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Racine N, Pitt T, Premji S, McDonald SW, Patten SB, Tough S, Madigan S. Prevalence of Common Child Mental Health Disorders Using Administrative Health Data and Parent Report in a Prospective Community-Based Cohort from Alberta, Canada: Prévalence des troubles communs de santé mentale de l'enfant à l'aide des données de santé administratives et des rapports des parents dans une cohorte prospective communautaire d'Alberta, Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024:7067437241271708. [PMID: 39169746 DOI: 10.1177/07067437241271708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
OBJECTIVE Knowing the prevalence of mental health difficulties in young children is critical for early identification and intervention. In the current study, we examine the agreement among three different data sources estimating the prevalence of diagnoses for attention deficit hyperactivity disorder (ADHD) and emotional disorders (i.e., anxiety or mood disorder) for children between birth and 9 years of age. METHODS Data from a prospective pregnancy cohort was linked with provincial administrative health data for children in Alberta, Canada. We report the positive agreement, negative agreement, and Cohen's Kappa of parent-reported child diagnoses provided by a health professional ("parent report"), exceeding a clinical cut-off on a standardized questionnaire completed by parents (the Behavior Assessment System for Children, 3rd edition ["BASC-3"]), and cumulative inpatient, outpatient, or physician claims diagnoses ("administrative data"). RESULTS Positive and negative agreement for administrative data and parent-reported ADHD diagnoses were 70.8% and 95.6%, respectively, and 30.5% and 94.9% for administrative data and the BASC-3, respectively. For emotional disorders, administrative data and parent-reported diagnoses had a positive agreement of 35.7% and negative agreement of 96.30%. Positive and negative agreement for emotional disorders using administrative data and the BASC-3 were 20.0% and 87.4%, respectively. Kappa coefficients were generally low, indicating poor chance-corrected agreement between these data sources. CONCLUSIONS The data sources highlighted in this study provide disparate agreement for the prevalence of ADHD and emotional disorder diagnoses in young children. Low Kappa coefficients suggest that parent-reported diagnoses, clinically elevated symptoms using a standardized questionnaire, and diagnoses from administrative data serve different purposes and provide discrete estimates of mental health difficulties in early childhood.Plain Language Title: Prevalence of child mental health disorders according to different data sources in Canada.
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Affiliation(s)
- N Racine
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - T Pitt
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
- Provincial Population and Public Health, Alberta Health Services, Calgary, Alberta, Canada
| | - S Premji
- Centre for Health Economics, University of York, Heslington, York, UK
| | - S W McDonald
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
- Provincial Population and Public Health, Alberta Health Services, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - S B Patten
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry, Peter Lougheed Hospital, Calgary, Alberta, Canada
| | - S Tough
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - S Madigan
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
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Faller J, Le LKD, Chatterton ML, Perez JK, Chiotelis O, Tran HNQ, Sultana M, Hall N, Lee YY, Chapman C, Newton N, Slade T, Sunderland M, Teesson M, Mihalopoulos C. A systematic review of economic evaluations for opioid misuse, cannabis and illicit drug use prevention. BJPsych Open 2023; 9:e149. [PMID: 37551098 PMCID: PMC10594094 DOI: 10.1192/bjo.2023.515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/15/2023] [Accepted: 06/08/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Substance use disorders negatively affect global disease burden. Effective preventive interventions are available, but whether they provide value for money is unclear. AIMS This review looks at the cost-effectiveness evidence of preventive interventions for cannabis use, opioid misuse and illicit drug use. METHOD Literature search was undertaken in Medline, CINAHL, PsycINFO, EconLit through EBSCOhost and EMBASE, up to May 2021. Grey literature search was conducted as supplement. Studies included were full economic evaluations or return-on-investment (ROI) analyses for preventing opioid misuse, cannabis and illicit drug use. English-language restriction was used. Outcomes extracted were incremental cost-effectiveness ratios (ICER) or ROI ratios, with costs presented in 2019 United States dollars. Quality was assessed with the Drummond checklist. RESULTS Eleven full economic evaluation studies were identified from 5674 citations, with all studies conducted in high-income countries. Most aimed to prevent opioid misuse (n = 4), cannabis (n = 3) or illicit drug use (n = 5). Modelling was the predominant methodology (n = 7). Five evaluated school-based universal interventions targeting children and adolescents (aged <18 years). Five cost-benefit studies reported cost-savings. One cost-effectiveness and two cost-utility analysis studies supported the cost-effectiveness of interventions, as ICERs fell under prespecified value-for-money thresholds. CONCLUSIONS There are limited economic evaluations of preventive interventions for opioid misuse, cannabis and illicit drug use. Family-based intervention (ParentCorps), school-based interventions (Social and Emotional Training and Project ALERT) and a doctor's programme to assess patient risk of misusing narcotics ('the Network System to Prevent Doctor-Shopping for Narcotics') show promising cost-effectiveness and warrant consideration.
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Affiliation(s)
- Jan Faller
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Long Khanh-Dao Le
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Mary Lou Chatterton
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Joahna Kevin Perez
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia
| | - Oxana Chiotelis
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Huong Ngoc Quynh Tran
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Marufa Sultana
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Natasha Hall
- Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
| | - Yong Yi Lee
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia; School of Public Health, The University of Queensland, Australia; and Policy and Epidemiology Group, Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Matt Sunderland
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Cathrine Mihalopoulos
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Australia; and Deakin Health Economics, Institute for Health Transformation, School of Health and Social Development, Deakin University, Australia
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Psychosoziales Versorgungskonzept für Familien mit psychischen Kern- oder Begleitproblemen. PSYCHOTHERAPEUT 2021. [DOI: 10.1007/s00278-021-00559-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tesson S, Butow PN, Marshall K, Fonagy P, Kasparian NA. Parent-child bonding and attachment during pregnancy and early childhood following congenital heart disease diagnosis. Health Psychol Rev 2021; 16:378-411. [PMID: 33955329 DOI: 10.1080/17437199.2021.1927136] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Diagnosis and treatment of congenital heart disease (CHD) can present challenges to the developing parent-child relationship due to periods of infant hospitalization and intensive medical care, parent-infant separations, child neurodevelopmental delay and feeding problems, and significant parent and child distress and trauma. Yet, the ways in which CHD may affect the parent-child relationship are not well-understood. We systematically reviewed the evidence on parental bonding, parent-child interaction, and child attachment following CHD diagnosis, according to a pre-registered protocol (CRD42019135687). Six electronic databases were searched for English-language studies comparing a cardiac sample (i.e., expectant parents or parents and their child aged 0-5 years with CHD) with a healthy comparison group on relational outcomes. Of 22 unique studies, most used parent-report measures (73%) and yielded mixed results for parental bonding and parent-child interaction quality. Observational results also varied, although most studies (4 of 6) found difficulties in parent-child interaction on one or more affective or behavioural domains (e.g., lower maternal sensitivity, lower infant responsiveness). Research on parental-fetal bonding, father-child relationships, and child attachment behaviour was lacking. Stronger evidence is needed to determine the nature, prevalence, and predictors of relational disruptions following CHD diagnosis, and to inform targeted screening, prevention, and early intervention programs for at-risk dyads.
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Affiliation(s)
- Stephanie Tesson
- School of Psychology, The University of Sydney, Sydney, Australia.,Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, Australia
| | - Phyllis N Butow
- School of Psychology, The University of Sydney, Sydney, Australia.,Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, Australia
| | - Kate Marshall
- Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, The University of New South Wales, Sydney, Australia
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Nadine A Kasparian
- Heart Centre for Children, The Sydney Children's Hospitals Network, Sydney, Australia.,Cincinnati Children's Center for Heart Disease and Mental Health, Heart Institute and the Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Peterson C, Kearns MC. Systematic Review of Violence Prevention Economic Evaluations, 2000-2019. Am J Prev Med 2021; 60:552-562. [PMID: 33608188 PMCID: PMC7987799 DOI: 10.1016/j.amepre.2020.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 11/28/2022]
Abstract
CONTEXT Health economic evaluations (e.g., cost-effectiveness analysis) can guide the efficient use of resources to improve health outcomes. This study aims to summarize the content and quality of interpersonal violence prevention economic evaluations. EVIDENCE ACQUISITION In 2020, peer-reviewed journal articles published during 2000-2019 focusing on high-income countries were identified using index terms in multiple databases. Study content, including violence type prevented (e.g., child abuse and neglect), outcome measure (e.g., abusive head trauma clinical diagnosis), intervention type (e.g., education program), study methods, and results were summarized. Studies reporting on selected key methods elements essential for study comparison and public health decision making (e.g., economic perspective, time horizon, discounting, currency year) were assessed. EVIDENCE SYNTHESIS A total of 26 economic evaluation studies were assessed, most of which reported that assessed interventions yielded good value for money. Physical assault in the community and child abuse and neglect were the most common violence types examined. Studies applied a wide variety of cost estimates to value avoided violence. Less than two thirds of the studies reported all the key methods elements. CONCLUSIONS Comprehensive data collection on violence averted and intervention costs in experimental settings can increase opportunities to identify interventions that generate long-term value. More comprehensive estimates of the cost of violence can improve opportunities to demonstrate how prevention investment can be offset through avoided future costs. Better adherence to health economic evaluation reporting standards can enhance comparability across studies and may increase the likelihood that economic evidence is included in violence prevention decision making.
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Affiliation(s)
- Cora Peterson
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
| | - Megan C Kearns
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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Macniven R, Jeffries TL, Meharg D, Talbot F, Rambaldini B, Edwards E, Hickie IB, Sloan M, Gwynne K. What Solutions Exist for Developmental Delays Facing Indigenous Children Globally? A Co-Designed Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E285. [PMID: 33321773 PMCID: PMC7763469 DOI: 10.3390/children7120285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/27/2020] [Accepted: 12/08/2020] [Indexed: 11/16/2022]
Abstract
Early childhood is important for future cognitive and educational outcomes. Programs overcoming barriers to engagement in early education for Indigenous children must address family cultural needs and target developmental delays. This systematic review identifies culturally adapted programs to improve developmental delays among young children, in response to an identified priority of a remote Indigenous community. Five databases (the Cochrane Library, Embase, Medline, Scopus and CINAHL) were searched for English language papers in January 2018. Study quality was assessed, and findings were analysed thematically. Findings were presented to the community at an event with key stakeholders, to determine their inclusion and face validity. Seven relevant studies, published between 1997 and 2013, were identified by the researchers and each study was supported by the community for inclusion. Three studies included on Native American children and four studies included children from non-Indigenous disadvantaged backgrounds. Findings were reported narratively across four themes: storytelling to improve educational outcomes; family involvement improved development; culturally adapted cognitive behavioural therapy to reduce trauma; rewards-based teaching to improve child attention. Limited published research on culturally adapted and safe interventions for children with developmental delays exists but these four themes from seven studies identify useful components to guide the community and early childhood program development.
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Affiliation(s)
- Rona Macniven
- School of Population Health, University of New South Wales, Sydney 2052, Australia
- Poche Centre for Indigenous Health, Faculty of Health and Medicine, The University of Sydney, Sydney 2006, Australia; (T.L.J.J.); (D.M.); (F.T.); (B.R.); (K.G.)
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2109, Australia
| | - Thomas Lee Jeffries
- Poche Centre for Indigenous Health, Faculty of Health and Medicine, The University of Sydney, Sydney 2006, Australia; (T.L.J.J.); (D.M.); (F.T.); (B.R.); (K.G.)
| | - David Meharg
- Poche Centre for Indigenous Health, Faculty of Health and Medicine, The University of Sydney, Sydney 2006, Australia; (T.L.J.J.); (D.M.); (F.T.); (B.R.); (K.G.)
| | - Folau Talbot
- Poche Centre for Indigenous Health, Faculty of Health and Medicine, The University of Sydney, Sydney 2006, Australia; (T.L.J.J.); (D.M.); (F.T.); (B.R.); (K.G.)
| | - Boe Rambaldini
- Poche Centre for Indigenous Health, Faculty of Health and Medicine, The University of Sydney, Sydney 2006, Australia; (T.L.J.J.); (D.M.); (F.T.); (B.R.); (K.G.)
| | - Elaine Edwards
- Toomelah Public School, Boggabilla 2409, Australia; (E.E.); (M.S.)
| | - Ian B. Hickie
- Brain and Mind Centre, The University of Sydney, Sydney 2006, Australia;
| | - Margaret Sloan
- Toomelah Public School, Boggabilla 2409, Australia; (E.E.); (M.S.)
| | - Kylie Gwynne
- Poche Centre for Indigenous Health, Faculty of Health and Medicine, The University of Sydney, Sydney 2006, Australia; (T.L.J.J.); (D.M.); (F.T.); (B.R.); (K.G.)
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney 2109, Australia
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Kaplan SA, Gourevitch MN. Leveraging Population Health Expertise to Enhance Community Benefit. Front Public Health 2020; 8:88. [PMID: 32296672 PMCID: PMC7136395 DOI: 10.3389/fpubh.2020.00088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 03/03/2020] [Indexed: 11/16/2022] Open
Abstract
As the Internal Revenue Service strengthens the public health focus of community benefit regulations, and many states do the same with their tax codes, hospitals are being asked to look beyond patients in their delivery system to understand and address the needs of geographic areas. With the opportunities this affords come challenges to be addressed. The regulations' focus on population health is not limited to a defined clinical population—and the resulting emphasis on upstream determinants of health and community engagement is unfamiliar territory for many healthcare systems. At the same time, for many community residents and community-based organizations, large medical institutions can feel complicated to engage with or unwelcoming. And for neighborhoods that have experienced chronic underinvestment in upstream determinants of health—such as social services, housing and education—funds made available by hospitals through their community health improvement activities may seem insufficient and unreliable. Despite these regulatory requirements, many hospitals, focused as they are on managing patients in their delivery system, have not yet invested significantly in community health improvement. Moreover, although there are important exceptions, community health improvement projects have often lacked a strong evidence base, and true health system-community collaborations are relatively uncommon. This article describes how a large academic medical center tapped into the expertise of its population health research faculty to partner with local community-based organizations to oversee the community health needs assessment and to design, implement and evaluate a set of geographically based community-engaged health improvement projects. The resulting program offers a paradigm for health system investment in area-wide population health improvement.
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Affiliation(s)
- Sue A Kaplan
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, United States
| | - Marc N Gourevitch
- Department of Population Health, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, United States
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Sentalin PBR, Pinheiro ADO, de Oliveira RR, Zângaro RA, Campos LA, Baltatu OC. Obesity and metabolic syndrome in children in Brazil: The challenge of lifestyle change. Medicine (Baltimore) 2019; 98:e15666. [PMID: 31083270 PMCID: PMC6531096 DOI: 10.1097/md.0000000000015666] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The purpose of this observational study was to examine the prevalence of obesity in children of 6 to 8 years of age from primary public schools over a period of 6 years and the associated environmental and metabolic health risk factors.This was a cohort observational study to investigate the prevalence of obesity in children from 14 state primary schools in Vinhedo, Sao Paulo state. Environmental and metabolic health risk factors for obesity were investigated in a cross-sectional survey.This present study revealed 74.0% of children with obesity consumed fried foods and sweets at school, and 84.0% consumed snacks and soft drinks at home. This cohort reported to have engaged in physical activity for less than 3 hours per week at school (93.0%) and at home (85.0%). There was a high prevalence of increased waist circumference and insulin resistance among children with obesity (84.9% and 84.5%, respectively). The body mass index had a significant Spearman correlation with waist circumference, insulin resistance, and triglycerides.Childhood obesity was associated with a high prevalence of both environmental and metabolic risk factors. Also, the authors conclude that the lack of parents' awareness of childhood obesity and its risk factors represents a substantial barrier to lifestyle counseling.
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Affiliation(s)
| | | | - Robson Rocha de Oliveira
- School of Health Sciences at Anhembi Morumbi University—Laureate International Universities, Sao Jose dos Campos
| | | | - Luciana Aparecida Campos
- Center of Innovation, Technology and Education (CITE)
- School of Health Sciences at Anhembi Morumbi University—Laureate International Universities, Sao Jose dos Campos
| | - Ovidiu Constantin Baltatu
- Center of Innovation, Technology and Education (CITE)
- School of Health Sciences at Anhembi Morumbi University—Laureate International Universities, Sao Jose dos Campos
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