1
|
Donelan J, Douglas S, Willson A, Lester T, Daly S. Implementing Measurement-Based Care in a Youth Partial Hospital Setting: Leveraging Feedback for Sustainability. Adm Policy Ment Health 2024:10.1007/s10488-024-01358-2. [PMID: 38575735 DOI: 10.1007/s10488-024-01358-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 04/06/2024]
Abstract
This paper describes the successful implementation of Measurement-Based Care (MBC) within a Partial Hospitalization Program (PHP) for children and adolescents. Measurement-based care (MBC), the practice of using patient-reported measures routinely to inform decision-making, is associated with improved clinical outcomes for behavioral health patients (Jong et al., Clinical Psychology Review 85, 2021; Fortney & Sladek, 2015). MBC holds great promise in partial hospital programs (PHP) to improve outcomes, yet implementation strategies are as complex as the setting itself. This paper provides a case study example of MBC implementation in a PHP for youth. Over the course of 18 months, an interdisciplinary staff of approximately 20 behavioral health professionals provided partial hospitalization level of care to 633 (39% in-person, 61% telehealth) youth from ages 5 to 18 years old. MBC in this setting incorporated daily patient self-report and weekly caregiver-reported measurements. This descriptive reconstruction, which includes examples of the data that were used during the implementation project, illustrates specific barriers and facilitators in a successful implementation in the local PHP setting. Implementation strategies to address workflow integration, leadership and supervision, and coaching are described, including evolution of these strategies over the course of implementation. Practical considerations for implementing MBC in youth PHP settings are discussed. Finally, the authors explore the potential relationships between the data-driven MBC model of decision making and the development of resilient organizations.
Collapse
Affiliation(s)
- Jill Donelan
- Department of Psychiatry Baystate Health, Springfield, MA, USA.
- Mirah, Boston, MA, USA.
| | - Susan Douglas
- Department of Leadership, Policy, and Organizations, Vanderbilt University, Nashville, TN, USA
| | - Ariane Willson
- Department of Leadership, Policy, and Organizations, Vanderbilt University, Nashville, TN, USA
| | - Tyrena Lester
- Department of Psychiatry Baystate Health, Springfield, MA, USA
| | - Stephanie Daly
- Department of Psychiatry Baystate Health, Springfield, MA, USA
| |
Collapse
|
2
|
Helander M, Fredriksson M, Lohela-Karlsson M. Exploring stakeholders' perceived problems associated with the care and support of children and youth with mental ill health in Sweden: a qualitative study. J Health Popul Nutr 2024; 43:30. [PMID: 38378621 PMCID: PMC10880220 DOI: 10.1186/s41043-024-00520-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/05/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Care and support for children and youth with mental ill health have become more specialized and are provided by an increasing number of stakeholders. As a result, services are often fragmented, inefficient and unco-ordinated, with negative consequences for the service user and their family. Enhanced collaboration could lead to improved care and support but requires a shared understanding and a joint problem formulation between involved stakeholders to commence. The aim of this study was to explore different stakeholders' perceived problems associated with delivering care and support to children and youth with mental ill health and to discuss how the perceived problems relate to collaboration. METHODS A qualitative descriptive study was conducted, using short statements of perceived problems written by stakeholders involved in the care and support of children and youth with mental ill health during an inter-organizational workshop. The 26 stakeholders represented school and student health, primary health care, specialist care, social services, and different service user organizations. Data were collected during February 2020. Inductive content analysis with a summative approach was used when analysing the data. RESULTS The perceived problems were summarized in a model consisting of four main categories: Resources and governance; Collaboration and co-ordination; Knowledge and competence; and Stigma and confidence, containing 24 subcategories. These categories and subcategories were distributed over three levels: Societal level, Organizational level and Individual level. The perceived problems were shared on the category level but to some extent varied between stakeholder groups on the subcategory level. The perceived problems were either directly or indirectly related to collaboration. CONCLUSIONS The perceived problems often acted as barriers to achieving successful collaboration. The problems were distributed on all three levels in the developed model, indicating a complex problem. Even though the perceived problems were shared by stakeholders on an overall level, the findings indicate that the stakeholders did not have a completely shared understanding of the perceived problems, as they tended to focus on aspects most relevant to their own organization or perceptions. The challenge is to find which perceived problems are appropriate for inter-organization problem-solving and which can be solved within individual organizations.
Collapse
Affiliation(s)
- Malin Helander
- Centre for Clinical Research, Västmanland Hospital Västerås, Uppsala University, 721 89, Västerås, Region Västmanland, Sweden.
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
| | - Mio Fredriksson
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Malin Lohela-Karlsson
- Centre for Clinical Research, Västmanland Hospital Västerås, Uppsala University, 721 89, Västerås, Region Västmanland, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| |
Collapse
|
3
|
Stewart SL, Withers A, Graham AA, Poss JW, Donnelly N. Examining the Biopsychosocial Factors Related to Lifetime History of Concussion in Children and Youth. Child Psychiatry Hum Dev 2024; 55:36-47. [PMID: 35729361 DOI: 10.1007/s10578-022-01384-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 11/03/2022]
Abstract
This study investigated the prevalence of lifetime concussions, related psychosocial problems, and post-concussion recovery rates in a clinical sample of children and youth. Participants were 24,186 children and youth (M = 11.9 years, SD = 3.5) who completed an interRAI Child and Youth Mental Health Assessment at mental health agencies across Ontario, Canada. In addition to the expected physiological correlates, results found concussions to be more prevalent in children and youth with attention deficit hyperactivity disorders, anxiety disorders, disruptive behaviour disorders, mood disorders, and those involved in self-harm, harm to others, destructive aggression, and internalizing and externalizing symptoms. The results of this study add to our understanding of children and youth's experiences with concussions. Clinical implications and recommendations are discussed to maximize the effectiveness of evidence-based interventions related to concussion recovery.
Collapse
Affiliation(s)
- Shannon L Stewart
- Faculty of Education, University of Western Ontario, 1137 Western Rd, London, ON, N6G 1G7, Canada
| | - Abigail Withers
- Faculty of Education, University of Western Ontario, 1137 Western Rd, London, ON, N6G 1G7, Canada.
| | - Alana A Graham
- Faculty of Education, University of Western Ontario, 1137 Western Rd, London, ON, N6G 1G7, Canada
| | - Jeffrey W Poss
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G5, Canada
| | - Nicholas Donnelly
- Faculty of Education, University of Western Ontario, 1137 Western Rd, London, ON, N6G 1G7, Canada
| |
Collapse
|
4
|
Walsh-Garcia S, Spirtos M, Mockler D, Cremin K. The Impact of Complex Trauma on Occupations and Daily Functioning in Childhood: A Scoping Review. Phys Occup Ther Pediatr 2024:1-24. [PMID: 38186049 DOI: 10.1080/01942638.2023.2299272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/20/2023] [Indexed: 01/09/2024]
Abstract
AIMS To explore the impact of complex trauma on occupations and daily functioning in childhood through empirical studies and asses the extent and state of available evidence. METHODS The five-stage scoping review framework by Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR: Tricco et al.) were followed. EMBASE, MEDLINE, CINAHL, PsychINFO, and Web of Science databases were systematically searched. Included studies were empirical research published in English up to December 2022, reporting on the impact of complex trauma on daily functioning or occupations in children experiencing such trauma, defined as prolonged exposure to interpersonal trauma arising within the primary caregiving system. RESULTS Eight studies were included. They reported impacts on personal and instrumental activities of daily living, sleep, education, work, play, leisure, and social participation. Some domains lacked comprehensive investigation, and studies lacked descriptions of specific effects on these areas. CONCLUSIONS The review reveals a lack of robust empirical evidence on the impact of complex trauma on occupations and daily functioning in childhood, with limited depth for comprehensive analysis on the extent of children's occupational life impact. Further research is warranted to address identified gaps.
Collapse
Affiliation(s)
- Síomha Walsh-Garcia
- Discipline of Occupational Therapy, Trinity College Dublin, The University of Dublin, Ireland
| | - Michelle Spirtos
- Discipline of Occupational Therapy, Trinity College Dublin, The University of Dublin, Ireland
| | - David Mockler
- The Library of Trinity College Dublin, Trinity College Dublin, The University of Dublin, Ireland
| | - Katie Cremin
- Discipline of Occupational Therapy, Trinity College Dublin, The University of Dublin, Ireland
| |
Collapse
|
5
|
Patel J, Katapally TR, Khadilkar A, Bhawra J. The interplay between air pollution, built environment, and physical activity: Perceptions of children and youth in rural and urban India. Health Place 2024; 85:103167. [PMID: 38128264 DOI: 10.1016/j.healthplace.2023.103167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
The role of physical inactivity as a contributor to non-communicable disease risk in children and youth is widely recognized. Air pollution and the built environment can limit participation in physical activity and exacerbate non-communicable disease risk; however, the relationships between perceptions of air pollution, built environment, and health behaviours are not fully understood, particularly among children and youth in low and middle-income countries. Currently, there are no studies capturing how child and youth perceptions of air pollution and built environment are associated with physical activity in India, thus, this study investigated the association between perceived air pollution and built environment on moderate-to-vigorous physical activity (MVPA) levels of Indian children and youth. Online surveys captured MVPA, perception of air pollution as a problem, built environment factors, as well as relevant sociodemographic characteristics from parents and children aged 5-17 years in partnership with 41 schools across 28 urban and rural locations during the Coronavirus disease lockdowns in 2021. After adjusting for age, gender, and location, a significant association was found between the perception of air pollution as a problem and MVPA levels (β = -18.365, p < 0.001). Similarly, the perception of a high crime rate was associated with lower MVPA levels (β = -23.383, p = 0.002). Reporting the presence of zebra crossings, pedestrian signals, or attractive natural sightings were associated with higher MVPA levels; however, this association varied across sociodemographic groups. These findings emphasize the importance of addressing air pollution and improving the built environment to facilitate outdoor active living, including active transportation, among children and youth - solutions that are particularly relevant not only for preventing non-communicable disease risk but also for climate change mitigation.
Collapse
Affiliation(s)
- Jamin Patel
- DEPtH Lab, Faculty of Health Sciences, Western University, London, Ontario, N6A 5B9, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, N6A 3K7, Canada
| | - Tarun Reddy Katapally
- DEPtH Lab, Faculty of Health Sciences, Western University, London, Ontario, N6A 5B9, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, N6A 3K7, Canada; Children's Health Research Institute, Lawson Health Research Institute, 750 Base Line Road East, Suite 300, London, Ontario, N6C 2R5, Canada; Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, 411 001, India
| | - Anuradha Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, 411 001, India
| | - Jasmin Bhawra
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, 411 001, India; School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, M5B 2K3, Canada.
| |
Collapse
|
6
|
Joisten C, Wessely S, Prinz N, Wiegand S, Gohlke B, Keiser S, Moliterno P, Nielinger J, Torbahn G, Wulff H, Holl RW. BMI Z-Score (SDS) versus Calculated Body Fat Percentage: Association with Cardiometabolic Risk Factors in Obese Children and Adolescents. Ann Nutr Metab 2023; 80:29-36. [PMID: 38128491 PMCID: PMC10857797 DOI: 10.1159/000535216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION BMI or BMI-standardized deviation score (SDS) in children and adolescents is still the standard for weight classification. [BMJ. 2019;366:4293] developed a formula to calculate body fat percentage (%BF) based on age, sex, height, weight, and ethnicity. Using data from the German/Austrian APV registry, we investigated whether the calculated %BF is superior to BMI-SDS in predicting arterial hypertension, dyslipidaemia, and impaired glucose metabolism. METHODS 94,586 children and adolescents were included (12.5 years, 48.3% male). Parental birth country (BC) was used to depict ethnicity (15.8% migration background); 95.67% were assigned to the ethnicity "white." %BF was calculated based on the Hudda formula. The relationship between BMI-SDS or %BF quartiles and outcome variables was investigated by logistic regression models, adjusted for age, sex, and migration background. Vuong test was applied to analyse predictive power. RESULTS 58.4% had arterial hypertension, 33.5% had dyslipidaemia, and 11.6% had impaired glucose metabolism. Boys were significantly more often affected, although girls had higher calculated %BF (each p < 0.05). After adjustment, both models revealed significant differences between the quartiles (all p < 0.001). The predictive power of BMI-SDS was superior to %BF for all three comorbidities (all p < 0.05). DISCUSSION The prediction of cardiometabolic comorbidities by calculated %BF was not superior to BMI-SDS. This formula developed in a British population may not be suitable for a central European population, which is applicable to this possibly less heterogeneous collective. Additional parameters, especially puberty status, should be taken into account. However, objective determinations such as bioimpedance analysis may possibly be superior to assess fat mass and cardiometabolic risk than calculated %BF.
Collapse
Affiliation(s)
- Christine Joisten
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - Stefanie Wessely
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
| | - Nicole Prinz
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - Susanna Wiegand
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, Berlin, Germany
| | - Bettina Gohlke
- Pediatric Endocrinology and Diabetology Division, Children’s Hospital, University of Bonn, Bonn, Germany
| | - Sabine Keiser
- Elisabeth-Krankenhaus Rheydt, Center for Child and Youth Medicine, Moenchengladbach, Germany
| | - Paula Moliterno
- Austrian Academic Institute for Clinical Nutrition, Vienna, Austria
| | - Jens Nielinger
- CJD Nord Fachklinik für Kinder und Jugendliche, Garz, Germany
| | - Gabriel Torbahn
- Department of Pediatrics, Paracelsus Medical University, Klinikum Nürnberg, Nurnberg, Germany
- AdieuPositas, Ambulante Therapie für Kinder und Jugendliche, Munich, Germany
| | - Hagen Wulff
- Institute of Exercise and Public Health, University of Leipzig, Leipzig, Germany
| | - Reinhard W. Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - for the APV initiative
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Cologne, Germany
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, Berlin, Germany
- Pediatric Endocrinology and Diabetology Division, Children’s Hospital, University of Bonn, Bonn, Germany
- Elisabeth-Krankenhaus Rheydt, Center for Child and Youth Medicine, Moenchengladbach, Germany
- Austrian Academic Institute for Clinical Nutrition, Vienna, Austria
- CJD Nord Fachklinik für Kinder und Jugendliche, Garz, Germany
- Department of Pediatrics, Paracelsus Medical University, Klinikum Nürnberg, Nurnberg, Germany
- AdieuPositas, Ambulante Therapie für Kinder und Jugendliche, Munich, Germany
- Institute of Exercise and Public Health, University of Leipzig, Leipzig, Germany
| |
Collapse
|
7
|
Weist MD, Hoover SA, Daly BP, Short KH, Bruns EJ. Propelling the Global Advancement of School Mental Health. Clin Child Fam Psychol Rev 2023; 26:851-864. [PMID: 37247024 PMCID: PMC10225778 DOI: 10.1007/s10567-023-00434-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 05/30/2023]
Abstract
Rates of mental health problems and disorders in children and youth have been increasing for at least three decades, and these have escalated due to the pandemic and multiple other societal stressors. It is increasingly recognized that students and families frequently struggle to receive needed care through traditional locations such as specialty mental health centers. Upstream mental health promotion and prevention strategies are gaining support as a public health approach to supporting overall population well-being, better utilizing a limited specialty workforce, and reducing illness. Based on these recognitions, there has been a progressive and escalating movement toward the delivery of mental health support to children and youth "where they are," with a prominent and more ecologically valid environment being schools. This paper will provide a brief review of the escalating mental health needs of children and youth, advantages of school mental health (SMH) programs in better meeting these needs, example model SMH programs from the United States and Canada, and national and international SMH centers/networks. We conclude with strategies for further propelling the global advancement of the SMH field through interconnected practice, policy, and research.
Collapse
|
8
|
Weist MD, Garbacz A, Schultz B, Bradshaw CP, Lane KL. Revisiting the Percentage of K-12 Students in Need of Preventive Interventions in Schools in a "Peri-COVID" Era: Implications for the Implementation of Tiered Programming. Prev Sci 2023:10.1007/s11121-023-01618-x. [PMID: 38007704 DOI: 10.1007/s11121-023-01618-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 11/28/2023]
Abstract
As the public health framework has been implemented in schools through multi-tiered systems of support, as in Positive Behavioral Interventions and Supports (PBIS), a prominent interpretation has been that 80% of students will benefit from universal or Tier 1 schoolwide behavior support, around 15% will require added selective or Tier 2 targeted support, and 5% will require the more intensive selective or Tier 3 intervention. The PBIS framework also emphasizes the use of tiered logic, with strengthened efforts at the universal and selective levels when student behavioral or mental health needs exceed expected levels. The prediction that 5% of students will require indicated support was based mostly on students at risk for discipline encounters (i.e., office discipline referral data) and, more recently, systematic screening data, but this percentage remains an interpretation of the public health framework. Further, epidemiologic data over the past decade show that rates of childhood mental health disorders have risen and are even higher now as schools struggle to recover from the COVID-19 pandemic-much higher than 15% and 5% for selective and indicated levels. Thus, we believe it is time to revisit projections of the number of students in need of Tier 2 and Tier 3 support. In this position paper, we review the evidence for escalating youth mental health needs and discuss the implications for the tiered prevention framework in schools. We describe strategies to expand the availability of preventive intervention supports beyond Tier 1 efforts and conclude with recommendations for practice, policy, and research in this peri-COVID recovery era.
Collapse
Affiliation(s)
- Mark D Weist
- University of South Carolina, Columbia, SC, 29208, USA.
| | | | | | | | | |
Collapse
|
9
|
Smith KS, Kinsella EA, Moodie S, McCorquodale L, Teachman G. Mindfulness and therapeutic relationships: A phenomenological inquiry into paediatric occupational therapists' practices. Scand J Occup Ther 2023; 30:1441-1450. [PMID: 37256557 DOI: 10.1080/11038128.2023.2217670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 05/19/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND A growing body of literature points to the potential of mindfulness to support therapeutic relationships, and the importance of the therapeutic relationship when working with children and youth, yet little attention has been paid to this topic in occupational therapy. AIMS/OBJECTIVES The aim of this study was to inquire into occupational therapists' experiences of mindfulness in the therapeutic relationship with children and youth. MATERIALS AND METHODS Hermeneutic phenomenology was the methodological approach, with Heidegger's concepts of being-with and care as theoretical underpinnings of the study. Eight North American occupational therapists participated in semi-structured interviews that elicited first-hand accounts of mindfulness in the therapeutic relationship with children and youth. Interviews were transcribed verbatim and analysed using a phenomenological approach. RESULTS Four key themes were identified: fostering a safe space, enhancing presence, being authentic, and cultivating acceptance. CONCLUSIONS AND SIGNIFICANCE The findings offer insights regarding the potential affordances of mindfulness to support clinicians in the development of therapeutic relationships with children and youth. Further, this study highlights research priorities for future inquiry.
Collapse
Affiliation(s)
- Kirsten Sarah Smith
- Graduate Program in Health and Rehabilitation Sciences, University of Western Ontario, London, Canada
| | - Elizabeth Anne Kinsella
- Graduate Program in Health and Rehabilitation Sciences, University of Western Ontario, London, Canada
- Department of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Sheila Moodie
- Graduate Program in Health and Rehabilitation Sciences, University of Western Ontario, London, Canada
- National Centre for Audiology, University of Western Ontario, London, Canada
| | - Lisa McCorquodale
- Graduate Program in Health and Rehabilitation Sciences, University of Western Ontario, London, Canada
- School of Occupational Therapy, University of Western Ontario, London, Canada
| | - Gail Teachman
- Graduate Program in Health and Rehabilitation Sciences, University of Western Ontario, London, Canada
- School of Occupational Therapy, University of Western Ontario, London, Canada
| |
Collapse
|
10
|
Liu C, Grotta A, Hiyoshi A, Berg L, Wall-Wieler E, Martikainen P, Kawachi I, Rostila M. Parental death and initiation of antidepressant treatment in surviving children and youth: a national register-based matched cohort study. EClinicalMedicine 2023; 60:102032. [PMID: 37396801 PMCID: PMC10314171 DOI: 10.1016/j.eclinm.2023.102032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 07/04/2023] Open
Abstract
Background Population-based longitudinal studies on bereaved children and youth's mental health care use are scarce and few have assessed the role of surviving parents' mental health status. Methods Using register data of individuals born in Sweden in 1992-1999, we performed a matched cohort study (n = 117,518) on the association between parental death and subsequent initiation of antidepressant treatment among individuals bereaved at ages 7-24 years. We used flexible parametric survival models to estimate the hazard ratios (HRs) over time after bereavement, adjusting for individual and parental factors. We further examined if the association varied by age at loss, sex, parental sociodemographic factors, cause of death, and the surviving parents' psychiatric care. Findings The bereaved were more likely to initiate antidepressants treatment than the nonbereaved matched individuals during follow-up (incidence rate per 1000 person years 27.5 [26.5-28.5] vs. 18.2 [17.9-18.6]). The HRs peaked in the first year after bereavement and remained higher than the nonbereaved individuals until the end of the follow-up. The average HR over the 12 years of follow-up was 1.48 (95% confidence interval [1.39-1.58]) for father's death and 1.33 [1.22-1.46] for mother's death. The HRs were particularly high when the surviving parents received psychiatric care before bereavement (2.11 [1.89-2.56] for father's death; 2.14 [1.79-2.56] for mother's death) or treated for anxiety or depression after bereavement (1.80 [1.67-1.94]; 1.82 [1.59-2.07]). Interpretation The risk of initiating antidepressant treatment was the highest in the first year after parental death and remained elevated over the next decade. The risk was particularly high among individuals with surviving parents affected by psychiatric morbidity. Funding The Swedish Research Council.
Collapse
Affiliation(s)
- Can Liu
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sweden
- Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Solna, Stockholm, Sweden
| | - Alessandra Grotta
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sweden
| | - Ayako Hiyoshi
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Lisa Berg
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sweden
| | | | - Pekka Martikainen
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Finland
- Laboratory of Population Health, Max Planck Institute for Demographic Research, Germany
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, United States
| | - Mikael Rostila
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sweden
| |
Collapse
|
11
|
Turner BJ, Robillard CL, Gretton A, Eslami A. Rapid psychiatric readmission in youth: A five-year retrospective Cohort Study. Psychiatry Res 2023; 325:115228. [PMID: 37178503 DOI: 10.1016/j.psychres.2023.115228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/28/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023]
Abstract
This study describes predictors of psychiatric readmission among youth, including rapid readmission within 30 days of discharge. A retrospective chart review identified demographic features, diagnoses, and reasons for initial admission among 1324 youth admitted to the child and adolescent psychiatric emergency unit at a Canadian children's hospital. 22% of youth had at least one readmission and 8.8% had at least one rapid readmission during the five-year period. Personality disorder (HR=1.64, 95% CI=1.07, 2.52) and self-harm concerns (HR=0.65, 95% CI=0.48, 0.89) predicted odds of readmission Reducing readmission is an important goal, particularly for youth with personality concerns.
Collapse
Affiliation(s)
| | | | | | - Ali Eslami
- BC Children's Hospital, Canada; University of British Columbia, Canada
| |
Collapse
|
12
|
Yamaguchi S, Tuong J, Tisdall EKM, Bentayeb N, Holtom A, Iyer SN, Ruiz-Casares M. "Youth as accessories": Stakeholder Perspectives on Youth Participation in Mental Health Policymaking [Part II]. Adm Policy Ment Health 2023; 50:84-99. [PMID: 36357818 PMCID: PMC9648874 DOI: 10.1007/s10488-022-01230-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 10/12/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE To elicit stakeholder perspectives on the findings from our scoping review on youth participation in mental health policymaking, we conducted a global consultation with young people and adults directly involved in mental health policymaking. METHOD Forty-four stakeholders from 16 countries, including 15 young people, 9 policymakers and 20 facilitators of youth participation, took part in individual interviews and/or focus groups. They were asked about how the review findings contrasted with their own experiences in mental health policymaking. The transcribed data were thematically analyzed. RESULTS All participants viewed lived experience as valuable in identifying policy gaps. Youth pointed out that children and youth with disabilities, diverse sexual orientations, and/or gender identities were often excluded, and spoke about feelings of being an "accessory", illustrating a lack of power-sharing in a tokenized policymaking process. Adult participants' accounts highlighted the challenges inherent in policymaking such as the need for political knowledge and institutional time constraints. A range of cultural, socio-economic, and political barriers to youth participation, that were often context-specific, were identified. CONCLUSIONS The diverse perspectives of stakeholders extended the review results. Based on our findings, we recommend that adults and institutions: (1) recognize lived experience as expertise in shaping mental health policies; (2) include diverse groups; (3) reduce tokenistic relationships through the creation of safer spaces, adult feedback, co-production, and social accountability; and (4) adopt an intersectional approach to address cultural, socio-economic, and political barriers to participation. Methodologically, our work demonstrates why stakeholder consultations are an essential component of scoping reviews.
Collapse
Affiliation(s)
- Sakiko Yamaguchi
- CHILD-BRIGHT Network, Research Institute of the McGill University Health Centre, Montreal, QC, Canada. .,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada. .,Department of Psychiatry, McGill University, 1033 Pine Ave W, H3A 1A1, Montreal, QC, Canada.
| | - Josie Tuong
- grid.14709.3b0000 0004 1936 8649Department of Anatomy and Cell Biology, McGill University, Montreal, QC Canada
| | - E. Kay M. Tisdall
- grid.4305.20000 0004 1936 7988Childhood and Youth Studies, MHSES, University of Edinburgh, Edinburgh, UK
| | - Naïma Bentayeb
- grid.459278.50000 0004 4910 4652SHERPA University Institute, CIUSSS du Centre-Ouest-de-l’île-de-Montréal, Montreal, QC Canada ,grid.420828.40000 0001 2165 7843École Nationale d’Administration Publique, Montreal, QC Canada ,grid.14709.3b0000 0004 1936 8649School of Social Work, McGill University, Montreal, QC Canada
| | - Alexandra Holtom
- grid.14709.3b0000 0004 1936 8649School of Social Work, McGill University, Montreal, QC Canada
| | - Srividya N. Iyer
- Douglas Research Centre, ACCESS Open Minds (Youth Mental Health Network), Montreal, QC Canada ,grid.14709.3b0000 0004 1936 8649Department of Psychiatry, McGill University, 1033 Pine Ave W, H3A 1A1 Montreal, QC Canada
| | - Mónica Ruiz-Casares
- grid.459278.50000 0004 4910 4652SHERPA University Institute, CIUSSS du Centre-Ouest-de-l’île-de-Montréal, Montreal, QC Canada ,grid.14709.3b0000 0004 1936 8649Department of Psychiatry, McGill University, 1033 Pine Ave W, H3A 1A1 Montreal, QC Canada ,School of Child and Youth Care, Toronto Metropolitan University, Toronto, ON Canada
| |
Collapse
|
13
|
Yamaguchi S, Bentayeb N, Holtom A, Molnar P, Constantinescu T, Tisdall EKM, Tuong J, Iyer SN, Ruiz-Casares M. Participation of Children and Youth in Mental Health Policymaking: A Scoping Review [Part I]. Adm Policy Ment Health 2023; 50:58-83. [PMID: 36357819 DOI: 10.1007/s10488-022-01223-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 11/12/2022]
Abstract
Although youth participation is oft-acknowledged as underpinning mental health policy and service reform, little robust evidence exists about the participation of children and youth in mental health policymaking. A scoping review based on Arksey and O'Malley's framework was conducted to identify and synthesize available information on children and youth's participation in mental health policymaking. Published studies up to November 30, 2020 were searched in Medline (OVID), PsycINFO (OVID), Scopus, and Applied Social Sciences Index and Abstracts (PROQUEST). Further studies were identified through Google Scholar and a grey literature search was conducted using Google and targeted web searches from October to December, 2020. Three reviewers performed screening and data extraction relevant to the review objective, followed by an online consultation. From 2,981 records, 25 publications were included. A lack of diversity among the youth involved was found. Youth were often involved in situational analysis and policy design, but seldom in policy implementation and evaluation. Both the facilitators of and barriers to participation were multifaceted and interconnected. Despite a range of expected outcomes of participation for youth, adults, organizations, and communities, perceived and actual effects were neither substantially explored nor reported. Our recommendations for mental health policymaking highlight the inclusion of children and youth from diverse groups, and the creation of relational spaces that ensure safety, inclusiveness, and diversity. Identified future research directions are: the outcomes of youth participation in mental health policymaking, the role of adults, and more generally, how the mental health of children and youth shapes and is shaped by the policymaking process.
Collapse
Affiliation(s)
- Sakiko Yamaguchi
- CHILD-BRIGHT Network, Research Institute of the McGill University Health Centre, Montreal, QC, Canada. .,School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada. .,Department of Psychiatry, McGill University, 1033 Pine Ave W, Montreal, QC, H3A 1A1, Canada.
| | - Naïma Bentayeb
- CIUSSS du Centre-Ouest-de-L'île-de-Montréal, SHERPA University Institute, Montreal, QC, Canada.,École Nationale d'Administration Publique, Montreal, QC, Canada.,School of Social Work, McGill University, Montreal, QC, Canada
| | | | - Paula Molnar
- School of Social Work, McGill University, Montreal, QC, Canada
| | - Teodora Constantinescu
- CIUSSS du Centre-Ouest-de-L'île-de-Montréal, SHERPA University Institute, Montreal, QC, Canada
| | - E Kay M Tisdall
- Childhood and Youth Studies, MHSES, University of Edinburgh, Edinburgh, UK
| | - Josie Tuong
- Department of Anatomy and Cell Biology, McGill University, Montreal, QC, Canada
| | - Srividya N Iyer
- Department of Psychiatry, McGill University, 1033 Pine Ave W, Montreal, QC, H3A 1A1, Canada.,Douglas Research Centre, ACCESS Open Minds (Youth Mental Health Network), Montreal, QC, Canada
| | - Mónica Ruiz-Casares
- Department of Psychiatry, McGill University, 1033 Pine Ave W, Montreal, QC, H3A 1A1, Canada.,CIUSSS du Centre-Ouest-de-L'île-de-Montréal, SHERPA University Institute, Montreal, QC, Canada.,School of Child & Youth Care, Toronto Metropolitan University, Toronto, ON, Canada
| |
Collapse
|
14
|
Theall L, Ninan A, Arbeau K, Mannone J, Stewart SL. Interrupting the Cycle: Association of Parental Stress and Child/Youth Psychotropic Medication Nonadherence. Child Psychiatry Hum Dev 2022:10.1007/s10578-022-01448-y. [PMID: 36306028 PMCID: PMC9614754 DOI: 10.1007/s10578-022-01448-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/28/2022]
Abstract
Efficacy of psychotropic medication depends in large part on successful adherence to prescribed regimens. This study investigated child/youth nonadherence in relation to family dynamics and informal support. The participants were 10,225 children and youth prescribed psychotropic medication and receiving services from 50 Ontario mental health agencies, assessed with the interRAI™ Child and Youth Mental Health (ChYMH) and ChYMH-Developmental Disability (ChYMH-DD) tools. Findings suggest a cycle of parental stress and child/youth medication nonadherence possibly leading to or even perpetuated by worsening psychiatric symptoms. Informal supports do not appear to moderate this cycle. While the present data cannot speak to causes of medication nonadherence in children/youth or where the cycle begins, the results are consistent with the extant literature calling for attention to parental wellbeing to support children/youth for optimal therapeutic benefits. Understanding home dynamics related to nonadherence can assist care planning that engages the family to achieve best possible child/youth outcomes.
Collapse
Affiliation(s)
- Laura Theall
- Applied Research & Education, Child and Parent Resource Institute, 600 Sanatorium Road, N6H 3W7, London, ON, Canada.
| | - Ajit Ninan
- Applied Research & Education, Child and Parent Resource Institute, 600 Sanatorium Road, N6H 3W7, London, ON, Canada
- Division of Child and Adolescent Psychiatry, Western University, Parkwood Institute Mental Health Care Building, F4-430, N6C 0A7, London, ON, Canada
| | - Kim Arbeau
- Applied Research & Education, Child and Parent Resource Institute, 600 Sanatorium Road, N6H 3W7, London, ON, Canada
| | - Jessica Mannone
- Applied Research & Education, Child and Parent Resource Institute, 600 Sanatorium Road, N6H 3W7, London, ON, Canada
| | - Shannon L Stewart
- Faculty of Education, Western University, 1151 Richmond Street, N6A 3K7, London, ON, Canada
| |
Collapse
|
15
|
Õunpuu S, Pierz K, Garibay E, Acsadi G, Wren TAL. Stance and swing phase ankle phenotypes in youth with Charcot-Marie-Tooth type 1: An evaluation using comprehensive gait analysis techniques. Gait Posture 2022; 98:216-225. [PMID: 36179412 DOI: 10.1016/j.gaitpost.2022.09.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/09/2022] [Accepted: 09/19/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Charcot-Marie-Tooth disease (CMT) results in muscle weakness and contracture leading to a wide variety of gait issues including atypical ankle kinematics in both stance and swing. Knowledge of the stance and swing phase kinematic patterns for CMT type 1 (CMT1), the most common CMT type, will improve our understanding of expected gait outcomes and treatment needs to improve gait function. RESEARCH QUESTION What are the stance/swing phase ankle phenotypes in CMT1? METHODS A prospective convenience sample of 25 participants with CMT1, ages 7-19 years, underwent comprehensive gait analysis following standard procedures. Ankle phenotypes based on peak ankle dorsiflexion in terminal stance and mid-swing were defined and compared using linear mixed models. RESULTS Patients with CMT1 presented with three stance phase ankle phenotypes: 21 limbs (42 %) with reduced (mean 5°, SD 2°), 19 limbs (38 %) with typical (mean 11°, SD 1°) and 10 limbs (20 %) with excessive (mean 15°, SD 2°) peak dorsiflexion in terminal stance (p < 0.05). There were two swing phase phenotypes: 19 limbs (38 %) with typical (mean -1.7°, SD 1.5°) and 31 limbs (62 %) with excessive (mean -5.6°, SD 1.4°) plantarflexion in mid-swing (p < 0.002). Eleven patients (44 %) had ankles that were classified into different stance groups, and 9 patients (36 %) had ankles that were classified into different swing groups. The most common combination of stance/swing ankle phenotypes was decreased dorsiflexion in terminal stance with increased plantarflexion in mid-swing (16 sides, 32 %). SIGNIFICANCE This study shows that youth with CMT1 have multiple combinations of combined ankle kinematics for stance and swing. The ankle phenotypes identified in this study reflect contributions of both dorsi/plantarflexor weakness and plantarflexor contracture, which require different treatment approaches. Comprehensive gait analysis can distinguish between multiple ankle phenotypes to assist in determining the most appropriate treatment to improve gait for individual patients.
Collapse
Affiliation(s)
- Sylvia Õunpuu
- Center for Motion Analysis, Connecticut Children's Medical Center, Farmington, CT, USA.
| | - Kristan Pierz
- Center for Motion Analysis, Connecticut Children's Medical Center, Farmington, CT, USA; Division of Orthopedics, Connecticut Children's Medical Center, Hartford, CT, USA
| | - Erin Garibay
- Center for Motion Analysis, Connecticut Children's Medical Center, Farmington, CT, USA
| | - Gyula Acsadi
- Division of Neurology, Connecticut Children's Medical Center, Farmington, CT, USA
| | - Tishya A L Wren
- Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
16
|
Hoge MA, Vanderploeg J, Paris M, Lang JM, Olezeski C. Emergency Department Use by Children and Youth with Mental Health Conditions: A Health Equity Agenda. Community Ment Health J 2022; 58:1225-1239. [PMID: 35038073 PMCID: PMC8762987 DOI: 10.1007/s10597-022-00937-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 12/26/2021] [Indexed: 11/22/2022]
Abstract
There are growing concerns regarding the referral of children and youth with mental health conditions to emergency departments (EDs). These focus on upward trends in utilization, uncertainty about benefits and negative effects of ED visits, and inequities surrounding this form of care. A review was conducted to identify and describe available types of data on ED use. The authors' interpretation of the literature is that it offers compelling evidence that children and youth in the U.S. are being sent to EDs for mental health conditions at increasing rates for reasons frequently judged as clinically inappropriate. As a major health inequity, it is infrequent that such children and youth are seen in EDs by a behavioral health professional or receive evidence-based assessment or treatment, even though they are kept in EDs far longer than those seen for reasons unrelated to mental health. The rate of increase in these referrals to EDs appears much greater for African American and Latinx children and youth than White children and is increasing for the publicly insured and uninsured while decreasing for the privately insured. A comprehensive set of strategies are recommended for improving healthcare quality and health equity. A fact sheet is provided for use by advocates in pressing this agenda.
Collapse
Affiliation(s)
- Michael A. Hoge
- grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Jeffrey Vanderploeg
- grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
- grid.475976.eChild Health and Development Institute, Farmington, CT USA
- grid.208078.50000000419370394Department of Psychiatry, UConn Health, Farmington, CT USA
| | - Manuel Paris
- grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Jason M. Lang
- grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
- grid.475976.eChild Health and Development Institute, Farmington, CT USA
- grid.208078.50000000419370394Department of Psychiatry, UConn Health, Farmington, CT USA
| | - Christy Olezeski
- grid.47100.320000000419368710Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| |
Collapse
|
17
|
Dass-Brailsford P, Thomley RSH, Jain D, Jarrett ES. The Mental Health Consequences of Hurricane Matthew on Haitian Children and Youth: An Exploratory Study. J Child Adolesc Trauma 2022; 15:899-909. [PMID: 35958720 PMCID: PMC9360302 DOI: 10.1007/s40653-021-00413-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/14/2021] [Indexed: 06/15/2023]
Abstract
Haiti has experienced many major natural disasters in the past decade that included Hurricane Matthew which led to mass damage to property, a depletion of basic resources, human fatalities and injuries, and mental health consequences that affected the poorest. The current study focused on the psychological effects of Hurricane Matthew on Haitian children and adolescents. Children display heightened depression, and PTSD symptoms in the aftermath of disasters (Hausman et al., Journal of Family Psychology 34:836-845, 2020), however, the researchers anticipated that children living in orphanages would display more severe mental health symptoms than those living with their families, because of their additional stressor of family loss. Using a convenience sample, quantitative data was collected using several instruments, in a survey format, that were individually administered to a sample of 77 adolescents. Participants had high depressive scores and reported multiple adverse events and limited access to basic needs. In comparing subgroups, we found children who were in orphanages reported significantly fewer adverse childhood experiences than those living with their families. This is likely because orphanages in Haiti consistently provide children with a safe and stable environment, buffering them against the traumatic effects of disasters. In contrast, children living with their families reported witnessing or experiencing interpersonal violence, neglect and abuse in addition to disaster-related stress. Before addressing the issues faced by disaster-affected children in Haiti, the systemic issues that maintain the socio-economic deprivation of so many citizens must be addressed. An important step is for policymakers to collaborate with mental health providers to develop community interventions that are low-cost and easily accessible. These interventions must consider and incorporate the social context and cultural patterns of help-seeking and treatment utilization in Haiti.
Collapse
Affiliation(s)
| | | | - Dipana Jain
- The Chicago School of Professional Psychology, Washington, DC USA
| | | |
Collapse
|
18
|
Yuan B, Huang X, Li J, He L. Socioeconomic disadvantages and vulnerability to the pandemic among children and youth: A macro-level investigation of American counties. Child Youth Serv Rev 2022; 136:106429. [PMID: 35221406 PMCID: PMC8864086 DOI: 10.1016/j.childyouth.2022.106429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 04/27/2021] [Accepted: 02/19/2022] [Indexed: 06/14/2023]
Abstract
This study intends to reveal the underlying structural inequity in vulnerability to infection of the novel coronavirus disease pandemic among children and youth. Using multi-source data from New York Times novel coronavirus disease tracking project and County Health Rankings & Roadmap Program, this study shows that children and youth in socioeconomically disadvantaged status are faced with disproportionate risk of infection in this pandemic. On the county level, socioeconomic disadvantages (i.e., single parent family, low birthweight, severe housing problems) contribute to the confirmed cases and death cases of the novel coronavirus disease. Policymakers should pay more attention to this vulnerable group to implement more targeted and effective epidemic prevention and control.
Collapse
Affiliation(s)
- Bocong Yuan
- School of Tourism Management, Sun Yat-sen University, Guangzhou, China
| | - Xinting Huang
- School of Management, Xi'an Jiaotong University, Xi'an, China
| | - Jiannan Li
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, China
| | - Longtao He
- Research Institute of Social Development, Southwestern University of Finance and Economics, Chengdu, China
| |
Collapse
|
19
|
Saunders TJ, Rollo S, Kuzik N, Demchenko I, Bélanger S, Brisson-Boivin K, Carson V, da Costa BGG, Davis M, Hornby S, Huang WY, Law B, Ponti M, Markham C, Salmon J, Tomasone JR, Van Rooij AJ, Wachira LJ, Wijndaele K, Tremblay MS. International school-related sedentary behaviour recommendations for children and youth. Int J Behav Nutr Phys Act 2022; 19:39. [PMID: 35382828 PMCID: PMC8979784 DOI: 10.1186/s12966-022-01259-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/24/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Existing sedentary behaviour guidelines for children and youth target overall sedentary behaviour and recreational screen time, without any specific recommendations regarding school-related sedentary behaviours (i.e., sedentary behaviours performed during the school day, or within the influence of school). The purpose of this paper is to describe the development of international evidence-based recommendations for school-related sedentary behaviours for children and youth, led by the Sedentary Behaviour Research Network (SBRN). METHODS A panel of international experts was convened by SBRN in November 2020 to guide the development of these recommendations for children and youth aged ~ 5-18 years. The recommendations were informed by 1) age-relevant existing sedentary behaviour guidelines, 2) published research on the relationship between overall sedentary behaviour and health, 3) a de novo systematic review on the relationship between school-related sedentary behaviours and health and/or academic outcomes, and 4) a de novo environmental scan of the grey literature to identify existing recommendations for school-related sedentary behaviours. Draft recommendations were presented to the Expert Panel in June 2021. Following thorough discussion and modifications, updated recommendations were distributed for stakeholder feedback from July 9-26. Feedback was received from 148 stakeholders across 23 countries, leading to additional updates to the recommendations. Following further rounds of discussion and updates with the Expert Panel in August and September 2021, consensus was achieved on the final recommendations. RESULTS A healthy day includes breaking up extended periods of sedentary behaviour and incorporating different types of movement into homework whenever possible, while limiting sedentary homework. School-related screen time should be meaningful, mentally or physically active, and serve a specific pedagogical purpose that enhances learning. Replacing sedentary learning activities with movement-based learning activities, and replacing screen-based learning activities with non-screen-based learning activities, can further support students' health and wellbeing. DISCUSSION This paper presents the first evidence-based recommendations for school-related sedentary behaviours for children and youth. These recommendations will support the work of parents, caregivers, educators, school system administrators, policy makers, researchers and healthcare providers interested in promoting student health and academic success.
Collapse
Affiliation(s)
- Travis J Saunders
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada.
| | - Scott Rollo
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Nicholas Kuzik
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Iryna Demchenko
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | - Stacey Bélanger
- Digital Health Task Force, Canadian Paediatric Society, Ottawa, Canada
| | | | - Valerie Carson
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Bruno G G da Costa
- School of Physical and Health Education, Nipissing University, North Bay, Ontario, Canada
| | - Melanie Davis
- Physical and Health Education Canada, Ottawa, Canada
| | - Susan Hornby
- Pan-Canadian Joint Consortium for School Health Secretariat, Summerside, Canada
| | - Wendy Yajun Huang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Barbi Law
- School of Physical and Health Education, Nipissing University, North Bay, Ontario, Canada
| | - Michelle Ponti
- Digital Health Task Force, Canadian Paediatric Society, Ottawa, Canada
| | - Chris Markham
- Ontario Physical and Health Education Association, Ottawa, Canada
| | - Jo Salmon
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | | | - Lucy-Joy Wachira
- Physical Education, Exercise and Sports Science, Kenyatta University, Nairobi, Kenya
| | | | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Canada
- Department of Health Sciences, Carleton University, Ottawa, Canada
| |
Collapse
|
20
|
Pells K, Breed A, Uwihoreye C, Ndushabandi E, Elliott M, Nzahabwanayo S. 'No-One Can Tell a Story Better than the One Who Lived It': Reworking Constructions of Childhood and Trauma Through the Arts in Rwanda. Cult Med Psychiatry 2022; 46:632-653. [PMID: 34907486 PMCID: PMC9436865 DOI: 10.1007/s11013-021-09760-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 11/21/2022]
Abstract
The intergenerational legacies of conflict and violence for children and young people are typically approached within research and interventions through the lens of trauma. Understandings of childhood and trauma are based on bio-psychological frameworks emanating from the Global North, often at odds with the historical, political, economic, social and cultural contexts in which interventions are enacted, and neglect the diversity of knowledge, experiences and practices. Within this paper we explore these concerns in the context of Rwanda and the aftermath of the 1994 Genocide Against the Tutsi. We reflect on two qualitative case studies: Connective Memories and Mobile Arts for Peace which both used arts-based approaches drawing on the richness of Rwandan cultural forms, such as proverbs and storytelling practices, to explore knowledge and processes of meaning-making about trauma, memory, and everyday forms of conflict from the perspectives of children and young people. We draw on these findings to argue that there is a need to refine and elaborate understandings of intergenerational transmission of trauma in Rwanda informed by: the historical and cultural context; intersections of structural and 'everyday' forms of conflict and social trauma embedded in intergenerational relations; and a reworking of notions of trauma 'transmission' to encompass the multiple connectivities between generations, temporalities and expressions of trauma.
Collapse
Affiliation(s)
- Kirrily Pells
- Social Research Institute, University College London, 18 Woburn Square, London, WC1H 0NR, UK.
| | - Ananda Breed
- School of Fine & Performing Arts, College of Arts, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS Lincolnshire UK
| | | | - Eric Ndushabandi
- University of Rwanda, Kigali, Rwanda ,Institute of Research and Dialogue for Peace, PO Box 7109, Kigali, Rwanda
| | | | | |
Collapse
|
21
|
Hume K, Steinbrenner JR, Odom SL, Morin KL, Nowell SW, Tomaszewski B, Szendrey S, McIntyre NS, Yücesoy-Özkan S, Savage MN. Evidence-Based Practices for Children, Youth, and Young Adults with Autism: Third Generation Review. J Autism Dev Disord 2021; 51:4013-4032. [PMID: 33449225 PMCID: PMC8510990 DOI: 10.1007/s10803-020-04844-2] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2020] [Indexed: 12/21/2022]
Abstract
This systematic review describes a set of practices that have evidence of positive effects with autistic children and youth. This is the third iteration of a review of the intervention literature (Odom et al. in J Autism Dev Disorders 40(4):425-436, 2010a; Prevent School Fail 54(4):275-282, 2010b; Wong et al. in https://autismpdc.fpg.unc.edu/sites/autismpdc.fpg.unc.edu/files/imce/documents/2014-EBP-Report.pdf ; J Autism Dev Disorders 45(7):1951-1966, 2015), extending coverage to articles published between 1990 and 2017. A search initially yielded 31,779 articles, and the subsequent screening and evaluation process found 567 studies to include. Combined with the previous review, 972 articles were synthesized, from which the authors found 28 focused intervention practices that met the criteria for evidence-based practice (EBP). Former EBPs were recategorized and some manualized interventions were distinguished as meeting EBP criteria. The authors discuss implications for current practices and future research.
Collapse
Affiliation(s)
- Kara Hume
- School of Education, The University of North Carolina at Chapel Hill, CB 3500 Peabody Hall, Chapel Hill, NC, 27599, USA.
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA.
| | - Jessica R Steinbrenner
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
| | - Samuel L Odom
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
| | - Kristi L Morin
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
- College of Education, Lehigh University, Iacocca Hall, 111 Research Drive, Bethlehem, PA, 18015, USA
| | - Sallie W Nowell
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
| | - Brianne Tomaszewski
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
| | - Susan Szendrey
- Department of Allied Health Sciences, The University of North Carolina at Chapel Hill, Bondurant Hall, Campus Box 7120, Chapel Hill, NC, 27599-7120, USA
| | - Nancy S McIntyre
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
- College of Health Professionals and Sciences, University of Central Florida, 12805 Pegasus Drive, Orlando, FL, 32816, USA
| | - Serife Yücesoy-Özkan
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
- Department of Special Education, Anadolu Üniversitesi, Eğitim Fakültesi, Özel Eğitim Bölümü, Tepebaşı, Eskisehir, 26470, Turkey
| | - Melissa N Savage
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
- College of Education, University of North Texas, 1300 W. Highland St., Denton, TX, 76201, USA
| |
Collapse
|
22
|
Yang W, Wong SHS, Sum RKW, Sit CHP. The association between physical activity and mental health in children with special educational needs: A systematic review. Prev Med Rep 2021; 23:101419. [PMID: 34150477 PMCID: PMC8193140 DOI: 10.1016/j.pmedr.2021.101419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/11/2021] [Accepted: 05/25/2021] [Indexed: 12/13/2022] Open
Abstract
The association between physical activity (PA) and mental health in typically developing children has been amply documented, but little is known about the corresponding association in children with special educational needs (SEN). This systematic review aimed to synthesize the evidence for the association between PA and mental health in children with SEN. A systematic literature search of five databases (PsycINFO, SPORTDiscus, PubMed, Web of Science, and CINAHL) was conducted, and the publication year was between October 2010 and February 2021. Two researchers performed abstract and full text screening and extracted the data independently. Inclusion and exclusion criteria followed the PICOS framework, and the quality of eligible studies was assessed using the McMaster critical review form. Eighteen studies that met the inclusion criteria and had quality ratings ≥ 60% were included in this review. PA was positively associated with overall psychological well-being and its subtypes (including enjoyment, self-worth, self-competence, mental wellness, and quality of life), and negatively associated with anxiety and fatigue. Body composition, age, and sex were moderators of the association. The findings of this review indicated that PA was consistently associated with mental health in children with SEN. These associations were the most powerful when PA was conducted in unstructured types such as free play and recess activities. Structured types including physical education classes were more strongly related to mental health than overall PA (combined structured and unstructured types). Future PA interventions are needed to promote mental health in children with SEN.
Collapse
Affiliation(s)
- Wen Yang
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong
| | - Stephen Heung-Sang Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong
| | - Raymond Kim-Wai Sum
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong
| | - Cindy Hui-Ping Sit
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong
| |
Collapse
|
23
|
Berg KA, Francis MW, Ross K, Spilsbury JC. Opportunities to improve sleep of children exposed to interpersonal violence: A social-ecological perspective. Child Youth Serv Rev 2021; 127:106082. [PMID: 36090582 PMCID: PMC9455662 DOI: 10.1016/j.childyouth.2021.106082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Over 25% of U.S. children are witness to traumatic intrafamilial or community violence each year, and sleep medicine and developmental research jointly suggest that trauma-exposed youth experience more sleep disturbance than their non-exposed counterparts. Sleep medicine literature emphasizes physical and social environmental factors affecting sleep, and trauma literature underscores children's seeking out physically and emotionally safe and predictable environments during trauma recovery. This study employed a hermeneutic phenomenological framing to explore the lived experiences of 65 violence-exposed children and families, and to examine how youths' social and physical sleep environments facilitated or impeded sleep in the aftermath of trauma. Children's sleep experiences following violence exposure shared two primary essences of experience: a) navigating external threats that agitated sleep after trauma; and b) exercising agency over sleep and related environments to restabilize emotional security. Clinicians and social services coordinators working with children and families are uniquely positioned to indicate sleep assessments as part of treatment following trauma, and to also facilitate identification of tangible, sleep-supportive and changeable factors in sleep environments.
Collapse
Affiliation(s)
- Kristen A. Berg
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, United States
| | - Meredith W. Francis
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, United States
| | - Kristie Ross
- School of Medicine, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, United States
| | - James C. Spilsbury
- School of Medicine, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, United States
| |
Collapse
|
24
|
Abstract
In the aftermath of high-profile incidents involving Black, Indigenous and People of Color (BIPOC) in North America, there is a growing awareness of the pervasiveness of systemic racism and the role that agencies play in perpetuating racism and racial inequities. In the child and youth mental health sector, the journey to improving racial equity is impeded by a lack of consistent frameworks or guidelines. In this commentary, we explore five domains of organizational practices that are prominent in the literature and support diverse clients, communities and staff, including: (1) organizational leadership and commitment, (2) inter-organizational and multisectoral partnerships, (3) workforce diversity and development, (4) client and community needs and engagement, and (5) continuous improvement. As we highlight these domains, we urge researchers, policy makers, and child and youth mental health service providers to work together to advance racial equity in meaningful ways.
Collapse
Affiliation(s)
- Gabrielle Lucente
- Ontario Centre of Excellence for Child & Youth Mental Health, Children's Hospital of Eastern Ontario, 695 Industrial Ave., Ottawa, ON, K1G 0Z1, Canada.
| | - Julia Kurzawa
- Ontario Centre of Excellence for Child & Youth Mental Health, Children's Hospital of Eastern Ontario, 695 Industrial Ave., Ottawa, ON, K1G 0Z1, Canada
| | - Evangeline Danseco
- Ontario Centre of Excellence for Child & Youth Mental Health, Children's Hospital of Eastern Ontario, 695 Industrial Ave., Ottawa, ON, K1G 0Z1, Canada
| |
Collapse
|
25
|
Statz M, Heidbrink L. Unintended Trauma: The Role of Public Health Policy in the Detention of Migrant Children. Lancet Reg Health Am 2021; 2:100012. [PMID: 36779034 PMCID: PMC9903659 DOI: 10.1016/j.lana.2021.100012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Michele Statz
- University of Minnesota Medical School, 1035 Campus Drive, Duluth, MN 55812, USA, Tel: 608-566-0876,Corresponding Author.
| | - Lauren Heidbrink
- California State University, Long Beach, 1250 Bellflower Boulevard, LA3-200A, Long Beach, CA 90840, USA, Tel: 562.985.8530
| |
Collapse
|
26
|
Steinhardt F, Dolva AS, Jahnsen R, Ullenhag A. Exploring two subdimensions of participation, involvement and engagement: A scoping review. Scand J Occup Ther 2021; 29:441-463. [PMID: 34242105 DOI: 10.1080/11038128.2021.1950207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The conceptualisation of participation is an ongoing discussion with importance for measurement purposes. The aim of this study was to explore the two subjective subdimensions of participation, involvement and engagement. The purpose was related to measure development within the field of paediatric rehabilitation. METHODS In a scoping review, following the PRISMA-ScR, the databases MEDLINE, PubMed, Academic Research Complete, PsychINFO, and Business Source Complete were searched for publications that described engagement and/or involvement constructs. RESULTS Thirty-nine publications met the inclusion criteria. Involvement could be conceptualised as an unobservable state of motivation, arousal, or interest towards a specific activity or product. Building a consensus over different fields of research, engagement can be seen as the individual's behavioural, cognitive and affective investment during role performance. CONCLUSIONS This scoping review points in a direction that the two subdimensions of participation need to be separated, with involvement being a more stable internal state of interest towards an activity, and engagement referring to the specific behaviour, emotions, and thoughts meanwhile participating in a specific setting. Clear definition of concepts will enhance the development of measures to evaluate rehabilitation interventions in the field of occupational therapy and related fields.
Collapse
Affiliation(s)
- Friedolin Steinhardt
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Anne-Stine Dolva
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Reidun Jahnsen
- Department of Neurosciences for Children, Oslo University Hospital, Oslo, Norway.,Institute of Health and Society, CHARM, University of Oslo, Oslo, Norway
| | - Anna Ullenhag
- Department of Health, Care and Social Welfare, Mälardalens University, Sweden
| |
Collapse
|
27
|
Lateef R, Alaggia R, Collin-Vézina D. A scoping review on psychosocial consequences of pandemics on parents and children: Planning for today and the future. Child Youth Serv Rev 2021; 125:106002. [PMID: 35990215 PMCID: PMC9375174 DOI: 10.1016/j.childyouth.2021.106002] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 02/16/2021] [Accepted: 03/21/2021] [Indexed: 05/16/2023]
Abstract
The COVID-19 worldwide pandemic has forced individuals into an unnatural way of life. Families with children experience unique stressors, such as school closures, disrupted childcare arrangements, requirement of parents to uptake additional responsibilities such as homeschooling, possible financial strain, and lack of breathing space between family members. The adjustments required of parents and children during a pandemic presumably impacts the psychosocial wellbeing of parents and children in different ways. To better under the psychosocial consequences of pandemics on parents, children, and youth, this scoping review used Arksey and O'Malley (2005) five-stage framework to examine the existing research literature on Severe Acute Respiratory Syndrome (SARS), Influenza Type A virus (H1N1), and COVID-19 to answer the following two research questions: (1) What are the psychosocial consequences of pandemics on parents of children and youth? (2) What are the psychosocial consequences of pandemics on children and youth? With the application of inclusion criteria, 29 articles were selected for analysis. Four major themes, including sub-themes emerged: 1) Each family members' emotions influence one another; 2) Parents experience greater levels of psychosocial problems than adults without children; 3) During a pandemic, parents require informal (social) and formal (specialized professional) support and; 4) Psychosocial consequences of pandemics on children/youth are understudied, indicating the need for more research on children/youth under the age of 20 years. Clinical prevention and intervention suggestions to support the psychosocial wellbeing of parents, children and youth during a pandemic are discussed.
Collapse
Affiliation(s)
- Rusan Lateef
- McGill University, 3506 University Street, Montreal, Quebec H3A 2A7, Canada
| | - Ramona Alaggia
- University of Toronto, 246 Bloor Street West, Toronto, Ontario M5S 1V4, Canada
| | | |
Collapse
|
28
|
Musser ED, Riopelle C, Latham R. Child maltreatment in the time of COVID-19: Changes in the Florida foster care system surrounding the COVID-19 safer-at-home order. Child Abuse Negl 2021; 116:104945. [PMID: 33546917 PMCID: PMC7837623 DOI: 10.1016/j.chiabu.2021.104945] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Media outlets have suggested that rates of child maltreatment may increase during the global COVID-19 pandemic. The few empirical studies that have examined pandemic related changes in rates of child maltreatment have relied predominantly on reports of suspected maltreatment. OBJECTIVE This study examines rates of documented, substantiated child maltreatment resulting in foster care placement, as well as demographic correlates of child maltreatment within the foster care system, before and during the COVID-19 pandemic. PARTICIPANTS AND SETTING Data were available for all youth in the FL foster care system from January 1, 2001 through June 30, 2020 (i.e., > 304,000 youth; > 1.1 million total placements). METHODS This study utilizes data from the Florida State Automated Child Welfare Information System (SACWIS). RESULTS Results revealed a decrease in the number of youths placed in the FL foster care system during the COVID-19 pandemic with the greatest reduction in April, 2020 during the Safer-at-Home Order (24 % fewer youth in 2020 than 2019). In contrast, the percentage of placements into foster care due to maltreatment increased by 3.34 %. Demographic-linked differences were observed in placement rates and exposure to maltreatment. CONCLUSIONS While prior work suggests that reports of child maltreatment have decreased during the COVID-19 pandemic, this study demonstrates that overall rates of substantiated maltreatment resulting in foster care placement have increased for White youth, while rates of placement of due to inadequate supervision, emotional neglect, and/or parental substance use have decreased for Black youth. Implications for policy and future research are discussed.
Collapse
Affiliation(s)
- Erica D Musser
- Department of Psychology and Center for Children and Families, Florida International University, Miami, FL, United States.
| | - Cameron Riopelle
- Data Services, University of Miami Libraries, University of Miami, Miami, FL, United States
| | - Robert Latham
- Children & Youth Law Clinic and University of Miami School of Law, University of Miami, Miami, FL, United States
| |
Collapse
|
29
|
Duong MT, Bruns EJ, Lee K, Cox S, Coifman J, Mayworm A, Lyon AR. Rates of Mental Health Service Utilization by Children and Adolescents in Schools and Other Common Service Settings: A Systematic Review and Meta-Analysis. Adm Policy Ment Health 2021; 48:420-439. [PMID: 32940884 DOI: 10.1007/s10488-020-0108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 05/18/2023]
Abstract
A meta-analysis was conducted to examine the relative rates of youth mental health service utilization across settings among the general population and among those with elevated mental health symptoms or clinical diagnoses. Rates of school-based mental health were compared to outpatient, primary care, child welfare, juvenile justice, and inpatient. Nine studies presented rates of mental health service use for general-population youth in the U.S., and 14 studies presented rates for youth with elevated symptoms or clinical diagnoses. Random effects meta-analysis was used to calculate mean proportions of youth receiving care in each sector. Of general population youth, 7.28% received school mental health services. Rates for other sectors are as follows: 7.26% in outpatient settings, 1.76% in primary care, 1.80% in inpatient, 1.35% in child welfare, and 0.90% juvenile justice. For youth with elevated mental health symptoms or diagnoses, 22.10% of youth were served by school-based mental health services, 20.56% outpatient settings, 9.93% primary care, 9.05% inpatient, 7.90% child welfare, and 4.50% juvenile justice. Schools and outpatient settings are the most common loci of mental health care for both the general population and samples of youth with elevated symptoms or clinical diagnoses, although substantial amounts of care are also provided in a range of other settings. Results hold potential for informing resource allocation, legislation and policy, intervention development, and research. Given that mental health services are delivered across many settings, findings also point to the need for interconnection across child-serving sectors, particularly schools and outpatient clinics.
Collapse
Affiliation(s)
- Mylien T Duong
- Education, Research, and Impact, Committee for Children, Seattle, USA.
| | - Eric J Bruns
- University of Washington School of Medicine, Seattle, USA
| | - Kristine Lee
- University of Washington School of Medicine, Seattle, USA
| | - Shanon Cox
- University of Washington School of Medicine, Seattle, USA
| | | | | | - Aaron R Lyon
- University of Washington School of Medicine, Seattle, USA
| |
Collapse
|
30
|
Katewongsa P, Pongpradit K, Widyastari DA. Physical activity level of Thai children and youth: Evidence from Thailand's 2018 report card on physical activity for children and youth. J Exerc Sci Fit 2021; 19:71-74. [PMID: 33335552 PMCID: PMC7732870 DOI: 10.1016/j.jesf.2020.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/08/2020] [Accepted: 11/08/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND While enabling and supporting factors have been in place to facilitate the pupils to be more active, only a fourth of Thai children have met the WHO recommendation. OBJECTIVE This study aims to present the physical activity (PA) level of Thai children and youth, based on the indicators established by Active Health Kids Global Alliance's Report Card (RC). METHODS The 2016 Thailand RC Survey and the 2015-2017 Thailand's Surveillance on Physical Activity (SPA) were employed for the analysis. PA of Thai children aged 6-17 years old was assessed in 9 aspects 1) Overall PA, 2) Organized Sports and PA, 3) Active Play, 4) Active Transportation, 5) Sedentary Behavior, 6) Family and Peers, 7) School, 8) Community and Environment, and 9) Government. RESULTS Only 26.2% of Thai children and youth met the recommended level of 60 min MVPA. Boys are generally more active compared to girls in all age groups (34.9% versus 16.3%, respectively). Almost half had participated in organized sports and/or PA program, but only 8.7% of Thai children and youth engaged in unstructured/unorganized active play. The settings and source of influence indicators achieved better grades, shown by 71.0% of family members (e.g., parents, guardians) facilitated PA and sports opportunities for their children. CONCLUSION Although schools' facilities are available, Thai curriculum provides less opportunity for the children to move during classes and have enough playing time during recess. As there is no standardized guidance for PA in Thai schools, Thailand needs to promote a unified PA in order to improve PA and to reduce recreational screen time of children and youth.
Collapse
Affiliation(s)
- Piyawat Katewongsa
- Institute for Population and Social Research, Mahidol University, Thailand
- Thailand Physical Activity Knowledge Development Centre (TPAK), Institute for Population and Social Research, Mahidol University, Thailand
| | - Kornkanok Pongpradit
- Institute for Population and Social Research, Mahidol University, Thailand
- Thailand Physical Activity Knowledge Development Centre (TPAK), Institute for Population and Social Research, Mahidol University, Thailand
| | - Dyah Anantalia Widyastari
- Institute for Population and Social Research, Mahidol University, Thailand
- Thailand Physical Activity Knowledge Development Centre (TPAK), Institute for Population and Social Research, Mahidol University, Thailand
| |
Collapse
|
31
|
de Lannoy L, Rhodes RE, Moore SA, Faulkner G, Tremblay MS. Regional differences in access to the outdoors and outdoor play of Canadian children and youth during the COVID-19 outbreak. Can J Public Health 2020; 111:988-994. [PMID: 33057923 PMCID: PMC7556599 DOI: 10.17269/s41997-020-00412-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/25/2020] [Indexed: 01/07/2023]
Abstract
To reduce the spread of COVID-19, public health authorities across the country have recommended that Canadians keep their distance, wash their hands, and stay home. To enforce these measures, restrictions on outdoor behaviour have been implemented, limiting access to parks and recreational outdoor spaces. New evidence shows that COVID-19 restrictions are associated with an overall lower amount of time spent in outdoor play among Canadian children and youth. This is concerning, as outdoor play is important for children's physical and mental health and helps provide them with a sense of control during times of uncertainty and stress. As policies on access to the outdoors during the COVID-19 outbreak vary by province, it is possible that policy differences have led to regional differences in changes in outdoor play among children and youth. In this commentary, we examine regional differences in outdoor play among children and youth across Canada, and the association between provincial policies related to COVID-19 and outdoor play. We argue that through the recovery process, in the event of a second wave of infections, and in preparing for future public health challenges, policy decisions should consider ways to preserve outdoor play for Canadian children and youth.
Collapse
Affiliation(s)
- Louise de Lannoy
- Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1 Canada
| | - Ryan E. Rhodes
- Behavioural Medicine Laboratory, School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 1700 STN CSC, Victoria, BC V8W 2Y2 Canada
| | - Sarah A. Moore
- Department of Therapeutic Recreation, Faculty of Child, Family, and Community Studies, Douglas College, 1250 Pinetree Way, Coquitlam, BC V3B 7X3 Canada
- School of Health and Human Performance, Dalhousie University, PO Box 15000, Halifax, NS B3H 4R2 Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, 6081 University Blvd, Vancouver, BC V6T 1Z1 Canada
| | - Mark S. Tremblay
- Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1 Canada
- Department of Pediatrics, University of Ottawa, 401 Smyth Road, Ottawa, ON K1H 8L1 Canada
| |
Collapse
|
32
|
Duong MT, Bruns EJ, Lee K, Cox S, Coifman J, Mayworm A, Lyon AR. Rates of Mental Health Service Utilization by Children and Adolescents in Schools and Other Common Service Settings: A Systematic Review and Meta-Analysis. Adm Policy Ment Health 2020; 48:420-439. [PMID: 32940884 DOI: 10.1007/s10488-020-01080-9] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 01/21/2023]
Abstract
A meta-analysis was conducted to examine the relative rates of youth mental health service utilization across settings among the general population and among those with elevated mental health symptoms or clinical diagnoses. Rates of school-based mental health were compared to outpatient, primary care, child welfare, juvenile justice, and inpatient. Nine studies presented rates of mental health service use for general-population youth in the U.S., and 14 studies presented rates for youth with elevated symptoms or clinical diagnoses. Random effects meta-analysis was used to calculate mean proportions of youth receiving care in each sector. Of general population youth, 7.28% received school mental health services. Rates for other sectors are as follows: 7.26% in outpatient settings, 1.76% in primary care, 1.80% in inpatient, 1.35% in child welfare, and 0.90% juvenile justice. For youth with elevated mental health symptoms or diagnoses, 22.10% of youth were served by school-based mental health services, 20.56% outpatient settings, 9.93% primary care, 9.05% inpatient, 7.90% child welfare, and 4.50% juvenile justice. Schools and outpatient settings are the most common loci of mental health care for both the general population and samples of youth with elevated symptoms or clinical diagnoses, although substantial amounts of care are also provided in a range of other settings. Results hold potential for informing resource allocation, legislation and policy, intervention development, and research. Given that mental health services are delivered across many settings, findings also point to the need for interconnection across child-serving sectors, particularly schools and outpatient clinics.
Collapse
Affiliation(s)
- Mylien T Duong
- Education, Research, and Impact, Committee for Children, Seattle, USA.
| | - Eric J Bruns
- University of Washington School of Medicine, Seattle, USA
| | - Kristine Lee
- University of Washington School of Medicine, Seattle, USA
| | - Shanon Cox
- University of Washington School of Medicine, Seattle, USA
| | | | | | - Aaron R Lyon
- University of Washington School of Medicine, Seattle, USA
| |
Collapse
|
33
|
Powell BJ, Haley AD, Patel SV, Amaya-Jackson L, Glienke B, Blythe M, Lengnick-Hall R, McCrary S, Beidas RS, Lewis CC, Aarons GA, Wells KB, Saldana L, McKay MM, Weinberger M. Improving the implementation and sustainment of evidence-based practices in community mental health organizations: a study protocol for a matched-pair cluster randomized pilot study of the Collaborative Organizational Approach to Selecting and Tailoring Implementation Strategies (COAST-IS). Implement Sci Commun 2020; 1. [PMID: 32391524 PMCID: PMC7207049 DOI: 10.1186/s43058-020-00009-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Implementing and sustaining evidence-based programs with fidelity may require multiple implementation strategies tailored to address multi-level, context-specific barriers and facilitators. Ideally, selecting and tailoring implementation strategies should be guided by theory, evidence, and input from relevant stakeholders; however, methods to guide the selection and tailoring of strategies are not well-developed. There is a need for more rigorous methods for assessing and prioritizing implementation determinants (barriers and facilitators) and linking implementation strategies to determinants. The Collaborative Organizational Approach to Selecting and Tailoring Implementation Strategies (COAST-IS) is an intervention designed to increase the effectiveness of evidence-based practice implementation and sustainment. COAST-IS will enable organizational leaders and clinicians to use Intervention Mapping to select and tailor implementation strategies to address their site-specific needs. Intervention Mapping is a multi-step process that incorporates theory, evidence, and stakeholder perspectives to ensure that implementation strategies effectively address key determinants of change. Methods COAST-IS will be piloted with community mental health organizations that are working to address the needs of children and youth who experience trauma-related emotional or behavioral difficulties by engaging in a learning collaborative to implement an evidence-based psychosocial intervention (trauma-focused cognitive behavioral therapy). Organizations will be matched and then randomized to participate in the learning collaborative only (control) or to receive additional support through COAST-IS. The primary aims of this study are to (1) assess the acceptability, appropriateness, feasibility, and perceived utility of COAST-IS; (2) evaluate the organizational stakeholders' fidelity to the core elements of COAST-IS; and (3) demonstrate the feasibility of testing COAST-IS in a larger effectiveness trial. Discussion COAST-IS is a systematic method that integrates theory, evidence, and stakeholder perspectives to improve the effectiveness and precision of implementation strategies. If effective, COAST-IS has the potential to improve the implementation and sustainment of a wide range of evidence-based practices in mental health and other sectors. Trial registration This study was registered in ClinicalTrials.gov (NCT03799432) on January 10, 2019 (last updated August 5, 2019).
Collapse
Affiliation(s)
- Byron J Powell
- Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130, USA.,Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amber D Haley
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sheila V Patel
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lisa Amaya-Jackson
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.,National Center for Child Traumatic Stress, Durham, NC, USA.,North Carolina Child Treatment Program, Center for Child and Family Health, Durham, NC, USA
| | - Beverly Glienke
- North Carolina Child Treatment Program, Center for Child and Family Health, Durham, NC, USA
| | - Mellicent Blythe
- North Carolina Child Treatment Program, Center for Child and Family Health, Durham, NC, USA.,School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rebecca Lengnick-Hall
- Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130, USA
| | - Stacey McCrary
- Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130, USA
| | - Rinad S Beidas
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA, USA
| | - Cara C Lewis
- MacColl Center for Health Care Innovation, Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Gregory A Aarons
- Department of Psychiatry, Child and Adolescent Services Research Center, University of California San Diego School of Medicine, San Diego, CA, USA
| | - Kenneth B Wells
- Department of Psychiatry and Behavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,The Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Mary M McKay
- Brown School, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130, USA
| | - Morris Weinberger
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
34
|
Tutenel P, Ramaekers S, Heylighen A. Understanding children's spatiality in cancer care environments: Untangling everyday practices around an IV-stand in a paediatric day-care ward. Health Place 2019; 60:102211. [PMID: 31557607 DOI: 10.1016/j.healthplace.2019.102211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 08/21/2019] [Accepted: 09/16/2019] [Indexed: 11/21/2022]
Abstract
Since the turn of the 21st century we see a renewed interest in the impact of hospital environments on children's well-being. In this article, we study the spatiality of children affected by cancer, i.e., their encounters with the day-care ward they are situated in. First we elaborate on these encounters through Schatzki's practice theory and Gibson's theory of affordances. Then we clarify our thinking in a case study and turn as empirical focus to a 'thing', an intravenous-pump and stand (IV-stand). The data used are field notes and videos shot by two children in a day-care ward, tinged with examples from literature and coincidental encounters with the IV-stand. Through carefully untangling everyday practices around the IV-stand, we show their complexity and offer a more nuanced understanding of child-friendly environments.
Collapse
|
35
|
Abstract
The transformation of the American family under the second demographic transition has created more opportunities for parents to have children with multiple partners, but data limitations have hampered prevalence estimates of multiple-partner fertility from the perspective of children. This study uses nationally representative data from the 1979 and 1997 cohorts of the National Longitudinal Surveys of Youth to examine cohort change in children's exposure to multiple-partner fertility. We find that one in five children in the 1979 cohort had at least one half-sibling by their 18th birthday, and the prevalence grew to more than one in four children by the 1997 cohort. A strong educational gradient in exposure to half-siblings persists across both cohorts, but large racial/ethnic disparities have narrowed over time. Using demographic decomposition techniques, we find that change in the racial/ethnic and socioeconomic composition of the U.S. population cannot explain the growth in exposure to half-siblings. We conclude by discussing the shifting patterns of fertility and family formation associated with sibling complexity and considering the implications for child development and social stratification.
Collapse
|
36
|
Abstract
Background The public Educational Psychology Services provide mental health services for children and youth in Israel, alongside the Ministry of Health and the Ministry of Social Affairs and Services. The Psychological and Counseling Services Division of the Ministry of Education (known as SHEFI - Sherut Psychology Yeutzi), funds and supervises local Educational Psychology Services which are aimed at supporting child development and enhancing the emotional welfare of children and their families. The demand for the services of educational psychologists is increasing. Yet this demand is not being met due to the insufficient number of job slots allocated, the geographical distances in outlying peripheral areas, the already high loads in the psychologists’ daily routine, and other such problems. A wide range of effective psychological services can be offered via the internet. The internet therefore has the potential to serve as a useful and efficient missing link between the high demands for educational psychology services on the one hand and the ability and desire among educational psychologists to meet those needs on the other. Moreover, even if the services were fully staffed, the resources would still be insufficient to provide personal (face-to-face) treatment for all, so that internet-based access to services would still need to be developed. Those services provide unique advantages such as overcoming distance and enabling higher availability of mental health professionals. The objectives of the current study were to describe the prevalence of public educational psychology services available online in Israel, with specific focus on the Arab minority and the peripheral regions, and to highlight the benefits of expanding those services. Method During 2016, we conducted a survey comprising all 252 Public Educational Psychology Service units in Israel (n = 170 in the Jewish sector, and n = 82 in the Arab sector). The method used to search for online sites was in line with the actions taken by an average end-user searching for information on the internet. Results The survey found that 125 of the units in the Jewish sector (73.5% of those units) and all 82 units in the Arab sector had no online site at all, constituting 82.2% of all the units in Israel. Of the 45 Jewish websites located by the survey, 42 (93.3% of the sites) were not user friendly (not interactive), and only three offered the possibility of interacting with psychologists (6.7% of the sites). Nevertheless, all the sites (n = 45) offered a high degree of quality and variety that exceeded basic information. Conclusion We believe that the presence of educational psychologists on the internet is essential in order to meet the challenges presented by the growing needs of students, parents and teachers in the current digital era. The survey revealed that the public educational psychology system in Israel has not yet bridged the technological gap. Special attention should be directed to the peripheral regions and to the Arab sector, where the technological services can make a significant contribution. The local public services’ attempts to create and operate websites (45 Jewish websites according to the survey), are indicative of the determination to offer psychological support to the community at large, and of the ambition to overcome availability and accessibility problems. The concept of internet services might be useful not only for the SHEFI, but also for the array of mental health services for children and youth in Israel. Thus, we recommend that a policy should be formulated regarding internet-based mental health services for children and youth in Israel, and we call for a collaboration between the various ministries in implementing this process.
Collapse
Affiliation(s)
- Sarit Alkalay
- Department of Psychology, Max Stern Jezreel Valley College, 1930600, Emek Jezreel, Israel.
| | - Avivit Dolev
- Technion (Israel Institute of Technology), Faculty of Education in Science and Technology, Haifa, Israel
| |
Collapse
|
37
|
Prowse RJL, Naylor PJ, Olstad DL, Carson V, Storey K, Mâsse LC, Kirk SFL, Raine KD. Food marketing in recreational sport settings in Canada: a cross-sectional audit in different policy environments using the Food and beverage Marketing Assessment Tool for Settings (FoodMATS). Int J Behav Nutr Phys Act 2018; 15:39. [PMID: 29848329 PMCID: PMC5977555 DOI: 10.1186/s12966-018-0673-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 04/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children's recreational sport settings typically sell energy dense, low nutrient products; however, it is unknown whether the same types of food and beverages are also marketed in these settings. Understanding food marketing in sports settings is important because the food industry often uses the promotion of physical activity to justify their products. This study aimed to document the 'exposure' and 'power' of food marketing present in public recreation facilities in Canada and assess differences between provinces with and without voluntary provincial nutrition guidelines for recreation facilities. METHODS Food marketing was measured in 51 sites using the Food and beverage Marketing Assessment Tool for Settings (FoodMATS). The frequency and repetition ('exposure') of food marketing and the presence of select marketing techniques, including child-targeted, sports-related, size, and healthfulness ('power'), were assessed. Differences in 'exposure' and 'power' characteristics between sites in three guideline provinces (n = 34) and a non-guideline province (n = 17) were assessed using Pearson's Chi squared tests of homogeneity and Mann-Whitney U tests. RESULTS Ninety-eight percent of sites had food marketing present. The frequency of food marketing per site did not differ between guideline and non-guideline provinces (median = 29; p = 0.576). Sites from guideline provinces had a significantly lower proportion of food marketing occasions that were "Least Healthy" (47.9%) than sites from the non-guideline province (73.5%; p < 0.001). Use of child-targeted and sports-related food marketing techniques was significantly higher in sites from guideline provinces (9.5% and 10.9%, respectively), than in the non-guideline province (1.9% and 4.5% respectively; p values < 0.001). It was more common in the non-guideline province to use child-targeted and sports-related techniques to promote "Least Healthy" items (100.0% and 68.4%, respectively), compared to the guideline provinces (59.3% and 52.0%, respectively). CONCLUSIONS Recreation facilities are a source of children's exposure to unhealthy food marketing. Having voluntary provincial nutrition guidelines that recommend provision of healthier foods was not related to the frequency of food marketing in recreation facilities but was associated with less frequent marketing of unhealthy foods. Policy makers should provide explicit food marketing regulations that complement provincial nutrition guidelines to fulfill their ethical responsibility to protect children and the settings where children spend time.
Collapse
Affiliation(s)
- Rachel J L Prowse
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Kate Storey
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Louise C Mâsse
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sara F L Kirk
- Healthy Populations Institute, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
- Centre for Health and Nutrition, University of Alberta, Edmonton, Alberta, Canada.
| |
Collapse
|
38
|
Prowse RJL, Naylor PJ, Olstad DL, Carson V, Mâsse LC, Storey K, Kirk SFL, Raine KD. Reliability and validity of a novel tool to comprehensively assess food and beverage marketing in recreational sport settings. Int J Behav Nutr Phys Act 2018; 15:38. [PMID: 29848321 PMCID: PMC5977740 DOI: 10.1186/s12966-018-0667-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 03/19/2018] [Indexed: 12/02/2022] Open
Abstract
Background Current methods for evaluating food marketing to children often study a single marketing channel or approach. As the World Health Organization urges the removal of unhealthy food marketing in children’s settings, methods that comprehensively explore the exposure and power of food marketing within a setting from multiple marketing channels and approaches are needed. The purpose of this study was to test the inter-rater reliability and the validity of a novel settings-based food marketing audit tool. Methods The Food and beverage Marketing Assessment Tool for Settings (FoodMATS) was developed and its psychometric properties evaluated in five public recreation and sport facilities (sites) and subsequently used in 51 sites across Canada for a cross-sectional analysis of food marketing. Raters recorded the count of food marketing occasions, presence of child-targeted and sports-related marketing techniques, and the physical size of marketing occasions. Marketing occasions were classified by healthfulness. Inter-rater reliability was tested using Cohen’s kappa (κ) and intra-class correlations (ICC). FoodMATS scores for each site were calculated using an algorithm that represented the theoretical impact of the marketing environment on food preferences, purchases, and consumption. Higher FoodMATS scores represented sites with higher exposure to, and more powerful (unhealthy, child-targeted, sports-related, large) food marketing. Validity of the scoring algorithm was tested through (1) Pearson’s correlations between FoodMATS scores and facility sponsorship dollars, and (2) sequential multiple regression for predicting “Least Healthy” food sales from FoodMATS scores. Results Inter-rater reliability was very good to excellent (κ = 0.88–1.00, p < 0.001; ICC = 0.97, p < 0.001). There was a strong positive correlation between FoodMATS scores and food sponsorship dollars, after controlling for facility size (r = 0.86, p < 0.001). The FoodMATS score explained 14% of the variability in “Least Healthy” concession sales (p = 0.012) and 24% of the variability total concession and vending “Least Healthy” food sales (p = 0.003). Conclusions FoodMATS has high inter-rater reliability and good validity. As the first validated tool to evaluate the exposure and power of food marketing in recreation facilities, the FoodMATS provides a novel means to comprehensively track changes in food marketing environments that can assist in developing and monitoring the impact of policies and interventions. Electronic supplementary material The online version of this article (10.1186/s12966-018-0667-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Rachel J L Prowse
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Louise C Mâsse
- BC Children's Hospital Research Institute, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Kate Storey
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Sara F L Kirk
- Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, Edmonton, AB, Canada. .,Centre for Health & Nutrition, University of Alberta, Edmonton, AB, Canada.
| |
Collapse
|
39
|
Kranjac AW, Kimbro RT, Denney JT, Osiecki KM, Moffett BS, Lopez KN. Comprehensive Neighborhood Portraits and Child Asthma Disparities. Matern Child Health J 2018; 21:1552-1562. [PMID: 28181157 DOI: 10.1007/s10995-017-2286-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objectives Previous research has established links between child, family, and neighborhood disadvantages and child asthma. We add to this literature by first characterizing neighborhoods in Houston, TX by demographic, economic, and air quality characteristics to establish differences in pediatric asthma diagnoses across neighborhoods. Second, we identify the relative risk of social, economic, and environmental risk factors for child asthma diagnoses. Methods We geocoded and linked electronic pediatric medical records to neighborhood-level social and economic indicators. Using latent profile modeling techniques, we identified Advantaged, Middle-class, and Disadvantaged neighborhoods. We then used a modified version of the Blinder-Oaxaca regression decomposition method to examine differences in asthma diagnoses across children in these different neighborhoods. Results Both compositional (the characteristics of the children and the ambient air quality in the neighborhood) and associational (the relationship between child and air quality characteristics and asthma) differences within the distinctive neighborhood contexts influence asthma outcomes. For example, unequal exposure to PM2.5 and O3 among children in Disadvantaged and Middle-class neighborhoods contribute to asthma diagnosis disparities within these contexts. For children in Disadvantaged and Advantaged neighborhoods, associational differences between racial/ethnic and socioeconomic characteristics and asthma diagnoses explain a significant proportion of the gap. Conclusions for Practice Our results provide evidence that differential exposure to pollution and protective factors associated with non-Hispanic White children and children from affluent families contribute to asthma disparities between neighborhoods. Future researchers should consider social and racial inequalities as more proximate drivers, not merely as associated, with asthma disparities in children.
Collapse
Affiliation(s)
- Ashley W Kranjac
- Department of Sociology, Kinder Institute Urban Health Program, Rice University, 6500 Main Street #1020, Houston, TX, 77030, USA.
| | - Rachel T Kimbro
- Department of Sociology, Kinder Institute Urban Health Program, Rice University, 6500 Main Street #1020, Houston, TX, 77030, USA
| | - Justin T Denney
- Department of Sociology, Kinder Institute Urban Health Program, Rice University, 6500 Main Street #1020, Houston, TX, 77030, USA
| | - Kristin M Osiecki
- Department of Public Health, University of Illinois- Springfield, Springfield, IL, USA
| | - Brady S Moffett
- Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Keila N Lopez
- Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| |
Collapse
|
40
|
Graça J, Calheiros MM, Patrício JN, Magalhães EV. Emergency residential care settings: A model for service assessment and design. Eval Program Plann 2018; 66:89-101. [PMID: 29055262 DOI: 10.1016/j.evalprogplan.2017.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/07/2017] [Accepted: 10/10/2017] [Indexed: 06/07/2023]
Abstract
There have been calls for uncovering the "black box" of residential care services, with a particular need for research focusing on emergency care settings for children and youth in danger. In fact, the strikingly scant empirical attention that these settings have received so far contrasts with the role that they often play as gateway into the child welfare system. To answer these calls, this work presents and tests a framework for assessing a service model in residential emergency care. It comprises seven studies which address a set of different focal areas (e.g., service logic model; care experiences), informants (e.g., case records; staff; children/youth), and service components (e.g., case assessment/evaluation; intervention; placement/referral). Drawing on this process-consultation approach, the work proposes a set of key challenges for emergency residential care in terms of service improvement and development, and calls for further research targeting more care units and different types of residential care services. These findings offer a contribution to inform evidence-based practice and policy in service models of residential care.
Collapse
Affiliation(s)
- João Graça
- Instituto Universitário de Lisboa (ISCTE-IUL), CIS-IUL, Lisboa, Portugal; Instituto de Ciências Sociais (ICS), Universidade de Lisboa, Portugal.
| | - Maria Manuela Calheiros
- Instituto Universitário de Lisboa (ISCTE-IUL), CIS-IUL, Lisboa, Portugal; Centro de Investigação em Ciência Psicológica, Faculdade de Psicologia, Universidade de Lisboa, Portugal
| | | | | |
Collapse
|
41
|
Makadia LD, Roper PJ, Andrews JO, Tingen MS. Tobacco Use and Smoke Exposure in Children: New Trends, Harm, and Strategies to Improve Health Outcomes. Curr Allergy Asthma Rep 2017; 17:55. [PMID: 28741144 DOI: 10.1007/s11882-017-0723-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE OF REVIEW Every day in the USA, approximately 4000 adolescents begin smoking and the adolescent brain is particularly susceptible to nicotine addiction. We present current pediatric trends on tobacco use and exposures, various new products used by adolescents, the adverse biological and behavioral effects of tobacco use and exposures, and tobacco control strategies to eliminate tobacco-related illnesses and deaths in the pediatric population. RECENT FINDINGS Twelve-20% of women continue to smoke during pregnancy. New research reveals cognitive differences and behavior-control disorders are seen in elementary school children from prenatal and postnatal exposures. Traditional cigarette smoking has decreased in adolescents; novel and appealing tobacco products have captured their attention, particularly electronic cigarettes, and rates double and often triple from middle to high school. Children with asthma and those living in multi-housing units have higher rates of secondhand smoke exposure than non-asthmatics and children living in single-home dwellings. There is no "safe or risk-free" level of tobacco use or exposure. Tobacco use and exposure in childhood and adolescence must be decreased using evidenced-based strategies to improve child health.
Collapse
Affiliation(s)
- Luv D Makadia
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - P Jervey Roper
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | | | - Martha S Tingen
- Department of Pediatrics, Georgia Prevention Institute, Medical College of Georgia, Augusta University, HS-1755, 1499 Walton Way, Augusta, GA, 30912, USA.
| |
Collapse
|
42
|
Cox RS, Irwin P, Scannell L, Ungar M, Bennett TD. Children and youth's biopsychosocial wellbeing in the context of energy resource activities. Environ Res 2017; 158:499-507. [PMID: 28709032 DOI: 10.1016/j.envres.2017.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 06/29/2017] [Accepted: 07/05/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Children and youth emerge as key populations that are impacted by energy resource activities, in part because of their developmental vulnerabilities, as well as the compounding effects of energy systems on their families, communities, and physical environments. While there is a larger literature focused on fossil fuel emissions and children, the impacts of many aspects of energy systems on children and youth remain under examined and scattered throughout the health, social science, and environmental science literatures. OBJECTIVES This systematic interdisciplinary review examines the biological, psychosocial, and economic impacts of energy systems identified through social science research - specifically focused on household and industrial extraction and emissions - on children and youth functioning. METHODS A critical interpretive search of interdisciplinary and international social sciences literature was conducted using an adaptive protocol focusing on the biopsychosocial and economic impacts of energy systems on children and youth. The initial results were complemented with a purposeful search to extend the breadth and depth of the final collection of articles. DISCUSSION Although relatively few studies have specifically focused on children and youth in this context, the majority of this research uncovers a range of negative health impacts that are directly and indirectly related to the development and ongoing operations of natural resource production, particularly oil and gas, coal, and nuclear energy. Psychosocial and cultural effects, however, remain largely unexamined and provide a rich avenue for further research. CONCLUSIONS This synthesis identifies an array of adverse biopsychosocial health outcomes on children and youth of energy resource extraction and emissions, and identifies gaps that will drive future research in this area.
Collapse
Affiliation(s)
- Robin S Cox
- ResiliencebyDesign Research Lab, School of Humanitarian Studies, Royal Roads University, Victoria, BC, Canada.
| | - Pamela Irwin
- ResiliencebyDesign Research Lab, School of Humanitarian Studies, Royal Roads University, Victoria, BC, Canada
| | - Leila Scannell
- ResiliencebyDesign Research Lab, School of Humanitarian Studies, Royal Roads University, Victoria, BC, Canada
| | - Michael Ungar
- Resilience Research Centre, Dalhousie University, Halifax, NS, Canada
| | - Trevor Dixon Bennett
- ResiliencebyDesign Research Lab, School of Humanitarian Studies, Royal Roads University, Victoria, BC, Canada
| |
Collapse
|
43
|
Chapman AR. Can human rights standards help protect children and youth from the detrimental impact of alcohol beverage marketing and promotional activities? Addiction 2017; 112 Suppl 1:117-121. [PMID: 27283366 DOI: 10.1111/add.13484] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 03/08/2016] [Accepted: 06/02/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS The alcohol industry in the Latin American and Caribbean (LAC) region promotes demand for alcohol products actively through a number of channels, including advertising and sponsorship of sports and other events. This paper evaluates whether human rights instruments that Latin American countries have ratified can be used to limit children's exposure to alcohol advertising and promotion. METHODS A review was conducted of the text of, and interpretative documents related to, a series of international and regional human rights instruments ratified by most countries in the LAC region that enumerate the right to health. RESULTS The Convention on the Rights of the Child has the most relevant provisions to protect children and youth from alcohol promotion and advertising. Related interpretive documents by the United Nations Committee on the Rights of the Child affirm that corporations hold duties to respect and protect children's right to health. CONCLUSION Human rights norms and law can be used to regulate or eliminate alcohol beverage marketing and promotional activities in the Latin American region. The paper recommends developing a human rights based Framework Convention on Alcohol Control to provide guidance.
Collapse
Affiliation(s)
- Audrey R Chapman
- Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, CT, USA
| |
Collapse
|
44
|
Young NL, Wabano MJ, Usuba K, Mishibinijima D, Jacko D, Burke TA. Reliability of the Aboriginal Children's Health and Well-Being Measure (ACHWM). Springerplus 2016; 5:2082. [PMID: 28018790 PMCID: PMC5142163 DOI: 10.1186/s40064-016-3776-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 12/01/2016] [Indexed: 11/10/2022]
Abstract
PURPOSE The aim of this research was to evaluate the reliability of the Aboriginal Children's Health and Well-Being Measure© (ACHWM). METHODS Two cohorts of children from Wiikwemkoong Unceded Territory were recruited for this study. Each child completed the ACHWM independently on a computer tablet running a customized survey app. The data from the first and second cohorts were used to estimate the internal consistencies using Cronbach's alpha. A subgroup of the second cohort completed the survey twice, within the same day. The data from this subgroup was used to evaluate the test-retest reliability using a random effects Intra-class Correlation Coefficient (ICC). RESULTS There were 124 participants in the first cohort and 132 participants in the second cohort. The repeated measures subgroup was comprised of 29 participants from the second cohort. The internal consistency statistic (Cronbach's alpha) was 0.93 for the first and second cohorts. The test-retest reliability ICC was 0.94 (95% CI 0.86-0.97) for the ACHWM summary scores based on the repeated measures subgroup. CONCLUSIONS These results establish the internal consistency and the test-retest validity of the ACHWM. This important finding will enable Aboriginal communities to use this measure with confidence and promote the voices of their children in reporting their health. The ACHWM is an essential data gathering tool that enables evidence-based health care for Aboriginal communities.
Collapse
Affiliation(s)
- Nancy L Young
- Laurentian University, 935 Ramsey Lake Road, Sudbury, ON Canada
| | - Mary Jo Wabano
- Naandwechige Gamig Wiikwemkoong Health Centre, Wiikwemkoong, ON Canada
| | - Koyo Usuba
- Laurentian University, 935 Ramsey Lake Road, Sudbury, ON Canada
| | | | - Diane Jacko
- Nadmadwin Mental Health, Wiikwemkoong, ON Canada
| | - Tricia A Burke
- Laurentian University, 935 Ramsey Lake Road, Sudbury, ON Canada
| |
Collapse
|
45
|
Mistry RS, White ES, Chow KA, Griffin KM, Nenadal L. A Mixed Methods Approach to Equity and Justice Research: Insights from Research on Children's Reasoning About Economic Inequality. Adv Child Dev Behav 2016; 50:209-36. [PMID: 26956075 DOI: 10.1016/bs.acdb.2015.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Mixed methods research approaches are gaining traction across various social science disciplines, including among developmental scientists. In this chapter, we discuss the utility of a mixed methods research approach in examining issues related to equity and justice. We incorporate a brief overview of quantitative and qualitative monomethod research approaches in our larger discussion of the advantages, procedures, and considerations of employing a mixed methods design to advance developmental science from an equity and justice perspective. To better illustrate the theoretical and practical significance of a mixed methods research approach, we include examples of research conducted on children and adolescents' conceptions of economic inequality as one example of developmental science research with an equity and justice frame.
Collapse
Affiliation(s)
- Rashmita S Mistry
- University of California at Los Angeles, Los Angeles, CA, United States.
| | | | - Kirby A Chow
- Society for Research in Child Development/American Association for the Advancement of Science Policy Fellow, Washington, DC, United States
| | | | - Lindsey Nenadal
- University of California at Los Angeles, Los Angeles, CA, United States
| |
Collapse
|
46
|
Yurk Quadlin N. When children affect parents: Children's academic performance and parental investment. Soc Sci Res 2015; 52:671-685. [PMID: 26004488 DOI: 10.1016/j.ssresearch.2014.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 08/31/2014] [Accepted: 10/23/2014] [Indexed: 06/04/2023]
Abstract
Sociologists have extensively documented the ways that parent resources predict children's achievement. However, less is known about whether and how children's academic performance shapes parental investment behaviors. I use data from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K) and longitudinal fixed effects models to examine how changes in teacher assessments are related to changes in the conferral of various parent resources. Overall, I find that the relationship between achievement and investment varies based on the directionality in children's achievement and the type of resource at hand. Children whose performance improves receive a broad range of enrichment resources, while declines in performance are met with corrective educational resources. Results are largely consistent whether language or math assessments are used to predict investment, and also among children whose achievement does not change over time. I discuss these patterns, along with implications for the use of parent resources in education and family research.
Collapse
Affiliation(s)
- Natasha Yurk Quadlin
- Indiana University, Department of Sociology, Ballantine Hall 744, 1020 E. Kirkwood Ave., Bloomington, IN 47405, United States.
| |
Collapse
|
47
|
Abstract
Children and youth (referred to as 'children' in the present statement), whether actual patients or volunteers, frequently participate in medical education. The present position statement discusses the numerous ethical challenges that may arise including respect for persons, truth telling and confidentiality. The statement provides guidelines that may be helpful to educators from a wide variety of disciplines.
Collapse
|
48
|
Greenwood ML, de Leeuw SN. Social determinants of health and the future well-being of Aboriginal children in Canada. Paediatr Child Health 2012; 17:381-4. [PMID: 23904782 PMCID: PMC3448539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2012] [Indexed: 06/02/2023] Open
Abstract
Aboriginal children's well-being is vital to the health and success of our future nations. Addressing persistent and current Aboriginal health inequities requires considering both the contexts in which disparities exist and innovative and culturally appropriate means of rectifying those inequities. The present article contextualizes Aboriginal children's health disparities, considers 'determinants' of health as opposed to biomedical explanations of ill health and concludes with ways to intervene in health inequities. Aboriginal children experience a greater burden of ill health compared with other children in Canada, and these health inequities have persisted for too long. A change that will impact individuals, communities and nations, a change that will last beyond seven generations, is required. Applying a social determinants of health framework to health inequities experienced by Aboriginal children can create that change.
Collapse
Affiliation(s)
- Margo Lianne Greenwood
- National Collaborating Centre for Aboriginal Health and the First Nations Studies Program
| | - Sarah Naomi de Leeuw
- Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia
| |
Collapse
|