Updates

In a one-hour Zoom presentation for the McMaster University Child Health Conference on March 13, Christine Schwartz addressed the topic of COVID-19 and children’s mental health.

An Adjunct Professor with the Children’s Health Policy Centre and lead writer for the Children’s Mental Health Research Quarterly, Schwartz has a clinical psychology practice with children and youth and is co-author of a recent paper on COVID and children’s mental health.

Speaking to the group at McMaster, she advised that there are going to be a significantly greater number of children who will need mental health services following the pandemic, particularly with respect to anxiety.

“Children who experience socioeconomic inequalities are much more likely to develop emotional and behavioural concerns,” she noted, adding that data are already starting to show that needs are increasing.

In addition to her presentation, Schwartz also moderated a lively question and answer session.

The annual research symposium was founded in 2016 by a group of Bachelor of Health Sciences students at McMaster specializing in child health.

Faculty members and students from the Vancouver School of Theology attended a Feb. 16, 2021 one-hour workshop about COVID-19 and children with Children’s Health Policy Centre director, Charlotte Waddell.

Aimed at future United Church ministers who will be working with children and youth, the workshop addressed how participants could be community leaders by providing messages of comfort to children.

Despite the current challenging situation in BC, Waddell advised participants to always give kids messages of hope. “Always be a role model — wearing a mask, washing your hands — but also point to the positive,” she said.

“We have excellent public health leadership and vaccines are getting out now,” she said. “We must tell kids we will get through this.”

A longitudinal study of children with autism spectrum disorder from across Canada has shown that “doing well” is possible — even in the context of continuing to meet diagnostic criteria for the disorder. The Pathways study has been following children since they were first diagnosed — known as an inception cohort — and now is tracking children into their teens.

“These results support a strengths-based approach to treatment planning that should include robust support for children and youth and families to increase the likelihood of doing well,” the study concluded.

The paper was published March 29/21 in the Journal of the American Medical Association Open. Peter Szatmari from the University of Toronto is lead author. Charlotte Waddell, director of the Children’s Health Policy Centre, is also an author. She is a longstanding co-investigator with the team.

The paper can be viewed here.

Recently invited to deliver an international seminar about the British Columbia Healthy Connections Project, scientific director Dr. Nicole Catherine spoke to a group of researchers, policymakers and practitioners from around the world. Catherine began by describing the sustained research-policy-practitioner collaborations that support the 10-year Canadian scientific study of the Nurse Family Partnership (NFP) that is being conducted in BC in four Regional Health Authorities.

NFP was developed nearly 40 years ago by Dr. David Olds and colleagues in the United States, to help girls and young women and their children who are facing disadvantages such as low income. The program starts early — in pregnancy, before children are even born — and involves intensive home visits by public health nurses, continuing until children reach their second birthday.

The study is what Catherine described as a “robust” size, with 739 participants and their 727 children, with 200 of these mothers identifying as Indigenous. An analysis of participant characteristics at study entry, in early pregnancy, was published in 2019 showing that the trial reached pregnant girls and young women experiencing socioeconomic disadvantage (i.e., young age, preparing to parent while single, having limited income, having limited education).

Many (47–56%) had associated health and social adversities including unstable housing, a history of childhood maltreatment, or severe anxiety or depression. In fact, 90% were experiencing three or more adversities. “Our data show unacceptable rates of socioeconomic disadvantage for some BC girls and young women who are preparing to parent for the first time,” Catherine told the group. “NFP was designed to support these children and these young mothers.”

While the research interviews were completed in November 2019, analysis is continuing. Main outcome results showing how well NFP works in BC are expected to be announced in 2021/2022. In the meantime, two findings have already been identified.

• Prenatal findings published in the academic journal, Canadian Medical Association Journal Open suggest that NFP reduced the number of cigarettes smoked, for pregnant smokers — which is important, given that even low-level cigarette smoking is harmful to a fetus. NFP also reduced prenatal cannabis use, an emerging public health problem.
• The BC Healthy Connections Project achieved an outstanding participant retention rate (83%–91%) for the six research interviews conducted with each family starting in pregnancy and through until children reached aged two years. The study team successfully completed 4,000 in-person and telephone interviews over six years. This was especially encouraging, Catherine said, because girls and young women experiencing considerable disadvantage are often considered “hard-to-reach” by researchers and practitioners. The study team’s development and use of a standardized retention protocol helped them engage and retain this underserved population. “The onus is on us,” says Catherine. “It’s not that these families are ‘hard-to-reach’— it’s that we ‘need-to-reach’ them.”

The seminar was followed by a conversation with researchers, policymakers and practitioners in various countries around the globe currently considering, evaluating or implementing NFP. This list included Australia, Bulgaria, England, Northern Ireland, United States, Norway and Scotland. Videos from all presenters may be viewed here; Catherine’s presentation is third on the list.