Updates

The COVID-19 public health emergency is putting a lot of pressure on parents, caregivers and others who work with children. They must explain challenging concepts to help children manage their fears and keep routines as stable as possible.

To assist with these challenges, we offer the following suggestions:

• Create situations for children to comfortably ask questions at their own pace. Answer questions honestly using concepts that children can easily understand. For example, explain that the new coronavirus is one of many different types of viruses, like the ones that cause colds. And be ready to repeat your answers as children may re-ask the same questions as a way to gain reassurance.
• Help children manage their fears by modelling calmness and by providing accurate information. This can include explaining the steps you are taking to keep them healthy and safe. (See sidebar, below.) It may also involve highlighting the many actions that community members are taking to protect everyone. And avoid letting children be exposed to media sources that could unnecessarily increase their anxiety.
• Maintain children’s regular routines as much as possible. Fun activities, like playing outdoors and bike riding, are still possible even with physical distancing. Similarly, technology can help with other important activities like play dates and connecting with grandparents.
• Encourage children to think about ways they can help others. This could include, for example, helping neighbours who may need things delivered to their doors, sending positive messages to loved ones who may not be near, or communicating with other children about doing schoolwork together, remotely.

Our sidebar, below, gives helpful resources for parents and families. For children who are experiencing more severe anxiety, the book Helping Your Anxious Child may be particularly useful. (Many local bookstores are offering free shipping for online and phone orders.) The book provides guidance to parents of school-age children on ways to teach cognitive-behavioural strategies to reduce anxiety, including recognizing worries and changing the thinking that encourages them.

Collectively, we have faced serious challenges in the past — including wars, 9/11 and wildfires. We will weather this latest crisis as well, with strong public health leadership and with the support of everyone who cares for and works with children.

Resources for parents and families

New resources to help children — and their parents or caregivers — cope with COVID are being developed rapidly. These include:

• a comic explaining the virus and how to keep safe
• a silent video showing good handwashing techniques
• a new book on handwashing aimed at kids
• a webpage highlighting relaxation exercises
• Seven support strategies to meet the unique needs of children on the Autism Spectrum
• General information on COVID and kids from Canada’s pediatricians
• COVID info sheets — in more than 30 languages
• Info on how to support youth with anxiety disorders
• The CARD system for coping with fears and anxieties

A significant percentage of very young mothers in BC are coping with low income, poor education and mental health challenges. These were the issues highlighted by Katie Hjertaas, Ange Cullen and Charlotte Waddell speaking at SFU Vancouver’s inaugural Lunch ‘n’ Learn event, Feb. 6,  on the topic Improving Children’s Lives Through Research.

This new series of lunch hour sessions showcases how SFU’s Vancouver research is making a positive difference in society.

Hjertaas, Cullen and Waddell came to their understanding of the challenges facing very young mothers in part through working on the BC Healthy Connections Project (BCHCP). This randomized controlled trial aims to assess Nurse-Family Partnership (NFP), an intensive, home-based nursing program for very young mothers and their children. NFP runs throughout pregnancy and the child’s first two years of life.

The talk showed that the 739 girls and young women in the study were coping with daunting challenges when they first enrolled:

• 83% were living on less than $20,000 per year
• Half were coping with not having grade 12 or equivalent, and those still in school had their education interrupted by pregnancy
• Many experienced housing instability
• 74% were coping with mental or physical health problems that affected their daily activities
• 56% reported experiencing maltreatment when they were children themselves.

Findings from this study are already informing public health policy locally, nationally and beyond — with more reports to come, particularly on how NFP can benefit children.

The Children’s Health Policy Centre marked the closure of research interviews for the BC Healthy Connections Project, its randomized controlled trial assessing the Nurse-Family Partnership program, with a celebration on Dec. 10.

The trial, which is sponsored by the BC government, involves 739 young mothers and their 744 children. Nurse-Family Partnership is a landmark public health program that begins even before children are born. It involves intensive home visits by nurses, which continue until children reach their second birthday. Program outcomes will be compared with BC’s existing health and social services to learn how we can better improve children’s mental health and development.

Above, CHPC director Charlotte Waddell is shown with SFU’s Dean of Health Sciences Tania Bubela, cutting a cake. Also attending was the Scientific Director and Co-Principal Investigator for the BC Healthy Connections Project (BCHCP) Nicole Catherine and many members of the BCHCP team from over the past eight years.

Guests of honour included BC’s former Provincial Health Officer, Perry Kendall, the Executive Director of BC’s Public Health Services, Kim Bruce and BC Ministry of Health Nurse-Family Partnership Provincial Coordinator Donna Jepsen.

A paper by the BC Healthy Connections Project team has just been published in the prestigious journal BMC Public Health.

This “baseline” paper provides a profile of participants in a BC-based scientific evaluation of the Nurse Family Partnership (NFP) program when they first entered the study, in early pregnancy. The paper reveals a group of girls and young women coping with substantial adversities. In addition to low income, most also face single parenthood, limited education, housing instability, severe anxiety or depression and experiences of maltreatment themselves when they were younger.

“Despite Canada’s public programs,” the paper concludes, “these pregnant girls and young women were not being adequately reached by social services. Our study adds new data to inform early intervention planning, suggesting that unacceptably high levels of socioeconomic disadvantage exist for some young British Columbians.”

The paper suggests that greater health and social supports and services are warranted for the young mothers and children involved, as well as for populations like them. The authors note that most of the adversities they have depicted are avoidable — with NFP being the starting point for prevention programming that can better support young families.

BMC Public Health is an open access, peer-reviewed journal, publishing articles on the epidemiology of disease and the understanding of all aspects of public health. The journal has a special focus on the social determinants of health, the environmental, behavioural, and occupational correlates of health and disease, and the impact of health policies, practices and interventions on the community.

A full copy of the paper may be seen here.

The BC Healthy Connections Project is continuing to follow these girls and young women and their children. Future reports will cover prenatal findings and the impact of NFP on child development and mental health when children reach age two years.