Search

IntroductionFew studies have assessed patterns of substance use among Canadian adolescents. This cross-sectional study examined substance use classes among Canadian secondary school students and associations with anxiety and depression. MethodsThis study used data from Year 6 (2017/18) of the COMPASS study. Students (n = 51 767) reported their substance use (alcohol, cannabis, cigarette and e-cigarette use) and anxiety and depression symptoms. We employed latent class analysis to identify substance use classes and multinomial logistic regression to examine how anxiety and depression were associated with class membership. ResultsOverall, 40% of students indicated having anxiety and/or depression (50% in females; 29% in males) and 60% of students reported substance use (60% in females; 61% in males). We identified three substance use classes: poly-use, dual use, and non-use. Females with both anxiety and depression had the highest odds of being in the poly-use class compared to the non-use class (odds ratio [OR] = 4.09; 95% confidence interval [CI]: 3.59–4.65) followed by females with depression only (OR = 2.65; 95% CI: 2.31–3.04) and males with both anxiety and depression (OR = 2.48; 95% CI: 2.19–2.80). Symptomatology was also associated with belonging to the dual use class except among males with anxiety only (OR = 1.13; 95% CI: 0.94–1.37). ConclusionCanadian secondary school students are engaging in dual and poly-substance use, and anxiety and depression were associated with such use. Females had a higher prevalence of anxiety and depression and should be a priority population for mental health programming.

IntroductionPeu d’études ont évalué les habitudes de consommation de substances chez les adolescents canadiens. Cette étude transversale porte sur les catégories de consommation de substances chez les élèves du secondaire au Canada et leurs associations avec l’anxiété et la dépression. MéthodologieCette étude repose sur des données de l’année 6 (2017-2018) de l’étude COMPASS. Les élèves (n = 51 767) ont fait état de leur consommation de substances (alcool, cannabis, cigarettes et cigarettes électroniques) et de leurs symptômes d’anxiété et de dépression. Nous avons utilisé une analyse par classes latentes pour créer les catégories de consommation de substances et une analyse de régression logistique multinomiale pour examiner la manière dont l’anxiété et la dépression étaient associées à l’appartenance à une catégorie. RésultatsDans l’ensemble, 40 % des élèves ont indiqué souffrir d’anxiété ou de dépression (50 % des filles et 29 % des garçons) et 60 % des élèves ont fait état d’une consommation de substances (60 % des filles et 61 % des garçons). Nous avons établi trois catégories de consommation de substances : la polyconsommation, la double consommation et la non-consommation. Les plus susceptibles d’appartenir à la catégorie de polyconsommation plutôt qu’à la catégorie de non-consommation étaient les filles souffrant à la fois d’anxiété et de dépression (rapport de cote [RC] = 4,09; intervalle de confiance [IC] à 95 % : 3,59 à 4,65]), suivies des filles souffrant de dépression uniquement (RC = 2,65; IC à 95 % : 2,31 à 3,04) et des garçons souffrant à la fois d’anxiété et de dépression (RC = 2,48; IC à 95 % : 2,19 à 2,80). La symptomatologie a également été associée à l’appartenance à la catégorie de double consommation, sauf pour les garçons souffrant d’anxiété uniquement (RC = 1,13; IC à 95 % : 0,94 à 1,37). ConclusionLes élèves du secondaire au Canada s’adonnent à une double consommation et à une polyconsommation de substances, et on a pu associer l’anxiété et la dépression à ces types de consommation. Les filles affichent une prévalence plus élevée d’anxiété et de dépression et devraient, de ce fait, constituer une priorité en matière de programmation en santé mentale.

Background: Measuring, assessing and managing outcomes in school practice environments is difficult due to the complex nature of school communities as well as the recent shift in service-delivery models towards tiered approaches. In tiered approaches, multiple levels of service are offered to better match students' needs. Each level of service may require different outcomes and management techniques. Research to date on outcomes has focused on measuring outcomes in medical settings, leaving a substantive gap in the literature regarding practice in schools. Aims The first aim was to explore how school-based speech-language therapists approached outcomes management as their clinical programmes transitioned to tiered service-delivery models The second aim was to describe the successes and challenges in outcomes management reported by clinicians in this context. Methods & Procedures: A secondary deductive-inductive content analysis was performed using qualitative interviews with 24 clinical managers and senior therapists from schools across Ontario, Canada. Using a framework of outcomes measurement, assessment and management in schools based on previous research studies, data were grouped into broad categories deductively, and then the content of each category was further explored using inductive coding. Iterative peer debriefing and reflexive journaling were key strategies to increase the trustworthiness of the results. Findings & Results: Participants reported measuring and qualitatively assessing seven key outcomes for school-based practice. These included: (1) student progress and achievement, (2) student participation and inclusion in the school community, (3) stakeholder perspectives, (4) 'buy-in', (5) expanded capacities, (6) responsiveness to needs and (7) accountability to systems. Participants reported more challenges than successes in outcomes management during this transition to tiered services. Challenges were attributed to idiosyncratic organizational barriers, the transition to tiered models and the philosophy of working within the educational system.

This study measured physical activity (PA) and explored its correlates among children with multimorbidity (co-occurring chronic physical and mental illness; MM) versus those with chronic physical illness only (PI). This study used baseline data from the Multimorbidity in Children and Youth Across the Life Course (MY LIFE) study, an on-going cohort study following 263 children with a PI 2 to 16 years of age (mean age: 9.8 years, SD = 4.0; 47.7% female). PA was measured using accelerometry, and demographic and psychosocial variables were collected using questionnaires. Of the 55 children with MM and the 85 with PI with valid accelerometer data, 38.1% and 41.2%, respectively, met average daily PA guidelines. Correlates of moderate-to-physical PA (MVPA) among children with MM were age, [rho](53) = -0.45, p = 0.001, body mass index (BMI), [rho](48) = -0.28, p = 0.04, self-perceived behavioral conduct, [rho](24) = -0.45, p = 0.02, physical health-related quality of life, [rho](51) = 0.56, p < 0.001, and peer support, [rho](52) = 0.27, p = 0.04. Correlates of MVPA among children with PI were age, [rho](83) = -0.40, p < 0.001, sex, [rho](83) = -0.26, p = 0.01, self-perceived social competence, [rho](31) = 0.42, p = 0.02, self-perceived athletic competence, [rho](31) = 0.48, p = 0.005, physical health-related quality of life, [rho](83) = 0.34, p = 0.001, participation in community sport, [rho](31) = 0.41, p = 0.02, and family functioning, [rho](83) = 0.26, p = 0.02. These results demonstrate that children with PI and MM are insufficiently active and their PA is correlated with demographic and psychosocial factors.

The prevalence of Fetal Alcohol Spectrum Disorder (FASD) may be underestimated as it can be difficult to diagnose in early childhood possibly reflecting unique developmental trajectories relative to other Neurodevelopmental Disabilities (NDDs). Using data collected via the Early Development Instrument (EDI) between 2010 and 2015, we examined the prevalence of kindergarten children with FASD and their concurrent developmental outcomes. We found that the prevalence of FASD ranged from 0.01 to 0.31%. A greater percentage of children with FASD had teacher-reported home problems that interfered with their classroom functioning. Overall children with FASD had higher mean scores on the developmental domains compared to children with NDDs. Results of the current study can inform strategies and policies for early identification and intervention.

Background: A substantial proportion of children have a physical illness; these children commonly experience physical–mental comorbidity. To assess child mental health, brief scales that can be used in clinical and research settings are needed. This study assessed the validity and reliability of parent‐reported Ontario Child Health Study Emotional Behavioural Scale‐Brief Version (OCHS‐EBS‐B) scores. Methods: Data come from a longitudinal study of children aged 2–16 years with a physical illness recruited from outpatient clinics at a pediatric hospital. Confirmatory factor analysis and McDonald's coefficient assessed the factor structure and internal consistency reliability of the OCHS‐EBS‐B, respectively. Point biserial correlations assessed agreement between the OCHS‐EBS‐B and Mini International Neuropsychiatric Interview for Children and Adolescents (MINI‐KID), a structured diagnostic interview. The Wilcoxon rank sum test compared OCHS‐EBS‐B scores between children with versus without physical–mental comorbidity (known‐group validity). Results: The three‐factor structure of the OCHS‐EBS‐B was replicated in this sample of children with physical illness (χ2 = 196.23(272), p < 0.001; CFI = 0.98; TLI = 0.98; SRMR = 0.06; RMSEA [90% CI] = 0.034 [0.027, 0.044]). It had excellent internal consistency reliability (ω = 0.86–0.92) and was moderately correlated with the MINI‐KID (baseline: rpb = 0.43–0.51; 6 months: rpb = 0.55–0.65). OCHS‐EBS‐B scores were significantly higher among children with versus without physical–mental comorbidity. Conclusions: Findings confirm psychometric evidence that the OCHS‐EBS‐B is a valid and reliable measure of mental health in children with chronic physical illness. Its brevity and robust psychometric properties make the OCHS‐EBS‐B a strong candidate for routine use in integrated pediatric physical and mental health services. [ABSTRACT FROM AUTHOR]

The prevalence of Fetal Alcohol Spectrum Disorder (FASD) may be underestimated as it can be difficult to diagnose in early childhood possibly reflecting unique developmental trajectories relative to other Neurodevelopmental Disabilities (NDDs). Using data collected via the Early Development Instrument (EDI) between 2010 and 2015, we examined the prevalence of kindergarten children with FASD and their concurrent developmental outcomes. We found that the prevalence of FASD ranged from 0.01 to 0.31%. A greater percentage of children with FASD had teacher-reported home problems that interfered with their classroom functioning. Overall children with FASD had higher mean scores on the developmental domains compared to children with NDDs. Results of the current study can inform strategies and policies for early identification and intervention., Author(s): Jacqueline Pei [sup.1] , Caroline Reid-Westoby [sup.2] , Ayesha Siddiqua [sup.3] , Yomna Elshamy [sup.1] , Devyn Rorem [sup.1] , Teresa Bennett [sup.2] , Catherine Birken [sup.4] [sup.5] , [...]

Background and Aims: Behavioral economic theory predicts that high alcohol demand and high proportionate alcohol‐related reinforcement are important determinants of risky alcohol use in emerging adults, but the majority of research to date has been cross‐sectional in nature. The present study investigated prospective and dynamic relationships between alcohol demand and proportionate alcohol‐related reinforcement in relation to heavy drinking days and alcohol problems. Design: Longitudinal cohort with assessments every 4 months for 20 months. Setting: Ontario, Canada. Participants: Emerging adults reporting regular heavy episodic drinking (n = 636, Mage = 21.44; 55.8% female). Measurements Heavy drinking days (HDD; Daily Drinking Questionnaire), alcohol problems (Brief Young Adult Alcohol Consequences Questionnaire), alcohol demand (Alcohol Purchase Task) and proportionate alcohol‐related reinforcement (Activity Level Questionnaire). Findings Linear mixed effects models revealed that behavioral economic indicators and alcohol‐related outcomes significantly decreased over the study, consistent with 'aging out' of risky alcohol use. Random intercept cross‐lagged panel models revealed significant between‐person relationships, such that higher alcohol demand and alcohol‐related reinforcement were positively associated with HDD and alcohol problems (random intercepts = 0.187–0.534, Ps < 0.01). Moreover, alcohol demand indicators (particularly the rate of change in elasticity of the demand curve, as measured by α, and the maximum expenditure, Omax) and proportionate alcohol‐related reinforcement significantly forecasted changes in HDD at all time points (|βs| = 0.063–0.103, Ps < 0.05) in cross‐lagged relationships, with bidirectional associations noted for the rate of change in elasticity (βs = −0.085 to −0.104, Ps < 0.01). Proportionate alcohol‐related reinforcement also significantly forecasted changes in alcohol problems at all time points (βs = 0.072–0.112, Ps < 0.01). Conclusions: Multiple behavioral economic indicators (demand elasticity, maximum expenditure and reinforcement ratio) forecast changes in heavy episodic drinking and alcohol problems over the course of emerging adulthood. These results further implicate alcohol demand and proportionate alcohol‐related reinforcement as etiologically and developmentally important mechanisms in alcohol use trajectories. [ABSTRACT FROM AUTHOR]