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Background: Primary healthcare services have principal responsibility for providing child and youth wellbeing and mental health services, but have lacked appropriate measurement instruments to assess the wellbeing of Indigenous children and youth or to evaluate the effectiveness of programs and services designed to meet their needs. This review assesses the availability and characteristics of measurement instruments that have been applied in primary healthcare services in Canada, Australia, New Zealand and the United States (CANZUS countries) to assess the wellbeing of Indigenous children and youth. Methods: Fifteen databases and 12 websites were searched in December 2017 and again in October 2021. Pre-defined search terms pertained to Indigenous children and youth, CANZUS country names, and wellbeing or mental health measures. PRISMA guidelines were followed, with eligibility criteria guiding screening of titles and abstracts, and selected full-text papers. Results are presented based on the characteristics of documented measurement instruments assessed according to five desirability criteria: development for Indigenous youth populations, adherence to relational strength-based constructs, administration by child and or youth self-report, reliability and validity, and usefulness for identifying wellbeing or risk levels. Results: Twenty-one publications were found that described the development and or use by primary healthcare services of 14 measurement instruments, employed across 30 applications. Four of the 14 measurement instruments were developed specifically for Indigenous youth populations, four focused solely on strength-based wellbeing concepts but none included all Indigenous wellbeing domains. Conclusion: There is a diversity of measurement instruments available, but few fit our desirability criteria. Although it is possible that we missed relevant papers and reports, this review clearly supports the need for further research to develop, refine or adapt instruments cross-culturally to measure the wellbeing of Indigenous children and youth. [ABSTRACT FROM AUTHOR]

Anxiety disorders are the most common mental health concerns affecting Canadian children and adolescents. The Canadian Paediatric Society has developed two position statements that summarize current evidence regarding the diagnosis and management of anxiety disorders. Both statements offer evidence-informed guidance to support paediatric health care providers (HCPs) making decisions around the care of children and adolescents with these conditions. The objectives of Part 1, which focuses on assessment and diagnosis, are to: (1) review the epidemiology and clinical characteristics of anxiety disorders and (2) describe a process for assessment of anxiety disorders. Specific topics are reviewed, including prevalence, differential diagnosis, co-occurring conditions, and the process of assessment. Approaches are offered for standardized screening, history-taking, and observation. Associated features and indicators that distinguish anxiety disorders from developmentally appropriate fears, worries, and anxious feelings are considered. Note that when the word 'parent' (singular or plural) is used, it includes any primary caregiver and every configuration of family. [ABSTRACT FROM AUTHOR]

Background: Immigrant children exhibit significant variation in their mental health outcomes despite disproportionate exposure to socio-economic adversity compared to their non-immigrant peers. Identifying aspects of neighbourhood and family contexts that are most salient for immigrant children's mental health can help to inform and target interventions to prevent mental disorder and promote mental well-being among this population. Methods: The study analyzed multi-informant data from 943 first- and second-generation immigrant caregiver and child dyads from the Hamilton Youth Study, a representative sample of immigrant and non-immigrant families in Hamilton, Ontario. Multivariate multilevel regression models examined associations between neighbourhood and family characteristics and processes, and parent and child self reports of internalizing and externalizing problems. Results: Positive and negative parenting behaviours were significantly associated with internalizing and externalizing problems, with negative parenting demonstrating associations with externalizing problems across both parent and child reports (b = 0.26–1.27). Neighbourhood social disorder and parental trauma exposure were associated with greater internalizing and externalizing problems, and neighbourhood immigrant concentration was associated with fewer externalizing problems for parent reports only. Adding parental distress and parenting behaviour to the models reduced the coefficients for parental trauma exposure by 37.2% for internalizing problems and 32.5% for externalizing problems and rendered the association with neighbourhood social disorder non-significant. Besides the parenting variables, there were no other significant correlates of child-reported internalizing and externalizing problems. Conclusions: Results highlight the importance of parenting behaviour and parental experiences of trauma and distress for immigrant children's mental health. While not unique to immigrants, the primacy of these processes for immigrant children and families warrants particular attention given the heightened risk of exposure to migration-related adverse experiences that threaten parental and family well-being. To prevent or mitigate downstream effects on child mental health, it is imperative to invest in developing and testing trauma-informed and culturally responsive mental health and parenting interventions for immigrant families. [ABSTRACT FROM AUTHOR]

Background Obesity is a global public health concern. Given the widespread disruption caused by the SARS-CoV-2 pandemic, it is important to evaluate its impact on children with chronic health conditions. This study examines the health of paediatric patients with obesity enrolled in a tertiary hospital weight management program, before and 1 year into the COVID-19 pandemic. Methods This is a retrospective chart review of patients aged 2 to 17 years enrolled in a paediatric weight management clinic. Mental health outcomes (i.e. new referrals to psychologist, social work, eating disorder program, incidence of dysregulated eating, suicidal ideation, and/or self-harm) and physical health (anthropometric measures) were compared before and 1 year into the pandemic. Results Among the 334 children seen in either period, there was an increase in referrals to psychologist (12.4% versus 26.5%; P=0.002) and the composite mental health outcome (17.2% versus 30.2%; P=0.005) during the pandemic compared with pre-pandemic. In a subset of children (n=30) with anthropometric measures in both periods, there was a lower rate of decline in BMIz score (–1.5 [2.00] versus –0.3 [0.73]/year; P=0.002) and an increase in adiposity (–0.8 [4.64] versus 2.7 [5.54]%/year; P=0.043) during the pandemic. Discussion The pandemic has impacted the mental and physical health of children with obesity engaged in a weight management clinic. While our study provides evidence of a negative impact on mental health outcomes and less improvement in anthropometric measures, future research when patients return to in-person care will enable further examination of our findings with additional objective measures. [ABSTRACT FROM AUTHOR]