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Stokes K, Houghton M, Gato J, Tasker F. Surveying Psychological Wellbeing in a Post-Pandemic World: The Role of Family and Social Support for LGBTQ+ and Cisgender Heterosexual Adults in the UK. Healthcare (Basel) 2024; 12:1634. [PMID: 39201192 PMCID: PMC11353760 DOI: 10.3390/healthcare12161634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 08/13/2024] [Accepted: 08/14/2024] [Indexed: 09/02/2024] Open
Abstract
Studies have emphasized the importance of social support in mitigating the relationship between psychological distress and mental health effects, with family of origin and family of formation providing key sources of social support over the life course. However, LGBTQ+ people may experience family of origin relationships as a source of distress, while partners and friends may buffer the relationship between minority stress and psychological wellbeing. Through our online survey (March-June 2022), which was conducted when the social restrictions of the COVID-19 pandemic were lifted in the UK, we considered the association between psychological wellbeing and sources of social support by sampling n = 1330 LGBTQ+ and cisgender heterosexual adults. LGBTQ+ adults generally experienced poorer psychological wellbeing outcomes than did cisgender heterosexual people. For LGBTQ+ adults, social support from family of origin, a special person, or friends was not associated with depression, anxiety, or stress levels, but social support from family or a special person was positively associated with higher levels of life satisfaction. Our findings indicate the importance of considering negative as well as positive wellbeing.
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Affiliation(s)
- Katie Stokes
- School of Psychological Sciences, Birkbeck University of London, London WC1E 7HX, UK; (K.S.); (M.H.)
| | - Marie Houghton
- School of Psychological Sciences, Birkbeck University of London, London WC1E 7HX, UK; (K.S.); (M.H.)
| | - Jorge Gato
- Faculty of Psychology and Education Sciences, University of Porto, 4099-002 Porto, Portugal;
| | - Fiona Tasker
- School of Psychological Sciences, Birkbeck University of London, London WC1E 7HX, UK; (K.S.); (M.H.)
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Poteat VP, Calzo JP, Richburg A, Marx RA, Yoshikawa H. How Gender-Sexuality Alliances cultivate a sense of school belonging from week to week for LGBTQ+ youth. J Sch Psychol 2024; 105:101329. [PMID: 38876548 DOI: 10.1016/j.jsp.2024.101329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 06/16/2024]
Abstract
School belonging can facilitate positive youth development and educational outcomes. Given that LGBTQ+ youth face marginalization in schools, there is a need to identify school supports that could still promote their sense of school belonging. We considered Gender-Sexuality Alliances (GSAs) as LGBTQ+ affirming school clubs. Among 92 LGBTQ+ student members of GSAs in nine states who completed weekly diary surveys over an 8-week period (Mage = 15.83 years, SD = 1.29; 50% youth of color; 51% trans or non-binary), we considered whether a youth's GSA experiences from meeting to meeting predicted their relative levels of school belonging in days following these meetings. There was significant within-individual (37%) and between-individual (63%) variability in youth's sense of school belonging during this time. Youth reported relatively higher school belonging on days following GSA meetings where they perceived greater group support (p = .04) and took on more leadership (p = .01). Furthermore, youth who, on average, reported greater advisor responsiveness (p = .01) and leadership (p = .01) in GSA meetings over the 8-week period reported greater school belonging than others. Findings showcase the dynamic variability in LGBTQ+ youth's sense of school belonging from week to week and carry implications for how schools and GSAs can support LGBTQ+ youth and sustain their ties to school.
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Affiliation(s)
- V Paul Poteat
- Boston College, 140 Commonwealth Ave., Campion Hall 307, Chestnut Hill, MA 02467, United States of America.
| | - Jerel P Calzo
- San Diego State University, United States of America
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Hunt GR, Higgins DJ, Willis ML, Mathews B, Lawrence D, Meinck F, Pacella R, Thomas HJ, Scott JG, Erskine HE, Malacova E, Haslam DM. The Prevalence of Peer Sexual Harassment During Childhood in Australia. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241245368. [PMID: 38591149 DOI: 10.1177/08862605241245368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Sexual harassment inflicted by adolescents on their peers is a major public health issue, but its prevalence across childhood is not known. We provide the first nationally representative data on the prevalence of peer sexual harassment across childhood, using cross-sectional data from the Australian Child Maltreatment Study (ACMS). The ACMS surveyed 8,503 people aged 16 and over about their experiences of child maltreatment and associated health outcomes. The prevalence of peer sexual harassment was assessed using the Juvenile Victimization Questionnaire (JVQ)-R2 Adapted Version (ACMS), with survey data weighted to reflect characteristics of the Australian population. Overall, 1 in 10 (10.4% (95% Confidence Intervals (CI) [9.7, 11.3])) Australians experienced peer sexual harassment during childhood. Peer sexual harassment is an issue disproportionately affecting gender-diverse individuals (24.0%, 95% CI [15.5, 35.2]) and women (15.3%, 95% CI [14.0, 16.7%]), compared to men (5.0%, 95% CI [4.3, 5.9]). Rates of peer sexual harassment were also very high among sexuality diverse participants (prevalence estimates ranging between 14.2% and 29.8%). Peer sexual harassment was predominately inflicted by male peers (9.6%, 95% CI [8.9, 10.4]), compared to 1.8% (95% CI [1.5, 2.2]) reporting harassment from female peers. These findings have implications for understanding and reducing attitudes supporting peer sexual harassment in childhood, particularly against girls and gender and sexuality diverse youth, and associations with other gendered violence both in childhood and later life.
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Affiliation(s)
| | | | | | - Ben Mathews
- Queensland University of Technology, Brisbane, Australia
- Johns Hopkins University, Bloomberg School of Public Health, MD, USA
| | | | - Franziska Meinck
- University of Edinburgh, UK
- North-West University, Vanderbijlpark, South Africa
- University of the Witwatersrand, Johannesburg, South Africa
| | | | - Hannah J Thomas
- Queensland Centre for Mental Health Research, Wacol, Australia
- The University of Queensland, Brisbane, Australia
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - James G Scott
- The University of Queensland, Brisbane, Australia
- Children's Health QLD, South Brisbane, Australia
| | - Holly E Erskine
- Queensland Centre for Mental Health Research, Wacol, Australia
| | - Eva Malacova
- QIMR Berghofer, Medical Research Institute, Brisbane, QLD, Australia
| | - Divna M Haslam
- Queensland University of Technology, Brisbane, Australia
- The University of Queensland, Brisbane, Australia
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Junewicz A, Wachtel JM, Okparaeke E, Guo F, Farahmand P, Lois R, Li A, Stein CR, Baroni A. The persistent impact of the COVID-19 pandemic on pediatric emergency department visits for suicidal thoughts and behaviors. Suicide Life Threat Behav 2024; 54:38-48. [PMID: 37933542 DOI: 10.1111/sltb.13016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 10/04/2023] [Accepted: 10/19/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION We examined data from a large, high acuity, pediatric psychiatric emergency department (ED) to assess both the immediate and longer-term impact of the pandemic on ED visits for suicidal thoughts and behaviors (STBs) among youth. METHODS Youth ages 5-17 years presenting at a pediatric psychiatric ED in New York, NY from March 2019-November 2021 were included in this study. Visits were categorized as pre-pandemic, pandemic year 1, or pandemic year 2. We examined changes in demographic and clinical characteristics among patients presenting across the three time periods, as well as multivariable associations between these characteristics and STBs. RESULTS Over 32 months, 2728 patients presented at 4161 visits. The prevalence of a discharge diagnosis of STBs increased from 21.2% pre-pandemic to 26.3% (p < 0.001) during pandemic year 1, and further increased to 30.1% (p = 0.049) during pandemic year 2. Youth were 21% more likely to receive a discharge diagnosis of STBs in pandemic year 1 (RR 1.21, 95% CI 1.07, 1.36) and 35% more likely in pandemic year 2 (RR 1.35, 95% CI 1.19, 1.52) compared to pre-pandemic baseline. CONCLUSIONS In a large, high-acuity ED, STBs continued to increase 20 months after the initial COVID-19 lockdown. These findings highlight the persistent detrimental impact of the pandemic on youth mental health.
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Affiliation(s)
- Alexandra Junewicz
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
- NYC Health+Hospitals Bellevue, New York City, New York, USA
| | - Jonathan M Wachtel
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
| | - Eugene Okparaeke
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
- NYC Health+Hospitals Bellevue, New York City, New York, USA
| | - Fei Guo
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
| | - Pantea Farahmand
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
- NYC Health+Hospitals Bellevue, New York City, New York, USA
| | - Rebecca Lois
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
| | - Annie Li
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
- NYC Health+Hospitals Bellevue, New York City, New York, USA
| | - Cheryl R Stein
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
| | - Argelinda Baroni
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, New York City, New York, USA
- NYC Health+Hospitals Bellevue, New York City, New York, USA
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Closson K, Zulu B, Jesson J, Dietrich JJ, Pakhomova T, Basham CA, Beksinska M, Kaida A. Examining gender and sexual orientation differences in physical intimate partner violence experienced and perpetrated by youth living in eThekwini district South Africa during the COVID-19 pandemic. BMC Public Health 2023; 23:2300. [PMID: 37990170 PMCID: PMC10664660 DOI: 10.1186/s12889-023-17199-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 11/09/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Young women and Lesbian, Gay, Bisexual, Trans, Non-binary/no gender, or Questioning (LGBTQ+) youth in South Africa face some of the highest global levels of intimate partner violence (IPV). Given limited evidence in the wake of the COVID-19 pandemic, which has fuelled IPV globally, we aimed to describe and compare experiences and perpetration of IPV of youth aged 16-24 by sexual orientation and gender identity (SOGI). METHODS During the study period (December 2021-May 2022), youth aged 16-24 from eThekwini district, South Africa completed an online survey to understand multilevel impacts of the pandemic on youth. Participants were asked about experiences and perpetration of physical IPV since the start of the COVID-19 pandemic (March 2020). Descriptive statistics and adjusted logistic regressions compared the likelihood of experiencing and/or perpetrating physical IPV between cisgender and transgender inclusive heterosexual men; heterosexual women; gay, bisexual, or questioning men [GBQM]; lesbian, gay, bisexual, or questioning women [LGBQW]; or gender/sexual non-conforming youth [non-conforming]. RESULTS Of 1,588 youth (mean age = 21.7 [SD = 2.3]; 71.7% Black) with non-missing SOGI and physical IPV data, 238 (15.0%) were LGBTQ+ (40.3% LGBQW and 36.1% non-conforming). Overall, 14.6% of respondents experienced physical IPV and 9.8% perpetrated physical IPV since the start of the pandemic, which differed by SOGI (12.3% of heterosexual men, 13.9% of heterosexual women, 22.0% of GBQM, 18.2% of LGBQW, and 25.0% of non-conforming youth experienced and 10.3% of heterosexual men; 7.7% of heterosexual women; 10.0% of GBQM; 18.2% of LGBQW; and 16.7% of non-conforming youth perpetrated). In adjusted models, compared to heterosexual women, non-conforming youth had increased odds of experiencing (adjusted odds ratio [aOR] = 2.36; 95%CI, 1.26-4.39) physical IPV and compared to heterosexual men, non-conforming youth had greater odds of perpetrating physical IPV (aOR = 2.19; 95%CI, 1.07-4.48) during the pandemic. CONCLUSION Over one in six youth in our study experienced and one in ten perpetrated physical IPV since the onset of the COVID-19 pandemic, with gender and sexual non-conforming youth experiencing and perpetrating IPV at significantly greater rates than cisgender/heterosexual peers. Our findings highlight the need for gender transformative efforts that move beyond the gender binary to support healthy relationships and IPV prevention for LGBTQ + youth in South Africa and globally.
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Affiliation(s)
- Kalysha Closson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Center on Gender Equity and Health, School of Medicine, University of California, San Diego, California, USA
| | - Bongiwe Zulu
- Maternal Adolescent and Child Health Research Unit (MRU), Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Julie Jesson
- Center for Epidemiology and Research in POpulation Health (CERPOP), Université de Toulouse, Toulouse, France
| | - Janan J Dietrich
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Tatiana Pakhomova
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - C Andrew Basham
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA
| | - Mags Beksinska
- Maternal Adolescent and Child Health Research Unit (MRU), Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.
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Vaillancourt T, Farrell AH, Brittain H, Krygsman A, Vitoroulis I, Pepler D. Bullying before and during the COVID-19 pandemic. Curr Opin Psychol 2023; 53:101689. [PMID: 37690185 DOI: 10.1016/j.copsyc.2023.101689] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 09/12/2023]
Abstract
The rates of bullying during the COVID-19 pandemic, a time of unprecedented public health and social restrictions, were compared to earlier times when students attended school in person. Several studies indicated a notable decrease in the prevalence of bullying victimization and perpetration during the pandemic, particularly when online learning was implemented. But studies from countries with fewer social restrictions indicated increases in rates of bullying during the pandemic. Mixed results regarding prevalence rates for some bullying forms (e.g., cyberbullying) were also found. Racialized youth and LGBTQ+ youth reliably reported higher rates of bullying victimization during the pandemic, consistent with pre-pandemic patterns. Reasons for the inconsistencies in findings likely relate to diverse methods, timeframes, and sampling techniques, as well as different experiences with pandemic social restrictions. More longitudinal studies are needed to assess whether bullying involvement did in fact "change" during, compared to before, the pandemic. The findings point to the importance of peer relationships and hint at the potential of increased teacher supervision as a bullying prevention strategy.
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Affiliation(s)
- Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada; School of Psychology, Faculty of Social Sciences, University of Ottawa, Ontario, Canada.
| | - Ann H Farrell
- Department of Child and Youth Studies, Brock University, St. Catharines Ontario, Canada
| | - Heather Brittain
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada
| | - Amanda Krygsman
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada
| | - Irene Vitoroulis
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada; School of Psychology, Faculty of Social Sciences, University of Ottawa, Ontario, Canada
| | - Debra Pepler
- Department of Psychology, York University, Toronto, Ontario, Canada
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Hastings PD, Hodge RT. Considering the experiences and adjustment of sexual and gender minority youths during the COVID-19 pandemic. Curr Opin Psychol 2023; 53:101660. [PMID: 37517165 DOI: 10.1016/j.copsyc.2023.101660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 08/01/2023]
Abstract
Sexual and gender minority (SGM) adolescents and emerging adults experienced social and structural inequities and evinced more psychosocial adjustment difficulties than cisgender, heterosexual youths before the onset of the COVID-19 pandemic. The unique array of stressors confronting SGM youths during the pandemic - including separation from affirming and supportive peers, teachers and communities, and mandated co-residence with potentially rejecting family members - may have exacerbated these discrepancies. Conversely, social distancing and remote learning may have reduced direct exposure to discrimination outside the home, and many SGM youths leveraged their personal and social resources to cope with pandemic-related stressors. This review considers the empirical literature on the academic, psychological, and social consequences of the COVID-19 pandemic for SGM youths.
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Affiliation(s)
- Paul D Hastings
- Department of Psychology, University of California Davis, Davis, CA, USA; Center for Mind and Brain, University of California Davis, Davis, CA, USA.
| | - Ryan T Hodge
- Center for Mind and Brain, University of California Davis, Davis, CA, USA; Department of Human Ecology, University of California Davis, Davis, CA, USA
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Stewart SE, Best J, Selles R, Naqqash Z, Lin B, Lu C, Au A, Snell G, Westwell-Roper C, Vallani T, Ewing E, Dogra K, Doan Q, Samji H. Age-specific determinants of psychiatric outcomes after the first COVID-19 wave: baseline findings from a Canadian online cohort study. Child Adolesc Psychiatry Ment Health 2023; 17:20. [PMID: 36747252 PMCID: PMC9901839 DOI: 10.1186/s13034-023-00560-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/09/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Canadians endured unprecedented mental health (MH) and support access challenges during the first COVID-19 wave. Identifying groups of individuals who remain at risk beyond the acute pandemic phase is key to guiding systemic intervention efforts and policy. We hypothesized that determinants of three complementary, clinically actionable psychiatric outcomes would differ across Canadian age groups. METHODS The Personal Impacts of COVID-19 Survey (PICS) was iteratively developed with stakeholder feedback, incorporating validated, age-appropriate measures. Baseline, cross-sectional online data collected between November 2020-July 2021 was used in analyses. Age group-specific determinants were sought for three key baseline MH outcomes: (1) current probable depression, generalized anxiety disorder, obsessive-compulsive disorder and/or suicide attempt during COVID-19, (2) increased severity of any lifetime psychiatric diagnosis, and (3) inadequate MH support access during COVID-19. Multivariable logistic regression models were constructed for children, youth (self- and parent-report), young adults (19-29 years) and adults over 29 years, using survey type as a covariate. Statistical significance was defined by 95% confidence interval excluding an odds ratio of one. RESULTS Data from 3140 baseline surveys were analyzed. Late adolescence and early adulthood were identified as life phases with the worst MH outcomes. Poverty, limited education, home maker/caregiver roles, female and non-binary gender, LGBTQ2S + status and special educational, psychiatric and medical conditions were differentially identified as determinants across age groups. INTERPRETATION Negative psychiatric impacts of COVID-19 on Canadians that include poor access to MH support clearly persisted beyond the first wave, widening pre-existing inequity gaps. This should guide policy makers and clinicians in current and future prioritization efforts.
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Affiliation(s)
- S. Evelyn Stewart
- grid.17091.3e0000 0001 2288 9830Department of Psychiatry, University of British Columbia, Vancouver, BC Canada ,grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital Research Institute, Vancouver, BC Canada
| | - John Best
- grid.17091.3e0000 0001 2288 9830Department of Psychiatry, University of British Columbia, Vancouver, BC Canada ,grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital Research Institute, Vancouver, BC Canada
| | - Robert Selles
- grid.17091.3e0000 0001 2288 9830Department of Psychiatry, University of British Columbia, Vancouver, BC Canada ,grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital Research Institute, Vancouver, BC Canada
| | - Zainab Naqqash
- grid.17091.3e0000 0001 2288 9830Department of Psychiatry, University of British Columbia, Vancouver, BC Canada ,grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital Research Institute, Vancouver, BC Canada
| | - Boyee Lin
- grid.17091.3e0000 0001 2288 9830Department of Psychiatry, University of British Columbia, Vancouver, BC Canada ,grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital Research Institute, Vancouver, BC Canada
| | - Cynthia Lu
- grid.17091.3e0000 0001 2288 9830Department of Psychiatry, University of British Columbia, Vancouver, BC Canada ,grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital Research Institute, Vancouver, BC Canada
| | - Antony Au
- grid.17091.3e0000 0001 2288 9830Department of Psychiatry, University of British Columbia, Vancouver, BC Canada ,grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital Research Institute, Vancouver, BC Canada
| | - Gaelen Snell
- grid.61971.380000 0004 1936 7494Faculty of Health Sciences, Simon Fraser University, Burnaby, BC Canada ,grid.17091.3e0000 0001 2288 9830Faculty of Medicine, University of British Columbia, Vancouver, BC Canada
| | - Clara Westwell-Roper
- grid.17091.3e0000 0001 2288 9830Department of Psychiatry, University of British Columbia, Vancouver, BC Canada ,grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital Research Institute, Vancouver, BC Canada
| | - Tanisha Vallani
- grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital Research Institute, Vancouver, BC Canada ,grid.17091.3e0000 0001 2288 9830Faculty of Medicine, University of British Columbia, Vancouver, BC Canada
| | - Elise Ewing
- grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital Research Institute, Vancouver, BC Canada ,grid.17091.3e0000 0001 2288 9830Faculty of Medicine, University of British Columbia, Vancouver, BC Canada
| | - Kashish Dogra
- grid.17091.3e0000 0001 2288 9830Department of Psychiatry, University of British Columbia, Vancouver, BC Canada ,grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital Research Institute, Vancouver, BC Canada
| | - Quynh Doan
- grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital Research Institute, Vancouver, BC Canada ,grid.17091.3e0000 0001 2288 9830Department of Pediatrics, University of British Columbia, Vancouver, BC Canada
| | - Hasina Samji
- grid.414137.40000 0001 0684 7788British Columbia Children’s Hospital Research Institute, Vancouver, BC Canada ,grid.418246.d0000 0001 0352 641XBritish Columbia Centre for Disease Control, Vancouver, BC Canada
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