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Background: We investigated the effectiveness of Nurse‐Family Partnership (NFP), a prenatal‐to‐age‐two‐years home‐visiting programme, in British Columbia (BC), Canada. Methods: For this randomised controlled trial, we recruited participants from 26 public health settings who were: <25 years, nulliparous, <28 weeks gestation and experiencing socioeconomic disadvantage. We randomly allocated participants (one‐to‐one; computer‐generated) to intervention (NFP plus existing services) or comparison (existing services) groups. Prespecified outcomes were prenatal substance exposure (reported previously); child injuries (primary), language, cognition and mental health (problem behaviour) by age two years; and subsequent pregnancies by 24 months postpartum. Research interviewers were masked. We used intention‐to‐treat analyses. (ClinicalTrials.gov, NCT01672060.) Results: From 2013 to 2016 we enrolled 739 participants (368 NFP, 371 comparison) who had 737 children. Counts for child injury healthcare encounters [rate per 1,000 person‐years or RPY] were similar for NFP (223 [RPY 316.17]) and comparison (223 [RPY 305.43]; rate difference 10.74, 95% CI ‐46.96, 68.44; rate ratio 1.03, 95% CI 0.78, 1.38). Maternal‐reported language scores (mean, M [SD]) were statistically significantly higher for NFP (313.46 [195.96]) than comparison (282.77 [188.15]; mean difference [MD] 31.33, 95% CI 0.96, 61.71). Maternal‐reported problem‐behaviour scores (M [SD]) were statistically significantly lower for NFP (52.18 [9.19]) than comparison (54.42 [9.02]; MD ‐2.19, 95% CI −3.62, −0.75). Subsequent pregnancy counts were similar (NFP 115 [RPY 230.69] and comparison 117 [RPY 227.29]; rate difference 3.40, 95% CI ‐55.54, 62.34; hazard ratio 1.01, 95% CI 0.79, 1.29). We observed no unanticipated adverse events. Conclusions: NFP did not reduce child injuries or subsequent maternal pregnancies but did improve maternal‐reported child language and mental health (problem behaviour) at age two years. Follow‐up of long‐term outcomes is warranted given that further benefits may emerge across childhood and adolescence. [ABSTRACT FROM AUTHOR]

Background: The standard approach for classifying child/youth psychiatric disorder as present or absent in epidemiological studies is lay‐administered structured, standardized diagnostic interviews (interviews) based on categorical taxonomies such as the DSM and ICD. Converting problem checklist scale scores (checklists) to binary classifications provides a simple, inexpensive alternative. Methods: Using assessments obtained from 737 parents, we determine if child/youth behavioral, attentional, and emotional disorder classifications based on checklists are equivalent psychometrically to interview classifications. We test this hypothesis by (1) comparing their test–retest reliabilities based on kappa (κ), (2) estimating their observed agreement at times 1 and 2, and (3) in structural equation models, comparing their strength of association with clinical status and reported use of prescription medication to treat disorder. A confidence interval approach is used to determine if parameter differences lie within the smallest effect size of interest set at ±0.125. Results: The test–retest reliabilities (κ) for interviews compared with checklists met criteria for statistical equivalence: behavioral,.67 and.70; attentional,.64 and.66; and emotional,.61 and.65. Observed agreement between the checklist and interviews on classifications of disorder at times 1 and 2 was, on average, κ =.61. On average, the β coefficients estimating associations with clinical status were.59 (interviews) and.63 (checklists); and with prescription medication use,.69 (interviews) and.71 (checklists). Behavioral and attentional disorders met criteria for statistical equivalence. Emotional disorder did not, although the coefficients were stronger numerically for the checklist. Conclusions: Classifications of child/youth psychiatric disorder from parent‐reported checklists and interviews are equivalent psychometrically. The practical advantages of checklists over interviews for classifying disorder (lower administration cost and respondent burden) are enhanced by their ability to measure disorder dimensionally. Checklists provide an option to interviews in epidemiological studies of common child/youth psychiatric disorders. [ABSTRACT FROM AUTHOR]

Background: A better understanding of factors contributing to the observed variability in estimates of test–retest reliability in published studies on standardized diagnostic interviews (SDI) is needed. The objectives of this systematic review and meta‐analysis were to estimate the pooled test–retest reliability for parent and youth assessments of seven common disorders, and to examine sources of between‐study heterogeneity in reliability. Methods: Following a systematic review of the literature, multilevel random effects meta‐analyses were used to analyse 202 reliability estimates (Cohen's kappa = ҡ) from 31 eligible studies and 5,369 assessments of 3,344 children and youth. Results: Pooled reliability was moderate at ҡ = .58 (CI 95% 0.53–0.63) and between‐study heterogeneity was substantial (Q = 2,063 (df = 201), p < .001 and I2 = 79%). In subgroup analysis, reliability varied across informants for specific types of psychiatric disorder (ҡ = .53–.69 for parent vs. ҡ = .39–.68 for youth) with estimates significantly higher for parents on attention deficit hyperactivity disorder, oppositional defiant disorder and the broad groupings of externalizing and any disorder. Reliability was also significantly higher in studies with indicators of poor or fair study methodology quality (sample size <50, retest interval <7 days). Conclusions: Our findings raise important questions about the meaningfulness of published evidence on the test–retest reliability of SDIs and the usefulness of these tools in both clinical and research contexts. Potential remedies include the introduction of standardized study and reporting requirements for reliability studies, and exploration of other approaches to assessing and classifying child and adolescent psychiatric disorder. [ABSTRACT FROM AUTHOR]

Introduction: Self‐completed checklists measuring youth mental health problems produce dimensional scale scores and can be converted to categorical classifications representing the presence/absence of psychopathology. We test whether categorical classifications from scale scores are equivalent psychometrically to categorical classifications of the same problems obtained by lay‐administered standardized structured diagnostic interviews. Methods: The sample of n = 325 youth aged 12–18 (44% male) and their parent/caregivers come from combined test–retest reliability studies conducted in Ontario, Canada, from 2011 to 2015. Ontario Child Health Study Emotional Behavioural Scales‐Brief Version (OCHS‐EBS‐B) scores converted to categorical classifications of emotional and behavioral problems were compared with interview classifications. We test hypotheses of statistical equivalence and inferiority, using a confidence interval approach to detect if differences lie within the smallest effect size of interest of ±0.18. We compare categorical classifications on: (1) test–retest reliability (ҡ), (2) content validity (between‐instrument agreement), and (3) construct validity (strength of association with three mental health‐related constructs). Results: Average test–retest reliabilities were 0.695 (checklists) and 0.670 (interviews). The reliability of checklist emotional problem classifications was not inferior to interview classifications and the difference in reliability between instruments for behavioral problems was small (−0.036). Average between‐instrument agreement was ҡ = 0.586 (observed) and ҡ = 0.841 (corrected for attenuation due to measurement error) indicating high content overlap. Statistical equivalence criteria were met in 5 of 6 construct validity comparisons. Conclusions: Categorical classifications of emotional and behavioral problems from youth‐reported checklists are, on balance, equivalent to interview classifications. Checklists represent a simple, brief, inexpensive alternative to interviews. [ABSTRACT FROM AUTHOR]

Background: Preterm birth is associated with an increased risk of depression and anxiety, but it is not known if this is due to greater exposure to risk, or if perinatal adversity amplifies the impact of traditional risk factors. This study sought to determine if exposure to perinatal adversity modifies associations between traditional risk and resilience factors and depression and anxiety in adulthood. Methods: A sample of 142 extremely low‐birth‐weight (ELBW < 1,000 g) survivors and 133 sociodemographically matched normal birth weight (NBW) control participants was followed longitudinally to 22–26 years of age. Separate postnatal risk and resilience scales were created using eight risk and seven resilience factors, respectively. Depression and anxiety were assessed using the internalizing scale of the Young Adult Self‐Report (YASR). This scale was also dichotomized at the 90th percentile to define clinically significant psychopathology. Results: While the average number of risk exposures did not differ between groups, ELBW survivors were more susceptible to risk than NBW control participants. For the ELBW group, each additional risk factor resulted in a 2‐point increase in internalizing scores, and two and a half times the odds of clinically significant internalizing symptoms (OR = 2.47, 95% CI = 1.63, 3.76). The protective effect of resiliency factors was also blunted among ELBW survivors. Conclusions: Extremely low‐birth‐weight survivors may be more sensitive to traditional risk factors for psychopathology and less protected by resiliency factors. Intervention strategies aimed at preventing or reducing exposure to traditional childhood risk factors for psychopathology may reduce the burden of mental illness in adult survivors of prematurity. [ABSTRACT FROM AUTHOR]

Background: Although structured interviews are assumed to be scientifically superior to checklists for measuring youth psychopathology, few studies have tested this hypothesis. Interviews place a much greater burden on respondents, making it critical to determine their added value when quantifying psychiatric symptoms. Methods: Confirmatory factor analysis was used to compare interviews and checklists in community ( N = 251) and clinically referred ( N = 406) samples of youth aged 5 to 17 years. We examined the associations between mother-reported externalizing symptoms assessed by interview versus checklist against (a) teacher-reported externalizing symptoms, and (b) child’s gender, academic performance, single- versus two-parent family, and family income. Models in which associations were estimated freely were contrasted to models in which the interview and the checklist were constrained to have equal associations with the variables. Finding these models fit comparably would suggest no difference between interviews and checklists. Results: In the community sample, both the constrained and unconstrained models provided comparable fit to the data, suggesting no marked differences between interviews and checklists. In the clinical sample, associations with the interview were generally stronger. Reducing the number of items on the interview to match those on the 6-item checklist eliminated these differences, suggesting that the increased reliability of the interview scales, afforded by additional items, enhanced their quantification of psychopathology. Conclusions: Consistent with previous studies, interviews were not notably superior to checklists for the measurement of externalizing symptoms. When only a few items are used, small performance differences between checklists and interviews may be due to scale length. [ABSTRACT FROM AUTHOR]