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Objectives Pain affects all children and youth, yet acute and procedural pain remains undertreated in Canadian hospitals. To improve pain management practices in paediatric hospitals, it is necessary to understand how healthcare professionals (HCPs) wish for educational interventions to be designed to improve their pain management practice. Methods Semi-structured interviews were conducted with 18 HCPs between October and December 2020. Snowball sampling was used to first recruit interested members from the hospital's Pediatric Pain Management Committee. Interviews were conducted per participant preference and included Zoom, telephone, and in-person interviews. Recruitment ceased when data were determined sufficiently rich. A thematic analysis of verbatim transcripts and reflexive field notes were used to create a data set focused on knowledge mobilization and clinical education. Results Three core themes were identified: (a) the necessity for just-in-time education for HCPs; (b) the availability of clinical pain champions to educate staff; and (c) the provision of resources to educate children and their families about available pain management interventions. Just-in-time education included suggestions for in-service training, hands-on training, and regular updates on the latest research. Pain champions, including clinical nurse educators, were stressed as being important in motivating staff to improve their pain management practices. Participants noted the lack of resources for patient and family education on pain management and suggested providing more multimodal resources and educational opportunities. Conclusion Having local champions introduce pain management initiatives and just-in-time education positively impacts the implementation climate, which also helps HCPs provide evidence-based education and resources to patients and families. [ABSTRACT FROM AUTHOR]

The release of a Canadian Indigenous Early Learning and Child Care Framework highlights the importance of recent, Indigenous-specific information to describe the landscape of child care among Indigenous children in Canada; however, there has been a gap in identity-specific, national data on child care for Indigenous children. The purpose of the current study was to address data gaps on participation in child care for First Nations children living off reserve, Métis, and Inuit children. Furthermore, two years of data are examined which provide information on child care use both prior to and during the first year of the COVID-19 pandemic. In 2019, First Nations children living off reserve (49%) and Inuit children (42E %)1 were significantly less likely to participate in child care compared with non-Indigenous children (60%), although Métis children (60%) were equally likely to participate in child care compared with non-Indigenous children. Only First Nations children living off reserve (40%) were significantly less likely than non-Indigenous children (53%) to participate in child care in 2020. In terms of the type of child care used, Inuit children were more likely to be in a daycare centre (70%) compared with non-Indigenous children (52%) in 2019, although Inuit children's participation in a daycare centre dropped to 46E% in 2020. This is likely due to public health restrictions which closed many child care centres during the pandemic, as over one-third of child care in the territories is centre-based. The findings provide important information about patterns of child care use for Indigenous children both before and during the pandemic. [ABSTRACT FROM AUTHOR]

Background: Specificities regarding the quality and quantity of sleep of preterm infants and their parents following discharge of the preterm infant from the hospital are not well known. Given this lack of knowledge, the links between the sleep characteristics of these parents, family functioning, and their psychological well-being are also unclear. Objectives: The purpose of this article is to summarize the research protocol of a cross-sectional, mixed-methods, convergent design study, which aims to evaluate the sleep patterns of preterm infants and both their parents and document the associations between sleep quality, parents' psychological well-being, and family functioning during the posthospitalization period. Methods: A convenience sample is used to recruit 30 families. For quantitative data collection, a questionnaire booklet consisting of validated questionnaires is used to measure sleep quality of each family member, parental psychological well-being, and family functioning completed by each parent. An actigraph and a sleep diary measure sleep quantity of each parent and the preterm infant. Afterward, semistructured interviews are carried out with each parent to explore their perceptions and needs concerning their infant's and their own sleep quality. For data analysis, qualitative and quantitative data are analyzed separately and then merged to allow for an integrative interpretation of the results. Results: The research project is ongoing; 25 of 30 families have completed the data collection. Data analysis is underway. Discussion: This research will provide a global portrait of the families' sleep 1 month after the preterm infant is discharged from the hospital, which is not well known to date. The results will help healthcare providers involved with preterm infants and their families after discharge from the hospital to increase their comprehension of the families' reality and adapt their interventions to meet these needs. [ABSTRACT FROM AUTHOR]

Purpose: Children who are refugees and who live with disabilities are among the most at-risk groups for marginalization due to compounded disadvantages from the intersection of risk factors such as refugee status and disability status. Despite their high risk, there is no systematic data collected on this group and scant literature on the topic contributing to a feeling of invisibility. The purpose of this study is to better understand the experiences of Syrian refugee families with children living with disabilities. Design/methodology/approach: The authors conducted a narrative inquiry into the experiences of two Syrian refugee families with children living with disabilities. Narrative inquiry is a way to understand experience as a storied phenomenon. Findings: In attending to the families' stories of their experiences across time, place and social contexts, two narrative threads resonated across their experiences including waiting and a struggle for agency as well as disruption and continuity. Research limitations/implications: Narrative inquiry does not produce generalizable results but, rather, gives insight into the unique experiences of individuals. Originality/value: To understand the complexities of the experience of a refugee family with a child living with disabilities, attending to their lived and told stories is essential. [ABSTRACT FROM AUTHOR]

Upon arrival in Canada, immigrants are thrust into a new food environment, which is at an advanced stage of the nutrition transition continuum, encompassing reduced physical activity, sedentary lifestyles, and energy dense diets. In addition to the influence of readily available energy dense foods, immigrant children's food environments may also be impacted by limited availability of traditional foods, economic-constraints, time-constraints, parents' cooking skills, parents' child feeding styles, and school food environments. The study involved in-depth interviews with 22 immigrant parents regarding their family experiences of the food and nutrition environment, along with 22 participants from settlement agencies, community schools, English-as-a-second-language programmes, and healthcare organizations. Many newcomers shared experiences that highlighted drastic changes to their food environment upon arrival, including reduced access to open air fresh produce markets, increased access to large supermarkets, fast-paced lifestyles, and the pervasive presence of fast foods and snack foods. Some parents indicated that food purchase decisions were impacted by children's demands and that their children's school environments affected the types of foods their children would eat. A few service providers mentioned negative impacts on breastfeeding, and the change in physical environment as part of the nutrition environment due to association with vitamin D status. The early years are a pivotal time in the development of eating patterns; so supportive food and nutrition environments in homes, communities, and schools can ensure that children develop healthy eating habits to support long-term health. [ABSTRACT FROM AUTHOR]

We examined the categorization of relationships between child complainants and accused perpetrators in cases of child sexual abuse (CSA). Researchers that have focused on complainant-accused relationships and other case variables, often combining two extrafamilial complainant-accused relationship categories: Relationships where the accused is connected to the child through their position in the community (i.e. community connections) and relationships where the non-relative accused is known to the child through a connection to the child's family (i.e. non-relative family connections). Using a database of 4,237 Canadian judicial decisions in cases of CSA, we reviewed a subset of 1,515 judicial decisions to explore differences between these two relationship categories. Compared to cases involving non-relative family connections, cases involving community connections had more male complainants, more multiple complainants, older complainants, higher frequencies of abuse, longer durations, and longer delays. We conclude that community and non-relative family connections are distinct relationships that should be separated for analyses in future research. Practical implications of recognizing the distinctiveness of non-relative family and community connection relationship categories in the context of abuse prevention and treatment are also discussed. [ABSTRACT FROM AUTHOR]

Purpose: Refugees living with disabilities are among the most vulnerable, isolated and marginalized populations, and, of this group, children are particularly vulnerable. The purpose of this study is to identify current knowledge and research gaps specific to the experiences of refugee families who have children with disabilities. The authors assess the quality of evidence and describe the theoretical underpinnings of research that focuses on refugee families who have children with disabilities. Design/methodology/approach: The authors searched nine electronic databases from database inception for English language, peer-reviewed publications. The authors identified themes from the included studies. Findings: The authors identified 10 studies that fit their inclusion criteria and shown key findings in the form of six themes. Families who have children with disabilities experience structural barriers; their experiences are impacted by family factors and the degree and kind of support received, as well as the knowledge of parents about their rights. Gender differences made visible the precarious situations experienced by girls with disabilities. Gaps in educational standards and the capacity of schools, particularly in refugee camps, were highlighted. Research limitations/implications: The authors show that there is a lack of evidence-based research focusing on refugee children's own experiences of living with disabilities. Children's experiences that were visible were, for the most part, attended to through other's accounts of their experiences. Many studies that the authors found (the current knowledge to date) describe children with disabilities through third-party accounts, including parents, caregivers and those who provided services to this population. There is an urgent need to explore the experiences of children who have disabilities and are displaced from their home country. Originality/value: This systematic review focuses on refugee children experiences that has not been conducted before and identifies the research gaps for this group. Attention to how disabilities are understood philosophically and who are defined as refugees are needed in order for the research to accrue in ways that build a consistent body of literature. Without some consistency, it is not possible for studies to build on one another. [ABSTRACT FROM AUTHOR]

To examine household income trajectories of children with and without neurodisability over a period of 6 years. We used four cycles of the Canadian National Longitudinal Survey of Children and Youth, a longitudinal study of the development and well-being of Canadian children from birth into adulthood. While household income increased over time for both groups, families of children with neurodisability had consistently lower household income compared to families of children without neurodisability even after controlling for child and family socio-demographic characteristics. The presence of an interaction effect between parent work status and child with neurodisability at baseline indicated that among children whose parent(s) were not working at baseline, household incomes did not differ between children with and without neurodisability. The association between child with neurodisability and lower household income may not hold for all types of parents', working status is an important consideration. Findings support the health selection hypothesis that health status shapes diverging economic conditions over time: children with a ND have lower household incomes than children without a ND child across all waves of the Canadian National Longitudinal Survey of Youth. Income gaps did not increase or decrease over time; rehabilitation services and policies must consider the lower average incomes associated with raising a child with a ND. Social assistance support likely plays a key role in closing the gap, especially for non-working families. [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]

Child poverty remains a persistent problem in Canada and is well known to lead to poor health outcomes. The Canada Child Benefit (CCB) is a cash transfer program in effect since 2016, which increased both the benefit amount and number of families eligible for the previous child benefit. While the CCB has decreased child poverty rates, not all eligible families have participated. Clinicians can play an important role in screening for uptake of the program and helping families navigate the application process through several free resources. While prior research on past programs has shown benefit of similar cash transfer programs to both child and parental outcomes (both health and social), the CCB has not yet been extensively studied. Research would be valuable in both assessing the cost effectiveness of the program, especially across different income groups, and improving implementation in hard-to-reach populations. [ABSTRACT FROM AUTHOR]

Though summer learning loss has been widely documented across both the United States and Canada, there is little knowledge on how parents and teachers view the use of technology in the context of summer vacation, and what the role of digital tools are in potentially alleviating achievement gaps due to summer learning loss. Drawing on 71 parent and 37 teacher interviews from a large-scale Canadian study examining summer learning loss in Ontario through summer literacy and numeracy programs for students (grades 1–3), this study highlights the complexities associated with using digital tool in both home and school life in the summer. Through extensions of Bourdieu's theory of cultural capital, we suggest that digital tools are becoming a new type of valued skillset that parents and educators are acknowledging. In specific, our main findings center around three interrelated themes: i) comfort with technology; ii) home-school connections; and iii) perception of children as digital natives. Results may be fruitful for parents, educators, and policymakers to understand the larger role that digital technology plays amongst Canadian families and teachers during the summer months and school year. Capturing these discussions can maximize both school and home use of digital tools. [ABSTRACT FROM AUTHOR]

Children exposed to domestic violence may be at risk of homicide. Through an analysis of 140 domestic homicide cases in Ontario, Canada, this study sought to identify unique factors that heighten the risk for children in these circumstances. Two groups of domestic homicide cases were compared: cases with no children (No Children, n = 39) and cases where children were part of the family system (Children, n = 101). Further comparison was made of cases in which children were killed (n = 20) to cases in which children were present but not killed (n = 81). Overall, there were few unique differences between the groups and most of the significant findings were based on expected demographic characteristics related to having children in the family. Other significant results included a higher percentage of reports made to legal counsel/services within child-specific cases and a higher percentage of reports made to family members in cases where children were not killed. These results indicate that children who lose parents to domestic homicide share similar high-risk circumstances as children who have been killed in this context. Practical implications of the study's findings are discussed. Highlights: This study examined children's risk of homicide in the context of domestic violence. The study compared domestic homicide cases of families with and without children. Study results generally indicated few unique differences between groups. Results suggest that children exposed to domestic homicide are at similar risk to children who are not domestic homicide victims. [ABSTRACT FROM AUTHOR]

The revised version of Canada's Food Guide, released in January 2019, issued new guidance by combining meat and alternatives with milk and alternatives into a single group called "protein foods" and emphasized selecting plant-based foods from this category more often. Though the changes represent a simple depiction of a healthy plate, the new Food Guide has opened knowledge gaps about protein foods and exposed new concerns about the interpretation and implementation of the Food Guide among vulnerable groups, particularly children and the elderly. To address key knowledge and research gaps, nutrition leaders need to reach a consensus on key messages to best inform the development of tools and resources to support practitioners in translating messages to consumers, including foodservice standards. Among consumers, families with young children are a primary target for these resources as they develop their life-long habits to ensure they have the knowledge and skills to select, prepare, and consume nutrient-rich protein foods. The new Food Guide provides an opportunity to address the existing knowledge gaps, develop tools and resources to support health professionals, and design interventions that will help Canadian families choose, prepare, and eat nutrient-rich protein foods. Novelty * An updated Canadian regulatory framework is needed for protein labelling and content/health claims. * There are knowledge gaps about protein foods consumption and food literacy needed to optimize nutritional health. * Mandatory nutrition policies are needed to safeguard the provision of high-quality protein foods across institutions that serve children and older adults. [ABSTRACT FROM AUTHOR]

The majority of refugees are children and youth and their integration and life-course transitions are a research priority. This paper examines the timing of refugee children and youths' entrance into the labour market and family formation (marriage/common law union and parenthood). It does so by examining how admission category, knowledge of a host country's official languages, and age at arrival shape their transition to adulthood. Using data from the Canadian Longitudinal Immigration Database and Heckman selection estimation, the paper finds minimal variation in refugee children and youths' entry into the labour market compared to children of other immigrant streams. It also finds that refugee children and youth start forming families at a younger age than children of economic class immigrants, but at an older age than family class children. The analysis also shows limited effects of knowledge of official language prior to arrival while age at arrival has a robust impact on their adulthood transitions. These findings shed light on the unique patterns of life-course transition among refugee children and youth and contribute to a better conceptualization of their experiences relative to children and youth of other immigrants. [ABSTRACT FROM AUTHOR]

Objective: This study estimated trajectories of health‐related quality of life (HRQOL) over a 10‐year period among children newly diagnosed with epilepsy. We also modeled the characteristics of children, parents, and families associated with each identified trajectory. Methods: Data came from the HERQULES (Health‐Related Quality of Life in Children With Epilepsy Study), a Canada‐wide prospective cohort study of children (aged 4‐12 years) with newly diagnosed epilepsy. Parents reported on their children's HRQOL at diagnosis, and at 0.5‐, 1‐, 2‐, 8‐, and 10‐year follow‐ups using the Quality of Life in Childhood Epilepsy Questionnaire–55. Trajectories of HRQOL were identified using latent class growth models. Characteristics of children, parents, and families at the time of diagnosis that were associated with each trajectory were identified using multinomial logistic regression. Results: A total of 367 children were included. Four unique HRQOL trajectories were identified; 11% of the cohort was characterized by low and stable scores, 18% by intermediate and stable scores, 35% by intermediate scores that increased then plateaued, and 43% by high scores that increased then plateaued. Absence of comorbidities, less severe epilepsy, and better family environment (greater satisfaction with family relationships and fewer family demands) at the time of diagnosis were associated with better long‐term HRQOL trajectories. Although the analyses used estimates for missing values and accounted for any nonrandom attrition, the proportion of children with poorer HRQOL trajectories may be underestimated. Significance: Children with new onset epilepsy are heterogenous and follow unique HRQOL trajectories over the long term. Overall, HRQOL improves for the majority in the first 2 years after diagnosis, with these improvements sustained over the long term. [ABSTRACT FROM AUTHOR]

Health care policy positions breastfeeding as an important part of the solution to household food insecurity; however, there are critical gaps in our knowledge of the relationship between breastfeeding duration (exposure variable) and household food insecurity (outcome variable). Our objective was to examine this relationship. A cross-sectional study was conducted from 2008 to 2016 of healthy urban children (N = 3838) who were 0 to 3 years old and recruited from The Applied Research Group for Kids (TARGet Kids!), a practice-based research network in Toronto, Canada. Total breastfeeding duration was collected from parent-reported questionnaires. Household food insecurity was measured using 1-item and 2-item food insecurity screens. Multivariable regression analysis was performed adjusting for prespecified covariates. The median total breastfeeding duration was 10.5 months (interquartile range, 6.0–14.0), and 14.7% of households were food insecure. After adjusting for child characteristics (age, sex), maternal characteristics (age, ethnicity, education, employment), and family characteristics (number of children, single parent family, neighborhood equity score), there was no significant association between total breastfeeding duration and household food insecurity (odds ratio, 0.99; 95% confidence interval, 0.98–1.01). Although low-income families had an increased odds of being household food insecure (P ≤.001), we found no significant association between total breastfeeding duration and household food insecurity at varying income levels. We found no association between breastfeeding duration and household food insecurity, regardless of family income. Although breastfeeding is associated with improved child health outcomes and considered to be part of the solution to household food insecurity, interventions focused on social determinants may provide more promising targets for the prevention of household food insecurity. [ABSTRACT FROM AUTHOR]

The kindergarten program, Tools of the Mind (Tools), has been shown to improve executive functions (as assessed by laboratory measures) and academic performance. The objective here was to see if Tools can improve executive functions in the real world (in the classroom), academic outcomes not previously investigated, reduce bullying and peer ostracism, and increase teachers’ and students’ joy in being in the classroom. This first randomized controlled trial of Tools in Canada included 351 kindergarten children (mean age 5.2 years at entry; 51% female) in 18 public schools. Stratified randomization resulted in teachers and students in both groups being closely matched. Teachers in both groups received the same number of training hours and same funds for new materials. Outcome measures were pre and post standardized academic skill assessments and teacher online survey responses. This study replicated that Tools improves reading and shows for the first time that it improves writing (far exceeding levels the school districts had seen before), self-control and attention-regulation in the real world (e.g., time on task without supervision), reduces teacher burnout and children being ostracized or excluded, and increases the joy students and teachers experience in school. By Spring, Tools teachers were still enthusiastic about teaching; control teachers were exhausted. These results were not only better than the control group but also better than Tools teachers experienced the year before Tools. Thus, children in a kindergarten curriculum that emphasized play, improving self-regulation, working together and helping one another, and hands-on learning performed better academically, showed less bullying and peer ostracism and more kindness and helping behavior than students in more traditional classes, and teacher enthusiasm for teaching soared. Tools reduced initial disparities separating children, schools, and teachers. [ABSTRACT FROM AUTHOR]

Efforts to improve cultural competence in pediatric hearing loss services should be informed by evidence of how culture can affect services, yet there is a paucity of research in the field of audiology. The aim of this study was to gain insight into practitioners' experiences with offering early hearing loss services to minority culture families. Specifically, the objective was to examine possible barriers and facilitators to improving cultural competence in early hearing loss services by exploring the perspectives of the providers of care from across Canada. A survey, informed by our previous studies, was disseminated to practitioners providing hearing loss services. Responses to all survey questions were analyzed descriptively. Open-ended questions were analyzed with simple content analysis. Results indicate practitioners reported barriers at each stage of service delivery: during diagnoses, amplification discussions, language assessments, and interventions. Practitioners also described various strategies used to facilitate culturally competent care. Findings stemming from this study can be used to inform practitioners seeking to provide culturally competent care. [ABSTRACT FROM AUTHOR]

This exploratory study compares the profile of child welfare maltreatment-related investigations involving lone-parent families with and without co-residing grandparents. Based on data from the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2008), a weighted national representative sample of 92,885 maltreatment-related investigations involving children aged zero to fifteen in lone-parent families with no other care-givers at home (n  =   87,738) and with a co-resident grandparent (n  =   5,147) was examined. Multigenerational households were characterised, according to child welfare workers' reports, by younger child's age, youngster parent's age and Aboriginal status. After controlling for the child's age, children in multigenerational families had reduced odds of suicidal thoughts and academic difficulties. However, they were more likely to be identified as having parents with drug/solvent use problems and cognitive impairments, as living in more overcrowded households, and as experiencing more moves. Lone parents in multigenerational households were evaluated to have stronger social support systems and a greater likelihood, nonetheless, of risk-only investigations. Finally, multigenerational households were reported to have child welfare cases that remained open for ongoing services. These findings shed light on the profile of children in contact with welfare services living in multigenerational lone-parent households and have implications for designing child welfare programs. [ABSTRACT FROM AUTHOR]

Introduction: La Maison Bleue is a community-based perinatal health and social centre in Montreal that provides services during pregnancy up to age five to families living in vulnerable contexts. The study aimed to describe: 1) the challenges and protective factors that affect the well-being of migrant families receiving care at La Maison Bleue; and 2) how La Maison Bleue strengthens resilience among these families. Methods: We conducted a focused ethnography. Immigrants, refugees, asylum seekers and undocumented migrants were invited to participate. We collected data from November to December 2017 via semi-structured interviews and participant observation during group activities at La Maison Bleue. Data were thematically analysed. Results: Twenty-four mothers participated (9 interviewed, 17 observed). Challenges to well-being included family separation, isolation, loss of support, the immigration process, an unfamiliar culture and environment, and language barriers. Key protective factors were women’s intrinsic drive to overcome difficulties, their positive outlook and ability to find meaning in their adversity, their faith, culture and traditions, and supportive relationships, both locally and transnationally. La Maison Bleue strengthened resilience by providing a safe space, offering holistic care that responded to both medical and psychosocial needs, and empowering women to achieve their full potential towards better health for themselves and their families. Conclusion: Migrant mothers have many strengths and centres like La Maison Bleue can offer a safe space and be an empowering community resource to assist mothers in overcoming the multiple challenges that they face while resettling and raising their young children in a new country. [ABSTRACT FROM AUTHOR]

This study examined profiles of participation in extracurricular activities (ECAs) in 4th grade children (N = 27,121; Mean age = 9.20 years; SD = .54; 51% male) in British Columbia, Canada. Latent class analyses were used to establish activity profiles and determine class membership; ANCOVA was used to investigate differences in mental wellbeing (optimism, life satisfaction, self-concept) and perceived overall health between groups. Data came from a cross-sectional, population-level child self-report survey (i.e., the Middle Years Development Instrument) implemented with 4th grade children in public schools. We found four distinct ECA profiles: participation in “All Activities”, “No activities”, “Sports” (i.e., individual and team sports), and “Individual activities” (i.e., educational programs, arts/music, individual sports). Wellbeing and health scores were highest for children in the “All Activities” and the “Sports” clusters, and lowest for those in “No Activities” and the cluster reflecting individual activities (i.e., “Individual activities”). Results are discussed in the context of previous research, and with respect to practical relevance. [ABSTRACT FROM AUTHOR]

Objectives: The Healthy Kids Community Challenge is a large-scale, centrally-coordinated, community-based intervention in Ontario, Canada that promotes healthy behaviours towards improving healthy weights among children. With the goal of exploring tools available to evaluators, we leveraged electronic medical records from primary care physicians to assess child weights prior to launch of the Healthy Kids Community Challenge. This study compares the baseline (i.e. pre-intervention) prevalence of overweight and obesity in children 1–12 years of age living within and outside Healthy Kids Community Challenge communities. Design: Cross-sectional analysis of a primary care patient cohort. Setting: Electronic Medical Record Administrative data Linked Database (EMRALD) in Ontario, Canada. Participants: A cohort of 19 920 Ontario children who are rostered to an EMRALD physician. Children were 1–12 years of age at a primary care visit with recorded measured height and weight, between January 1, 2014 and December 31, 2015. Outcome measure: Overweight and obesity as determined by age- and sex-standardized body mass index using World Health Organization’s Growth Standards. Results: In Healthy Kids Community Challenge communities, 25.6% (95% CI 24.6–26.6%) of children had zBMI above normal (i.e. >1) compared to 26.7% (95% CI 25.9–27.5%) for children living outside of Healthy Kids Community Challenge communities. Conclusions: Despite some differences in sociodemographic characteristics, zBMI of children aged 1–12 years were similar inside and outside of Healthy Kids Community Challenge community boundaries prior to program launch. [ABSTRACT FROM AUTHOR]

Purpose: To (1) determine the association between exposure to maternal depressive symptoms in childhood and offspring suicide-related thoughts (SRT) and attempts (SA) in youth and young adults and (2) identify effect measure modifiers (offspring sex, family structure, maternal perceived social support, and social cohesion) of the association in 1.Method: A cohort was constructed by linking all cycles from the National Longitudinal Survey of Children and Youth, a Canadian nationally representative survey, from 1994 to 2009 in 16,903 subjects 0 to 25 years. Exposure to maternal-reported depressive symptoms was measured when offspring were between 0 and 10 years. Offspring self-reported incident and recurrent SRT and SA were measured between 11 and 25 years. Time-to-event models under a counting process framework were used to estimate adjusted hazard ratios (HR) and relative rates (RR) and 95% confidence intervals (CI). Effect measure modifiers were examined across adjusted stratum-specific estimates.Results: In offspring exposed to maternal depressive symptoms, the adjusted rates of incident SRT and SA (HR: 1.67, 95% CI 1.37, 2.08; HR: 1.93, 95% CI 1.43, 2.50) and of recurrent SRT and SA (RR: 1.61, 95% CI 1.33, 1.96; RR: 1.87, 95% CI 1.40, 2.36) were significantly elevated compared to non-exposed offspring. The stratum-specific rates of incident and recurrent SRT and SA were significantly elevated in females but not in males.Conclusions: Girls exposed to maternal depressive symptoms in childhood are a target group for childhood suicide preventive strategies. Family-based preventions, and strategies to identify and effectively treat maternal depressive episodes could be beneficial for suicide prevention in offspring. [ABSTRACT FROM AUTHOR]

This article explores organizational conditions for change to promote active Indigenous representation and service outcome improvements in a provincial child welfare program responsible for the ongoing oppression of Indigenous Peoples. Specific structural and environmental variables that support or impede Indigenous professionals' efforts toward critically needed improvements to Indigenous child welfare services are explored. Amidst the ongoing humanitarian crisis level of Indigenous children in care, the results indicate that developing highly specialized and equitably resourced Indigenous services, rather than ongoing ineffective and vague organizational approaches toward "indigenizing" provincial child welfare programs, are strongly indicated. [ABSTRACT FROM AUTHOR]

The article informs about longer-term ramifications of the Covid-19 Pandemic for children, families, and their communities. Topics include online schooling is an inadequate long-term solution; and interactions at school are critical developmentally because children learn the skills necessary to form and maintain adult relationships.

Background: Food insecurity is associated with a wide array of negative health outcomes and higher health care costs but there has been no population-based study of the association of food insecurity and mortality in high-income countries. Methods: We use cross-sectional population surveys linked to encoded health administrative data. The sample is 90,368 adults, living in Ontario and respondents in the Canadian Community Health Survey (CCHS). The outcome of interest is all-cause mortality at any time after the interview and within four years of the interview. The primary variable of interest is food insecurity status, with individuals classed as “food secure”, “marginally food insecure”, “moderately food insecure”, or “severely food insecure”. We use logistic regression models to determine the association of mortality with food insecurity status, adjusting for other social determinants of health. Results: Using a full set of covariates, in comparison to food secure individuals, the odds of death at any point after the interview are 1.28 (CI = 1.08, 1.52) for marginally food insecure individuals, 1.49 (CI = 1.29, 1.73) for moderately food insecure individuals, and 2.60 (CI = 2.17, 3.12) for severely food insecure individuals. When mortality within four years of the interview is considered, the odds are, respectively, 1.19 (CI = 0.95, 1.50), 1.65 (CI = 1.37, 1.98), and 2.31 (CI = 1.81, 2.93). Interpretation: These findings demonstrate that food insecurity is associated with higher mortality rates and these higher rates are especially large for the most severe food insecurity category. Efforts to reduce food insecurity should be incorporated into broader public health initiatives to reduce mortality. [ABSTRACT FROM AUTHOR]

It has been suggested that Canadian-born Major League Baseball (MLB) players are more likely to bat left-handed, possibly owing to the fact that they learn to play ice hockey before baseball, and that there is no clear hand-preference when shooting with a hockey stick; approximately half of all ice hockey players shoot left. We constructed a database on active (i.e., October, 2016) MLB players from four countries/regions based on place of birth (Canada, United States of America [USA], Dominican Republic and South Asia [i.e., Japan, Taiwan and South Korea]), including information on which hand they use to bat and throw. We also extracted information on all Canadian-born MLB players, dating back to 1917. Our results confirm that the proportion of left-handed batters born in Canada is higher when compared to the other countries selected; also, since 1917, the proportion of Canadian MLB players who bat left has been consistently higher than the league average. We also compared the proportion of left-handed batters in Canada with players born in states in the USA grouped into high, average and low based on hockey participation. The proportion of MLB players born in states with a high level of hockey participation were more likely to bat left, although the differences were significant at trend level only (p < .10). Lastly, we found that while Canadians were more likely to bat left-handed, this did not correspond with a greater left-hand dominance, as determined by throwing hand. In conclusion, the present study confirms that Canadian-born MLB players are more likely to bat left-handed when compared to American, Dominican Republic and South Asian-born MLB players, providing partial support for the hockey influence on batting hypothesis. [ABSTRACT FROM AUTHOR]

Applying a loss and grief perspective, this article explores lived experiences and perceptions of social workers and human service professionals who provided psychosocial supports and services to children, youth, and families recovering from the 2013 flood in southern Alberta, Canada. Five interrelated themes emerged from the analysis: (a) challenges with providing services while experiencing personal loss; (b) lack of funding for long-term postdisaster psychosocial recovery; (c) parenting in the context of disaster-related loss; (d) children’s and youth’s experiences of disaster-related loss and grief; and (e) the impact of the flood on family socioeconomic status. Recommendations for research, education and practice are discussed. [ABSTRACT FROM AUTHOR]

In Canada, Indigenous women are more likely than non-Indigenous women to be survivors of sexual assault and experience sexual assaults that are more serious in terms of physical injury and other health-related consequences. Despite their related needs for care and support, there is a paucity of research to date that has examined their uptake of specialized acute health services post sexual assault. To address this gap, we explored the presentation, sociodemographic, assailant, assault, and service use characteristics of Indigenous women, as compared to non-Indigenous adult and adolescent women aged 12 and older presenting to 30 of 35 hospital-based sexual assault treatment centres in Ontario from 2009 to 2011, using bivariate analyses. Of the 948 women in our sample, 116 (12%) identified as being Indigenous. Indigenous survivors differed significantly from non-Indigenous survivors on many presentation, sociodemographic, and assault characteristics. For example, they were more likely to present to a hospital within 24 hours of being assaulted and a treatment centre serving a primarily rural population. They tended to be younger, were more likely to be living in an institutional setting, report community or group affiliations and government or community services as sources of social support, and be assaulted by a parent, guardian, or other relative. In terms of receipt of services, they were more likely to have undergone safety planning and to be referred to child protection or community agencies. They reported high levels of satisfaction with the services received, however, were less likely than non-Indigenous survivors to rate the overall care provided as excellent or good. On the whole, the results of our study suggest that Indigenous women value acute hospital-based sexual assault services. However, they experience sexual assaults in contexts different from non-Indigenous survivors. It is important for health care providers to be attuned to this so that they can appropriately respond to their unique needs. [ABSTRACT FROM AUTHOR]

This article uses pupil records and patient files from Toronto, along with other sources, to examine the interconnected rise of special education classes and the complete exclusion from public schools of children labelled with a form of mental deficiency referred to as ‘‘idiocy’’ or ‘‘imbecility’’ or later represented by an intelligence quotient below fifty. It was the first provincial special education laws that also enabled schools to legally exclude some children not just from the new special classes but also from public schooling altogether. Drawing on eugenics and the ideas of mental deficiency experts, school officials justified exclusion by claiming that some types of disabled children were ‘‘ineducable’’ – they could not learn or their presence in schools would harm others’ learning. The article looks at student experiences to show how exclusion curtailed their schooling. It also examines how families responded to the exclusion. Families were historical actors, despite the limitations imposed on them by their circumstances, by the policies and prevailing attitudes about class, gender, and single mothers, and by the nature of their family member’s disability. The article contributes to ‘‘the new disability history,’’ a growing subfield. [ABSTRACT FROM AUTHOR]

Background: High rates of food insecurity are documented among Inuit households in Canada; however, data on food insecurity prevalence and seasonality for Inuit households with children are lacking, especially in city centres. This project: (1) compared food consumption patterns for households with and without children, (2) compared the prevalence of food insecurity for households with and without children, (3) compared food consumption patterns and food insecurity prevalence between seasons, and (4) identified factors associated with food insecurity in households with children in Iqaluit, Nunavut, Canada.Methods: Randomly selected households were surveyed in Iqaluit in September 2012 and May 2013. Household food security status was determined using an adapted United States Department of Agriculture Household Food Security Survey Module. Univariable logistic regressions were used to examine unconditional associations between food security status and demographics, socioeconomics, frequency of food consumption, and method of food preparation in households with children by season.Results: Households with children (n = 431) and without children (n = 468) participated in the survey. Food insecurity was identified in 32.9% (95% CI: 28.5-37.4%) of households with children; this was significantly higher than in households without children (23.2%, 95% CI: 19.4-27.1%). The prevalence of household food insecurity did not significantly differ by season. Demographic and socioeconomic characteristics of the person responsible for food preparation, including low formal education attainment (ORSept = 4.3, 95% CI: 2.3-8.0; ORMay = 3.2, 95% CI: 1.8-5.8), unemployment (ORSept = 1.1, 95% CI: 1.1-1.3; ORMay = 1.3, 95% CI: 1.1-1.5), and Inuit identity (ORSept = 8.9, 95% CI: 3.4-23.5; ORMay = 21.8, 95% CI: 6.6-72.4), were associated with increased odds of food insecurity in households with children. Fruit and vegetable consumption (ORSept = 0.4, 95% CI: 0.2-0.8; ORMay = 0.5, 95% CI: 0.2-0.9), as well as eating cooked (ORSept = 0.5, 95% CI: 0.3-1.0; ORMay = 0.5, 95% CI: 0.3-0.9) and raw (ORSept = 1.7, 95% CI: 0.9-3.0; ORMay = 1.8, 95% CI: 1.0-3.1) fish were associated with decreased odds of food insecurity among households with children, while eating frozen meat and/or fish (ORSept = 2.6, 95% CI: 1.4-5.0; ORMay = 2.0, 95% CI: 1.1-3.7) was associated with increased odds of food insecurity.Conclusions: Food insecurity is high among households with children in Iqaluit. Despite the partial subsistence livelihoods of many Inuit in the city, we found no seasonal differences in food security and food consumption for households with children. Interventions aiming to decrease food insecurity in these households should consider food consumption habits, and the reported demographic and socioeconomic determinants of food insecurity. [ABSTRACT FROM AUTHOR]

The present study examined predictors of emotional problems amongst a nationally representative cohort of recent immigrants in Canada. Specifically, the effects of parenting status were examined given the association between parenting stress and mental health. Data came from the Longitudinal Survey of Immigrants to Canada (N = 7055). Participants were recruited 6-months post landing (2001–2002) and followed up at 2 and 4 years. Self-reported emotional problems over time were considered as a function of parenting status (Two Parent, Lone Parent, Divorced Non-Parent, Non-Divorced Non-Parent) and sociodemographic characteristics. Odds of emotional problems were higher among Two Parent, OR = 1.12 (1.01, 1.24), Lone Parent, OR = 2.24 (1.75, 2.88), and Divorced Non-Parent, OR = 1.30 (1.01, 1.66) immigrants compared to Non-Divorced Non-Parents. Visible minority status, female gender, low income, and refugee status were associated with elevated risk. Findings reveal that immigrant parents are at risk for emotional health problems during the post-migration period. Such challenges may be compounded by other sociodemographic risk. [ABSTRACT FROM AUTHOR]

Background: Very little is understood about the developmental antecedents of sexual behaviour prior to adolescence.Aims: Our aim was to examine the impact of different forms of intimate partner violence on early childhood sexual development.Methods: We used data from an ongoing prospective longitudinal cohort study of Canadian families. Intimate partner violence of various kinds was measured using a modified version of the Conflict Tactics Scale. Measures of child sexual development were based on the Child Sexual Behavior Inventory. Both measures relied on parental report.Results: Sexual coercion between parental figures, but not physical violence or emotional aggression, was significantly associated with intrusive sexual behaviours shown by 3- to 5-year-old children.Conclusions: It may seem unlikely that 3- to 5- year-old children can understand that their parents are in a sexually coercive relationship, but our findings suggest that they are sufficiently aware of such behaviours when they occur that they may start to model their own behaviour on them. Clinicians and social workers may need to be more aware of this possibility. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the performance of the INTERGROWTH-21st Project newborn standard vis-a-vis the current Canadian birth weight-for-gestational age reference. Methods: All hospital-based singleton live births in Canada (excluding Quebec) between 2002 and 2012 with a gestational age between 33 and 42 weeks were included using information obtained from the Canadian Institute for Health Information. Small- and large-for gestational age centile categories of the INTERGROWTH standard and Canadian reference were contrasted in terms of frequency distributions and rates of composite neonatal morbidity/mortality. Results: Among 2,753,817 singleton live births, 0.87% and 9.63% were <3rd centile and >97th centile, respectively, of the INTERGROWTH standard, while 2.27% and 3.55% were <3rd centile and >97th centile, respectively, of the Canadian reference. Infants <3rd centile and >97th centile had a composite neonatal morbidity/mortality rate of 46.4 and 12.9 per 1,000 live births, respectively, under the INTERGROWTH standard and 30.9 and 16.6 per 1,000 live births, respectively, under the Canadian reference. The INTERGROWTH standard <3rd centile and >97th centile categories had detection rates of 3.14% and 9.74%, respectively, for composite neonatal morbidity/ mortality compared with 5.48% and 4.60%, respectively for the Canadian reference. Similar patterns were evident in high- and low-risk subpopulations. Conclusions: The centile distribution of the INTERGROWTH newborn standard is left shifted compared with the Canadian reference, and this shift alters the frequencies and neonatal morbidity/mortality rates associated with specific centile categories. Further outcome-based research is required for defining abnormal growth categories before the INTERGROWTH newborn standard can be used. [ABSTRACT FROM AUTHOR]

Children do not know everything that adults know, nor do adults know everything that children know. The present research examined the universality of beliefs about child and adult knowledge and their development with 4- and 7-year-old Canadian and Japanese children (N = 96). In both countries, all children were able to identify adult-specific knowledge and only older children displayed beliefs about child-specific knowledge. However, Japanese and Canadian children differed in whether they used their own knowledge in deciding whether a person who knew an item was a child or an adult. In addition, parental and child beliefs were related in Japan but not in Canada. These findings indicate that children growing up in different cultures may take different paths in developing beliefs about age-related knowledge. Implications for theories of socio-cognitive development and learning are discussed. [ABSTRACT FROM AUTHOR]

Previous work has demonstrated that three overarching vulnerabilities-genetic, environmental, and temperamental-contribute to the development of child anxiety. The purpose of our study was to assess: (a) the relationship between an environmental vulnerability, family enmeshment, and child anxiety; (b) whether parental anxiety accounts for this relationship; and (c) whether this relationship is mediated by levels of child Behavioral Inhibition System sensitivity, a highly persistent temperamental variable demonstrating positive associations with child anxiety. Our study included 38 Canadian parent-child dyads from an urban area, of which 33 children were Caucasian and 18 were girls. Children were aged 9 or 11 years ( M = 10.21, SD = 1.07). Children completed measures of anxiety and sensitivity towards threat and parents completed measures of family enmeshment. The results supported a significant positive relationship between family enmeshment and child anxiety; parental anxiety did not account for this relationship; and the relationship was partially mediated by Behavioral Inhibition System sensitivity. Specifically, when the effect of Behavioral Inhibition System sensitivity was controlled for, the association between family enmeshment and child anxiety became non-significant. The results suggest that family enmeshment is associated with levels of child anxiety largely through the function of children's sensitivity to threat. Enmeshed families may increase children's susceptibility to anxiety through their effect on child temperament, specifically sensitivity to threat. [ABSTRACT FROM AUTHOR]

Background Participating in everyday life is essential to the healthy development and emotional well-being of children. However, little is known about siblings of children with complex care needs (CCN), and their perspectives and experiences of participating in everyday life. The aim of this paper is to present research findings that add to our understanding of how siblings of children with CCN view and experience participation in everyday life. Methods To arrive at a detailed and accurate understanding of the siblings' perspectives and experiences, we used the qualitative research design of ethnography. Sixteen siblings (seven brothers, nine sisters) of children with CCN were recruited. The siblings ranged in age between 7 and 25 years, with a mean age of 14 years. All siblings took part in opened-ended interviews and completed ecomaps to describe how they participate. Five siblings also took part in the photovoice method. Analysis involved several iterative steps, congruent with ethnography. Results Four main themes emerged as follows: (1) participation is about being part of a group; (2) it feels good; (3) I love my sibling but...; and (4) promoting participation. Siblings of children with CCN identified challenges to participation and also described ways that they participate that relate to the care of their sibling. Conclusions Siblings prioritized the relationship with their sisters and brothers with CCN in their life, and a great deal of their participation was chosen with their sibling in mind. Sibling-to-sibling relationships were distinct and meaningful and, as a result, participation was always done mindfully and with the family needs at the forefront. Nonetheless, clinicians caring for children with CCN must keep in mind the challenges that siblings of children with CCN experience and provide strategies to siblings that will help to promote their participation in everyday life. [ABSTRACT FROM AUTHOR]

Background: Physical activity is associated with the reduction of several chronic conditions in adults. Additionally, physical activity is extremely important for children for their development and cognitive functioning and also to create a physically active lifestyle that continues into adulthood. Despite the known benefits of physical activity, only one in five adults are achieving the public health recommendations of 150 minutes of moderate-to-vigorous physical activity per week and only 13 % of boys and 6 % of girls between the ages of 5 and 17 years are meeting the guidelines of 60 minutes per day. This study aims to evaluate whether a planning condition improves adherence to regular physical activity compared to an education-only control condition among families. Families are eligible if there is at least one child between the ages of 6 and 12 years who is not meeting the Canadian Physical Activity Guidelines.Methods/design: A six-month longitudinal randomized controlled trial will be used to compare the two conditions. Materials will be delivered at baseline with 'booster' sessions at six weeks and three months. Participants will be assessed at baseline and at six months with a fitness test, as well as questionnaires and accelerometery at baseline, six weeks, three months and six months. A total of 137 families have been recruited thus far from Greater Victoria. This study is ongoing and recruitment will continue until December 2015 with the target goal of reaching 160 families.Discussion: This protocol describes the implementation of a randomized controlled trial that utilizes planning strategies to try and increase physical activity among families. Research findings could be useful in public health in providing effective strategies to families to help decrease sedentary lifestyles. Additionally, findings may help to inform future interventions aimed at increasing physical activity among families.Trial Registration: This trial was registered on June 5, 2012 with the Clinical Trials Registry maintained by the National Library of Medicine at the National Institutes of Health. The registration ID is NCT01882192. [ABSTRACT FROM AUTHOR]

In this article, as a child and family mental health therapist, I connect the feminist concept of 'provisioning' and the experiences of 'young carers' to critically examine the family care contributions made by older children living in poverty. I present the findings of a qualitative study consisting of two focus groups in which ten ( n = 10) welfare-reliant lone mothers living in Toronto, Canada described the nature and significance of the contributions made by their older children (11-17 years old) to help their families 'make ends meet'. Using grounded theory, two main categories emerged: (1) the nature of the provisioning by older children, and (2) the significance of the contributions. The implications of the findings suggest that mental health approaches with older children living in poverty inappropriately misrepresent and pathologise their emotional distress and family contributions. [ABSTRACT FROM AUTHOR]

The article discusses feminist sociologists' scholarship on the sociology of the family in Canada from the 1960s through the early 21st century, including in regard to the social conditions of women in the family. An overview of the employment of women in Canada, including upper-class families' employing women of color to perform housework and childcare, is provided. The social conditions of Canadian parents, including in regard to the high cost of child rearing, the historical ideology regarding the duties of mothers and the Canadian government's parental leave policy, are discussed.

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Abstract: While we have some understanding of the impact caring for children with complex care needs has on families, little is known about how these families experience participation. This longitudinal qualitative study aimed to extend our limited understanding of how the changing geographies of care influence the ways that Canadian families with children with complex care needs participate in everyday life. The findings in this article focus on parents'' conceptualizations of participation including their perspectives of participation involving themselves, their children, and their family unit. Sixty-eight parents from 40 families took part in the study. Conradson''s (2005) conceptualization of therapeutic landscapes that focuses on the relational dimensions of the self-landscape encounter guided the study. Data collection methods included ethnographic methods of interviewing and photovoice. As a summary of their views, parents within this study described participation as a dynamic and reciprocal social process of involvement in being with others. For participation in everyday life to be meaningful, the attributes of choice, safety, acceptance, accessibility, and accommodation had to be present. Participation was valued by parents because it resulted in positive outcomes. Overall, meaningful participation contributed to them and their children having a life. Having a life referred to being involved in a place where families feel that they belong, are accepted, and are able to contribute to the landscape they participate in. The decision to choose to participate became contingent upon the availability of resources and the parents'' ability to harness them. Harnessing resources referred to the work parents must do to get the necessary resources to make it possible for them and their children to have a life. Having a life for parents required significant physical, mental, psychological and spiritual work by parents. At times the personal resources of parents were so taxed that the possibility for meaningful participation was something less than what they desired. The families'' stories raise questions of societal obligations to promote meaningful participation. This study lends support for further improvements that may enrich the lives of families with children with complex care needs. [Copyright &y& Elsevier]

An essay is presented on Aboriginal people of Canada. It offers a history of indigenous people and examines building of the Canadian national identity including treaties signed by the Canadian government to gain control of Aboriginal land. The author discusses the residential school system under which children were forcibly taken away from their families.

In this article, the author discusses residential schools of Canada which includes children's stories of loneliness, physical, mental, and sexual abuses. He informs that over 150,000 children were forcibly taken away from their families. He also discusses the post-traumatic stress disorder (PTSD) of attending residential school. The author mentions that his father underwent his Independent Assessment Process (IAP) regarding his experience at the Residential schools.

The impact of bilingual exposure on language learning has not been systematically studied in children with Autism Spectrum Disorders. This study compared the social abilities and language levels of children (mean age = 56 months) with ASDs from bilingual (n = 45) and monolingual (n = 30) environments. Bilingually-exposed children were subgrouped based on simultaneous bilingual exposure from infancy (SIM, n = 24) versus sequential post-infancy bilingual exposure (SEQ, n = 21). Despite significantly different amounts of bilingual exposure across all groups ( p = <0.001) and significantly stronger social interaction scores in the SIM group compared to the SEQ group on the Vineland Adaptive Behavior Scales-II Interpersonal subdomain ( p = 0.025), there were no significant group differences in language level. Bilingually-exposed children with ASDs did not experience additional delays in language development. [ABSTRACT FROM AUTHOR]

Family policy in Canada is primarily concerned with assisting parents raise their children. This fairly singular approach to family policy is ironic given that Canada does not have a nationally-coordinated family policy. The development of a national family policy has been hampered by Canada's decentralized governmental structure (i.e., federal and provincial, as well as territorial, governments) and other factors such as diverse geography and different traditions (e.g., a tradition of common law in English Canada, and civil law in Quebec). A recent addition to Canada's family policy is Bill C-38, The Civil Marriage Act (), the law legalizing same-sex marriage. To put Canada's same-sex marriage law into context, this article presents some preliminary statistics about same-sex marriage in Canada, and considers whether same-sex marriage legislation is a good example of Canadian family policy, or an exception to the rule that Canadian family policy focuses primarily on helping parents socialize their children. [ABSTRACT FROM AUTHOR]

We evaluated the effectiveness of a two-generation preschool programme (centre-based early childhood education, parenting education and family support) on receptive language skills in children living in culturally diverse families with low income. Using a with-in subject pre-test/post-test design, children (N = 112) showed a statistically significant improvement in receptive language skill as measured by the Peabody Picture Vocabulary Test, Third Edition. At post-test, the children continued to score below typically developing children of the same age. There were no statistically significant differences on receptive language skill with regard to child gender, culture, caregiver education, nor involvement in child welfare services. Only for children of Aboriginal ancestry (n = 40) was the amount of time spent in the programme significantly correlated with the amount of positive change in receptive language skill. When designing early intervention programmes for families with low income, targeting the specific needs of cultural sub-groups may improve outcomes. [ABSTRACT FROM AUTHOR]