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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., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Physical activity (PA) and screen time (ST) are associated with mental health in adolescents, though little is known about their inter-relationships. This study examined the associations of PA and ST with psychosomatic complaints in adolescents. Data from four cycles of the Canadian Health Behaviour in School-aged Children (HBSC) surveys, collected between 2002 and 2014, were analysed. Eight psychosomatic health complaints were assessed and dichotomised as frequent (≥2 complaints/week) vs. infrequent. PA was assessed by number of days/week participants were physically active for ≥60 min. Discretionary ST was assessed by adding three screen uses: television, electronic games, and computer. Of the 37,829 adolescents (age 13.74 (SD 1.51) years; 52% girls), 25% boys and 39% girls reported frequent psychosomatic complaints. Multilevel logistic analyses showed that ST levels were positively associated while PA levels were negatively associated with reporting frequent psychosomatic complaints in a dose-dependent manner. Compared with ST ≤ 2 hrs/d, ST ≥ 4 hrs/d in girls and ST ≥ 6 hrs/d in boys showed higher odds of reporting psychosomatic complaints. Participating in PA ≥ 60 min every day compared to no PA showed lower odds of reporting psychosomatic complaints by 44% in girls and 57% in boys. Prospective research is needed to understand the causal pathway of these dose-dependent relationships.

Objectives: Children's mental health and wellbeing declined during the first COVID-19 lockdown (Spring 2020), particularly among those from disadvantaged settings. We compared mental health and wellbeing of school-aged children observed pre-pandemic in 2018 and after the first lockdown was lifted and schools reopened in Fall 2020. Methods: In 2018, we surveyed 476 grade 4-6 students (9-12 years old) from 11 schools in socioeconomically disadvantaged communities in Northern Canada that participate in a school-based health promotion program targeting healthy lifestyle behaviours and mental wellbeing. In November-December 2020, we surveyed 467 grade 4-6 students in the same schools. The 12 questions in the mental health and wellbeing domain were grouped based on correlation and examined using multivariable logistic regression. Results: There were no notable changes pre-pandemic vs. post-lockdown in responses to each of the 12 questions or any of the sub-groupings. Conclusion: Supporting schools to implement health promotion programs may help mitigate the impact of the pandemic on children's mental health and wellbeing. The findings align with recent calls for schools to remain open as long as possible during the pandemic response., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Dabravolskaj, Khan, Veugelers and Maximova.)

Emerging research shows that Acceptance and Commitment Therapy (ACT) may improve mental health for caregivers. Parents of autistic children, adolescents, and adults (N = 54) were randomly assigned to either complete a brief group-based ACT intervention or remain on the waitlist. Participants completed surveys immediately prior to randomization, and 3-, 7-, and 17-weeks post-randomization. The primary outcome was depression symptoms and secondary outcomes included stress, goal attainment, positive affect, ACT psychological processes, child mental health, and family functioning. Mixed effects linear models testing Group × Time interaction indicated the Treatment group (n = 27) demonstrated greater post-intervention improvements than the Waitlist group (n = 27) in parent depression (p = 0.03, d = -0.64) and family distress (p = 0.04, d = -0.57). Treatment group parents also reported greater short-term gains in positive affect (p =< 0.001, d = 0.77) and personal goal attainment (p = 0.007, d = 0.80), compared to the Waitlist group. Although there was no significant Group × Time interaction for other outcomes, stress (b = -2.58, p = 0.01), defusion (b = -3.78, p = 0.001), and experiential avoidance (b = -4.22, p = 0.01) showed improvement for the Treatment group, but not the Waitlist group, at post-intervention. All Treatment group improvements were maintained at follow-up. Results suggest that a brief ACT group intervention is efficacious for improving some aspects of mental health for parents of autistic children.

This study investigated the relationship between traumatic life stress, trust, and prosocial behavior as a positive mental health outcome in Syrian refugee children in Canada. Trust is a resilience factor shown to promote adjustment after resettlement. The specific goals of the study were to test the influence of refugee children's traumatic life stress on their prosocial behavior and the mediating role of trust in this link. Five- to 12-year-old Syrian refugee children (N = 124) and their caregivers (N = 51) who recently resettled in Canada participated in this study. Children retrospectively reported their experiences of traumatic life stressors, and caregivers reported their children's current level of trust and prosocial behavior using questionnaires. Traumatic life stress (e.g., witnessing violence and conflict, separation from family, death of family members) was negatively related to refugee children's trust in others, while trust was related to more prosocial behaviors, confirming its mediating role. These results suggest that experiencing more traumatic life stressors is associated with less prosocial behaviors as a positive mental health outcome through lower levels of trust. The current findings suggest that fostering trust may be a promising avenue for intervention to promote prosocial behavior and resilience in refugee children who are resettling in a new society.

Indigenous young people in Canada are disproportionately overrepresented in suicide rates and alarmingly, young children are accounted for in these disparities. Since children spend much of their day at school, schools are a vital context for suicide prevention, identification, and intervention. However, research indicates that educators often report that they feel unprepared to address mental health challenges within the classroom. Indigenous communities are developing community driven responses to suicide that are culturally relevant and strengths based. It is critical that these models are considered when developing such suicide prevention within schools as they diverge from medicalized focused approaches and attend to broader social dimensions. It is imperative that educators and the education system are properly equipped with the training and resources to provide suicide prevention within schools and communities servicing Indigenous children. School psychologists can play an important role in providing this prevention leadership. Through interviews with educators, we learned about the types of supports that are needed within schools to address Indigenous child suicide, and in what ways school psychologists could enhance prevention efforts. Using a reflexive approach to thematic analysis, we identified four main themes related to support needed. Findings are discussed in conversation with the current state of child specific suicide and suicide prevention literature. Applied implications for suicide prevention within schools for Indigenous children, as well as future research and community-based recommendations are considered.

Introduction: Compared to their neurotypical peers, children and adolescents with neurodevelopmental disorders (NDs) experience worse mental health outcomes, including greater service use and functional impairment. Few studies, however, have examined the neurodevelopmental contributions to mental health complexity among those seeking community-based mental health services. Methods: Archival data from a publicly-funded mental health center was used to test the generalizability of a path model predicting service use among those with (n = 66) and without (n = 97) NDs. Results: Those with NDs were found to experience more symptoms and had greater service use than those without NDs, and there were notable differences in the predictive pathways across groups. Specifically, the paths from internalizing challenges, early life adversity, and biological sex were only significant among the ND group. Conclusions: These findings indicate that neurodevelopmental status is an important moderator of mental health outcomes that warrants consideration when treating complex cases.

Mental health literacy (MHL) encompasses understanding mental health and learning how to obtain and maintain good mental health. Increasing MHL may increase help-seeking behaviors and positive mental health. This study aimed to identify school-based MHL interventions for children/youth using a scoping review methodology following the Johanna Briggs Model. The interventions were assessed for quality of evidence using the National Institutes of Health Study Quality Assessment Tools. Six databases were searched: Scopus, APA PsycInfo, Cochrane Library, ERIC, PubMed, and ProQuest Psychology. Search terms included "mental health literacy," "intervention," and "children." The search yielded 27 studies after applying inclusion criteria. Eight of these studies were assessed as "poor" quality, twelve as "fair" quality, and seven as "good" quality. The results highlight the need for more research to implement and evaluate interventions to sustainably and feasibly incorporate school-based MHL interventions for children and youth into practice.

Research on adults indicates other-oriented perfectionism (requiring perfection from others) is associated with various consequential outcomes independent of self-oriented perfectionism (requiring perfection of the self) and socially prescribed perfectionism (believing others require perfection of the self). However, historically, the most widely used and researched measure of trait perfectionism in children, the Child-Adolescent Perfectionism Scale (CAPS), has omitted other-oriented perfectionism. In the present study, we address this by reporting on the multisource development and validation of the first self-report measure of other-oriented perfectionism specifically intended for youths: the Other-Oriented Perfectionism Subscale-Junior Form (OOPjr). Children (N = 107; M[subscript age] = 11.5, SD = 1.7) completed the OOPjr, CAPS, and measures of perfectionistic self-presentation, narcissism, social disconnection, depressive symptoms, and parental psychological control. Parents provided ratings of children's self-oriented, socially prescribed, and other-oriented perfectionism. Psychometric analyses indicated the OOPjr is a homogenous and internally reliable scale that, when factor analyzed alongside the CAPS, displays measurement invariance across gender and replicates the three-factor solution found in adults. Furthermore, parent ratings of other-oriented perfectionism showed unique positive relationships with OOPjr scores, but not CAPS scores. Likewise, other-oriented perfectionism had independent positive relationships with narcissistic superiority and achievement-oriented parental psychological control, after controlling for self-oriented and socially prescribed perfectionism. Overall, our findings provide preliminary support for the use of the OOPjr as a measure of other-oriented perfectionism in youths.

Developmental research during COVID-19 suggests that pandemic-related disruptions in family relationships are associated with children's mental health. Most of this research has focused on 1 child per family, thereby obfuscating patterns that are differentially operative at the family-wide (i.e., between-family) versus child-specific (i.e., within-family) levels of analysis. Thus, the current study evaluates multilevel, longitudinal associations between COVID-19 disruption, family relationships, and caregiver/child mental health using a sibling comparison methodology. Caregivers (N = 549 families with 1098 children between 5 and 18 years old) were recruited from the Prolific research panel (73% White-European; 68% female; 76% United Kingdom, 19% U.S.A.; median 2019 income $50,000-$74,999). Caregiver reports of COVID-19 disruption, psychological distress, family functioning, parenting, and child mental health (for 2 children per family) were provided during May (time 1) and July (time 2) 2020. A Bayesian multilevel path analysis with random effects revealed: (a) families were experiencing difficulties across domains when COVID-19 disruption was high; (b) COVID-19 disruption corresponded to greater sibling differences in mental health; and (c) the sibling with poorer mental health received lower quality parenting over time, especially in families who reported higher levels of differential parenting. Findings suggest that understanding children's mental health difficulties during COVID-19 requires a family system lens due to the multiple ways these consequences permeate across the family unit. Comprehensive interventions for children's mental health during this time will likely require an examination of caregiver, sibling, and whole-family dynamics in the context of evidence-based telehealth practice.

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While paediatric care providers are often the first point of contact for children or youth experiencing mental health challenges, they may lack the resources (e.g. access to a multidisciplinary team) or training to adequately identify or manage such problems. This joint statement describes the key roles and competencies required to assess and address child and youth mental health problems, and the factors that optimize outcomes in this age group. Evidence-informed guidance on screening for and discussing mental health concerns with young people and families is provided. Preventive and therapeutic interventions with demonstrated efficacy in community care settings are discussed. This foundational statement also focuses on the changes to medical education, health systems, and health policy that are needed to improve clinical practice and advocacy efforts in Canada, including appropriate remuneration models, stepped-care approaches, targeted government funding, and professional training and education. [ABSTRACT FROM AUTHOR]

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]

Building upon two previously published research papers exploring Canadian media reporting of childhood in the first wave of the pandemic, this paper investigates how constructions of childhood evolved from the first wave to the fourth wave of the pandemic. This qualitative research is guided by the central research question: Over the span of 2 years, from 2020 to 2022, what changes are evident in discourses reported within media focused on the impact of the COVID-19 global pandemic on Canadians under the age of 18 years? Findings from this study suggest that in the fourth wave young people were constructed as innocent victims of pandemic restrictions framed through an adult-centric lens; noticeably absent were representations of young people under the age of 18 in their voices. A key recommendation emerged from this study: any future research investigating the impact of the pandemic on young people under aged 18 years must include their full participation. [ABSTRACT FROM AUTHOR]

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: 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 this study, we examined feasibility, acceptability, and preliminary efficacy of a telepsychological positive parenting intervention (I–InTERACT-North, Internet-basedInteracting Together Everyday: Recovery After Childhood Traumatic Brain Injury) during the COVID-19 pandemic among Canadian families of children at-risk for neurodevelopmental challenges given congenital or neonatal conditions. I–InTERACT-North was developed to improve behavioral and emotional outcomes in children with neurological conditions by utilizing and adapting parenting strategies from several established family-focused programmes. A pragmatic prospective pre-post single-site pilot study design was used to assess feasibility, acceptabilty, and preliminary efficacy of I-InTERACT North during the COVID-19 pandemic. Thirty-five families of children ages three to nine years were referred between March 2020 and January 2021. Eighteen families enrolled, and 12 (67% adherence) completed the programme. Parents reported strong therapeutic alliance and programme acceptability with barriers due to competing time demands. Therapists reported high acceptability but perceived parental burnout. Parenting confidence (d = 0.70), and child behavior (d = 1.30) improved following the intervention. Results demonstrate the programme's value to families during the pandemic, while underscoring unique participation barriers. Future research and clinicial implications are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Northern communities in Canada experience a disproportionate burden of chronic diseases including mental illness. To mitigate the growing health inequalities, an ongoing Comprehensive School Health program promoting healthy lifestyle behaviours and mental health and well-being was expanded to rural and remote northern communities. We report on the program's impact on knowledge, attitudes, lifestyle behaviours (healthy eating, physical activity, screen time), weight status and the mental health and well-being of elementary school students during the first four years of implementation. Methods: Following a repeated cross-sectional design, we surveyed 440, 352 and 384 Grade 4 to 6 students (9--12 years old) from eight schools in 2016, 2018 and 2020/21, respectively. Students were approximately equally represented by girls and boys. Results: Between 2016 and 2018, students reported modest increases in vegetable and fruit consumption and dietary variety; declines in screen time; no changes in physical activity; and declines in attitudes toward healthy lifestyle and in mental health and well-being. Between 2018 and 2020/21, lifestyle behaviours deteriorated substantially, while attitudes and mental health and well-being continued to decline. Conclusions: A program that was successful in socioeconomically disadvantaged urban neighbourhoods had a favourable, though modest, impact on selected lifestyle behaviours, but not on attitudes and mental health and well-being, in rural and remote northern communities. In light of cultural differences and logistical challenges in Canada's North, systematic and proactive adaptations to local contexts, increased intensity, and longer program delivery are essential to facilitate sustainable improvements in lifestyle behaviours and mental health and well-being. [ABSTRACT FROM AUTHOR]

• Many mental health disorders first emerge during early childhood or adolescence. • Wait times for children's mental health services have been an international and widespread problem. • Long wait times prolong the emotional distress of children and/or adolescents and their caregivers which can exacerbate mental health difficulties. • The majority of research in this area has been conducted in the United Kingdom and Canada and focus on one waitlist strategy. • Common strategies include alternative service delivery models, increasing system capacity, and improving intake and assessment processes. Background: Although many mental health disorders first emerge during early childhood or adolescence, there is a significant gap between demand and availability of mental health resources, leading to long waitlists for services. Objective: The objective of this scoping review was to identify and characterize the research literature related to the range of waitlist management strategies that have been implemented in outpatient child and adolescent mental health care. Methods: Electronic databases reviewed included: Medline (Ovid), Embase (Ovid), PubMed, PsychINFO, SCOPUS, CINAHL, and ISI Web of Science. Grey literature databases included: OpenGrey, Conference Papers Index, and Proquest Digital Dissertations. Articles were screened by two reviewers in two steps: first by title and abstract, then full text level. Data were extracted using an a-priori developed data extraction framework, which was piloted and modified iteratively. Results: A total of 119 papers related to waitlist interventions in child and adolescent mental health were reviewed. Of these 119 papers, 11% were reviews, summary, or theoretical papers; 8% used a randomized control trial design and 2.5% were trial protocols. Most studies used less rigorous designs, such as uncontrolled before-and- after designs. The large majority focused on just one waitlist strategy each. The most commonly used approaches included: prioritization/triage and initial assessment; brief consultation and advice or brief therapy approaches; group-based models; interim services; increasing capacity; and strategies to decrease non-attendance. Most studies were conducted in the United Kingdom or Canada. Discussion: While mental health systems are complex, most studies examining waitlist initiatives explored the implementation of single initiatives. It is unlikely that a single waitlist strategy can be effective in managing wait times for children's mental health. Rather, consistent and systemic approaches to address wait times that consider the impact of the reduction approach on the patient, the program, and the community are needed. [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]

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]

Summary: Even though an extensive body of literature on children has swept the field of domestic violence in the last 30 years, little is known about how domestic violence shelter workers understand children's situations and how they intervene with them. This article seeks to address this gap in the literature, and presents the results of a study conducted with 48 advocates in the province of Québec (Canada). Findings: The data suggest that most of the participants adopt a child-centred perspective and consider the children in their own right during their stay. The accounts of the participants' practices also reveal that they perceive children as being vulnerable and at-risk. With a moderate emphasis on vulnerability and risk, the participants tend to support the children alongside their mothers, while associating potential risks with the behaviour of the perpetrator of domestic violence. However, with a strong focus on vulnerability and risk, participants tend to cast aside the perpetrators' behaviour and monitor the women-as-mothers during their stay while associating potential risk with their [in]actions under the circumstances. This can lead to mother-blaming, surveillance and more authoritarian interactions. Applications: The understanding of children living with domestic violence needs to remain rooted in a feminist analysis of violence against women in order to avoid some of the issues highlighted in the article. Furthermore, studies that seek to shed light on best social work practices when working with children in alliance with their mothers from a feminist perspective are crucially needed. [ABSTRACT FROM AUTHOR]

Migration is stressful and potentially detrimental to the mental health of immigrant children. However, they may draw tremendous mental health benefits by participating in group-based arts programs. In this literature review, we aimed to answer the question: how does participation in group-based arts programs impact the mental health of immigrant children in Canada? Findings indicated that factors at personal, interpersonal, and structural levels affect the mental health of these populations. Arts classes and programs at schools or communities would promote these children's mental health through both the direct impact of artworks and the facilitation of social support within groups. [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]

The closure of schools to prevent the spread of COVID-19 prompted concerns of deteriorating lifestyle behaviours, mental health, and wellbeing of children, particularly those in socioeconomically disadvantaged settings. We assessed changes in lifestyle behaviours (physical activity, screen time, eating habits and bed/wake-up times), mental health and wellbeing during the first lockdown in Spring 2020 as perceived by school children from disadvantaged settings, and examined determinants of these changes. Cross-sectional study. We surveyed 1095 grade 4 to 6 students (age 9–12 years) from 20 schools in socioeconomically disadvantaged communities in northern Canada. Students reported on changes in lifestyle behaviours, mental health and wellbeing during the lockdown. Determinants of these perceived changes were examined in multivariable regression models. A majority of students reported declines in physical activity, having late bed/wake-up times, and modest improvements in mental health and wellbeing. Many students reported increases rather than decreases in screen time and snacking. Positive attitudes toward being active, eating healthy, going to sleep on time and being healthy were strongly associated with maintaining healthy lifestyle behaviours during the lockdown. Positive attitudes toward active and healthy living and healthy lifestyle behaviours were associated with maintaining positive mental health and wellbeing during the lockdown. The considerable changes in lifestyle behaviors, superimposed on the pre-existing burden of unhealthy lifestyle behaviours, put this generation of children at increased risk for future chronic disease. Findings call for effective health promotion of active and healthy lifestyles to benefit both physical and mental health. [ABSTRACT FROM AUTHOR]

Children and youth are among the most vulnerable to the detrimental effects of disaster due to their unique physical, cognitive and psychological life stage. Despite their increased vulnerability, children and youth also demonstrate resilience when faced with the adverse circumstances of disasters, and can act as important catalysts for change in their families and communities. This article discusses research conducted with eighty-three children and youth (five to seventeen years) who experienced the 2013 flood in Alberta, Canada. A mixed-methods approach was utilised. The Child and Youth Resilience Measure was used to examine the factors that contribute to resilience post-disaster, including individual, care-giver and contextual factors. In-depth qualitative interviews further examined the specific ways in which individual, caregiver and contextual factors contribute to higher levels of resilience. Findings reveal that despite numerous post-flood challenges, children and youth had higher than average levels of resilience. The findings demonstrate that high levels of resilience are associated with individual factors, specifically peer support and caregiver factors, namely caregiver psychological support. We discuss the implications of these findings for social work policy and practice, and for understanding the factors that best support the resiliency processes and overall recovery of children and youth following disaster. [ABSTRACT FROM AUTHOR]

This study examined several factors affecting the perception of Canadian parents about their children's mental health during COVID-19. The contribution of this research included fresh evidence from examining the demographic and sociological factors influencing children's well-being during COVID-19 using the Canadian context. We used a cross-sectional dataset from Statistics Canada titled Impacts of COVID-19 on Canadians - Parenting during the Pandemic (2020). We relied on an ordered logit model and computed the respective odds ratios. Our results showed that parents with a university degree and those working from home are less concerned about their children's mental health. Nonetheless, having a disabled child, belonging to a minority, having children aged six-to fourteen-years old, and having lost a job or experienced a drop in working hours increased parents' worry. Additionally, having worries about being connected with family and friends, being concerned about work-life balance, feeling lonely at home, and waiting for the reopening of childcare services all increased the likelihood of parents' anxiety about their child's mental health. When running the analysis by province, we saw that being an immigrant and belonging to a minority increased parents' worry only in Ontario and British Columbia. Policymakers are encouraged to foster working-from-home practices as working from home has been linked to less worry about child mental health, mainly among mothers, as indicated in our gender heterogeneity analysis. In addition, it is advised that families with a disabled child, and families belonging to a minority received additional support. Lastly, policymakers are advised to consider the social cost of preventive measures and incorporate this into any future preventative policymaking as the social impact variables were robust across all models. • Examined perceptions of Canadian parents about their children's mental health during COVID-19. • Focused on the role of the individual, household, labor market, and social factors. • The findings demonstrate a key role for the social drivers. • Working from home reduces the likelihood of worry about children's mental health. • We document heterogeneous province and gender effects. [ABSTRACT FROM AUTHOR]

• The African immigrant population is increasing rapidly in Alberta and across Canada. • African immigrants face barriers accessing mainstream mental health (MH) supports. • Family-, community-, and structural-level stressors present challenges to child MH. • Family-, community-, and structural-level strategies can help promote child MH. • These strategies include measures to build and enhance resilience during childhood. Available evidence in Canada suggests mental health disparities between immigrant and non-immigrant children. Children born to immigrants face a greater risk of poor mental health outcomes. However, these comparisons often mask important ethno-racial differences in mental health risks and outcomes among immigrant populations. Recent evidence suggests African immigrant children have some of the poorest social and mental health outcomes in Canada. Despite this awareness, research has yet to identify community-based strategies for addressing the stressors underpinning such outcomes. This study used data obtained from focus groups with African immigrant parents in Alberta, Canada, to identify child mental health stressors and child mental health promotion strategies in the African immigrant community. These strategies, thematically partitioned into family-, community-, and structural-level interventions, include building supportive parent–child relationships, strengthening resilience in childhood, economic empowerment of families, destigmatizing mental illness, influencing institutional policies and practices, supporting labour integration, and enhancing access to mental health supports. Ways in which policymakers and service providers can support child mental health promotion efforts in the African immigrant community are also discussed. [ABSTRACT FROM AUTHOR]

Chronic pain affects 1 in 5 youth, many of whom manage their pain using a biopsychosocial approach. The COVID-19 pandemic has impacted the way that healthcare is delivered. As part of a larger program of research, this study aimed to understand the impact of the pandemic on pediatric chronic pain care delivery including impact on patients' outcomes, from the perspective of pediatric healthcare providers. A qualitative descriptive study design was used and 21 healthcare providers from various professional roles, clinical settings, and geographic locations across Canada were interviewed. Using a reflexive thematic analysis approach 3 themes were developed: (1) duality of pandemic impact on youth with chronic pain (i.e., how the pandemic influenced self-management while also exacerbating existing socioeconomic inequalities); (2) changes to the healthcare system and clinical practices (i.e., triaging and access to care); (3) shift to virtual care (i.e., role of institutions and hybrid models of care). These findings outline provider perspectives on the positive and negative impacts of the pandemic on youth with chronic pain and highlight the role of socioeconomic status and access to care in relation to chronic pain management during the pandemic in a high-income country with a publicly funded healthcare system. [ABSTRACT FROM AUTHOR]