Search

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: As a result of the public health measures put in place during the COVID-19 pandemic in Canada, many health services, including those for the treatment of eating disorders, were provided at a distance. This study aims to describe the adaptations made in specialized pediatric eating disorder programs in Canada and the impact of these adaptations on health professionals' experience of providing care. Methods: A mixed-methods design was used to survey healthcare professionals working in specialized pediatric eating disorder programs about adaptations to treatment made during the pandemic and the impact of these adaptations on their experience of providing care. Data were collected between October 2021 and March 2022 using a cross-sectional survey comprising 25 questions and via semi-structured interviews. Quantitative data were summarized using descriptive statistics and qualitative data were interpreted using qualitative content analysis. Results: Eighteen healthcare professionals in Canada completed the online survey, of whom six also participated in the semi-structured interviews. The cross-sectional survey confirmed that, unlike in pre-pandemic times, the majority of participants provided medical care (15/18) and mental health care (17/18) at a distance during the pandemic, with most participants using telephone (17/18) and videoconferencing (17/18). Most (16/18) health professionals indicated that virtual care would continue to be used as a tool in pediatric ED treatment after the pandemic. Participants used a combination of virtual and in-person care, with most reporting weighing patients both in clinic (16/18) and virtually (15/18). Qualitative content analysis generated five themes: (1) responding to increased demand with insufficient resources; (2) adapting to changes in care due to the COVID-19 pandemic; (3) dealing with uncertainty and apprehension; (4) virtual care as an acceptable and useful clinical tool, and (5) optimal conditions and future expectations. Most interview participants (5/6) had globally positive views of virtual care. Conclusions: Providing virtual multidisciplinary treatment for children and adolescents with eating disorders seemed feasible and acceptable to professionals during the pandemic. Moving forward, focusing on health professionals' perspectives and providing appropriate training in virtual interventions is essential given their central role in successful implementation and continued use of virtual and hybrid care models. [ABSTRACT FROM AUTHOR]

The PLAYshop program is a parent-focused physical literacy intervention for early childhood. This single-group mixed-methods pilot study aimed to explore the feasibility of virtually delivering and assessing the PLAYshop program. The virtual PLAYshop program included a virtual workshop, resources/basic equipment, and two booster emails (3-week and 6-week follow-up). Data on 34 preschool-aged children (3–5 years) and their parents from Edmonton and Victoria, Canada, were collected via an online questionnaire, virtual assessment session, and interview at single or multiple time points (baseline, post-workshop, 2-month follow-up). Intraclass correlation coefficients (ICCs), paired t-tests, repeated measures ANOVAs, and thematic analyses were conducted. Regarding feasibility, most parents (≥94%) were satisfied/extremely satisfied with the virtual workshop and planned to continue physical literacy activities post-workshop. The virtual assessment protocol for children's fundamental movement skills (FMS; overhand throw, underhand throw, horizontal jump, hop, one-leg balance) was feasible, with high completion rates (>90%) and reliable scoring (ICC = 0.79–0.99). For positive changes in potential outcomes, a medium effect size was observed for children's hopping skills (d = 0.54), and large effect sizes were observed for several parental outcomes (partial η2 = 0.20–0.54). The findings support the feasibility and potential positive outcomes of the virtual PLAYshop program. A larger randomized controlled efficacy trial is recommended. [ABSTRACT FROM AUTHOR]

Background: Patient-reported outcome measures (PROMs) play an important role in promoting and supporting patient and family-centered care. Implementing interventions like PROMs in routine clinical care require key stakeholders to change their behavior. The aim of this study was to utilize the Theoretical Domains Framework (TDF) to identify barriers and enablers to the implementation of PROMs in pediatric outpatient asthma clinics from healthcare providers' perspective. Methods: This TDF-guided qualitative descriptive study is part of a larger multi-phase project to develop the KidsPRO program, an electronic platform to administer, collect, and use PROMs in pediatrics. Semi-structured qualitative interviews were conducted with 17 participants, which included pediatricians, nurses, allied health professionals and administrative staff from outpatient asthma clinics. All the interviews were transcribed, deductively coded, inductively grouped in themes, and categorized into barriers and enablers. Results: We identified 33 themes within 14 TDF domains, which were further categorized and tabulated into 16 barriers and 17 enablers to implementing PROMs in asthma clinics. Barriers to behavioral change were attributed to personal, clinical, non-clinical, and other system-level factors; they ranged from limited awareness of PROMs to language barriers and patient's complex family background. Enablers ranged from a personal commitment to providing patient and family-centered care to administering PROMs electronically. Conclusion: This implementation of science-based systematic inquiry captured the complexity of PROMs implementation in pediatric outpatient clinical care for asthma. Considering the consistency in barriers and enablers to implementing PROMs across patient populations and care settings, many findings of this study will be directly applicable to other pediatric healthcare settings. [ABSTRACT FROM AUTHOR]

Background: In this paper we assess the quality of six deliberative stakeholder consultations regarding the implementation of a precision diagnostic for life-threatening pediatric brain tumors. Decision makers who base policy recommendations on the outputs of consultative exercises can presuppose that all deliberants are well informed of the policy issue, that participation in the deliberative process was fair, and that overcoming implementation barriers will necessarily result in practice change. Additional evidence is therefore needed to substantiate the informational quality of the deliberation, measure the equality of participation and study the effects on stakeholder reasoning to appropriately guide uptake of proposed recommendation(s). Methods: Using the DeVries framework for assessing the deliberative quality, we analyzed data from 44 post-consultation evaluation surveys completed by pediatric oncology and palliative care teams at two tertiary pediatric healthcare centers in Canada. We also conducted turn-taking and word-contribution analyses from the text transcriptions of each deliberation to assess equality of participation using descriptive statistics. Results: Deliberants agreed the quality of the deliberative process was fair (median ratings ranging from 9–10 out of 10) and the opportunities to receive expert information and discuss with others about the implementation of a new LDT were helpful (9.5 out of 10). While the session improved understanding of the implementation barriers and opportunities, it had marginal effects on deliberants' reasoning about whether LDTs would change their own clinical practice (3–10 out of 10). Participation was proportionate in at least four of the six deliberations, where no deliberant took more than 20% of total turns and contributed equal to, or less than 20% of total words. Conclusion: The quality assessment we performed demonstrates high informational value and perceived fairness of two deliberative stakeholder consultations involving pediatric palliative care and oncology teams in Canada. Quality assessments can reveal how the process of deliberation unfolds, whether deliberative outputs are the result of equitable participation among deliberants and what, if any, stakeholder voices may be missing. Such assessments should be routinely reported as a condition of methodological rigor and trustworthiness of deliberative stakeholder engagement research. [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]

COVID-19 restrictions have necessitated child/youth mental health providers to shift towards virtually delivering services to patients' homes rather than hospitals and community mental health clinics. There is scant guidance available for clinicians on how to address unique considerations for the virtual mental healthcare of children and youth as clinicians rapidly shift their practices away from in-person care in the context of the COVID-19 pandemic. Therefore, we bridge this gap by discussing a six-pillar framework developed at Hospital for Sick Children (SickKids) in Toronto, Ontario, Canada, for delivering direct to patient virtual mental healthcare to children, youth and their families. We also offer a discussion of the advantages, disadvantages, and future implications of such services. [ABSTRACT FROM AUTHOR]

Research suggests that exposure to stories about Black adults who are contributing positively to their community can reduce implicit pro-White/anti-Black racial bias in older children (ages 9-12). The aim of the current research was to replicate and extend this finding by investigating whether a different child-friendly manipulation exposing children to positive Black exemplars and negative White exemplars could decrease implicit pro-White/anti-Black racial bias in children aged 5 to 12 years, both immediately following the intervention and 1 hr later. In addition, a second aim of this research was to examine whether child-friendly positive exemplar exposure would similarly reduce adults' implicit racial bias. In a sample of White and Asian Canadians (N = 478; 182 male, 296 female), recruited from a community science center (children) and a public university in Vancouver (adults), 9- to 12-year-old children's racial bias was reduced up to 1 hr after this new intervention, while the effectiveness of the intervention on 5- to 8-year-old children's bias was less clear. Interestingly. this intervention did not reduce adult levels of bias. The results of a follow-up study (N = 96: 23 male, 72 female, 1 nonbinary) indicate that exposure to child exemplars can reduce bias in adults, but only when additional instructions are provided to internalize the presented association. Thus, the current study provides evidence that depicting counterstereotypical exemplars can reduce implicit racial bias in children for up to l hr after exemplar exposure, but there may be important developmental differences in the conditions required to change this bias. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Dental Hygiene is the property of Canadian Dental Hygienists Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study explored the feasibility of training school teaching assistants to provide the treatment, Dynamic Temporal and Tactile Cueing to treat childhood apraxia of speech (CAS, also known as developmental verbal dyspraxia). The study used a single case experimental design across behaviours and a qualitative evaluation of teaching assistant experiences using interviews. Two student-teaching assistant dyads participated. One child was aged 6;2 (6 years 2 months) and the other 5;6 at the time of the study. Both participants had speech characteristics consistent with the features outlined in the 2007 Technical Report on CAS from the American Speech and Language Hearing Association (ASHA). These included lengthened and disrupted coarticulatory transitions between sounds and syllables, inappropriate prosody and inconsistent errors on consonants and vowels. Treatment outcomes were measured using visual analysis and calculations of total-change improvement rate difference (TC-IRD) and composite IRD (C-IRD) based on percent of phonemes correct. Fidelity to the treatment protocol was measured using a Fidelity Score. Visual analysis of both child participant's data showed an upward trend for all treatment and similar words and a flatter trajectory for control words. Both child participants had a TC-IRD score of 100% for all treatment words. One child also had a TC-IRD score of 100% for their similar words and a TC-score of 25% for their control words. The second child had a TC-score of 67% for similar and control words. Both teaching assistants had a Fidelity Score of over 90%. Both teaching assistants reported positive experiences in conducting the program. Training teaching assistants may be an effective means of providing treatment to children with CAS while they are at school. Training teaching assistants also helps to improve their capacity which may have positive implications in their interactions with other children with speech sound disorders. [ABSTRACT FROM AUTHOR]

Aim: School nutrition policies can improve healthy food access for Indigenous First Nations children in Canada. This study explored First Nations students' perceptions of a school nutrition policy. Methods: The research was a process evaluation of school nutrition policy implementation using a mixed‐methods design. Students in grades 4–12 (n = 94) completed a 17‐question survey to capture their perceptions of the policy. Survey data informed an 11‐question semi‐structured interview guide. Transcripts from interviews with students (n = 20) were analysed using content analysis to identify barriers and facilitators to policy implementation. Results: Key facilitating factors to policy implementation were student support for the policy and taste preferences. Most students (87%) agreed that only healthy foods should be served at school and, in interviews, expressed a preference for healthy food choices. Barriers to policy implementation included foods available at school and lack of communication between students and their teachers and parents. Half (50%) of surveyed students reported that their eating habits at school were average; interviews explained that their diets could be improved by consuming more fruit and vegetables at school. Both surveys and interviews found that communication between students and their parents and teachers about what they ate and drank at school was low. Conclusions: To support children's healthy eating at school, the school nutrition policy could provide clear guidelines on foods permissible in the school, while considering social and environmental barriers to healthy eating. The involvement of First Nations children in the implementation and evaluation of school nutrition policies is recommended. [ABSTRACT FROM AUTHOR]

Background: Children begin developing fundamental motor skills, such as running and kicking, and pre-literacy skills, such as print awareness, during early childhood. Optimal development of these domains does not always occur naturally (especially in the context of an increasingly sedentary culture); however, they will when the child has opportunities to participate in early childhood education or programs that directly attend to these domains. The design of such programs should consider the relationship between motor abilities and complex cognitive abilities. Furthermore, given the high prevalence of inactivity, overweight/obesity, lack of school readiness, and motor coordination challenges, these programs should be designed for children across the spectrum of development including children with typical development since it is clear Canadian children are not developing optimally. Therefore, the objective of this study is to evaluate the effectiveness of a motor and pre-literacy skill program for a community sample of 3-4 year old children. Methods: A quasi-experimental study design was used to evaluate the program in 19 families (experimental group, n=8; control group, n=11). The program was run for one hour/week for 10 consecutive weeks and consisted of motor skill instruction, free-play, and an interactive reading circle. Motor and pre-literacy skills were assessed in all children pre- and post-intervention using the Peabody Developmental Motor Scales-2 and the Preschool Word and Print Awareness tool. Results: The average age of the children is 44 months and 47% were males. Two one-way ANCOVAs were conducted to detect a difference between experimental and wait-list control group on gross motor skills (stationary, locomotor, and object manipulation) and print awareness controlling for baseline scores. There was a significant effect of group on gross motor raw scores overall (F (1, 16)=4.67, p<.05) and print awareness (F (1, 16)=11.9, p<.05), after controlling for baseline scores. Discussion: This study was one of the first to examine the impact of a motor skill and pre-literacy program in preschool children with typical development. The results of this study will inform the continued development of the program as it becomes implemented in local and regional communities in Ontario, Canada. [ABSTRACT FROM AUTHOR]

The Canadian Society for Exercise Physiology (CSEP), with assistance from multiple partners, stakeholders and researchers, developed the first Canadian Physical Activity Guidelines for the Early Years (aged 0-4 years). These national guidelines were created in response to an urgent call from public health, health care, child care and fitness practitioners for healthy active living guidance for the early years. The guideline development process was informed by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument and the evidence assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The recommendations are informed by evidence from a systematic review that examined the relationships between physical activity and health indicators (healthy body weight, bone and skeletal health, motor skill development, psychosocial health, cognitive development and cardio-metabolic disease risk factors) for three age groups (infants aged <1 year; toddlers aged 1-2 years; preschoolers aged 3-4 years). The new guidelines include a preamble to provide context, followed by the specific recommendations. The final guidelines benefitted from an extensive on-line consultation process with input from over 900 domestic and international stakeholders, end-users and key informants. The final guideline recommendations state that for healthy growth and development, infants (aged <1 year) should be physically active several times daily - particularly through interactive floor-based play. Toddlers (aged 1-2 years) and preschoolers (aged 3-4 years) should accumulate at least 180 min of physical activity at any intensity spread throughout the day, including a variety of activities in different environments, activities that develop movement skills, and progression toward at least 60 min of energetic play by 5 years of age. More daily physical activity provides greater benefits. [ABSTRACT FROM AUTHOR]

The Canadian Society for Exercise Physiology (CSEP), with assistance from multiple partners, stakeholders, and researchers, developed the first Canadian Physical Activity Guidelines for the Early Years (aged 0-4 years). These national guidelines were created in response to an urgent call from public health, health care, child care, and fitness practitioners for healthy active living guidance for the early years. The guideline development process was informed by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument and the evidence assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The recommendations are informed by evidence from a systematic review that examined the relationships between physical activity and health indicators (healthy body weight, bone and skeletal health, motor skill development, psychosocial health, cognitive development, and cardio-metabolic disease risk factors) for three age groups (infants aged <1 year; toddlers aged 1-2 years; preschoolers aged 3-4 years). The new guidelines include a preamble to provide context, followed by the specific recommendations. The final guidelines benefitted from an extensive on-line consultation process with input from over 900 domestic and international stakeholders, end-users, and key informants. The final guideline recommendations state that for healthy growth and development, infants (aged <1 year) should be physically active several times daily - particularly through interactive floor-based play. Toddlers (aged 1-2 years) and preschoolers (aged 3-4 years) should accumulate at least 180 min of physical activity at any intensity spread throughout the day, including a variety of activities in different environments, activities that develop movement skills, and progression toward at least 60 min of energetic play by 5 years of age. More daily physical activity provides greater benefits. [ABSTRACT FROM AUTHOR]

The Canadian International Food Security Research Fund programme supported research and scaling up of nutrition‐ and gender‐sensitive agriculture innovations from 2009 to 2018. Women and girls were identified as agents of change and were targeted as the main programme beneficiaries. Projects were implemented in 25 countries through multistakeholder partnerships among universities, research institutions, public and private sectors, and civil society groups, reaching over 78 million people, mainly women and children. Approaches specific to nutrition included growing more nutritious crops, improving dietary diversity, value added processing, food fortification, and nutrition education. Scale‐up for impact was achieved through a number of pathways that started with evidence through rigorous research, followed by a combination of elements such as understanding local and regional contexts to identify specific bottlenecks and opportunities for the deployment and adoption of successful innovations, selecting politically effective or influential partners to lead the scaling up process, and investing in long‐term local capacity and leadership building. Overall, the knowledge generated in the programme indicate that well‐designed nutrition‐sensitive agriculture and food‐based interventions can have meaningful impacts on pathways that will lead to better health and well‐being of women and children through improving household and individual access to nutrient‐rich foods. Longer intervention times are needed to demonstrate changes in health indicators such as reduced stunting. This overview paper summarises the programme and showcases examples from studies that demonstrate the impact pathway for nutrition interventions that encompass efficacy and effectiveness studies, value‐added processing, cost effectiveness of interventions, and bringing a proven intervention to scale. [ABSTRACT FROM AUTHOR]