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Having a better understanding of individual factors associated with e-cigarette initiation can help improve prevention efforts. Therefore, this study aimed to (1) identify baseline characteristics associated with e-cigarette initiation, and (2) determine whether changes in these baseline characteristics were associated with e-cigarette initiation.This study used data from Year 6 (2017/18, baseline) and Year 7 (2018/19, follow-up) of the COMPASS study. The final sample included 12 315 students in Grades 9 to 11 who reported never having tried e-cigarettes at baseline. Students reported demographic information, other substance use, school behaviours, physical activity, sedentary behaviour, sleep, symptoms of anxiety and depression, and emotional regulation and flourishing scores. Hierarchical GEE models, stratified by gender, examined the association between (1) baseline characteristics and e-cigarette initiation at follow-up and (2) changes in baseline characteristics and e-cigarette initiation at follow-up.In total, 29% of students who had not yet initiated e-cigarette use reported initiating e-cigarette use at follow-up. Students in Grades 10 and 11 were less likely to initiate e-cigarette use. Other substance use, skipping school and meeting the physical activity guidelines at baseline and one-year changes to these behaviours were associated with e-cigarette initiation among both male and female students. Additionally, some differences were noted between females and males.Given that other health behaviours were associated with e-cigarette initiation, prevention approaches should target multiple health-risk behaviours to help prevent youth e-cigarette use. Additionally, school-based approaches may benefit by being implemented at the beginning of high school or in junior high school.Une meilleure compréhension des facteurs individuels associés à l’initiation à la cigarette électronique contribuerait à l’amélioration des mesures de prévention. Ainsi, cette étude vise à 1) relever les caractéristiques de départ associées à l’initiation à la cigarette électronique et 2) déterminer si des changements dans ces caractéristiques sont associés à l’initiation à la cigarette électronique chez les adolescents canadiens.Cette étude a utilisé les données de l’année 6 (2017-2018, année de référence) et de l’année 7 (2018-2019, année de suivi) de l’étude COMPASS. L’échantillon final comprenait 12 315 élèves de la 9e à la 11e année qui avaient déclaré ne jamais avoir essayé la cigarette électronique au cours de l’année de référence. Les renseignements fournis par les élèves portaient sur leurs caratéristiques individuelles, la consommation d’autres substances, les comportements scolaires, l’activité physique, les comportements sédentaires, les troubles du sommeil, les symptômes d’anxiété et de dépression, la régulation émotionnelle et l’épanouissement. Des modèles hiérarchiques faisant appel aux équations d’estimation généralisées (EEG), stratifiés selon le sexe, ont permis d’analyser l’association entre 1) les caractéristiques de départ et l’initiation à la cigarette électronique lors de l’année de suivi et 2) des changements dans les caractéristiques de départ et l’initiation à la cigarette électronique lors de l’année de suivi.Au total, 29 % des élèves qui n’avaient encore jamais essayé la cigarette électronique ont déclaré en avoir fait l’usage au moment du suivi. Les élèves de 10e et 11e année étaient proportionnellement moins nombreux à avoir essayé la cigarette électronique. La consommation d’autres substances, l’école buissonnière et le respect des directives en matière d’activité physique pendant l’année de référence ainsi que des changements vers ces comportements mesurés au moment du suivi ont été associés à l’initiation à la cigarette électronique à la fois chez les garçons et chez les filles. Certaines différences ont été observées entre les filles et les garçons.Étant donné que d’autres comportements liés à la santé ont été associés à l’initiation à la cigarette électronique, les stratégies de prévention devraient cibler les combinaisons de comportements à risque pour la santé afin de prévenir l’usage de la cigarette électronique chez les jeunes. De plus, mettre en œuvre des approches en milieu scolaire au début ou pendant le premier cycle du secondaire serait certainement bénéfique.Twenty-nine percent of students who had not yet initiated e-cigarette use reported initiating e-cigarette use at follow-up. Other substance use (i.e. alcohol, cannabis and cigarettes) was strongly associated with e-cigarette initiation. Students who met the Canadian physical activity guidelines were more likely to initiate e-cigarette use, and female students who met the screen time guidelines were less likely. Anxiety and depression were not significantly associated with e-cigarette initiation, but there was an association with higher emotional dysregulation for females and higher flourishing for males. The majority of students maintained their behaviours over time; results for changes from baseline were largely consistent with findings at baseline.Vingt-neuf pour cent des élèves qui n’avaient encore jamais essayé la cigarette électronique ont déclaré en avoir fait l’usage au moment du suivi. La consommation d’autres substances (alcool, cannabis et cigarettes) était fortement associée à l’initiation à la cigarette électronique. Les élèves qui respectaient les directives canadiennes en matière d’activité physique ont eu davantage tendance à commencer à utiliser la cigarette électronique et les filles qui respectaient les directives sur le temps passé devant un écran ont eu moins tendance à commencer à utiliser la cigarette électronique. Si l’initiation à la cigarette électronique n’était pas associée de façon significative avec l’anxiété et la dépression, elle était toutefois associée à un dérèglement émotionnel élevé chez les filles et à un épanouissement élevé chez les garçons. La majorité des élèves ont maintenu leurs comportements au fil du temps : les résultats concernant les changements par rapport à l’année de référence présentaient une forte concordance avec les observations se rapportant à l’année de référence.

Reducing youth cannabis use in Canada is a public health priority with schools of interest as a potential modifier of behavior and as a venue for prevention programming. This work aimed to provide a basis for future policy and programming by evaluating pre-legalization cannabis use change patterns in schools and the impact of school characteristics on these patterns. Average rates of cannabis use behavior change (initiation, escalation, reduction, cessation) were collected from 88 high schools located in Ontario and Alberta, Canada participating in the COMPASS prospective cohort study. There was little variability in cannabis use behaviors between schools with intra-class correlation coefficients lowest for cessation (0.02) and escalation (0.02) followed by initiation (0.03) and reduction (0.05). Modest differences were found based on school province, urbanicity and student-peer use. Cannabis ease of access rates had no significant effect. Fewer than half the schools reported offering school drug use prevention programs; these were not significantly associated with student cannabis use behaviors. In conclusion, current school-based cannabis prevention efforts do not appear sufficiently effective. Comprehensive implementation of universal prevention programs may reduce cannabis harms. Some factors (urbanicity, peer use rates) may indicate which schools to prioritize.

Given the recent increase in e-cigarette use among adolescents, there is a need to further explore how school programs are associated with e-cigarette initiation. The objective of this quasi-experimental study was to evaluate the impact of multiple school-based e-cigarette prevention and cessation programs on e-cigarette initiation among Canadian adolescents. This study used data from Year 6 (2017/18) and Year 7 (2018/19) of the COMPASS study in British Columbia, Alberta, Ontario, and Quebec, Canada. Students in grades 9 to 11 who had never tried e-cigarettes at baseline were included (n = 13,269). Schools (n = 88) reported whether they added programming that addressed e-cigarette or tobacco prevention or cessation. Generalized estimating equations were used to identify how added programs were associated with e-cigarette initiation at follow-up. At one-year follow-up (2018/19), 23% of schools added programs. Our evaluation results suggest that none of the activities taken by schools to prevent or reduce vaping among students significantly prevented vaping onset. In fact, female students at schools that reported adding a theme week had higher odds of e-cigarette initiation (OR 1.68 [95% CI 1.31-2.16]) and male students at schools that reported a cessation program had higher odds of e-cigarette initiation (OR 1.20 [95% CI 1.01-1.44]). These results suggest that schools may not know how to address e-cigarette use and that there can be risks to students if programs are not carefully implemented. Results point to the need for additional support to ensure that schools are taking evidence-based approaches that support all students.

Introduction Harmful effects of cannabis use in youth scale with frequency. In the context of approaching legalization in Canada, understanding the distinctions between youth who change and who maintain their cannabis use is essential for designing interventions and policy. A substantial number of characteristics may play a role. This study assessed whether and how youth who change their cannabis use differ from those who do not. Methods Cannabis use was reported by 8375 Canadian high school students participating in the COMPASS study. GEE multiple logistic regressions were then used to establish impact of 13 baseline demographic and behavioural exposure variables on the likelihood of membership in four frequency change groups at follow-up a year later: reduction, cessation, escalation, and maintenance. Results Groups were found to differ in several ways. Cessation group members (19.4% of users) were less likely to binge drink (OR 0.82), vape (OR 0.82), or attend class without completing homework (OR 0.72) than maintainers. Students who reduced their use (14.6% of users) were more likely to binge drink (OR 1.36), smoke (OR 1.20), and skip class (OR 1.21). Those who escalated (29.5% of users) were more likely to be male (OR 1.35) and to vape (OR 1.22). Conclusions Students who change their cannabis use differ in several demographic and behavioural characteristics. The results raise further concerns about the impact of e-cigarettes and the role of poly-substance use in high-risk trajectories. Distinct classes of cannabis users, essential for policy and intervention development, can be identified in high school populations.

Built environments have shown to be associated with health, with physical activity (PA) considered one of the critical pathways for achieving benefits. Navigating available evidence on the built environment and PA is challenging given the number of reviews.Examine the current state and quality of research looking at associations between built environments and total PA and domains of PA (i.e., leisure/recreation, transportation, school) among children and youth (1-18 years).We systematically searched the grey literature and six bibliographic databases from January 2000 to May 2020. Review quality was assessed using the AMSTAR2. Results by age group were synthesized using narrative syntheses and harvest plots, and certainty of the evidence was assessed using a modified GRADE approach.This overview included 65 reviews. Most reviews were of very low-to-low quality. High certainty was found for positive associations between transportation PA and walking/cycling/active transportation (AT) infrastructure. There was high certainty for positive associations between streets/play streets and total PA, alongside lower certainty for transportation and leisure PA. Very low-to-moderate certainty supports schoolyards designed to promote PA were positively associated with total PA, but mixed for school PA (except children). Less consistent positive associations were found for forests/trees, greenspace/open space, recreation facilities, street lighting, traffic safety, population/residential density, proximity/access to destinations, neighbourhood characteristics, and home environments. There is very low-to-moderate certainty for negative associations between greater distance to school and traffic volume and domains of PA. Generally, null or mixed associations were observed for aesthetics, parks, AT comfort infrastructure, land-use mix, street connectivity, urban/rural status, and public transit.There remains a need for high quality systematic reviews and studies to evaluate the effects of environmental changes across the pediatric age spectrum and using a PA domain approach. Given the global physical inactivity crisis the built environment remains and important means to promote PA among children/youth.

There is an association between sports participation and substance use. However, there is some evidence that intramural sports in high school may not have the same effect. Therefore, the objective of this research was to examine the longitudinal associations between intramural participation in high school and substance use.

In Canada, students are increasingly reliant on motorized vehicles to commute to school, and few meet the recommended overall physical activity guidelines. Infrastructure and built environments around schools may promote active commuting to and from school, thereby increasing physical activity. To date, few Canadian studies have examined this research question.This study is a cross-sectional analysis of 11,006 students, aged 11-20, who participated in the 2016/2017 Ontario Student Drug Use and Health Survey. The remote sensing-derived Normalized Difference Vegetation Index (NDVI), at a buffer of 500 m from the schools' locations, was used to characterize greenness, while the 2016 Canadian Active Living Environments (Can-ALE) measure was used for walkability. Students were asked about their mode of regular commuting to school, and to provide information on several socio-demographic variables. Multivariable logistic regression models were used to quantify associations between active commuting and greenness and the Can-ALE. The resulting odds ratios, and their 95% confidence intervals, were adjusted for a series of risk factors that were collected from the survey.Overall, 21% of students reported active commuting (biking or walking) to school, and this prevalence decreased with increasing age. Students whose schools had higher Can-ALE scores were more likely to be active commuters. Specifically, the adjusted odds ratio (OR) of being an active commuter for schools in the highest quartile of the Can-ALE was 2.11 (95% CI = 1.64, 2.72) when compared with those in the lowest. For children, aged 11-14 years, who attended schools in high dwelling density areas, a higher odds of active commuting was observed among those in the upper quartile of greenness relative to the lowest (OR = 1.41; 95% CI = 0.92, 2.15). In contrast, for lower dwelling density areas, greenness was inversely associated with active commuting across all ages.Our findings suggest that students attending schools with higher Can-ALE scores are more likely to actively commute to school, and that positive impacts of greenness on active commuting are evident only in younger children in more densely populated areas. Future studies should collect more detailed data on residential measures of the built environment, safety, distance between home and school, and mixed modes of commuting behaviours.RéSUMé: OBJECTIFS: Au Canada, les élèves comptent de plus en plus sur les véhicules à moteur pour faire le trajet entre la maison et l’école, et ils sont peu nombreux à avoir des niveaux d’activité physique globaux conformes aux recommandations des lignes directrices. Les infrastructures et les milieux bâtis autour des écoles pourraient promouvoir les déplacements actifs entre la maison et l’école, faisant ainsi augmenter l’activité physique. Jusqu’à maintenant toutefois, très peu d’études canadiennes ont examiné cette question de recherche. MéTHODE: La présente étude est une analyse transversale de 11 006 élèves de 11 à 20 ans ayant participé au Sondage sur la consommation de drogues et la santé des élèves de l’Ontario en 2016-2017. L’indice de végétation par différence normalisée (IVDN) dérivé par télédétection, utilisé dans un rayon de 500 m des établissements scolaires, a servi à caractériser la verdure, et l’indice d’accessibilité à la vie active dans les milieux de vie au Canada (AVA-Can) a servi à caractériser la marchabilité. Les élèves ont répondu à une question sur leur mode de transport habituel pour se rendre à l’école et donné des informations sur plusieurs variables sociodémographiques. Des modèles de régression logistique multivariée ont servi à chiffrer les associations entre les déplacements actifs, la verdure et l’AVA-Can. Les rapports de cotes ainsi obtenus, et leurs intervalles de confiance de 95 %, ont été ajustés en fonction d’une série de facteurs de risque retracés dans l’enquête. RéSULTATS: Dans l’ensemble, 21 % des élèves ont dit utiliser un mode de déplacement actif (vélo ou marche) pour se rendre à l’école, et cette prévalence était inversement liée à l’âge. Les élèves dont les écoles avaient un indice Can-ALE élevé étaient plus susceptibles d’employer un mode de transport actif. Spécifiquement, le rapport de cotes (RC) ajusté pour le fait de se rendre à l’école par un mode de transport actif dans le quartile supérieur de l’indice Can-ALE était de 2,11 (IC de 95 % = 1,64, 2,72) comparativement au quartile inférieur. Pour les enfants (11 à 14 ans) fréquentant des écoles dans des zones à forte densité d’habitation, des probabilités plus élevées de déplacements actifs ont été observées chez ceux du quartile de verdure supérieur que chez ceux du quartile inférieur (RC = 1,41; IC de 95 % = 0,92, 2,15). Par contre, dans les zones à faible densité d’habitation, la verdure étaient inversement associée aux déplacements actifs, à tout âge. CONCLUSION: Nos constatations indiquent que les élèves fréquentant des écoles dont l’indice Can-ALE est élevé sont plus susceptibles d’utiliser un mode de déplacement actif pour se rendre à l’école, et que l’effet positif de la verdure n’est manifeste que chez les jeunes enfants, dans les zones urbaines densément peuplées. Les études futures devraient obtenir des données plus détaillées sur les indicateurs résidentiels du milieu bâti, la sécurité, la distance entre la maison et l’école et les modes de déplacement mixtes.

This study examined the associations of micro-level factors with current alcohol use and binge drinking among a large sample of Canadian youth.This descriptive-analytical study was conducted among high school students enrolled in the COMPASS study between 2012/13 and 2017/18. We used generalized estimating equations modelling to determine associations between micro-level factors and likelihood of current versus non-current alcohol use and binge drinking among respondents.Students reporting current cannabis use were more likely to report current alcohol use over never use (odds ratio [OR] = 4.46, 95% confidence interval [CI]: 4.33-4.60) compared to students reporting non-current cannabis use. Students reporting current smoking of tobacco products were more likely to report current binge drinking over never binge drinking (OR = 2.52, 95% CI: 2.45-2.58), compared to non-smoking students. Students reporting weekly disposable incomes of more than $100 were more likely to report current over never binge drinking (OR = 2.14, 95% CI: 2.09-2.19), compared to students reporting no weekly disposable income.Higher disposable incomes, smoking of tobacco products and use of cannabis were associated with current alcohol use and binge drinking among youth. Findings may inform design of polysubstance use prevention efforts in high schools.Cette étude a permis d’examiner les associations entre microfacteurs et consommation d’alcool ainsi que consommation excessive d’alcool au sein d’un vaste échantillon de jeunes Canadiens.Cette étude descriptive et analytique a porté sur les élèves du secondaire ayant participé à l’étude COMPASS entre 2012-2013 et 2017-2018. Nous avons utilisé la modélisation par équations d’estimation généralisées pour déterminer chez les répondants les associations entre les microfacteurs et la probabilité de consommer de l’alcool et de consommer de l’alcool de manière excessive plutôt que ne pas consommer d’alcool.Les élèves ayant déclaré consommer du cannabis étaient plus susceptibles de déclarer consommer de l’alcool plutôt que n’en avoir jamais consommé (rapport de cotes [RC] = 4,46; intervalle de confiance [IC] à 95 % : 4,33 à 4,60), comparativement aux élèves ayant indiqué ne pas consommer de cannabis. Les élèves ayant déclaré fumer du tabac étaient plus susceptibles de déclarer consommer de l’alcool de manière excessive plutôt que ne l’avoir jamais fait (RC = 2,52; IC à 95 % : 2,45 à 2,58), comparativement aux élèves non-fumeurs. Les élèves ayant déclaré disposer d’un revenu hebdomadaire de plus de 100 $ étaient plus susceptibles de déclarer consommer de l’alcool de manière excessive plutôt que de ne l’avoir jamais fait (RC = 2,14; IC à 95 % : 2,09 à 2,19), comparativement aux élèves ayant indiqué ne disposer d’aucun revenu hebdomadaire.Un revenu disponible plus élevé, l’usage du tabac et la consommation de cannabis étaient associés à une consommation d’alcool et à une consommation excessive d’alcool chez les jeunes. Ces résultats peuvent éclairer la mise en place de mesures de prévention de l’usage de plusieurs substances dans les écoles secondaires.Prevalence of current alcohol use ranged between 52% and 58%, and rates of current binge drinking ranged between 34% and 41% for students in the COMPASS study between 2012/13 and 2017/18. Current cannabis use was associated with a 4.5-fold increased likelihood of current versus never alcohol use, and a 4-fold increased likelihood of current versus never binge drinking compared to nonusing students, between 2012/13 and 2017/18. Current smoking was associated with a 2-fold increased likelihood of current versus never alcohol use, and a 2.5-fold increased likelihood of current versus never binge drinking compared to non-smoking students between 2012/13 and 2017/18. Weekly disposable incomes of more than $100 were associated with an 87% increased likelihood of current versus never alcohol use, and a 2-fold increased likelihood of current versus never binge drinking compared to students with no disposable income between 2012/13 and 2017/18.La prévalence de la consommation d’alcool a varié entre 52 % et 58 % et les taux de consommation excessive d’alcool ont varié entre 34 % et 41 % chez les élèves de l’étude COMPASS entre 2012-2013 et 2017- 2018. Entre 2012-2013 et 2017-2018, comparativement aux élèves n’ayant jamais consommé de cannabis, les élèves qui en consommaient étaient 4,5 fois plus susceptibles de consommer de l’alcool plutôt que de n’en avoir jamais consommé, et 4 fois plus susceptibles d’avoir une consommation excessive d’alcool que de ne jamais avoir consommé d’alcool de manière excessive. Entre 2012-2013 et 2017-2018, comparativement aux élèves nonfumeurs, les fumeurs avaient une probabilité 2 fois supérieure de consommer de l’alcool que de n’en avoir jamais consommé, et une probabilité 2,5 fois supérieure d’avoir une consommation excessive d’alcool plutôt que de ne jamais avoir consommé d’alcool de manière excessive. De 2012-2013 à 2017-2018, comparativement aux élèves n’ayant aucun revenu disponible, chez les élèves disposant d’un revenu hebdomadaire supérieur à 100 $, la probabilité de consommer de l’alcool plutôt que de ne jamais en avoir consommé était supérieure de 87 % et la probabilité de consommer de l’alcool de manière excessive plutôt que de ne jamais l’avoir fait était multipliée par deux.

Ultra-processed food (UPF) consumption is increasing globally at an unprecedented rate. We investigated UPF consumption among Canadian adults and associated sociodemographic and health-related factors. This study was a secondary analysis of the Foodbook study (2014–2015), which collected self-reported data on foods consumed by Canadians during a 7-day period. UPF diversity was assessed by summing the different types of UPFs consumed in the previous week to produce a diversity score. Descriptive statistics summarized UPF diversity among subgroups in Canada. Regression models identified significant associations between UPF diversity, body mass index (BMI), and sociodemographic variables. This study included 6062 participants, aged 18 years and older, representing 24.7 million Canadian adults. Almost all Canadian adults (99.0%) consumed UPFs at least once weekly. The most common UPFs consumed were chocolate, chips/pretzels, cold breakfast cereal, and fast foods. UPF diversity was greatest among men, young respondents, those with high income, and those with obesity. When controlling for potential confounders, UPF diversity for men and women was significantly associated with younger age and higher BMI; it was also associated with region for women. This study suggests UPF consumption in Canada varies across sociodemographic subgroups, but ultimately is pervasive. Further research examining potential health risks associated with UPF consumption is encouraged to inform Canadian interventions. Novelty: Almost all Canadians consume at least one type of ultra-processed food weekly. Nearly half or more Canadians consume chocolate, chips/pretzels, cold breakfast cereal, or fast food at least once weekly. Gender, age, and BMI are consistently associated with ultra-processed food diversity.

In response to the current opioid crisis in Canada, establishing safe injection services (SIS) in high risk communities has become more prevalent. In November 2017, The Trailer opened in Ottawa, Canada and tracks client use, overdose treatment and overdoses reversed. We analyzed data collected between November 2017 and August 2018. During peak hours, demand for services consistently exceeded The Trailer's capacity. Overdoses treated and reversed in this facility increased substantially during this period. Results suggest The Trailer provided an important though not optimal (due to space restrictions) harm reduction service to this high-risk community.L’établissement de services d’injection supervisée (SIS) est devenu courant dans les collectivités à risque élevé afin de réagir à la crise des opioïdes qui sévit actuellement au Canada. Le service de La Roulotte (The Trailer), qui a ouvert ses portes en novembre 2017 à Ottawa (Canada), suit de près la consommation des clients, le traitement des surdoses et l'inversion des effets d’une surdose. Nous avons analysé les données recueillies entre novembre 2017 et août 2018 par ce service. Aux heures de pointe, la demande de services a constamment dépassé la capacité de La Roulotte. Le nombre de traitements de surdoses et d'inversions des effets d’une surdose a considérablement augmenté au cours de la période. D’après les résultats, La Roulotte a fourni un service important – quoique non optimal (en raison de contraintes d’espace) – de réduction des méfaits dans cette collectivité à risque élevé.The Trailer (supervised injection service) was established as a response to the opioid crisis in Ottawa, Canada. The Trailer offers a 24-hour service to clients. Overdose reversals during the tracking period increased significantly. The demand for services has consistently exceeded capacity.La Roulotte (service d’injection supervisée) a été établie en réponse à la crise des opioïdes à Ottawa, Canada. La Roulotte offre un service 24 heures sur 24 aux clients. Le nombre d’inversions des effets d’une surdose effectuées a augmenté considérablement au cours de la période de suivi. La demande de services a constamment dépassé la capacité de La Roulotte.

Background and Aims Youth poly-substance use, associated with long-term negative health and social outcomes, is of increasing concern following the rise of e-cigarette vaping and cannabis legalization in Canada. This work aimed to investigate current evidence on correlates of this behaviour to inform effective prevention and harm reduction programming. Design Cross-sectional sample taking part in a cohort study. Setting Canadian high schools (AB, BC, ON, QC) Participants 74,501 Canadian high school students who completed the COMPASS student questionnaire in 2018/2019. Measurements Self-report data on use of five substances (alcohol, cigarettes, e-cigarettes, cannabis, and opioids) alongside demographic factors, social and school support, and mental health-related measures. Results Of the 39% of youth who reported current substance use, 53% reported using two or more. E-cigarette vaping was most prevalent (28%) and most often combined with other substances. Feeling supported by friends and having no problem with seeking help at school were associated with higher levels of poly-substance use. Family support, school connectedness, and school support to resist drugs decreased the risk of substance co-use. Conclusions The evidence presented here suggests that interventions for youth poly-substance use should rely on joint efforts between parents, schools, and communities to focus on structural factors rather than problematizing the individual.

Objectives The Canadian prevalence and incidence of diabetes has increased by the greatest extent in young adulthood. The original Canadian Diabetes Risk Questionnaire (CANRISK) was created to assess dysglycemia risk among adults ≥40 years of age, but it has not been validated among younger adults. Furthermore, it is unclear whether a young adult-specific risk score would better identify dysglycemia in this age group. Methods Analyses were done on participants who completed the self-administered CANRISK and underwent anthropometric and blood glucose measurements, were 18 to 39 years of age, were not pregnant and had no previous diabetes diagnosis. A risk model was generated from a lenient stepwise function fit with predictors identified through univariate analyses. Risk scores were produced from adjusted odds ratios. Model performance was internally validated using bootstrap methods and compared with the original CANRISK prognostic tool. Results Of the 3,334 participants included in the study, 194 (5.8%) and 51 (1.5%) were living with prediabetes or undiagnosed diabetes, respectively. The model displayed an area under the curve of 73.0%, adjusted to 72.9% after bootstrapping; however, using the original CANRISK model resulted in similar results (area under the curve, 71.4%). Sensitivity and specificity of the new and original models were also comparable (78.8% vs 77.1% and 54.0% vs 55.0%, respectively). Conclusions The original CANRISK score performed well among young adults, even when compared with a young adult-specific model. We suggest that the cut point be lowered for young adults and the tool be permitted for use in this age group.

Neighbourhood greenness has been frequently associated with improved mental health in adulthood, yet its impact among youth is less clear. Additionally, though youth spend large portions of time at school, no study has investigated associations between school-based measures of greenness and students&rsquo, mental health in Canada. We addressed this gap by linking participant responses from the 2016&ndash, 2017 Ontario Student Drug Use and Health Survey to school-based features of the built environment. Our analyses included 6313 students, ages 11&ndash, 20. Measures of greenness were the mean and max of the annual mean Normalized Difference Vegetation Index within 500 m and 1000 m from the centroid of the school postal code. Measures of mental health included: serious psychological distress (Kessler 6-item Psychological Distress Scale), self-rated mental health (using a five-point Likert scale), suicide ideation, and suicide attempt. In our study population, the prevalence of serious psychological distress and low self-rated mental health was 16.7% and 20.3%, respectively. Suicide ideation was reported by 13.5% of participants, while 3.7% reported a suicide attempt. Quantity of greenness was similar between schools in the lower and upper quartiles. In logistic regressions, we found no association between objective school-based greenness and mental health, as assessed by multiple measures, both before and after adjustment. Null findings held true after stratification by season, as well. Whether other characteristics of school greenness (such as type, quality, or access and use) are more impactful to students&rsquo, mental health should be a focus of future analyses.

ObjectiveThe objective of this study was to examine associations between depression, anxiety and binge drinking among a large sample of Canadian youth, while testing the moderating effect of flourishing. This research uses data from the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, Sedentary Behaviour (COMPASS) study (2012–2021) with a large sample size collecting data on youth health behaviours within Canadian secondary schools.DesignCross-sectionalSetting14 secondary schools across Ontario and British Columbia, Canada.ParticipantsA sample of grade 9–12 students (n=6570) who participated in the Mental Health pilot of the COMPASS studyPrimary and secondary outcome measuresSelf-reported questionnaires assessed student binge drinking behaviours (5≥drinks), symptoms of depression (Center for Epidemiologic Studies Depression Scale (Revised)−10 scores≥10) and anxiety (Generalised Anxiety Disorder 7-item Scale scores≥10), and flourishing (Diener’s Flourishing Scale: 8–40).ResultsIn our sample of 6570 students, 37.0% of students reported binge drinking in the last year, and 41.4% and 31.7% of students report clinically-relevant symptoms of depression and anxiety, respectively. Anxiety (adjusted OR (AOR): 0.57, (99% CI 0.15 to 2.22)) and depression (AOR: 1.98, (99% CI 0.76 to 5.13)) symptoms were not found to be associated with binge drinking and we did not detect any moderating role of flourishing. Rather, factors that were associated with increased odds of binge drinking included sports team participation (AOR: 1.67, (99% CI 1.37 to 2.03)) and use of other substances (tobacco (AOR: 3.00, (99% CI 2.12 to 4.25)) and cannabis (AOR: 7.76, (99% CI 6.36 to 9.46))). Similar associations were found for frequency of binge drinking.ConclusionsConsistent with existing literature, binge drinking behaviours were problematic, as well as clinically-relevant symptoms of depression and anxiety. However, mental health problems and well-being may not be responsible for explaining patterns of binge drinking in youth. Targeted intervention efforts towards student athletes and concurrent substance users are necessary for addressing binge drinking in youth populations.

ObjectiveCanada federally legalised recreational cannabis use among adults in October 2018. The impact this will have on Canadian youth is cause for concern. The current study examined changes in youth cannabis use over the time prior to legalisation to explore the impact of the beginning federal discourse around legalisation during the 2016/2017 school year.DesignCOMPASS, a prospective cohort study based on annual self-administered questionnaires.SettingOntario and Alberta during the first 6 years of the COMPASS study (2012/2013 to 2017/2018).ParticipantsCanadian grade 9–12 students attending secondary schools participating in COMPASS. In total, 2 30 404 questionnaires were included in the analysis (Y1: 2012/2013, n=24 173; Y2: 2013/2014, n=45 298; Y3: 2014/2015, n=42 355, Y4: 2015/2016, n=40 436; Y5: 2016/2017, n=37 060; Y6: 2017/2018, n=34 897).Primary and secondary outcome measuresLifetime cannabis use, past-year cannabis use, weekly cannabis use, ease of access to cannabis and age at first cannabis use.ResultsCannabis never-use decreased between Y5 and Y6. Changes in age at first cannabis use mirrored this trend, with male students consistently starting younger. Cannabis access rates increased from Y4, mainly led by female students. Lifetime and past-year use rates were lowest in Y4 then increased in Y5 and Y6 due to a rise in the occasional use more common among female students, who reported use increases first. Non-white students were more likely use cannabis, with black and Aboriginal students the only two groups consistently reporting more weekly than occasional use, though with opposing trajectories. Overall, Aboriginal students had the highest odds of reporting lifetime, past-year and weekly use among the demographic groups examined.ConclusionAfter a steady decrease in patterns of cannabis among youth over several years, it appears that there has been a gradual increase in cannabis use among youth following the start of discourse around cannabis legalisation, with some populations of youth being at greater risk.

OBJECTIVE: Mandatory folic acid fortification was implemented in Canada in 1998 to reduce the risk of neural tube defects (NTD). Our objective was to assess the relationship between socio-demographic factors and folate status in non-supplement-consuming Canadian women of childbearing age. METHODS: Data on demographic factors, lifestyle factors, physical measures and red blood cell (RBC) folate concentration were collected from 1,008 non-supplement-consuming women aged 15-49 years in the Canadian Health Measures Survey (2007–2009). RBC folate ³906 nmol/L was used as a cut-off for optimal folate status for protection from NTD. RESULTS: Approximately 75% of non-supplement consuming women had an RBC folate concentration ³906 nmol/L. Young age (15-19 years), White ethnicity, less than secondary education, lowest income adequacy, smoking and high body mass index were associated with a higher prevalence of lower folate status. After adjustment, only young age (adjusted odds ratio [OR] 1.99–95% confidence interval [CI]: 1.25–3.18) was associated with lower folate status. Less than secondary education (adjusted OR 5.66, 95% CI: 1.10–29.04) and lowest income adequacy (adjusted OR 4.77, 95% CI: 1.06–21.49) were associated with lower folate status in women aged 15-24 and 25-49 years, respectively. CONCLUSIONS: Many risk factors for lower folate status identified before food fortification was implemented were not associated with folate status in our representative sample of non-supplement-consuming Canadian women. However, younger women, women aged 15-24 with less than secondary education and women aged 25-49 with low income adequacy remain at risk of lower folate status, supporting the continued promotion of folic acid supplement use to women of childbearing age.

BACKGROUND: This study assessed potential early-life factors and their interrelationships with obesity among young Canadian children. METHODS: Data from a nationally representative sample of children aged 6 to 11 years in the Canadian Health Measures Survey were analyzed. The associations of perinatal and early childhood behaviours and socio-economic factors with overweight or obesity were evaluated using multivariate logistic regression models. Adjusted population attributable risk fractions (PARFs) were calculated using multivariate logistic regression models. RESULTS: Of 968 term-born children, 21% were overweight and another 13% were obese. Maternal smoking during pregnancy (adjusted odds ratio, 2.26; 95% confidence interval, 1.23-4.15) was positively associated with obesity. This association was mediated by birth weight (suppression effect); once controlled, the strength of the association between smoking and child obesity increased by 12%. Birth weight per 100 g (1.05; 1.005-1.09) was significantly associated with obesity. Exclusive breastfeeding for 6 months (0.44; 0.31-0.61), adequate sleep hours (0.39; 0.16-0.94) and being physically active (0.50; 0.26-0.93) were found to be protective. Breastfeeding, whether exclusive or not, significantly reduced obesity risk among children whose mothers never smoked in pregnancy. PARFs indicated that 24.4%, 11.5%, 11.3% and 6.0% prevalent cases of child obesity might be prevented by exclusive breastfeeding, smoking cessation during pregnancy, adequate sleep during childhood, and avoiding high birth weight, respectively. CONCLUSIONS: This study identified multiple perinatal and childhood factors associated with obesity in young Canadian children. Effective prevention strategies targeting four modifiable maternal and child risk factors may reduce childhood obesity by up to 54% in Canada.

The 2009 to 2011 Canadian Health Measures Survey provides the most recent measured body mass index (BMI) data for children and adolescents. However, different methodologies exist for classifying BMI among children and youth. Based on the most recent World Health Organization classification, nearly a third of 5- to 17-year-olds were overweight or obese. The prevalence of obesity differed between boys and girls (15.1% versus 8.0%), most notably those aged 5 to 11, among whom the percentage of obese boys (19.5%) was more than three times that of obese girls (6.3%). These estimates indicate a higher prevalence of overweight/obesity among children than do estimates based on International Obesity Task Force cut-offs. Although the prevalence of overweight and obesity among children in Canada has not increased over the last decade, it remains a public health concern, given the tendency for excess weight to persist through to adulthood and lead to negative health outcomes.

Objectives: To examine the relationship between nicotine dependence and attitudes, predicted behaviours and support regarding restrictions on smoking. Design: Population-based, computer-assisted, telephone survey of adults in Ontario, Canada using a two-stage stratified sampling design; 1764 interviews were completed (65% response rate) yielding 424 (24%) cigarette smokers, of whom 354 (83%) smoked daily. The Heaviness of Smoking Index was used as a measure of nicotine dependence. Main outcome measure: Attitudes toward smoking restrictions, predicted compliance with more restrictions, and support for total smoking bans. Results: Attitudes favorable to smoking restrictions tended to decrease with increased nicotine dependence, but the associations were not statistically significant after adjusting for demographic variables. Predicted compliance with more restrictions on smoking decreased with higher levels of dependence, as did support for a total ban on smoking in restaurants, workplaces, bingo halls, and hockey arenas. Support for smoking bans in food courts, family fast food restaurants, and bars and taverns did not vary significantly with level of nicotine dependence. Conclusions: Level of nicotine dependence is associated with intended behaviors and support for smoking restrictions in some settings. These results have implications for tobacco control programs and policies.

64 subjects were administered both the Carleton University Responsiveness to Suggestion Scale and a modified version of the Stanford Hypnotic Susceptibility Scale, Form C. For half of the subjects both scales were preceded by administration of the Carleton hypnotic induction procedure. For the remaining subjects both scales were preceded by administration of the Stanford Hypnotic induction procedure. Contrary to a hypothesis propounded by Kihlstrom in 1985, type of induction procedure produced no significant differences on behavioral or subjective responding on either scale. Significant discrepancies between overt and subjective responding occurred on both scales; however, the magnitude of these discrepancies was not related to types of induction on either scale.

We hypothesized that phrasing a communication to move the arm as either a suggestion, a directive, or an instruction would differentially affect subjects' interpretations of the movement. 45 hypnotic and 45 non-hypnotic subjects who responded positively to a suggestion tended to describe the movement as involuntary both on open-ended questionnaires and later on an explicit involuntariness scale. Subjects given a directive to move the arm, or an instruction to reach for a pencil, rarely described their experience as involuntary on the open-ended questionnaires but sometimes rated it as involuntary on the scale. The ratings of involuntariness by subjects given suggestions seem likely to reflect interpretations made concurrently with the movement suggested. However, such ratings by subjects given directives or instructions are likely to reflect retrospective interpretations cued by the instrument used to assess subjects' experiences.

After hypnotic susceptibility testing, 484 subjects completed a 13-item questionnaire that assessed feelings and responses toward the hypnotic testing. Subjects were divided into two samples. Subjects' responses to the 13 items were factor analysed and yielded a 7-item factor that assessed subjects' tendency to resist hypnosis and hypnotic responding. These 7 items were combined into a resistance scale. Each scale item correlated substantially with the total scale score, and internal reliability of the scale was adequate. Resistance scores correlated significantly and negatively with objective and subjective dimensions of hypnotic susceptibility.

A version of the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C) modified for group testing was administered to 108 subjects. The final item on the scale was modified to enable (a) computation of a continuous amnesia score for each subject and (b) the measurement of serial organization on the recall trials during amnesia and after the cancellation of amnesia. Scores on the SHSS:C (computed without the amnesia item) and amnesia were significantly correlated. Furthermore, SHSS:C scores correlated significantly and negatively with three of four indexes of seriation during amnesia. Amnesia scores, however, correlated significantly with only one of the seriation measures, and in regression analyses the addition of amnesia to SHSS:C scores did not enhance prediction of any organization index. Methodological and theoretical implications are discussed.