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Latent class analysis was performed to identify clusters of items on the Longitudinal Study of Adolescent Health -- School Connectedness Scale among students. Cluster membership was explored by student-reported ethnicity. The sample included students attending Canadian secondary schools in two waves of the COMPASS study: Years 4 (Y4:2015/16) (N=40,436) and 7 (Y7:2018/19) (N=60,610). Results were comparable across waves. Four clusters resulted: strongly connected (Y4 66.6%; Y7 67.9%), socially disconnected (14.1%; 15.2%; perceptions of equitable treatment but lacking feelings of belonging), social belonging (11.9%; 10.3%; feelings of being part of their school and close to others, but less likely to perceive equitable treatment), and weakly connected (7.4%; 6.6%). White and Asian students were more likely to be 'strongly connected', while Black and 'other' or mixed ethnicity students were overrepresented in the 'weakly connected' and 'social belonging' clusters. Cluster variations merit attention to improve how racialized and ethnic minority youth experience school environments.

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.

Background: The school environment has the potential to influence student body mass index (BMI) through programs and policies. Our objective was to examine the effect of modifying obesity-related school policies and programs on youths' BMI trajectories. Methods: Obesity-related school policies and programs related to physical activity and healthy eating were collected from 41 schools across Ontario at baseline (2012-2013) and year 2 (2013-2014) of the COMPASS study. Self-reported height and weight were collected from the 4951 grades 9 and 10 students who attended those schools for 3 years. Linear mixed effects regression models examined the effect of modifying obesity-related school policies and programs on youths' BMI trajectories. Results: Between Y[subscript 1] and Y[subscript 2], 26 of the 41 schools implemented distinct new obesity-related programs or policies related to physical activity or healthy eating. Five of the interventions were associated with BMI trajectories of students attending those schools compared to students attending a pooled sample of control schools, predicting a higher BMI trajectory. Conclusions: Isolated programs and policies may not successfully improve youths' BMI trajectories. Further research is required to test the implementation of policies and programs that follow a comprehensive school health (CSH) approach, targeting BMI and associated behaviors.

Background: We explored priority areas of food safety education needed by high-school students within Ontario, Canada. Methods: We analyzed transcripts from semistructured interviews with 20 experts in food safety, food safety education in youth, and high-school education in Ontario. Inductive thematic analysis was used to identify priority food safety education needs. Results: We identified 4 priority action areas for food safety education targeting students: how to safely do the things they typically do with food; how to keep themselves and their kitchens clean and safe; how microorganisms grow and how they can result in foodborne disease; and how to keep food out of the "danger zone" 4°C to 60°C (40° F to 140° F). The results indicate that students need specific education around the use of microwaves, consumption of convenience meals, preparing and handling foods at school events, and safe transportation of food for lunches, school trips, and sporting events. Conclusions: High-school students need food safety education specific to their usual interactions with food, including the foods, tools, and settings students regularly encounter. Delivery of food safety education should emphasize sequences of safe food-handling behaviors for specific food interactions, such as reheating a meal in the microwave, rather than traditional food safety concepts, such as temperature abuse.

In particular research domains, the randomized control trial (RCT) is considered to be the only means for obtaining reliable estimates of the true impact of an intervention. However, an RCT design would often not be considered ethical, politically feasible, or appropriate for evaluating the impact of many policy, programme, or structural changes common in public health research. As such, researchers must use alternative yet robust research methods for determining the impact of such interventions. The evaluation of natural experiments (i.e. an intervention not controlled or manipulated by researchers), using various experimental and non-experimental design options can provide an alternative to the RCT. The following review highlights (a) the importance of evaluating natural experiments; (b) design considerations associated with evaluating natural experiments; (c) methods for reducing bias in natural experimental studies; and (d) the potential benefits of targeted systems to enable natural experiments in emerging priority domains moving forward.