgender youth — a rate approximately 24 times higher than cisgender counterparts. A Canadian study found even higher rates according to an anonymous survey. Researchers found that nearly 80% of transgender and nonbinary youth reported engaging in self-harm in the past year, approximately five times the rate for cisgender peers. As well, 65.2% of transgender and nonbinary youth reported suicidal ideation in the past year, five times the rate for cisgendered peers.

The high prevalence of mental health concerns for transgender and nonbinary young people underscores the need for easily accessible and effective mental health treatments with these populations. It is also imperative that public mental health services be provided with intensity that is proportionate to the needs, and be delivered by practitioners within settings and systems that are sensitive to the experiences of these young people. This approach aligns with the World Health Organization’s recognition of mental health as a basic human right. It is equally crucial to address 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.  Ensuring mental wellbeing for these young people also requires adequate monitoring of service use in relation to the needs, as well as monitoring of social determinants including preventable adversities. Such monitoring plays a vital role because “what gets counted counts.” In other words, comprehensive collective efforts encompassing mental healthcare, prevention and monitoring are needed to bring about mental health equity for transgender and nonbinary young people in BC.

Read the full report here. 

Catherine, N.L.A., MacMillan, H., Cullen, A., Zheng, Y., Xie, H., Boyle, M., Sheehan, D., Lever, R., Jack, S. M., Gonzalez, A., Gafni, A., Tonmyr, L., Barr, R., Marcellus, L., Varcoe, C., & Waddell, C. (2023). Effectiveness of nurse-home visiting in improving child and maternal outcomes prenatally to age two years: A randomised controlled trial (British Columbia Healthy Connections Project). Journal of Child Psychology and Psychiatry. https://doi.org/10.1111/jcpp.13846 Read More »

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