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Abstract Background Several recent global events may have impacted adolescent sleep and exacerbated pre-existing disparities by social positions (i.e., social roles, identity or sociodemographic factors, and/or group memberships that are associated with power and oppression due to the structures and processes in a given society at given time). Current understanding of sleep among adolescents is critical to inform interventions for a more equitable future, given the short and long-term consequences of inadequate sleep on health and well-being. This study aimed to provide contemporary evidence on sleep disparities by key social positions among adolescents in Canada. Methods Cross-sectional analyses were conducted using self-reported data collected during 2020–2021 (the first full school year after the COVID-19 pandemic onset) from 52,138 students (mean [SD] age = 14.9 [1.5]) attending 133 Canadian secondary schools. Multiple regression models were used to test whether sleep quality (how well students slept during past week), duration (weekday, weekend, weighted daily average), and guideline adherence (8–10 h/day) differed by sex and gender, race and ethnicity, and socioeconomic status (SES). Results Females reported a mean [95% CI] difference of -1.7 [-3.7, 0.4] min/day less sleep on weekdays than males, but 7.1 [4.5, 9.6] min/day more sleep on weekends, resulting in no difference in average daily sleep between males and females. Females were less likely to report good quality sleep compared to males (AOR = 0.57 [0.54, 0.60]). SES followed a generally monotonic trend where higher scores were associated with more sleep on weekdays (Δhighest: lowest = -28.6 [-39.5, -17.6]) and weekends (Δhighest: lowest = -17.5 [-3.8, -31.2]) and greater likelihood of higher sleep quality (AORhighest: lowest = 3.04 [2.35, 3.92]). Relative to White adolescents, weekday and average daily sleep duration were lower among all other racial identities; mean differences ranged from ∼ 5–15 min/day, with Black students reporting the least sleep. Conclusions Differences in sleep duration and quality were most profound among adolescents from the lowest and highest SES. Racial disparities were more evident on weekdays. Compensatory weekend sleep appears more pronounced in females than males. Addressing sleep inequities is critical, as a robust predictor of multiple health outcomes.

IntroductionThe COVID-19 pandemic intensified the impact of risk factors for adolescent mental health, including financial worry. Social support has shown to protect from negative mental health during times of stress. We examined the effect of financial worry on changes in anxiety and depression symptoms among Canadian adolescents prior to and during the pandemic, and assessed whether social support from family and friends moderated any changes. MethodsWe analyzed 2-year linked data from the 2018/19 (pre-pandemic) and 2020/21 (during-pandemic) waves of the COMPASS study, with reports from 12 995 Canadian secondary school students. A series of multilevel linear regressions were conducted to examine the main hypotheses under study. ResultsStudents scored an average (SD) of 7.2 (5.8) on the anxiety (GAD-7) and 10.0 (6.5) on the depression (CESD-10) scales; 16.1% reported they experienced financial worry during the pandemic. Financial worry was a strong and significant predictor of increased anxiety scores (+1.7 score between those reporting “true/mostly true” versus “false/mostly false”) during the pandemic, but not for depression scores. Low family and friend support were associated with anxiety, and low family support was associated with depression. No significant interactions were detected between social support and financial worry. ConclusionPandemic-related financial worry was significantly associated with anxiety in our large sample of Canadian adolescents. Clinical and public health initiatives should be aware of adolescents’ financial worry and its associations with anxiety during times of crisis.

IntroductionLa pandémie de COVID-19 a intensifié les effets des facteurs de risque associés à la santé mentale des adolescents, en particulier les préoccupations financières. Par ailleurs, on sait que le soutien social offre une protection contre les problèmes de santé mentale pendant les périodes de stress. C’est dans ce cadre que nous avons exploré l’effet des préoccupations financières sur les variations des symptômes d’anxiété et de dépression chez les adolescents canadiens avant et pendant la pandémie, pour déterminer si le soutien social apporté par la famille et les amis modérait ces variations. MéthodologieNous avons analysé des données couplées sur deux ans provenant des vagues 2018-2019 (avant la pandémie) et 2020-2021 (pendant la pandémie) de l’étude COMPASS pour 12 995 élèves canadiens du secondaire. Nous avons réalisé une série de régressions linéaires multiniveaux pour explorer les principales hypothèses à l’étude. RésultatsLes élèves ont obtenu un score moyen de 7,2 (écart-type : 5,8) pour l’anxiété (échelle GAD-7) et de 10,0 (6,5) pour la dépression (échelle CESD-10), et 16,1 % des élèves ont déclaré avoir eu des préoccupations financières pendant la pandémie. Les préoccupations financières ont constitué un facteur de prédiction important et statistiquement significatif de scores d’anxiété plus élevés (+1,7 entre ceux qui ont répondu « vrai/le plus souvent vrai » et ceux qui ont répondu « faux/le plus souvent faux ») pendant la pandémie, mais non en ce qui concerne les scores de dépression. Il existe un lien entre un faible soutien de la part de la famille et des amis et l’anxiété ainsi qu’entre un faible soutien de la part de la famille et la dépression. Aucune interaction importante n’a été observée entre le soutien social et les préoccupations financières. ConclusionLes préoccupations financières liées à la pandémie ont été fortement associées à l’anxiété dans notre large échantillon d’adolescents canadiens. Les initiatives cliniques et sanitaires doivent tenir compte des préoccupations financières des adolescents et de leurs liens avec l’anxiété en période de crise.

Abstract Background To assess whether changes in breakfast and water consumption during the first full school year after the emergence of the COVID-19 pandemic varied based on sex/gender, race/ethnicity, and socioeconomic status among Canadian adolescents. Methods Prospective annual survey data collected pre- (October 2019-March 2020) and post-COVID-19 onset (November 2020-June 2021) the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) study. The sample consisted of 8,128 students; mean (SD) age = 14.2 (1.3) years from a convenience sample of 41 Canadian secondary schools. At both timepoints self-reported breakfast and water consumption were dichotomized as daily or not. Multivariable logistic generalized estimating equations with school clustering were used to estimate differences in maintenance/adoption of daily consumption post-COVID-19 based on demographic factors, while controlling for pre-COVID-19 behaviour. Results Adjusted odds ratios (AOR) with 95% confidence intervals are reported. Females (AOR = 0.71 [0.63, 0.79]) and lower socioeconomic status individuals (AORLowest:Highest=0.41 [0.16, 1.00]) were less likely to maintain/adopt daily breakfast consumption than male and higher socioeconomic status peers in the 2020–2021 school year. Black identifying individuals were less likely than all other racial/ethnic identities to maintain/adopt plain water consumption every day of the week (AOR = 0.33 [0.15, 0.75], p

Abstract Background The impact of the COVID-19 pandemic and consequent public health restrictions on the mental health of adolescents is of global concern. The purpose of this study was to examine how Canadian adolescents coped during the early pandemic and whether different coping methods were associated with changes in mental health from before the pandemic to the early lockdown response. Methods Using two-year linked survey data (2018–2020) from a prospective cohort of secondary school students (n = 3,577), linear regression models were used to examine whether changes in mental health (anxiety [Generalized Anxiety Disorder-7 scale], depression [Center for Epidemiologic Studies Depression 10-item scale Revised], emotion regulation [Difficulties in Emotion Regulation Scale], psychosocial well-being [Flourishing scale]) were related to each coping behaviour. Results The most common reported coping behaviours included staying connected with friends online (78.8%), playing video games, watching TV/movies, and/or surfing the internet/social media (76.2%), studying or working on schoolwork (71.0%), and getting exercise (65.2%). The use of positive coping mechanisms during the early pandemic period (e.g., keeping a regular schedule, time with family, time with friends online) was associated with less adverse mental health changes from before to during the early lockdown; whereas, negative coping mechanisms (e.g., spending time alone, eating junk food) were consistently associated with more adverse mental health changes. Conclusion This study demonstrates the importance of social support and connections with both friends and family, as well as keeping and maintaining a routine, over the pandemic. Interventions supporting positive relationships and engagement in these coping behaviours may be protective for adolescent mental health during disruptive events.

Purpose: The purpose of this study was to assess if adolescent sub-populations in Canada (i.e., based on race/ethnicity, sex/gender, socioeconomic status, and urbanicity groups) experienced a larger change in sleep duration and guideline adherence between 2019 and 2020 (pre-pandemic) and the 2020–2021 (mid-pandemic) school years. Methods: Longitudinally linked data from 2019 to 2020 (pre-pandemic) and 2020–2021 (mid-pandemic) of a prospective cohort study of secondary school students (M = 14.2, SD = 1.3 years, N = 8209) in Canada were used for analyses. Regression modelling tested the main effects of race/ethnicity, sex/gender, socioeconomic status, and urbanicity on changes in sleep duration as well as adherence to Canada's 24-h Movement Guidelines for sleep (8–10 h/night). Interactions between identity variables (race/ethnicity or sex/gender) and other main effect variables were subsequently tested. Results: Females gained more sleep (4.5 [1.5, 7.5] min/day more) and increased guideline adherence (AOR = 1.16 [1.04, 1.30] than males on average. Asian race/ethnic identity was associated with less sleep gain than White identity −10.1 [-19.4, −0.8], but not guideline adherence. Individuals in large urban areas gained less sleep and adhered less to guidelines than individuals from any other level of urbanicity (−21.4 [-38.5, −4.2] to −15.5 [-30.7, −0.2] min/day). Higher individual SES scores were associated with greater sleep gain (linear trend: 11.16 [1.2–21.1]). The discrepancies in sleep gain and guideline adherence between males and females were significantly modified by race/ethnicity and urbanicity. Discussion: Increases in sleep duration may be one of the few benefits to adolescents during the COVID-19 pandemic but were not equally distributed across sub-populations. Efforts to promote better sleep adherence may need to account for sex/gender differences, especially in less urbanized areas and certain racial/ethnic groups.

Abstract Background Youth voice has been largely absent from deliberations regarding public health measures intended to prevent SARS-CoV-2 transmission, despite being one of the populations most impacted by school-based policies. To inform public health strategies and messages, we examined the level of student support of mask use in public spaces and school mask requirements, as well as factors associated with students’ perspectives. Methods We used cross-sectional survey data from 42,767 adolescents attending 133 Canadian secondary schools that participated in the COMPASS study during the 2020/2021 school year. Multinomial regression models assessed support for i) wearing a mask in indoor public spaces and ii) schools requiring students to wear masks, in association with COVID-19 knowledge, concerns, and perceived risk. Results Wearing masks in indoor public spaces was supported by 81.9% of students; 8.7% were unsupportive and 9.4% were neutral/undecided. School mask requirements were supported by 67.8%, with 23.1% neutral and 9.1% unsupportive. More females supported mask wearing in public spaces (83.9% vs. 79.1%) and school mask requirements (70.8% vs. 63.5%) than males. Students had increased odds of supporting mask use in public spaces and school mask requirements if they reported concerns about their own or their family’s health, had discussions regarding ways to prevent infection, perceived COVID-19 to be a risk to young people, and knew that signs are not always present in COVID-19 cases and that masks prevent SARS-CoV-2 transmission if someone coughs. Conclusions During the year following the beginning of the pandemic, most students supported the required use of masks in schools and wearing masks in indoor public spaces. Improving knowledge around the effectiveness of masks appears likely to have the largest impact on mask support in adolescent populations among the factors studied.

Physical activity may play a role in promoting or preventing substance use among youth. The purpose of this study was to examine the association between different types of physical activity [i.e., non-competitive school sport, competitive school sport, outside of school sport and minutes of moderate to vigorous physical activity (MVPA) per day] and substance use (i.e., current smoking, e-cigarette, cannabis, binge drinking) among Canadian youth. Interaction effects between physical activity and school connectedness were also examined. Using data from the COMPASS study (2018–19; n = 73,672), four multi-level logistic regression models were developed to investigate whether physical activity lessened or worsened the odds of (1) smoking; (2) e-cigarette use; (3) cannabis use; and (4) binge drinking. Models were stratified by gender to reflect the inherent differences between genders. Models were adjusted for demographic factors and other covariates. Sport participation was consistently associated with substance use, whereas less evidence was found for meeting MVPA guidelines. Non-competitive school sport lessened the odds of cannabis use for males and females. However, non-competitive school sport only lessened the odds of e-cigarette use for females but increased the odds of binge drinking for males. Participation in competitive school sport lessened the odds of cigarette smoking but increased the odds of e-cigarette use and binge drinking for males and females. Outside of school sport lessened the odds of cigarette smoking and cannabis use but increased the odds of e-cigarette use and binge drinking for males and females. A significant moderation effect was found for males participating in sport outside of school and meeting MVPA guidelines who were at a lower risk of e-cigarette use in the presence of high levels of school connectedness. Our study provides evidence for further consideration and provision of extracurricular activities, specifically non-competitive sport, in protecting against substance use. Caution is required in claiming that sport participation or physical activity, in general, is negatively associated with substance use among youth.

Abstract Background Emerging evidence suggests perceptions of being overweight account for many of the psychosocial consequences commonly associated with obesity. Previous research suggests an obesity achievement gap, yet limited research has explored weight perception in association with academic performance. Moreover, underweight perceptions have typically been excluded from research. The current study examined how BMI classification and weight perception relate to academic performance in a large cohort of youth. Methods We used cross-sectional survey data from 61,866 grade 9–12 students attending the 122 Canadian schools that participated in Year 6 (2017/2018) of the COMPASS study. Mixed effect regression models were used to examine associations between students’ BMI classification and weight perceptions and their math and English/French course grades. All models were stratified by sex and adjusted for sociodemographic covariates and school clustering. Results For English/French grades, males and females with overweight or underweight perceptions were less likely to achieve higher grades than their peers with perceptions of being at “about the right weight”, controlling for BMI and covariates. For math grades, females with overweight perceptions, and all students with underweight perceptions, were less likely to achieve higher grades than their peers with “about the right weight” perceptions. All students with BMIs in the obesity range were less likely to report grades of 60% or higher than their peers with “normal-weight” BMIs, controlling for weight perception and covariates. Overweight BMIs were predictive of lower achievement in females for English/French grades, and in males for math grades, relative to “normal-weight” BMIs. Results for students that did not respond to the weight and weight perception items resembled those for obesity BMI and overweight/underweight perceptions, respectively. Conclusions Overall, this study demonstrates that an obesity achievement gap remains when controlling for students’ perceptions of their weight, and that both underweight and overweight perceptions predict lower academic performance, regardless of BMI classification. Results suggest barriers to academic success exist among youth with larger body sizes, and those with perceptions of deviating from “about the right weight”.

This study examined changes in body mass and body mass index (BMI), physical activity, and dietary intake in Canadian university students during the first year of the COVID-19 pandemic. Two self-reported recall surveys were conducted: after the first lockdown in September 2020 (T1) and following the second lockdown in March 2021 (T2). Eligible participants were full-time undergraduate students attending a Canadian university and residing in Canada during the first year of the pandemic. At T1, 510 students (99 male, 411 female) completed the survey, and of those, 135 (32 males, 103 females) completed the survey at T2 (73% attrition). At both T1 and T2, most participants were 18–24 years of age (93% and 90%, respectively), Caucasian (73% and 78%, respectively), and resided in the province of Ontario (79% and 80%, respectively). Body mass increased from T1 to T2 (+0.91 ± 3.89 kg t(132) = −2.7, p = 0.008). BMI also increased from T1 to T2 (+0.30 ± 1.33 kg/m2 [t(130) = −2.5, p = 0.012), with a greater number of participants within the overweight range (19.8% versus 24.4%, respectively). At T1, 38% of the participants reported a decrease in physical activity, while the number of students reporting a decrease in activity increased to 56% at T2. Dietary energy intake decreased from 1678 ± 958 kcal/day at T1 to 1565 ± 842 kcal/day at T2 [c2(1) = 7.2, p = 0.007]. Diet quality also decreased, with participants not meeting the recommended daily allowance for essential macro and micronutrients. A decrease was observed in daily servings of fruits (−27%, p < 0.001), vegetables (−72%, p < 0.001), and grains (−68%, p < 0.001). In conclusion, despite a small decrease in dietary energy intake, a modest weight gain occurred during the first year of the COVID-19 pandemic in this cohort of Canadian university students, which was potentially related to decreased physical activity and diet quality.

Research is needed to develop evidence-based behavioral interventions for preventing and treating obesity that are specific to the schizophrenia population. This study is the precursor to such intervention research where we examined the utility of the social cognitions outlined within the Health Action Process Approach (HAPA) model for predicting moderate to vigorous physical activity (MVPA) intentions and behavior among individuals with schizophrenia or schizoaffective disorder. A prospective cohort design [baseline (T1), week 2 (T2), and week 4 (T3)] was used to examine the HAPA constructs and MVPA across a sample of 101 adults (Mage = 41.5 ± 11.7 years; MBMI = 31.2 ± 7.8 kg/m2; 59% male). Two hierarchical regression analyses were conducted controlling for age, gender, BMI, and previous self-reported MVPA. In the first regression, intentions at T1 were regressed onto the T1 motivational HAPA constructs (risk perception, affective attitudes, task self-efficacy) and social support; MVPA status (meeting vs. not meeting the MVPA guidelines) assessed via accelerometry at T3 was regressed onto T1 social support and intentions followed by T2 action and coping planning, and maintenance self-efficacy in the second analysis. Overall, the motivational and social support variables accounted for 28% of the variance in intentions, with affective attitudes (β = 0.33, p