Search

BackgroundThis study assessed the extent to which women's preconception binge drinking, tobacco use and cannabis use, reported prospectively in adolescence and young adulthood, predicted use of these substances during pregnancy and at 1 year postpartum.MethodsData were pooled from two intergenerational cohort studies: the Australian Temperament Project Generation 3 Study (395 mothers, 691 pregnancies) and the Victorian Intergenerational Health Cohort Study (398 mothers, 609 pregnancies). Alcohol, tobacco and cannabis use were assessed in adolescence (13–18 years), young adulthood (19–29 years) and at ages 29–35 years for those transitioning to parenthood. Exposures were weekly or more frequent preconception binge drinking (5 + drinks in one session), tobacco use and cannabis use. Outcomes were any alcohol, tobacco and cannabis use prior to awareness of the pregnancy, after awareness of pregnancy (up to and including the third trimester pregnancy) and at 1 year postpartum.ResultsFrequent preconception binge drinking, tobacco use and cannabis use across both adolescence and young adulthood were strong predictors of continued use post-conception, before and after awareness of the pregnancy and at 1 year postpartum. Substance use limited to young adulthood also predicted continued use post-conception.ConclusionsPersistent alcohol, tobacco use and cannabis use that starts in adolescence has a strong continuity into parenthood. Reducing substance use in the perinatal period requires action well before pregnancy, commencing in adolescence and continuing into the years before conception and throughout the perinatal period.

Little is known about the association between mental health and diminished food worry during the COVID-19 pandemic. This paper examines worry about having enough food to meet household needs and its association with mental health during the early months of the pandemic in Canada.Data are drawn from the first round of a multi-round mental health monitoring survey. Online surveys were administered between May 14 and 29, 2020, to a nationally representative sample of Canadian adults (n = 3000). Logistic regression models were used to examine associations between food worry and mental health indicators (anxious/worried, depressed, worse mental health compared with pre-pandemic, and suicidal thoughts/feelings), after adjusting for socio-demographic characteristics and pre-existing mental health conditions. Fully adjusted models explored the impact of controlling for financial worry due to the pandemic in the previous 2 weeks.Overall, 17.3% of the sample reported food worry due to the pandemic in the previous 2 weeks, with the highest prevalence found among those with a reported disability (29.3%), Indigenous identity (27.1%), or pre-existing mental health condition (25.3%). Compared with participants who did not report food worry, those who did had higher odds of reporting feeling anxious/worried (OR=1.36, 95% CI: 1.08-1.71) and suicidal thoughts/feelings (OR=1.87, 95% CI: 1.24-2.80) when controlling for socio-demographics, pre-existing mental health conditions, and financial worry.This paper provides insights about the associations between food worry and mental health in Canada during the COVID-19 pandemic and indicates the need for improved policies and social supports to mitigate food worry and associated mental health outcomes.RéSUMé: OBJECTIF: On en sait peu sur l’association entre la santé mentale et la diminution des inquiétudes liées à la nourriture durant la pandémie de COVID-19. Notre article porte sur l’inquiétude de ne pas avoir suffisamment de nourriture pour répondre aux besoins du ménage et son association avec la santé mentale au cours des premiers mois de la pandémie au Canada. MéTHODE: Nos données proviennent du premier cycle d’une enquête de surveillance de la santé mentale. Des sondages en ligne ont été administrés entre le 14 et le 29 mai 2020 à un échantillon national représentatif de Canadiennes et de Canadiens adultes (n = 3 000). Des modèles de régression logistique ont servi à examiner les associations entre les inquiétudes liées à la nourriture et quelques indicateurs de santé mentale (anxiété/inquiétude, dépression, santé mentale pire qu’avant la pandémie, pensées/sentiments suicidaires) après l’apport d’ajustements pour tenir compte du profil sociodémographique et des troubles de santé mentale préexistants. À l’aide de modèles entièrement ajustés, nous avons exploré l’effet de la prise en compte des soucis financiers dus à la pandémie au cours des deux semaines antérieures. RéSULTATS: Dans l’ensemble, le pourcentage de l’échantillon ayant fait état d’inquiétudes liées à la nourriture dues à la pandémie au cours des deux semaines antérieures était de 17,3 %, la plus forte prévalence ayant été constatée chez les répondants ayant un handicap déclaré (29,3 %), une identité autochtone (27,1 %) ou un trouble de santé mental préexistant (25,3 %). Comparativement aux participants n’ayant fait état d’aucune inquiétude liée à la nourriture, ceux qui ont fait état de telles inquiétudes présentaient une plus forte probabilité d’avoir déclaré des sentiments d’anxiété ou d’inquiétude (RC = 1,36, IC de 95 % : 1,08-1,71) et des pensées ou sentiments suicidaires (RC = 1,87, IC de 95 % : 1,24-2,80) après la prise en compte du profil sociodémographique, des troubles de santé mentale préexistants et des soucis financiers. CONCLUSION: Notre article jette un éclairage sur les associations entre les inquiétudes liées à la nourriture et la santé mentale au Canada durant la pandémie de COVID-19 et montre qu’il faudrait améliorer les politiques et les mesures de soutien social pour atténuer les inquiétudes liées à la nourriture et les résultats de santé mentale associés.

Introduction In extending work on early life antecedents of parenting, we investigate associations between childhood family history of disadvantage, adolescent socioemotional wellbeing, and age at first parenthood and subsequent parenting behaviour. Methods Parent-child interactions were recorded when participants in the longitudinal Dunedin Multidisciplinary Health and Development Study (New Zealand) had a three-year-old child. Data were available for 358 mothers and 321 fathers, aged between 17.7 and 41.5 at the time of their child's birth. Associations between parenting and antecedent data on socioeconomic disadvantage, adolescent wellbeing and mental health, as well as current adult mental health and age at parenting, were tested for using structural equation modelling. Results Family disadvantage in childhood and lower adolescent wellbeing was associated with less positive future parenting, but only adult (not adolescent) anxiety/depression symptoms were directly associated with parenting behaviour. Childhood family disadvantage was associated with further disadvantage across the life course that included less positive parenting of the next generation. In contrast, socioemotional wellbeing during adolescence and later age of onset of parenting were associated with more positive parenting. Conclusions Reducing childhood disadvantage and improving socioemotional wellbeing during childhood and adolescence is likely to have intergenerational benefits through better parenting of the next generation.

To examine associations between anxiety and depressive symptoms across adolescence and young adulthood with subsequent maternal- and paternal–infant bonding at 1 year postpartum. The data were from a prospective, intergenerational cohort study. Participants (381 mothers of 648 infants; 277 fathers of 421 infants) self-reported depression and anxiety at three adolescent waves (ages 13, 15 and 17 years) and three young adult waves (ages 19, 23 and 27 years). Subsequent parent–infant bonds with infants were reported at 1 year postpartum (parent age 29–35 years). Generalised estimating equations (GEE) separately assessed associations for mothers and fathers. Mean postpartum bonding scores were approximately half a standard deviation lower in parents with a history of persistent adolescent and young adult depressive symptoms (maternal βadj = − 0.45, 95% CI − 0.69, − 0.21; paternal βadj = − 0.55, 95% CI − 0.90, 0.20) or anxiety (maternal βadj = − 0.42, 95% CI − 0.66, − 0.18; paternal βadj = − 0.49, 95% CI − 0.95, 0.03). Associations were still mostly evident, but attenuated after further adjustment for postpartum mental health concurrent with measurement of bonding. Persistent symptoms of depression or anxiety spanning adolescence and young adulthood predict poorer emotional bonding with infants 1-year postbirth for both mothers and fathers.

Background Parental depression and anxiety have been consistently linked to offspring behavior problems across childhood. However, many of the risks for these common mental health problems are established well before pregnancy. This study takes advantage of rare, prospective data to examine relations between parental mental health histories (from adolescence onwards) and next generation offspring behavior problems. Methods Data were drawn from a multi-generational cohort study that has followed Australians from infancy to adulthood since 1983, and 1171 of their offspring assessed prospectively from pregnancy. Generalized estimating equation models were used to estimate associations between parents’ depression/anxiety symptoms in adolescence and young adulthood and offspring behavior problems at 1 year. Results In analyses of 648 mother-infant and 423 father-infant dyads, after adjustment for confounders and concurrent mental health problems, mean behavior problem scores in infants of mothers with a history of mental health problems in both adolescence and young adulthood were over half a standard deviation higher than those of mothers without problems during these periods, B = 2.19, 95% CI 1.21 – 3.17, β = 0.52. No association was observed for fathers. Limitations We only included infants born to participants aged 29–35 years and we assessed behavior problems via parent-report. Conclusions A mother's history of persistent depression and anxiety from adolescence to young adulthood can predict higher levels of behavior problems in her infant. Findings support calls for greater policy and prevention focus on preconception and postnatal mental health, particularly a mother's early emotional health history, prior to parenthood.

This study assessed gay, bisexual, and other men who have sex with men's (GBMSM) awareness of and intention to use GetCheckedOnline, an online sexually transmitted and blood-borne infection (STBBI) testing service.A cross-sectional study was conducted two years after launch among GBMSM 18 years of age in British Columbia, Canada. Participants were recruited through community venues, clinics, websites, and apps.Of 1272 participants, 32% were aware of GetCheckedOnline. Gay identity, regularly testing at an STBBI clinic, being out to one's healthcare provider, attending GBMSM community venues, and frequent social media use were associated with awareness. Among participants who were aware but had not used GetCheckedOnline, knowing GetCheckedOnline users, using social media, not knowing where else to test, and not wanting to see a doctor were associated with intention to use GetCheckedOnline.Early promotion of GetCheckedOnline resulted in greater awareness among those connected to GBMSM.RéSUMé: OBJECTIFS: Évaluer chez les hommes gais, bisexuels et les hommes ayant des relations sexuelles avec des hommes (gbHARSAH) la connaissance de GetCheckedOnline, un service de dépistage en ligne des infections transmissibles sexuellement et par le sang (ITSS), et l’intention d’utiliser ce service. MéTHODE: Deux ans après le lancement du service, une étude transversale a été menée auprès d’hommes gbHARSAH de plus de 18 ans en Colombie-Britannique, au Canada. Les participants ont été recrutés dans les milieux associatifs, les cliniques, sur des sites Web et au moyen d’applications. RéSULTATS: Sur 1 272 participants, 32 % connaissaient GetCheckedOnline. L’identité gaie, le dépistage périodique à une clinique d’ITSS, le fait d’avoir dévoilé son orientation sexuelle à son dispensateur de soins de santé, la fréquentation de milieux associatifs pour hommes gbHARSAH et l’utilisation fréquente des médias sociaux étaient associés à la connaissance du service. Chez les participants qui connaissaient GetCheckedOnline mais qui ne l’avaient pas utilisé, le fait de connaître des utilisateurs de GetCheckedOnline, l’utilisation des médias sociaux, le fait de ne pas savoir où se faire tester ailleurs et le fait de ne pas vouloir voir un médecin étaient associés à l’intention d’utiliser GetCheckedOnline. CONCLUSION: La promotion précoce de GetCheckedOnline a rehaussé la visibilité de ce service dans les milieux en lien avec les hommes gbHARSAH.

Purpose Much of the extant research on quality-of-life (QoL) in homelessness has focused narrowly on health-related QoL. Far less is known about broader subjective quality-of-life (SQoL). The purpose of this study was to examine levels and predictors of SQoL among homeless and vulnerably housed individuals in a 4-year longitudinal study. Methods Data were from the Health and Housing in Transition (HHiT) study, a prospective cohort study of 1190 individuals from three Canadian cities who were homeless or vulnerably housed. SQoL was measured using a scale designed specifically for this population. Predictor variables were time-varying indicators of housing status, substance use, and social support as well as baseline measures of physical and mental health problems. Generalized estimating equation (GEE) analysis examined these predictors of SQoL, adjusting for baseline age, gender, ethnicity, employment, income, and city of residence. Results Participants at baseline were 18 to 80 years old (M = 42.2; SD = 10.6), 66% male, 63% White, 60% unemployed, and 50% were currently homeless. Most areas of SQoL tended toward slight satisfaction, with dissatisfaction concerning finance and employment as notable exceptions. Demographic variables were not associated with SQoL. Homelessness and self-reported presence of 3+ chronic health conditions, mental health problems, and problematic substance use, as well as lower perceived social support, were independently associated with lower SQoL. Conclusions SQoL shows variation across different life areas for homeless and vulnerably housed individuals. In order to improve SQoL in this population, it is important to address poverty, employment, housing challenges, mental and physical health problems, and substance use as well as increase social supports.

ObjectivesTo describe the factors that influence gay, bisexual and other men who have sex with men’s (gbMSM) experiences with GetCheckedOnline.com (GCO) in British Columbia (BC), Canada. GCO clients complete an internet-based risk assessment and print a laboratory test requisition form for HIV and other STIs to take to a private laboratory for diagnostic services.MethodsDrawing on a purposive stratified sampling framework, we conducted 37 in-depth semistructured interviews with gbMSM who had used GCO at least once between 2015 and 2017.ResultsParticipants expressed a preference for GCO (instead of clinic-based testing) because of convenience, privacy and control over specimen collection (specifically with doing one’s own throat or anal swab). Participants preferred receiving their results online via GCO compared with phone or email follow-up by clinic staff. GCO was viewed positively because it offers gbMSM living outside of urban city centres easy access to diagnostic services, including access to pooled nucleic acid amplification testing. Many participants also continued to positively view the clinic-based services available for gbMSM in their community. These services were frequently described as highly competent, tailored and comprehensive in responding to more complex needs. For example, attending a clinic was viewed as preferential to GCO in instances where there was a desire to access services addressing co-occurring health issues (eg, mental health; substance use disorders). Almost all of the participants anticipated using both GCO and clinic-based services in the future.ConclusionsgbMSM report positive experiences and perceptions of GCO; however, they do not view GCO as a panacea. The results of this study point to the need to ensure that a wide range of integrated service options (eg, online; clinic-based) are available to address the range of sexual health needs of gbMSM living in BC's diverse settings.

Postnatal depression (PND) is common and predicts a range of adverse maternal and offspring outcomes. PND rates are highest among women with persistent mental health problems before pregnancy, and antenatal healthcare provides ideal opportunity to intervene. We examined antenatal perceived social support as a potential intervention target in preventing PND symptoms among women with prior mental health problems. A total of 398 Australian women (600 pregnancies) were assessed repeatedly for mental health problems before pregnancy (ages 14–29 years, 1992–2006), and again during pregnancy, two months postpartum and one year postpartum (2006–2014). Causal mediation analysis found that intervention on perceived antenatal social support has the potential to reduce rates of PND symptoms by up to 3% (from 15 to 12%) in women with persistent preconception symptoms. Supplementary analyses found that the role of low antenatal social support was independent of concurrent antenatal depressive symptoms. Combined, these two factors mediated up to more than half of the association between preconception mental health problems and PND symptoms. Trialling dual interventions on antenatal depressive symptoms and perceived social support represents one promising strategy to prevent PND in women with persistent preconception symptoms. Interventions promoting mental health before pregnancy may yield an even greater reduction in PND symptoms by disrupting a developmental cascade of risks via these and other pathways.This article is part of the theme issue ‘Multidisciplinary perspectives on social support and maternal–child health’.

ObjectivesIn the first wave of the COVID-19 pandemic, social isolation, school/child care closures and employment instability have created unprecedented conditions for families raising children at home. This study describes the mental health impacts of the COVID-19 pandemic on families with children in Canada.Design, setting and participantsThis descriptive study used a nationally representative, cross-sectional survey of adults living in Canada (n=3000) to examine the mental health impacts of the COVID-19 pandemic. Outcomes among parents with children Outcome measuresParticipants reported on changes to their mental health since the onset of the pandemic and sources of stress, emotional responses, substance use patterns and suicidality/self-harm. Additionally, parents identified changes in their interactions with their children, impacts on their children’s mental health and sources of support accessed.Results44.3% of parents with children 2 (1, n=3000)=16.2, p2 (1, n=3000)=43.8, p2 (1, n=3000)=8.0, p=0.005) and stress about being safe from physical/emotional domestic violence (11.5% vs 7.9%, χ2 (1, n=3000)=8.1, p=0.005). 24.8% (95% CI 21.4 to 28.4) of parents reported their children’s mental health had worsened since the pandemic. Parents also reported more frequent negative as well as positive interactions with their children due to the pandemic (eg, more conflicts, 22.2% (95% CI 19.0 to 25.7); increased feelings of closeness, 49.7% (95% CI 45.7 to 53.7)).ConclusionsThis study identifies that families with children

Background The COVID-19 pandemic has resulted in profound mental health impacts among the general population worldwide. As many in-person mental health support services have been suspended or transitioned online to facilitate physical distancing, there have been numerous calls for the rapid expansion of asynchronous virtual mental health (AVMH) resources. These AVMH resources have great potential to provide support for people coping with negative mental health impacts associated with the pandemic; however, literature examining use prior to COVID-19 illustrates that the uptake of these resources is consistently low. Objective The aim of this paper is to examine the use of AVMH resources in Canada during the COVID-19 pandemic among the general population and among a participant subgroup classified as experiencing an adverse mental health impact related to the pandemic. Methods Data from this study were drawn from the first wave of a large multiwave cross-sectional monitoring survey, distributed from May 14 to 29, 2020. Participants (N=3000) were adults living in Canada. Descriptive statistics were used to characterize the sample, and bivariate cross-tabulations were used to examine the relationships between the use of AVMH resources and self-reported indicators of mental health that included a range of emotional and coping-related responses to the pandemic. Univariate and fully adjusted multivariate logistic regression models were used to examine associations between sociodemographic and health-related characteristics and use of AVMH resources in the subgroup of participants who reported experiencing one or more adverse mental health impacts identified in the set of self-reported mental health indicators. Results Among the total sample, 2.0% (n=59) of participants reported accessing AVMH resources in the prior 2 weeks to cope with stress related to the COVID-19 pandemic, with the highest rates of use among individuals who reported self-harm (n=5, 10.4%) and those who reported coping “not well” with COVID-19–related stress (n=22, 5.5%). Within the subgroup of 1954 participants (65.1% of the total sample) who reported an adverse mental health impact related to COVID-19, 54 (2.8%) reported use of AVMH resources. Individuals were more likely to have used AVMH resources if they had reported receiving in-person mental health supports, were connecting virtually with a mental health worker or counselor, or belonged to a visible minority group. Conclusions Despite substantial government investment into AVMH resources, uptake is low among both the general population and individuals who may benefit from the use of these resources as a means of coping with the adverse mental health impacts of the COVID-19 pandemic. Further research is needed to improve our understanding of the barriers to use.

BackgroundRates of common mental health problems (depression/anxiety) rise sharply in adolescence and peak in young adulthood, often coinciding with the transition to parenthood. Little is known regarding the persistence of common mental health problems from adolescence to the perinatal period in both mothers and fathers.MethodsA total of 393 mothers (686 pregnancies) and 257 fathers (357 pregnancies) from the intergenerational Australian Temperament Project Generation 3 Study completed self-report assessments of depression and anxiety in adolescence (ages 13–14, 15–16, 17–18 years) and young adulthood (ages 19–20, 23–24, 27–28 years). The Edinburgh Postnatal Depression Scale was used to assess depressive symptoms at 32 weeks pregnancy and 12 months postpartum in mothers, and at 12 months postpartum in fathers.ResultsMost pregnancies (81%) in which mothers reported perinatal depression were preceded by a history of mental health problems in adolescence or young adulthood. Similarly, most pregnancies (83%) in which fathers reported postnatal depression were preceded by a preconception history of mental health problems. After adjustment for potential confounders, the odds of self-reporting perinatal depression in both women and men were consistently higher in those with a history of persistent mental health problems across adolescence and young adulthood than those without (ORwomen 5.7, 95% CI 2.9–10.9; ORmen 5.5, 95% CI 1.03–29.70).ConclusionsPerinatal depression, for the majority of parents, is a continuation of mental health problems with onsets well before pregnancy. Strategies to promote good perinatal mental health should start before parenthood and include both men and women.

Objectives The present study examined the degree to which early adolescents' relationship experiences in school (i.e., peer group belonging, peer victimization, and supportive relationships with adults)—at the individual level and at the school-level—were associated with their dispositional optimism, concurrently and over time. Method Self-report data from over 4000 4th and 7th graders were obtained via a population-level measure designed to assess students' supportive relationships, well-being, and resilience (i.e., the Middle Years Development Instrument). An indicator for family income (SES) was obtained through tax filer information. Results Multilevel modeling revealed that in Grade 4, greater peer belonging, fewer experiences of peer victimization, and higher levels of adult support in school were linked to higher optimism, above and beyond the effects of sex, age, English as a Second Language (ESL), and SES. Additionally, school-wide levels of peer belonging and adult support (i.e., indicators of a supportive social school climate) were significant positive school-level predictors of optimism. Longitudinally, school-wide peer belonging in Grade 4 was associated to increases in students' optimism from 4th to 7th grade. Conclusions The findings suggest that positive relationship experiences in school are key contributors to positive mental health, over and above the absence of negative relationship experiences (i.e., victimization). These findings also suggest that being embedded in a school with a positive social relational climate contributes to students' current and future positive mental health, over and above individual relationships with peers and adults. The present research extends previous research by identifying contextual assets that are linked to dispositional optimism and can be applied in the context of school-based intervention programs to promote positive mental health in schools.

This paper discusses the conceptualization, development, validation, and application of the Middle Years Development Instrument (MDI) – a population-based child self-report tool that assesses children's social-emotional development and well-being in the context of their home, school, and neighborhood. The MDI is administered at a population-level to 4th and 7th grade students within participating public school districts across British Columbia, Canada. Children respond to items in five domains: (1) social-emotional development, (2) connectedness to peers and adults, (3) school experiences, (4) physical health and well-being, and (5) constructive use of after-school time. Results are aggregated for schools and communities and reported back in comprehensive reports and community maps to inform planning and decision making at local and regional levels. Shared testimonials exemplify how MDI results have been used by educators, community organizers, and city planners as a catalyst for promoting children's social and emotional competence and facilitating collaboration between schools and communities.

ObjectivesInternet-based STI testing programmes may overcome barriers posed by in-clinic testing, though uptake could reflect social gradients. The role these services play in comparison to clinical testing services is unknown. We compared experiences of testing barriers between STI clinic clients to clients of GetCheckedOnline.com (GCO; where clients take a printed lab form to a lab).MethodsOur 10-month cross-sectional study was conducted after GCO was promoted to STI clinic clients and men who have sex with men (MSM). Clinic and GCO clients completed an online survey assessing testing barriers and facilitators; responses were compared using bivariate analysis (level of significance PResultsCompared with 321 clinic clients, the 73 GCO clients were more likely to be older (median 35 vs 30 years), MSM (45% vs 16%), be testing routinely (67% vs 39%), have delayed testing for any reason (76% vs 54%) and due to clinic distance (28% vs 9%), report delays due to wait times (50% vs 17%), embarrassment with testing (16% vs 6%), discomfort discussing sexual health where they usually go for testing (39% vs 22%), as well as discomfort discussing sexual history with (19% vs 5%) and fearing judgement from (30% vs 15%) any healthcare provider. GCO clients were less likely to have found clinic hours convenient (59% vs 77%) and clinic appointments easy to make (49% vs 66%), and more likely to report long wait times (50% vs 17%). We found no differences in technology skills/use.ConclusionsIn this urban setting, an internet-based testing service effectively engaged individuals experiencing testing barriers, with few social gradients in uptake. While some testing barriers could be addressed through increasing access to clinical services, others require social and structural changes, highlighting the importance of internet-based STI testing services to increasing test uptake.

Investigating the determinants of positive mental health, as opposed to focusing on mental illness, is a new research direction with important implications for population health promotion. Past research suggests that mental health develops in early childhood and that social factors including highest household educational attainment may play an important role. The current study examined the association between household educational attainment and adolescent self-reported positive mental health in a nationally representative Canadian sample using data from the 2011-12 Canadian Community Health Survey. The sample included 10,091 adolescents aged 12 to19 living at home with at least one parent. Household educational attainment was obtained from a Statistics Canada derived variable documenting the highest level of education in the household. Adolescent positive mental health was assessed using the Mental Health Continuum scale. Multivariable logistic regression analyses showed that after adjusting for household income, single parent status, and household size, adolescents had lower odds of experiencing positive mental health in households in which attempted but not completed post-secondary was the highest education level compared to completed post-secondary education (OR = 0.64, 95% CI = 0.44, 0.95). This association was strongest in adolescents aged 12 to14 (OR = 0.43, 95% CI = 0.21, 0.84) and females (OR = 0.50, 95% CI = 0.29, 0.88). Contrary to expectations, we did not find an incremental increasing association between adolescent positive mental health and household educational attainment. Instead, results suggested that common underlying factors may have contributed both to uncompleted post-secondary education in the household and adolescents’ diminished positive mental health., Highlights • Social factors including household educational attainment have been shown to predict child and adolescent mental health problems. • Associations with young people’s positive mental health are less clear. • Adolescents self-reported their positive mental health in a national survey. • Household non-completion of post-secondary school was associated with lower adolescent positive mental health. • This association was stronger among younger adolescents and females.

Evidence on the population-level mental health impacts of COVID-19 are beginning to amass; however, to date, there are significant gaps in our understandings of whose mental health is most impacted, how the pandemic is contributing to widening mental health inequities, and the coping strategies being used to sustain mental health. The first wave of a repeated cross-sectional monitoring survey was conducted between May 14-29, 2020 to assess the mental health impacts of the pandemic and to identify the disproportionate impacts on populations or groups identified as experiencing increased risks due to structural vulnerability and pre-existing health and social inequities. Respondents included a nationally representative probability sample (n = 3000) of Canadian adults 18 years and older. Overall, Canadian populations are experiencing a deterioration in mental health and coping due to the pandemic. Those who experience health, social, and/or structural vulnerabilities due to pre-existing mental health conditions, disability, income, ethnicity, sexuality, and/or gender are more likely to endorse mental health deterioration, challenging emotions, and difficulties coping. This monitoring study highlights the differential mental health impacts of the pandemic for those who experience health, social, and structural inequities. These data are critical to informing responsive, equity-oriented public health, and policy responses in real-time to protect and promote the mental health of those most at risk during the pandemic and beyond.

Highlights • Adverse mental health outcomes due to COVID-19 quarantine vary by reason for quarantine • Quarantine is associated with suicidal thoughts except when done due to recent travel • Quarantine surveillance should include active mental health assessment and outreach • Individuals who have quarantined during the COVID-19 pandemic are at increased risk for adverse mental health consequences beyond the quarantine period itself and should receive “flagged” for ongoing mental health monitoring, Since the onset of the COVID-19 pandemic, many jurisdictions, including Canada, have made use of public health measures such as COVID-19 quarantine to reduce the transmission of the virus. To examine associations between these periods of quarantine and mental health, including suicidal ideation and deliberate self-harm, we examined data from a national survey of 3000 Canadian adults distributed between May 14-29, 2020. Notably, participants provided the reason(s) for quarantine. When pooling all reasons for quarantine together, this experience was associated with higher odds of suicidal ideation and deliberate self-harm in the two weeks preceding the survey. These associations remained even after controlling for age, household income, having a pre-existing mental health condition, being unemployed due to the pandemic, and living alone. However, the associations with mental health differed across reasons for quarantine; those who were self-isolating specifically due to recent travel were not found to have higher odds of suicidal ideation or deliberate self-harm. Our research suggests the importance of accounting for the reason(s) for quarantine in the implementation of this critical public health measure to reduce the mental health impacts of this experience.

ObjectiveInternet-based HIV testing offers the potential to address privacy-related barriers to testing and increase frequency of testing but may result in missed opportunities related to sexual health education and prevention that typically occur in face-to-face encounters. In this study, we assessed the HIV test knowledge and sexual risk behaviour of clients testing for HIV through GetCheckedOnline, an internet-based sexually transmitted and bloodborne infection testing platform inclusive of HIV testing, in comparison to clients testing through a large sexual health clinic.MethodsWe concurrently recruited GetCheckedOnline clients and clinic clients from Vancouver, Canada, over the course of a 10-month period during 2015–2016. Participants completed baseline and 3-month questionnaires, anonymous and online. A six-item score was used to estimate knowledge of HIV test concepts typically conveyed during an HIV pretest encounter in a clinic. We used multiple regression to estimate associations between testing modality (online vs clinic based) and two outcomes—HIV test knowledge and change in condom use pre/post-test—with adjustment for relevant background factors.ResultsAmong 352 participants, online testers demonstrated higher HIV post-test knowledge than clinic-based testers (mean score 4.65/6 vs 4.09/6; p0.05). Men who have sex with men, clients with a university degree, those who have lived in Canada >10 years and English speakers had higher HIV post-test knowledge (p0.05).ConclusionsIn this comparative study between online and clinic-based testers, we found no evidence of decreased HIV test knowledge or decreased condom use following HIV testing through GetCheckedOnline. Our findings suggest that with careful design and attention to educational content, online testing services may not lead to missed opportunities for HIV education and counselling.

Objectives To describe the factors that influence gay, bisexual and other men who have sex with men’s (gbMSM) experiences with GetCheckedOnline.com (GCO) in British Columbia (BC), Canada. GCO clients complete an internet-based risk assessment and print a laboratory test requisition form for HIV and other STIs to take to a private laboratory for diagnostic services. Methods Drawing on a purposive stratified sampling framework, we conducted 37 in-depth semistructured interviews with gbMSM who had used GCO at least once between 2015 and 2017. Results Participants expressed a preference for GCO (instead of clinic-based testing) because of convenience, privacy and control over specimen collection (specifically with doing one’s own throat or anal swab). Participants preferred receiving their results online via GCO compared with phone or email follow-up by clinic staff. GCO was viewed positively because it offers gbMSM living outside of urban city centres easy access to diagnostic services, including access to pooled nucleic acid amplification testing. Many participants also continued to positively view the clinic-based services available for gbMSM in their community. These services were frequently described as highly competent, tailored and comprehensive in responding to more complex needs. For example, attending a clinic was viewed as preferential to GCO in instances where there was a desire to access services addressing co-occurring health issues (eg, mental health; substance use disorders). Almost all of the participants anticipated using both GCO and clinic-based services in the future. Conclusions gbMSM report positive experiences and perceptions of GCO; however, they do not view GCO as a panacea. The results of this study point to the need to ensure that a wide range of integrated service options (eg, online; clinic-based) are available to address the range of sexual health needs of gbMSM living in BC's diverse settings.

This study investigated how various risk and protective factors interface with child health and well-being at the population level. Specifically, we examined the association of income, social-contextual variables, and indicators of health-related habits and activities to children’s life satisfaction and perceived overall health. Child data were collected via a self-report survey, the Middle Years Development Instrument, which was administered in three demographically diverse Canadian school districts to 5026 grade 4 students (83 % of the students had complete data and were included in the analyses). Multiple regression and mediation analyses were conducted to examine the joint associations of social relationships with adults and peers, nutrition and sleep habits, and after school sports activities with children’s satisfaction with life and perceived health. Results indicate that peer belonging and relationships with adults at home and school were the strongest predictors of life satisfaction. Furthermore, the (small) association between income and life satisfaction was mediated by social relationship variables. Child reports of perceived health were predicted by peer belonging, adult relationships (home, school, neighborhood), after-school team sports, and nutrition habits. The (small) association between income and health was mediated by social relationships and team sports participation. Findings are discussed in light of previous research on social determinants and socio-economic gradients of children’s health and life satisfaction.

Mindfulness-based interventions (MBIs) can reduce teachers’ stress. The purpose of this mixed-method study, conducted within the context of a randomized-control trial of an MBI for teachers, was to examine four potential ways by which the MBI reduced teacher stress, including by (1) increasing their efficacy for regulating emotion on the job; (2) improving their ways of coping with stress at work; (3) increasing their efficacy for forgiving colleagues and students at work following conflict, as well as the tendency to do so; and (4) increasing teachers’ tendency to feel compassion for people generally, and for challenging students in particular. Public school teachers (n = 59) were randomized to an MBI or a waitlist control condition. They completed surveys at pre/post/follow-up and interviews at post-program designed to assess their coping with work stressors and their appraisals of their most challenging students. Survey data showed that efficacy beliefs and the tendency to forgive changed from pre/post for teachers in the MBI, and partially mediated reductions in stress from baseline to 4-month follow-up. Interview results showed a trend for teachers in the MBI to report more adaptive strategies for coping with job stress, and a tendency to evaluate challenging students in a more positive affective light. Implications for MBIs in teacher professional development are discussed.

Introduction In Sept 2014, the BC Centre for Disease Control (BCCDC) launched GetCheckedOnline (GCO), an online testing service for STI/HIV which is integrated with clinical and public health services and developed to reduce testing barriers. Based on a successful pilot in urban Vancouver (BC’s largest city) and alignment with regional health authority testing priorities, GCO was expanded to five other urban, suburban and rural communities across BC in Feb 2016. Here we examine differences in GCO uptake between Vancouver and expansion sites from the first year of scale-up in British Columbia (BC). Methods We used routinely collected GCO program data in combination with BC Public Health Laboratory testing data to describe differences between GCO clients in Vancouver and expansion sites. We compared demographic characteristics and testing history as well as key program measures including service uptake (percent creating a GCO account who submitted specimens) and positivity rates (percent positive of specimens submitted). Results Between Feb-Dec 2016, of 2397 clients creating accounts, 1297 (54%) submitted specimens; uptake was slightly lower in expansion sites (577 specimens, 51%) vs. Vancouver (720, 57%; p=0.001), with comparable positivity rates (6% vs. 5%; p=0.77). Compared to Vancouver, GCO clients in expansion sites were more likely to be younger (20–24 years of age) (20% vs. 13%) and symptomatic (20% vs. 14%), and less likely to be men who have sex with men (22% vs. 42%; p≤0.001 for all). GCO clients in expansion sites were more likely to be testing for the first time for both HIV (22% vs. 9%) and STI (16% vs. 9%; p Conclusion Scale-up of GCO to five smaller urban, suburban and rural communities across BC demonstrated differences in uptake and populations reached, including greater engagement of individuals not previously tested. Our study highlights the importance of differing regional contexts on the impact of online testing services and the need for their evaluation during scale-up.

Introduction Positive user experiences are key to trust and repeated use of online services (known as e-Loyalty). GetCheckedOnline (GCO) is an online testing service for HIV/STI where clients complete a risk assessment, print lab forms, submit specimens at a lab, and retrieve results online (if negative) or by phone. We surveyed GCO clients on their perceptions of using the service. Methods We invited first-time GCO users (who consented to be contacted for research) to complete an anonymous online survey 2 weeks following reporting of test results. Survey questions were analysed descriptively and included demographics, reason for test, and how participants heard about GCO. Satisfaction, convenience, ease of use, and e-Loyalty (intention to use again, recommend to others) were measured using 5-point Likert scales and collapsed (low to neutral vs high responses). Results Between July 2015-Sept 2016, 23% of 1099 first-time GCO users consented to be contacted for research and 136/208 (65%) of users contacted agreed to participate in the survey. Participants had a median age of 33 years, 80% were white, 67% male, 43% straight, and 43% men who have sex with men. The most common testing reasons were: routine test (64%), risk event/exposure (44%) and new relationship (22%). Participants heard about GCO from clinics/health providers (38%), campaigns (26%), social media (18%), and friends or partners (13%). Almost all participants were satisfied with GCO overall (93%) and with their experience of receiving results (96%), 92% agreed GCO was convenient, 87% found GCO easy to use, and 83% rated the experience of submitting specimens as good or excellent. E-Loyalty was also high: 97% intended to use GCO again and 96% would recommend GCO to others. Conclusion We found very high satisfaction with and loyalty to GCO among first-time users, indicating a successful service model from a client perspective. In addition to uptake and test outcomes, user experience is a key outcome for evaluation of online HIV/STI testing services.

Introduction Youth and men who have sex with men (MSM) are two priority populations with regards to sexual risk, HIV/STI prevalence, and barriers to sexual healthcare. In 2014, an online HIV/STI testing service called GetCheckedOnline (GCO) was implemented in Vancouver, Canada to address several barriers to testing. We investigated the acceptability and perceptions of GCO among youth and MSM, and identified how various social positions related to age, sexual identity, and geography affected preferences for online versus in-person testing. Methods We conducted in-depth, semi-structured interviews with 12 youth (ages 23–29) and 19 MSM (ages 30–71) who had used GCO at least once. Interviews were analysed for emergent themes and participants’ sociodemographic data were collected via a brief questionnaire. Results Youth participants identified predominantly as male (92%), Caucasian (58%), and heterosexual (50%). MSM participants identified as male (100%); Caucasian (84%); and gay, bisexual, or pansexual (68%, 26%, 5%). Both populations were motivated to use online testing for: convenience, not having to wait to get tested at a clinic, increased privacy/anonymity, and avoiding judgment from healthcare providers. Additionally, youth perceived online testing as modern and “the future.” MSM participants perceived GCO as providing increased control over tests ordered and decreased anxiety due to receiving results faster. For three rurally-based MSM, GCO offered a way to test discreetly without identifying one’s sexual orientation to a healthcare provider. Even among participants who reported routinely accessing face-to-face health services (including for health concerns other than STIs), GCO was described by most interviewees as advantageous in terms of convenience and privacy. Overall, 83% of youth and 84% of MSM said they would use GCO again. Conclusion GCO was regarded as an acceptable and preferred option for accessing testing. Convenience was the most common reason for wanting to test online, although this varied somewhat by age, sexual orientation, and geography.

Introduction Online STI testing programs are thought to overcome barriers posed by in-clinic testing, though uptake could reflect social gradients (e.g., technology access, higher education). To understand types of barriers mitigated by online STI testing we compared clients of a large STI clinic to clients of GetCheckedOnline (GCO). Methods Our study was conducted in Vancouver after GCO was promoted to provincial STI clinic clients and men who have sex with men (MSM). Clinic and GCO clients were invited to an online survey 2 weeks after receiving test results. Survey questions included barriers/facilitators of testing at individual, provider, clinic and societal levels. We conducted bivariate comparisons between groups (significant results shown at p Results GCO (n=87) were older than clinic clients (n=424; median 35 vs. 31 years) and a higher proportion were MSM (40.2% vs. 24.4. More GCO clients reported their reason for testing as routine (58.1% vs. 38.9%) and fewer for symptoms or STI contact (10.3% vs 33.5%). More GCO clients considered accessing online health resources important (76.1% vs 56.5%) but otherwise did not differ on technology skills/use. GCO clients were more likely to report delaying testing in the past year due to clinic distance (22.4% vs 9.7%), less likely to agree that clinic hours were convenient (58.2% vs 77.2%) or that making appointments was easy (49.4% vs. 65.4%), and more likely to report long wait times to see a health care provider (HCP) (47.6% vs 20.7%). GCO clients were more likely to be uncomfortable discussing their sexual history with HCP in general (15.5% vs 5.7%) and where they usually presented for health care (34.9% vs 20.6%), as well as reporting more fear of being judged by HCP (28.6% vs 15.4%). Conclusion Our study in Vancouver suggests that online testing services may effectively engage individuals with barriers to testing (i.e., clinic access, discomfort with HCP) with few social gradients in uptake. Further evaluation to verify these findings within different cities/populations is needed.

Introduction Online HIV/STI testing is an alternative to in-clinic testing, but may lead to missed opportunities for education due to the lack of provider-delivered pre/post-test counselling. GetCheckedOnline (GCO) is an online testing service offered through an urban STI clinic in Vancouver. It was designed to include concepts typically conveyed during in-clinic HIV counselling sessions (e.g., window period, public health reporting). The aim of this study was to compare knowledge of key HIV test concepts between clients testing through GCO and in-clinic. Methods GCO and clinic participants were concurrently recruited over 11 months. Participants were invited to complete an anonymous online survey 2 weeks after receipt of test results. Knowledge of key concepts related to HIV testing was measured using a 6-item true/false test previously developed through a modified Delphi process, cognitive testing and psychometric evaluation. Linear regression was used to assess the association between site (GCO vs. clinic) and overall test scores, after adjustment for age, education, immigration history, language, sexual orientation, and testing history. Results 404 HIV-negative participants were included in the analysis (73 GCO, 331 in-clinic). HIV test knowledge scores averaged 0.4 points higher among GCO (mean score 4.5) than among clinic (4.1) testers (p=0.01). Following adjustment for relevant covariates, this difference decreased to 0.2 points (p=0.15). Likewise, there was no difference in mean HIV test knowledge scores among first-time testers (n=50; 3.7 GCO, 3.6 in-clinic; p = 0.75). Conclusion Post-test knowledge of HIV test concepts addressed in standard pre-test counselling was high in both groups and not significantly different following adjustment. Our study suggests that equivalent education about core HIV testing concepts can be achieved through web-based HIV/STI testing, and illustrates the importance of designing services to intentionally address relevant educational messages covered in provider-delivered HIV test counselling.

Introduction Most research on the sexual health of gay, bisexual, and other men who have sex with men (MSM) relies upon convenience samples, which may not fully represent the MSM population. To investigate this form of selection bias, we concurrently sampled MSM from three distinct venue types, compared sociodemographic, behavioural, and STI testing characteristics across samples, and characterised the degree of overlap between them. Methods MSM 18+ years of age from British Columbia, Canada completed an anonymous survey during July-December 2016. Participants were recruited from: mobile sex-seeking apps (n=662); a MSM-branded STI clinic (n=303); and in-person at the Vancouver Pride Festival (n=307). Cross-sample comparisons with >10% relative difference and p Results MSM recruited from apps included more bisexual men (24%) than those recruited from the clinic (9%) or from Pride (7%), while MSM recruited from the clinic included more East Asian and Latino men (14% and 13%, respectively, vs. 13% and 6% from Pride, and vs. 5% and 3% recruited from apps). More 18–29 year-olds were recruited from the clinic (47%, vs. 29% Pride, 16% apps). A larger proportion of MSM recruited from apps reported >10 sex partners in the past year (35%, vs. 28% clinic, 21% Pride). Finally, more clinic participants tested for STI/HIV in the past year (82%) as compared with participants recruited from apps (75%) or Pride (73%). When asked which other venues they frequented, 19% of the total sample reported using all 3 recruitment venue types, while 11% of Pride participants, 7% of apps participants, and 4% of clinic participants reported only using the recruitment venue where sampled. Conclusion We found large differences between MSM sampled from apps, an STI clinic, and Pride, with 22% unlikely to be sampled if relying on a single venue type for recruitment. Our results underscore the importance of multiple sampling strategies in MSM research and provide specific cross-sample differences.

Introduction Gay, bisexual, and other men who have sex with men (MSM) in British Columbia (BC) have a high incidence of HIV/STI, with many reporting barriers to accessing testing. An online HIV/STI testing service, Get Checked Online (GCO), was launched in 2014 to reduce these barriers. In this study we examined reach and acceptability of GCO within the MSM community. Methods We surveyed MSM living in BC over 6 months in 2016. Participants were recruited at local pride events, bars, on the street, in sexual health clinics, through social media, and on gay hook-up apps and websites. Survey questions were analysed descriptively and included questions about the service itself, sexual health, technology use, and demographic characteristics. Results Of 1272 participants completing the survey, 78% identified as gay and 16% as bisexual, 73% identified as White, 52% reported being single, and 55% reported living in the city of Vancouver. 32% were aware of GCO, 13% had visited the website and 3% had tested through the service (10% among the 411 men aware of GCO). Among GCO-aware participants, 50% intended to test through the service in the future (vs. 47% among GCO-unaware), 51% reported talking about GCO with others and 22% knew someone who has used it. 46% reported that at times they would use GCO over their usual place of testing. The most common benefits reported by participants were testing without waiting for an appointment (50%), getting results online (46%), and saving time (38%). The most common drawbacks were not speaking with a doctor or nurse (39%), not being sure how the service works (26%), and worrying about the privacy of one’s online information (20%). Conclusion Approximately 2 years after GCO’s launch, a third of MSM in the region are aware of the service with 1 in 10 GCO-aware men testing through the service. Given high intention to use GCO, these findings highlight the importance of continuing promotion efforts to raise awareness of the service among MSM.

Optimism is associated with a number of positive health and life course outcomes among adults, yet less is known about the role of optimism during the formative early adolescent years. Using a strengths-based relational developmental systems model, this study explored the relation of dispositional optimism to individual-level characteristics and ecological assets in families, schools, and neighborhoods in a sample of early adolescents. Specifically, early adolescents’ optimism, personal characteristics (i.e., depressive symptoms, anxiety symptoms, self-concept, positive behavior), and ecological assets (i.e., perceived parent support, parent knowledge, dinner with an adult family member, school adult support, school connectedness, neighborhood adult support, neighborhood safe places) were assessed in 1,250 4th to 7th graders from 23 public elementary schools in seven urban school districts. Correlational and hierarchical regression analyses suggested that positive self-concept, low depressive symptoms, and high perceived parental support and school connectedness were most strongly associated with adolescents’ optimism. The importance of examining individual characteristics in conjunction with the relational features of early adolescents’ environments when understanding optimism is discussed.

Key Points Question What can population patterns of early childhood social-emotional functioning tell us about the emergence of mental health conditions? Findings In this cohort study that included 34 323 children in Canada, 6 latent social-emotional functioning profiles based on children’s relative strengths and vulnerabilities in social competence, internalizing, and externalizing symptoms at age 5 years were associated with the onset of subsequent mental health conditions between ages 6 and 14 years. Meaning This examination of early childhood social-emotional functioning profiles identified social disparities in profile membership and an association between profiles and the emergence of mental health conditions., Importance More than 50% of lifetime mental health disorders develop by early adolescence, and yet it is not well understood how early childhood social-emotional functioning varies in populations or how differences in functioning may be associated with emerging mental health conditions. Objectives To identify profiles of social-emotional functioning at kindergarten school entry (age 5 years) and to examine to what extent profiles are related to early-onset mental health conditions (ages 6-14 years). Design, Setting, and Participants This prospective cohort study followed up a population cohort of 34 552 children in British Columbia, Canada, from birth (born 1996-1998) to age 14 years (last follow-up, December 31, 2011). Data were analyzed from the Developmental Trajectories cohort that links British Columbia child development data from the Early Development Instrument (EDI) to British Columbia Ministry of Health and Ministry of Education records. Data were analyzed between May and September 2017. Exposures Early childhood social-emotional functioning (defined as social competence, internalizing, and externalizing symptoms) rated by the children’s kindergarten teachers. Main Outcomes and Measures Occurrences of physician-assessed mental health conditions throughout childhood and early adolescence, including depression, anxiety, conduct disorder, and attention-deficit/hyperactivity disorder (ADHD), calculated from billing codes from the International Classification of Diseases, Ninth Revision recorded in provincial health insurance data. Results Data from 34 323 children (mean [SD] age, 5.7 [0.3] years; 17 538 [51.1%] were boys) were analyzed at kindergarten and followed up to age 14 years (15 204 completed follow-up). Latent profile analysis identified 6 unique social-emotional functioning profiles at school entry, with 41.6% of children (n = 14 262) exhibiting comparative vulnerabilities in internalizing or externalizing behaviors. Prevalence of mental health conditions from ages 6 to 14 years was 4.0% for depression, 7.0% for anxiety, 5.5% for conduct disorder, 7.1% for ADHD, and 5.4% for multiple conditions. Zero-inflated Poisson analyses showed an association between social-emotional functioning profiles at kindergarten school entry and physician-assessed mental health conditions by age 14 years (range of adjusted odds ratios: depression, 1.10 [95% CI, 0.76-1.60] to 2.93 [95% CI, 1.93-4.44]; anxiety, 1.00 [95% CI, 0.74-1.36] to 1.73 [95% CI, 1.11-2.70]; conduct disorder, 2.17 [95% CI, 1.41-3.34] to 6.91 [95% CI, 4.90-9.74]; ADHD, 1.46 [95% CI, 1.11-1.93] to 8.72 [95% CI, 6.46-11.78]; and multiple conditions, 1.20 [95% CI, 0.88-1.63] to 6.81 [95% CI, 4.91-9.44]). Children with higher teacher ratings of aggression and hyperactivity had more frequent consultations for conduct disorder, ADHD, and multiple conditions. Conclusions and Relevance This study’s findings suggest that more than 40% of children enter the school system with relative vulnerabilities in social-emotional functioning that are associated with early-onset mental health conditions. The results raise important questions for using population-level early childhood development monitoring in the context of universal and proactive mental health strategies., This cohort study identifies 6 unique childhood social-emotional functioning profiles at kindergarten school entry and examines the association of these profiles with early-onset mental health conditions in children 6 to 14 years of age.

The effects of randomization to mindfulness training (MT) or to a waitlist-control condition on psychological and physiological indicators of teachers’ occupational stress and burnout were examined in 2 field trials. The sample included 113 elementary and secondary school teachers (89% female) from Canada and the United States. Measures were collected at baseline, post-program, and 3-month followup; teachers were randomly assigned to condition after baseline assessment. Results showed that 87% of teachers completed the program and found it beneficial. Teachers randomized to MT showed greater mindfulness, focused attention and working memory capacity, and occupational self-compassion, as well as lower levels of occupational stress and burnout at post-program and follow-up, than did those in the control condition. No statistically significant differences due to MT were found for physiological measures of stress. Mediational analyses showed that group differences in mindfulness and selfcompassion at post-program mediated reductions in stress and burnout as well as symptoms of anxiety and depression at follow-up. Implications for teaching and learning are discussed.

This study examined the relationship between the executive control process of inhibition and self-reported dispositional mindfulness, controlling for gender, grade, and cortisol levels in 99 (43% female) fourth- and fifth-graders ([Formula: see text] = 10.23 years, SD = 0.53). Students completed a measure of mindful attention awareness and a computerized executive function (EF) task assessing inhibitory control. Morning cortisol levels also were collected and were used as an indicator of neuroendocrine regulation. Hierarchical regression analyses revealed that, after controlling for gender, grade, and cortisol levels, higher scores on the mindfulness attention awareness measure significantly predicted greater accuracy (% correct responses) on the inhibitory control task. This research contributes to understanding the predictors of EF skills in early adolescents’ cognitive development. Specifically, it identifies mindfulness—a skill that can be fostered and trained in intervention programs to promote health and well-being—as significantly related to inhibitory processes in early adolescence.

Past studies have investigated relationships between peer acceptance and peer-rated social behaviors. However, relatively little is known about the manner in which indices of well-being such as optimism and positive affect may predict peer acceptance above and beyond peer ratings of antisocial and prosocial behaviors. Early adolescence-roughly between the ages of 9 and 14-is a time in the life span in which individuals undergo a myriad of changes at many different levels, such as changes due to cognitive development, pubertal development, and social role redefinitions. The present study investigated the relationship of self-reported affective empathy, optimism, anxiety (trait measures), and positive affect (state measure) to peer-reported peer acceptance in 99 (43% girls) 4th and 5th grade early adolescents. Because our preliminary analyses revealed gender-specific patterns, hierarchical regression analyses were conducted to investigate the predictors of peer acceptance separately for boys and for girls. Girls' acceptance of peers was significantly predicted by higher levels of empathy and optimism, and lower positive affect. For boys, higher positive affect, lower empathy, and lower anxiety significantly predicted peer acceptance. The results emphasize the importance of including indices of social and emotional well-being in addition to peer-ratings in understanding peer acceptance in early adolescence, and urge for more research on gender-specific peer acceptance.

Objectives Early identification of distinct patterns of child social–emotional strengths and vulnerabilities has the potential to improve our understanding of child mental health and well-being; however, few studies have explored natural groupings of indicators of child vulnerability and strengths at a population level. The purpose of this study was to examine heterogeneity in the patterns of young children9s social and emotional health and investigate the extent to which sociodemographic characteristics were associated. Design Cross-sectional study based on a population-level cohort. Setting All kindergarten children attending public schools between 2004 and 2007 in British Columbia (BC), Canada. Participants 35 818 kindergarten children (age of 5 years) with available linked data from the Early Development Instrument (EDI), BC Ministry of Health and BC Ministry of Education. Outcome measure We used latent profile analysis (LPA) to identify distinct profiles of social–emotional health according to children9s mean scores across eight social–emotional subscales on the EDI, a teacher-rated measure of children9s early development. Subscales measured children9s overall social competence, responsibility and respect, approaches to learning, readiness to explore, prosocial behaviour, anxiety, aggression and hyperactivity. Results Six social–emotional profiles were identified: (1) overall high social–emotional functioning, (2) inhibited-adaptive (3) uninhibited-adaptive, (4) inhibited-disengaged, (5) uninhibited-aggressive/hyperactive and (6) overall low social–emotional functioning. Boys, children with English as a second language (ESL) status and children with lower household income had higher odds of membership to the lower social–emotional functioning groups; however, this association was less negative among boys with ESL status. Conclusions Over 40% of children exhibited some vulnerability in early social–emotional health, and profiles were associated with sociodemographic factors. Approximately 9% of children exhibited multiple co-occurring vulnerabilities. This study adds to our understanding of population-level distributions of children9s early social–emotional health and identifies profiles of strengths and vulnerabilities that can inform future intervention efforts.

The authors hypothesized that a social and emotional learning (SEL) program involving mindfulness and caring for others, designed for elementary school students, would enhance cognitive control, reduce stress, promote well-being and prosociality, and produce positive school outcomes. To test this hypothesis, 4 classes of combined 4th and 5th graders (N = 99) were randomly assigned to receive the SEL with mindfulness program versus a regular social responsibility program. Measures assessed executive functions (EFs), stress physiology via salivary cortisol, well-being (self-reports), prosociality and peer acceptance (peer reports), and math grades. Relative to children in the social responsibility program, children who received the SEL program with mindfulness (a) improved more in their cognitive control and stress physiology; (b) reported greater empathy, perspective-taking, emotional control, optimism, school self-concept, and mindfulness, (c) showed greater decreases in self-reported symptoms of depression and peer-rated aggression, (d) were rated by peers as more prosocial, and (e) increased in peer acceptance (or sociometric popularity). The results of this investigation suggest the promise of this SEL intervention and address a lacuna in the scientific literature-identifying strategies not only to ameliorate children's problems but also to cultivate their well-being and thriving. Directions for future research are discussed.

Background: Despite the evidence showing the promise of HIV treatment as prevention (TasP) in reducing HIV incidence, a variety of ethical questions surrounding the implementation and “scaling up” of TasP have been articulated by a variety of stakeholders including scientists, community activists and government officials. Given the high profile and potential promise of TasP in combatting the global HIV epidemic, an explicit and transparent research priority-setting process is critical to inform ongoing ethical discussions pertaining to TasP. Methods: We drew on the Arksey and O’Malley framework for conducting scoping review studies as well as systematic approaches to identifying empirical and theoretical gaps within ethical discussions pertaining to population-level intervention implementation and scale up. We searched the health science database PubMed to identify relevant peer-reviewed articles on ethical and implementation issues pertaining to TasP. We included English language articles that were published after 2009 (i.e., after the emergence of causal evidence within this field) by using search terms related to TasP. Given the tendency for much of the criticism and support of TasP to occur outside the peer-reviewed literature, we also included grey literature in order to provide a more exhaustive representation of how the ethical discussions pertaining to TasP have and are currently taking place. To identify the grey literature, we systematically searched a set of search engines, databases, and related webpages for keywords pertaining to TasP. Results: Three dominant themes emerged in our analysis with respect to the ethical questions pertaining to TasP implementation and scale-up: (a) balancing individual- and population-level interests; (b) power relations within clinical practice and competing resource demands within health care systems; (c) effectiveness considerations and socio-structural contexts of HIV treatment experiences within broader implementation contexts. Conclusion: Ongoing research and normative deliberation is required in order to successfully and ethically scale-up TasP within the continuum of HIV care models. Based on the results of this scoping review, we identify several ethical and implementation dimensions that hold promise for informing the process of scaling up TasP and that could benefit from new research.