About
Children growing up in families with relatively lower socioeconomic standing are at greater risk of adverse social, cognitive and physical health outcomes. These disparities are shaped by a diverse range of social and structural factors, including greater exposure to stressed family relationships, social and economic exclusion and the biological embedding of stress that can impact children’s development over time.
This international collaboration, based out of Australia and New Zealand, investigates the extent to which preconception parental life histories — things that happen in a person’s life before they became a parent — predict their children’s early health and development.
We are using pooled data and cross-cohort replication analyses across three multi-generational cohort studies to investigate rare exposures and outcomes, including patterns of pre-conception substance use and mental health and their impacts on the next generation’s social emotional, and cognitive development.
Principal Investigator
- Dr. Kimberly Thomson, Assistant Professor, Faculty of Health Sciences, Simon Fraser University
Project Partners
- Australia-New Zealand Intergenerational Cohort Consortium:
- Deakin University
- Australian National University
- Murdoch Children’s Research Institute
- University of Otago
- University of Melbourne
- University of New South Wales
Publications
- Letcher, P., Greenwood, C. J., Macdonald, J. A., Ryan, J., O’Connor, M., Thomson, K. C., Biden, E., Painter, F., Olsson, C., Edwards, B., McIntosh, J., Spry, E. A., Hutchinson, D., Cleary, J., Slade, T., & Olsson, C. A. (2024). Life course predictors of child emotional distress during the COVID-19 pandemic: Findings from a prospective intergenerational cohort study. Journal of Child Psychology and Psychiatry. https://doi.org/10.1111/jcpp.13995
- Olsson, C. A., Letcher, P., & Thomson, K. C. (2024, July). Preconception origins of child mental health and wellbeing: Cross cohort insights from three Australasian intergenerational cohort studies [Webinar]. Australian Research Alliance for Children and Youth (ARACY), Melbourne, Australia.
- Olsson, C. A., Spry, E., Letcher, P., McAnally, H., Thomson, K. C., Macdonald, J., Greenwood, C., Youssef, G., Romaniuk, H., Iosua, E., & Sligo, J. (2020). The Australian and New Zealand Intergenerational Cohort Consortium: A study protocol for investigating mental health and well-being across generations. Longitudinal and Life Course Studies, 11(2), 267–281. https://doi.org/10.1332/175795920X15792720930280
- Thomson, K. C., Greenwood, C. J., Letcher, P., Spry, E. A., Macdonald, J. A., McAnally, H. M., Hines, L. A., Youssef, G. J., McIntosh, J. E., Hutchinson, D., & Hancox, R. J. (2021). Continuities in maternal substance use from early adolescence to parenthood: Findings from the intergenerational cohort consortium. Psychological Medicine, 51(16), 2851–2860. https://doi.org/10.1017/S0033291721003925
- Thomson, K. C., Romaniuk, H., Greenwood, C., Letcher, P., Spry, E., Macdonald, J. A., McAnally, H. M., Youssef, G. J., McIntosh, J., Hutchinson, D., Hancox, R. J., Patton, G. C., & Olsson, C. A. (2021). Adolescent antecedents of maternal and paternal perinatal depression: A 36-year prospective cohort. Psychological Medicine, 51(12), 2126–2133. https://doi.org/10.1017/S0033291720000902
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About
In Canada, approximately 10-15% of young children have mild to moderate emotional and behavioural problems. Left unaddressed, these problems can escalate across childhood, hurting young people’s mental health and wellbeing, social relationships and academic achievement.
Families need early intervention support, but BC’s health systems are at capacity. To solve this challenge, early intervention programs are adapting to include telehealth options and group-based delivery models. These models allow more families across BC to access early intervention programs.
This project gathers evidence on the potential effectiveness and health service delivery impacts of adapted early behaviour intervention programs for children and families. It uses the BC-based Confident Parents: Thriving Kids – Behaviour Program (CPTK-B) as a model.
CPTK-B is a skill-building program designed to help parents support their children ages 3–12 who are experiencing mild to moderate behaviour challenges. It is delivered by the Canadian Mental Health Association BC Division (CMHA BC). We will be analyzing CPTK-B program data to assess health systems impacts of telehealth and group-based program adaptations.
Principal Investigator
- Dr. Kimberly Thomson, Assistant Professor, Faculty of Health Sciences, Simon Fraser University
Funders
- SFU Faculty of Health Sciences Mowafaghian Child Health Faculty Awards
- Canadian Mental Health Association (CMHA) BC
Project Partners
- Canadian Mental Health Association (CMHA) BC
About
Public health interventions are more likely to be effective when they address the social conditions in which people are born, live and age. Increasingly, public health initiatives in BC are intervening at this “upstream” level, targeting public policies, systems and structures that perpetuate health inequities.
Evaluating the impacts of these initiatives introduces unique challenges that cannot be addressed with traditional evaluation tools. Yet, policymakers and health practitioners need evidence to determine whether they are doing the right things — and whether they are doing them right.
We aim to address this challenge by facilitating a series of conversations between policymakers, researchers and health practitioners. Through a series of online consultations and an in-person Thought Exchange event, we are bringing together researchers who do upstream health promotion evaluation and public health research users who use evaluation evidence to guide decision-making.
Together we will investigate how upstream evaluation is currently being conducted in BC, where efforts can be coordinated to improve innovation and capacity and what are the research priorities “moving upstream” in the realm of health promotion evaluation.
Principal Investigator
- Dr. Kimberly Thomson, Assistant Professor, Faculty of Health Sciences, Simon Fraser University
Funders
- Michael Smith Health Research BC
- Pacific Public Health Foundation
Project Partners
- BC Centre for Disease Control
- BC Health Authorities
Publications
- Gómez-Ramírez, O.*, Thomson, K. C.*, Fielden, S., & McKee, G. (2023, October). Lessons from evaluating the impact of upstream health promotion initiatives [Conference presentation]. Canadian Evaluation Society British Columbia Conference, Vancouver, BC, Canada. *Denotes equal contributions
- Thomson, K. C.*, Gómez-Ramírez, O.*, Fielden, S., & McKee, G. (2023, October). Lessons from evaluating the impact of upstream health promotion initiatives [Conference presentation]. British Columbia Centre for Disease Control Research Week, Vancouver, BC, Canada. *Denotes equal contributions
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About
The origins of mental health disorders begin early. Half of lifetime mental health disorders appear before age 14, pointing to a clear and urgent need for early detection and intervention. However, early detection and prevention remain poorly addressed, in part because of the difficulties identifying early subclinical symptoms and contexts associated with avoidable future mental health problems. As a consequence, only a fraction of health care spending is invested in prevention of mental health disorders, compared to treatment.
To address this challenge, we are analyzing evidence from BC’s population-based child development monitoring Early Development Instrument and Middle Years Development Instrument data to investigate early life course patterns of mental health and well-being. This project links data on kindergarten children’s early social-emotional functioning (rated by teachers) to children’s self-reported mental health and well-being in Grades 4 and 7.
Our goal is to identify early mental health indicators, common trajectories and mental health promotive factors associated with reduced mental health challenges to inform provincial and school-based policies, programming and services.
Principal Investigator
- Dr. Kimberly Thomson, Assistant Professor, Faculty of Health Sciences, Simon Fraser University
Funders
- Mowafaghian Child Health Faculty of Health Sciences Award
Project Partners
- Human Early Learning Partnership, University of British Columbia
Publications
- Oberle, E., Ji, X. R., Molyneux, T., Guhn, M., Forer, B., Thomson, K., Alkawaja, M., Kassan, A., & Gadermann, A. (2025). Mental well-being trends and school-based protective factors among adolescents in British Columbia (2015 to 2022): A population-based study. Social Science & Medicine, 365, 118201. https://doi.org/10.1016/j.socscimed.2025.118201
- Thomson, K. C., Gagné Petteni, M., Magee, C., Oberle, E., Georgiades, K., Schonert-Reichl, K. A., Janus, M., Guhn, M., & Gadermann, A. (2024). Changes in peer belonging, school climate, and the emotional health of immigrant, refugee, and non-immigrant adolescents. Journal of Adolescence, 96(6), 1592–1605. https://doi.org/10.1002/jad.12390
- Thomson, K. C., Richardson, C. G., Samji, H., Dove, N., Olsson, C. A., Schonert-Reichl, K. A., Shoveller, J., Gadermann, A. M., & Guhn, M. (2021). Early childhood social-emotional profiles associated with middle childhood internalizing and wellbeing. Journal of Applied Developmental Psychology, 76, 101301. https://doi.org/10.1016/j.appdev.2021.101301
- Thomson, K. C., Richardson, C. G., Gadermann, A. M., Emerson, S. D., Shoveller, J., & Guhn, M. (2019). Association of childhood social-emotional functioning profiles at school entry with early-onset mental health conditions. JAMA Network Open, 2(1), e186694. https://doi.org/10.1001/jamanetworkopen.2018.6694
- Thomson, K. C., Guhn, M., Richardson, C. G., Ark, T. K., & Shoveller, J. (2017). Profiles of children’s social emotional health at school entry and associated income, gender, and language inequalities: A cross sectional population-based study in British Columbia, Canada. BMJ Open, 7(7), e015353. https://doi.org/10.1136/bmjopen-2016-015353
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About
Investing in early prevention strategies is crucial for reducing the risk of substance use harms for children and youth. Schools can play an important role in connecting young people to prevention programs, but not all programs have equal evidence of effectiveness.
In this study, we conducted a systematic review of school-based substance use prevention programs that have been evaluated using randomized controlled trial (RCT) methods.
Our search was limited to substance use intervention programs for young people under 18 years of age, delivered either in schools or with school involvement, and evaluated in high income countries between 2009 and 2025. Participants needed to be followed up at least one year after the end of the program.
We found that several school-based programs showed evidence of effectiveness for prevention of substance use and related harms. However, many existing programs did not have RCT evidence of positive benefits. Local evaluations should be conducted even for evidence-based programs to ensure effectiveness for specific populations and context.
A report detailing these findings is available upon request. Please email us to receive a copy.
Principal Investigator
- Dr. Kimberly Thomson, Assistant Professor, Faculty of Health Sciences, Simon Fraser University
Funders
- BC Centre for Disease Control
Project Partners
- BC Centre for Disease Control
Publications
- Schwartz, C., Barican, J., White, O., Tang, J., Waddell, C., & Thomson, K. (2025). Substance use prevention programs with school involvement—What works? Children’s Health Policy Centre, Faculty of Health Sciences, Simon Fraser University. (report available on request).
- Simms, C., & Thomson, K. (2025, November 5–6). Understanding substance use prevention programs with school involvement [Conference presentation]. 2025 Canadian Conference on Tobacco and Nicotine, Virtual.
About
The EFry Voices project aimed to recognize and value the perspectives of mothers with young children who were accessing services at the Elizabeth Fry Society of Greater Vancouver, known as EFry. EFry is a community-based, non-profit organization that supports 15,000 women, girls and children annually, providing affordable housing units, shelters, mental health treatment and parenting programs. Led by Nicole Catherine in partnership with EFry, the project research team engaged 20 mothers who offered solutions to help address barriers to accessing services.
Funders
- Social Sciences and Humanities Research Council of Canada
- Mowafaghian Child Health Faculty of Health Sciences Award
Project Partners
- The Elizabeth Fry Society of Greater Vancouver
Methodology
- This community-engaged research study centred the voices of mothers with first-hand experience of marginalization, including socioeconomic disadvantage.
- From April to September 2022, the maternal participants generously took part in semi-structured interviews.
- A project advisory group provided their expertise. This group comprised an Indigenous Elder and members of the Fraser Health Authority and the BC Association of Pregnancy Outreach Programs.
Key Findings
Limitations to the provision of current services exist:
- Barriers: Lack of childcare and insufficient information and referrals to available services.
- What helped: Providing childcare services and resource lists online and in-person. Offering mothers access to peer groups.
Programs must focus on whole health:
- Barriers: Many mothers were not provided consistent supports for their mental health and housing needs. Some nutrition programs were inadequate and food options did not reflect cultural diversity.
- What helped: Programs that respected cultural diversity to support overall health. Programs that provided trauma-informed care across services, with clear program plans and offered in small groups.
Clients need to feel safe(er) when using services:
- Barriers: Some mothers felt that programs did not meet their expectations or felt that they experienced unfair treatment.
- What helped: When staff took steps to ensure fair treatment, mothers felt safer using the services.
What This Means
- Helping shape policies: This community partnership created important information to help improve inclusion policies for EFry and similar community groups and non-profits serving women, girls and children.
- Listening to mothers’ voices: Mothers who face marginalization are often left out of decisions on how health and social services are designed and provided. It’s important for researchers to honour the strengths and insights of mothers with lived experience.
- Fixing the bigger system: The study results show that making services easier to access is a system-wide issue. Big changes in how government and non-profit services work together are needed to provide better, more connected support.
Learn More
Catherine, N.L.A., Zheng, Y., Xie, H., Boyle, M., Jack, S., MacMillan, H., & Waddell, C. Effectiveness of Nurse-Family Partnership on child outcomes by patterns of program intensity: Secondary evidence from a randomized controlled trial (British Columbia Healthy Connections Project). Child Abuse & Neglect. https://doi.org/10.1016/j.chiabu.2025.107600
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Catherine, N.L.A., Zheng, Y., Xie, H., Boyle, M., Jack, S., MacMillan, H., & Waddell, C. Effectiveness of Nurse-Family Partnership on child outcomes by patterns of program intensity: Secondary evidence from a randomized controlled trial (British Columbia Healthy Connections Project). Child Abuse & Neglect. https://doi.org/10.1016/j.chiabu.2025.107600
Research Overview
This paper examines how program intensity influenced child outcomes in the Canadian scientific evaluation of the Nurse-Family Partnership (NFP) program. Led by Nicole Catherine, Associate Director of the Children’s Health Policy Centre, the research team found that when NFP was delivered as intended, with sustained intensity — meaning families received the majority of recommended nurse-home visits consistently throughout the program — children experienced greater benefits in language and mental health-problem behaviour by age two years.
Methodology
- The researchers conducted secondary analysis of data from the British Columbia Healthy Connections Project (BCHCP), a randomized controlled trial evaluation of NFP involving 739 maternal participants and their 737 children in British Columbia.
- Participants in the BCHCP were enrolled in early pregnancy and randomly assigned, like flipping a coin, to two different groups — NFP versus Comparison (the existing services on offer in BC) — to investigate whether NFP provided greater benefits for mothers and children by age two years.
- The BCHCP study team collected data at regular intervals across pregnancy and early childhood (2013 to 2019) including on child injuries, language, cognition and problem behaviour (mental health) at age two years.
Key Findings
- Delivering NFP as intended, with sustained intensity, led to greater benefits regarding maternal-reported child language and mental health-problem behaviour.
- Importantly, the research team also found benefits using a rigorous measure of child language development (Bayley Scales of Infant Development), where children were observed directly in the home. This method is considered less biased than mothers’ self report of their children’s language development.
Implications
- Benefits for kids: Sustaining long-term program engagement with young families experiencing disadvantage can make a difference for children. Improvements in language and mental health — as early as age two years — are associated with longer term benefits across childhood and the school years.
- Longitudinal research: It is important to follow the participating children across adolescence to assess long-term program effects on mental health and academic functioning.
- Funding priorities: Policymakers should fund evidence-informed prevention programs that commence early in pregnancy at adequate levels of intensity to maximize benefits for children in need and for society as a whole.
