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Purpose: Because physical-mental comorbidity in children is relatively common, this study tested for response shift (RS) in children with chronic physical illness using a parent-reported measure of child psychopathology. Methods: Data come from Multimorbidity in Children and Youth across Life-course (MY LIFE), a prospective study of n = 263 children aged 2–16 years with physical illness in Canada. Parents provided information on child psychopathology using the Ontario Child Health Study Emotional Behavioral Scales (OCHS-EBS) at baseline and 24 months. Oort's structural equation modeling was used to test for different forms of RS in parent-reported assessments between baseline and 24 months. Model fit was evaluated using root mean square error of approximation (RMSEA), comparative fit index (CFI), and standardized root mean residual (SRMR). Results: There were n = 215 (81.7%) children with complete data and were included in this analysis. Of these, n = 105 (48.8%) were female and the mean (SD) age was 9.4 (4.2) years. A two-factor measurement model provided good fit to the data [RMSEA (90% CI) = 0.05 (0.01, 0.10); CFI = 0.99; SRMR = 0.03]. Non-uniform recalibration RS was detected on the conduct disorder subscale of the OCHS-EBS. This RS effect had negligible impact on the longitudinal change in externalizing and internalizing disorders construct over time. Conclusions: Response shift detected on the conduct disorder subscale of the OCHS-EBS, indicated that parents of children with physical illness may recalibrate their responses on child psychopathology over 24 months. Researchers and health professionals should be aware of RS when using the OCHS-EBS to assess child psychopathology over time. [ABSTRACT FROM AUTHOR]

Purpose: Evidence from systematic reviews suggests that adult immigrants living in areas of higher immigrant density (areas with a higher proportion of foreign-born residents) tend to experience fewer mental health problems—likely through less discrimination, greater access to culturally/linguistically appropriate services, and greater social support. Less is known about how such contexts are associated with mental health during childhood—a key period in the onset and development of many mental health challenges. This study examined associations between neighbourhood immigrant density and youth mental health conditions in British Columbia (BC; Canada). Methods: Census-derived neighbourhood characteristics were linked to medical records for youth present in ten of BC's largest school districts from age 5 through 19 over the study period (1995–2016; n = 138,090). Occurrence of physician assessed diagnoses of mood and/or anxiety disorders, attention deficit hyperactivity disorder (ADHD), and conduct disorder was inferred through International Classification of Diseases (ICD) diagnostic codes in universal public health insurance records. Multi-level logistic regression was used to model associations between neighbourhood characteristics and odds of diagnoses for each condition; models were stratified by generation status (first-generation: foreign-born; second-generation: Canadian-born to a foreign-born parent; non-immigrant). Results: Higher neighbourhood immigrant density was associated with lower odds of disorders among first-generation immigrant youth (e.g., adjusted odds of mood-anxiety disorders for those in neighbourhoods with the highest immigrant density were 0.67 times lower (95% CI: 0.49, 0.92) than those in neighbourhoods with the lowest immigrant density). Such protective associations generally extended to second-generation and non-immigrant youth, but were—for some disorders—stronger for first-generation than second-generation or non-immigrant youth. Conclusions: Findings suggest there may be protective mechanisms associated with higher neighbourhood immigrant density for mental health conditions in immigrant and non-immigrant youth. It is important that future work examines potential pathways by which contextual factors impact immigrant and non-immigrant youth mental health. [ABSTRACT FROM AUTHOR]

Background: Children with chronic kidney disease (CKD) generally have worse educational and psychosocial outcomes compared with their healthy peers. This can impair their ability to manage their treatment, which in turn can have long-term health consequences through to adulthood. We attempted to capture the experiences of children with CKD and to describe the perspectives of their parents and caregivers on access to educational and psychosocial support. Methods: Children with CKD (n = 34) and their caregivers (n = 62) were sampled via focus groups from pediatric hospitals in Australia, Canada, and the USA. Sixteen focus groups were convened and the transcripts were analyzed thematically. Results: We identified four themes: disruption to self-esteem and identity (emotional turmoil of adolescence, wrestling with the sick self, powerlessness to alleviate child's suffering, balancing normality and protection); disadvantaged by lack of empathy and acceptance (alienated by ignorance, bearing the burden alone); a hidden and inaccessible support system (excluded from formal psychological support, falling behind due to being denied special considerations); and building resilience (finding partners in the journey, moving towards acceptance of the illness, re-establishing childhood). Conclusions: Children with CKD and their caregivers encountered many barriers in accessing psychosocial and educational support and felt extremely disempowered and isolated as a consequence. Improved availability and access to psychosocial and educational interventions are needed to improve the wellbeing and educational advancement of children with CKD. A higher resolution version of the Graphical abstract is available as Supplementary information. [ABSTRACT FROM AUTHOR]

In recent years, a lack of relevant contemporary Canadian data sources has led to a gap in our understanding of the experience of parental separation or divorce among children. Using the 2019 Canadian Health Survey on Children and Youth, we aim to update our understanding of this topic. Through cross-sectional analysis, we estimate the prevalence of the experience of parental breakup among children and describe the characteristics that correlate with this experience. Among children who have experienced parental breakup, we detail the prevalence of various types of parenting time arrangements as measured through the type of contact with the other parent not living in the surveyed household (equal, regular, irregular, remote only, none). Finally, a series of logistic regressions are employed to estimate the differential probability of children exhibiting mental health or functional difficulties according to (a) having experienced parental separation or divorce and (b) their subsequent type of contact with the other parent. Findings indicate that 18% of children aged 1–17 in Canada in 2019 had experienced the separation or divorce of their parents. The most common subsequent parenting time arrangement was to have regular visits with the other parent. Children who had experienced parental breakup were found to have significantly higher odds of exhibiting mental health or functional difficulties. Following parental breakup, the relative odds of having mental health or functional difficulties was highest among children who had irregular contact with the other parent. Dans les dernières années, le manque de données canadiennes contemporaines et pertinentes a nui à notre compréhension de l'expérience de la séparation ou du divorce des parents chez les enfants. En utilisant l'Enquête canadienne sur la santé des enfants et des jeunes de 2019, notre objectif est de mettre à jour notre compréhension de ce sujet. Grâce à des analyses transversales, nous estimons la prévalence de l'expérience de la rupture parentale chez les enfants et décrivons les caractéristiques qui sont corrélées avec cette expérience. Parmi les enfants qui ont vécu une rupture parentale, nous détaillons la prévalence de divers types d'arrangements du temps parental, mesurés par le type de contact avec l'autre parent ne vivant pas dans le ménage enquêté (égal, régulier, irrégulier, à distance seulement, aucun). Enfin, une série de régressions logistiques est utilisée pour estimer la probabilité différentielle que les enfants présentent des problèmes de santé mentale ou des difficultés fonctionnelles selon (a) qu'ils ont vécu la séparation ou le divorce de leurs parents et (b) le type de contact qu'ils ont eu avec l'autre parent par la suite. Les résultats indiquent que 18% des enfants âgés de 1 à 17 ans au Canada en 2019 avaient vécu la séparation ou le divorce de leurs parents. L'arrangement de temps parental le plus courant par la suite était d'avoir des visites régulières avec l'autre parent. On a constaté que les enfants qui avaient vécu une rupture parentale avaient significativement plus de chances de présenter des difficultés de santé mentale ou fonctionnelles. Après une rupture parentale, les enfants qui avaient des contacts irréguliers avec l'autre parent étaient les plus susceptibles d'avoir des problèmes de santé mentale ou des difficultés fonctionnelles. [ABSTRACT FROM AUTHOR]

African immigrant children experience some of the poorest mental health outcomes in Canada, yet limited research has systematically mental health determinants among this growing demographic. Our participatory action research project (PAR) explored, from the perspectives of parents, the factors influencing the mental health of African immigrant children in Alberta, Canada. The project utilized an intersectionality theoretical lens to collect and analyze data from a sample of 81 African immigrant parents who participated in nine conversation cafés and five focus groups. This PAR approach provided an ideal structure to engage parents and generate knowledge on the factors influencing their children's mental health. Parents identified racial discrimination, limited mental health awareness, limited access to mental health supports, changing family dynamics, parental absenteeism, and unresolved pre-migration trauma as factors influencing their children's mental health. These factors were perceived as contributing to children's experiences of material deprivation, social problems, and emotional difficulties. Our findings suggest that interventions to overcome these factors and enhance the mental health of African immigrant children must target transformation of the family, community, and cultural systems within which their lives are embedded, as well as the policies and institutions that produce and reproduce child mental health vulnerabilities. Highlights: Racism was perceived as causing employment difficulties, material deprivation, low educational attainment, and emotional difficulties in children. Changing family dynamics (e.g., marital divorce) resulting from resettlement pressures were perceived as a source of mental stress. Unresolved pre-migration traumas were reported as a risk factor for mood swings, interpersonal difficulties, and illicit drug use. Utilization of mental health supports was curtailed by stigma and limited mental health awareness. [ABSTRACT FROM AUTHOR]