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IntroductionFew studies have assessed patterns of substance use among Canadian adolescents. This cross-sectional study examined substance use classes among Canadian secondary school students and associations with anxiety and depression. MethodsThis study used data from Year 6 (2017/18) of the COMPASS study. Students (n = 51 767) reported their substance use (alcohol, cannabis, cigarette and e-cigarette use) and anxiety and depression symptoms. We employed latent class analysis to identify substance use classes and multinomial logistic regression to examine how anxiety and depression were associated with class membership. ResultsOverall, 40% of students indicated having anxiety and/or depression (50% in females; 29% in males) and 60% of students reported substance use (60% in females; 61% in males). We identified three substance use classes: poly-use, dual use, and non-use. Females with both anxiety and depression had the highest odds of being in the poly-use class compared to the non-use class (odds ratio [OR] = 4.09; 95% confidence interval [CI]: 3.59–4.65) followed by females with depression only (OR = 2.65; 95% CI: 2.31–3.04) and males with both anxiety and depression (OR = 2.48; 95% CI: 2.19–2.80). Symptomatology was also associated with belonging to the dual use class except among males with anxiety only (OR = 1.13; 95% CI: 0.94–1.37). ConclusionCanadian secondary school students are engaging in dual and poly-substance use, and anxiety and depression were associated with such use. Females had a higher prevalence of anxiety and depression and should be a priority population for mental health programming.

IntroductionPeu d’études ont évalué les habitudes de consommation de substances chez les adolescents canadiens. Cette étude transversale porte sur les catégories de consommation de substances chez les élèves du secondaire au Canada et leurs associations avec l’anxiété et la dépression. MéthodologieCette étude repose sur des données de l’année 6 (2017-2018) de l’étude COMPASS. Les élèves (n = 51 767) ont fait état de leur consommation de substances (alcool, cannabis, cigarettes et cigarettes électroniques) et de leurs symptômes d’anxiété et de dépression. Nous avons utilisé une analyse par classes latentes pour créer les catégories de consommation de substances et une analyse de régression logistique multinomiale pour examiner la manière dont l’anxiété et la dépression étaient associées à l’appartenance à une catégorie. RésultatsDans l’ensemble, 40 % des élèves ont indiqué souffrir d’anxiété ou de dépression (50 % des filles et 29 % des garçons) et 60 % des élèves ont fait état d’une consommation de substances (60 % des filles et 61 % des garçons). Nous avons établi trois catégories de consommation de substances : la polyconsommation, la double consommation et la non-consommation. Les plus susceptibles d’appartenir à la catégorie de polyconsommation plutôt qu’à la catégorie de non-consommation étaient les filles souffrant à la fois d’anxiété et de dépression (rapport de cote [RC] = 4,09; intervalle de confiance [IC] à 95 % : 3,59 à 4,65]), suivies des filles souffrant de dépression uniquement (RC = 2,65; IC à 95 % : 2,31 à 3,04) et des garçons souffrant à la fois d’anxiété et de dépression (RC = 2,48; IC à 95 % : 2,19 à 2,80). La symptomatologie a également été associée à l’appartenance à la catégorie de double consommation, sauf pour les garçons souffrant d’anxiété uniquement (RC = 1,13; IC à 95 % : 0,94 à 1,37). ConclusionLes élèves du secondaire au Canada s’adonnent à une double consommation et à une polyconsommation de substances, et on a pu associer l’anxiété et la dépression à ces types de consommation. Les filles affichent une prévalence plus élevée d’anxiété et de dépression et devraient, de ce fait, constituer une priorité en matière de programmation en santé mentale.

IntroductionLittle is known about gender differences in associations between weight control intentions and mental health in adolescents. Our objective was to examine these associations in a large sample of adolescent girls and boys. MethodsUsing data from Year 6 (2017–18) of the COMPASS study (n = 57 324), we performed a series of multivariable linear regressions to examine whether weight control intentions (gain, lose, stay the same, no intention) were associated with depression, anxiety and self-concept, while adjusting for relevant covariates including body mass index. Models were stratified by self-reported gender. ResultsCompared to those with no intentions, girls who intended to lose weight reported higher symptoms of depression (B = 0.52, p $lt; 0.001) and anxiety (B = 0.41, p $lt; 0.001) and poorer self-concept (B = 2.06, p $lt; 0.001). Girls who intended to gain weight also reported higher symptoms of depression (B = 0.54, p $lt; 0.001), anxiety (B = 0.50, p $lt; 0.001) and self-concept (B = 1.25, p $lt; 0.001). Boys who intended to lose weight reported greater symptoms of depression (B = 0.26, p $lt; 0.001) and anxiety (B = 0.33, p $lt; 0.001) and poor self-concept (B = 1.10, p $lt; 0.001). In boys, weight-gain intentions were associated with greater symptoms of anxiety (B = 0.17, p $lt; 0.05), but not depression or self-concept. ConclusionIntentions to gain or lose weight were associated with symptoms of mental disorder and poor self-concept in our large sample of adolescents, and these relationships differed in boys and girls. These findings have important implications for school-based programs promoting healthy weight and body image.

IntroductionLes différences entre les genres en lien avec les intentions de contrôle du poids et la santé mentale des adolescents sont peu connues. Notre objectif était d’examiner ces associations au sein d’un vaste échantillon d’adolescents et d’adolescentes. MéthodologieEn utilisant les données de l’année 6 (2017-2018) de l’étude COMPASS (n = 57 324), nous avons procédé à une série de régressions linéaires multivariables pour déterminer si les intentions de contrôle du poids (gain de poids, perte de poids, maintien du poids, aucune intention) étaient associées à la dépression, à l’anxiété et à l’image de soi, tout en tenant compte de covariables pertinentes, dont l’indice de masse corporelle. Les modèles ont été stratifiés en fonction du genre autodéclaré. RésultatsPar rapport aux filles sans intention en matière de contrôle du poids, les filles ayant l’intention de perdre du poids ont fait état de symptômes plus importants de dépression (B = 0,52, p $lt; 0,001) et d’anxiété (B = 0,41, p $lt; 0,001) ainsi que d’une moins bonne image d’elles-mêmes (B = 2,06, p $lt; 0,001). Les filles ayant l’intention de prendre du poids ont elles aussi fait état de symptômes plus marqués de dépression (B = 0,54, p $lt; 0,001) et d’anxiété (B = 0,50, p $lt; 0,001) ainsi qu’une moins bonne image d’elles-mêmes (B = 1,25, p $lt; 0,001). De leur côté, les garçons ayant l’intention de perdre du poids ont fait état de symptômes plus importants de dépression (B = 0,26, p $lt; 0,001) et d’anxiété (B = 0,33, p $lt; 0,001) ainsi que d’une mauvaise image d’eux-mêmes (B = 1,10, p $lt; 0,001). Enfin, toujours chez les garçons, les intentions de gain de poids étaient associées à des symptômes d’anxiété plus prononcés (B = 0,17, p $lt; 0,05), mais aucune différence n’a été observée en ce qui concerne les symptômes de dépression et d’image de soi. ConclusionLes intentions de gain ou de perte de poids étaient corrélées à des symptômes de troubles mentaux et à une mauvaise image de soi au sein du vaste échantillon d’adolescents sur lequel porte notre étude, avec des associations différentes chez les garçons et les filles. Ces résultats ont des implications importantes pour les programmes scolaires visant à promouvoir un poids santé et une image du corps saine.

IntroductionThe effectiveness of school nutrition regulations may be undermined by food environments surrounding schools. Given challenges in regulating external retail, some have recommended policies that ensure students are unable to leave school property during the day (closed campus policies; CCP). We aimed to examine whether CCP are associated with student eating behaviours. MethodsWe used student and school-administrator survey data from the 60 610 Grades 9 to 12 students and 134 Canadian secondary schools that participated in Year 7 (2018/19) of the COMPASS study. Multiple ordinal regression models tested school CCP as a predictor of weekday dietary behaviours (0–5 days), controlling for student-level (grade, sex, spending money, ethnicity) and school-level (urbanicity, province, area median household income, vending machines) covariates. ResultsCCP were reported by 16 schools. Students who attended CCP schools reported eating lunch purchased from fast food outlets or other restaurants and drinking sugar-sweetened beverages (SSBs; soft drinks and sports drinks; sweetened coffee or tea drinks) on fewer weekdays, but consumed snacks from school vending machines on more weekdays, relative to students at open campus schools. No significant differences were observed in student reports of eating home-packed or school cafeteria lunches or snacks purchased off-campus. ConclusionCCP may help improve adolescent diets by reducing SSB and lunchtime fast food consumption on weekdays; however, students already purchasing food may shift from off-campus to within-school options, highlighting the importance of ensuring healthy school food environments and encouraging students to bring home-prepared lunches. Future studies using experimental longitudinal designs are needed to determine the effect of CCP on various health behaviours and outcomes.

IntroductionL’efficacité de la réglementation sur l’alimentation en milieu scolaire est susceptible d’être compromise par l’environnement alimentaire à proximité des écoles. Comme il est difficile de réglementer la vente au détail à l’extérieur, certains recommandent l’adoption de règlements interdisant aux élèves de quitter le périmètre scolaire durant la journée. Notre objectif consiste à examiner si ces règlements ont une influence sur les comportements alimentaires des élèves. MéthodologieNous avons utilisé les données d’enquête recueillies auprès de 60 610 élèves de la 9e à la 12e année et auprès d’administrateurs de 134 écoles secondaires canadiennes qui ont participé à l’année 7 (2018-2019) du projet COMPASS. Nous avons appliqué des modèles de régression ordinale multiple pour déterminer si les règlements interdisant aux élèves de quitter le périmètre scolaire constituent un facteur prédictif des comportements alimentaires en semaine (0 à 5 jours), en contrôlant pour des covariables liées aux élèves (niveau scolaire, sexe, argent à dépenser, origine ethnique) et aux écoles (indice d’urbanisation, province, revenu médian des ménages du quartier, machines distributrices). RésultatsAu total, 16 écoles ont indiqué avoir adopté un règlement interdisant aux élèves de quitter le périmètre scolaire. Par rapport aux élèves fréquentant une école les autorisant à quitter le périmètre scolaire, les élèves fréquentant une école dotée d’un règlement leur interdisant de quitter ce périmètre ont déclaré manger moins souvent au cours de la semaine des repas achetés dans un restaurant rapide ou un autre type de restaurant et boire moins souvent des boissons sucrées (boissons gazeuses, boissons pour sportifs et thés ou cafés sucrés), mais acheter plus souvent des collations dans les machines distributrices de l’école. Aucune différence significative n’a été observée en ce qui concerne la consommation de repas préparés à la maison ou par la cafétéria de l’école et la consommation de collations achetées à l’extérieur de l’école. ConclusionLes règlements interdisant aux élèves de quitter le périmètre scolaire peuvent contribuer à améliorer l’alimentation des adolescents, car ces derniers réduisent alors la consommation de boissons sucrées et de repas rapides à l’heure du dîner en semaine, mais ces élèves étant susceptibles de remplacer les aliments achetés à l’extérieur de l’école par des aliments achetés à l’école, cela souligne l’importance de créer des environnements alimentaires sains dans les écoles et d’encourager les élèves à apporter des lunchs préparés à la maison. D’autres études fondées sur des modèles longitudinaux expérimentaux doivent être menées pour déterminer l’incidence des règlements interdisant aux élèves de quitter le périmètre scolaire sur divers comportements et résultats en matière de santé.

Throughout adolescence, both sleep and emotion regulation abilities undergo significant developmental changes. The maturational systems that govern sleep and emotion regulation are closely intertwined leading many researchers to posit a mutually reinforcing relationship. Although there is support for a bidirectional relationship among adults, empirical support for reciprocal relationships among adolescents is lacking. Given the notable developmental changes and instability that occur throughout adolescence, this is a critical period to examine whether sleep and emotion regulation abilities may be reciprocally related. Using a latent curve model with structured residuals, this study examined within-person reciprocal associations between sleep duration and emotion dysregulation among 12,711 Canadian adolescents (M[subscript age] = 14.30 years; 50% female). Participants self-reported their sleep duration and emotion dysregulation each year for 3 years beginning in Grade 9. After accounting for underlying developmental trajectories, the results did not support a bidirectional relationship between sleep duration and emotion dysregulation from one year to the next. However, there was evidence of contemporaneous associations between the residuals at each wave of assessment (r = -0.12) such that less sleep than expected was concurrently associated with higher-than-expected deviations in emotion dysregulation, or, conversely, that reporting greater emotion dysregulation than expected was associated with lower-than-expected sleep duration. In contrast to previous findings, the between-person associations were not supported. Taken together, these results indicate that the relationship between sleep duration and emotion dysregulation is primarily a within-person process rather than reflecting differences between individuals and likely operates on a more proximal timescale.

This study examined how schools prioritize ten key health concerns among their student populations over time and whether schools' prioritization of alcohol and other drug use (AODU) corresponds to students' substance use behaviours and cannabis legalization as a major policy change. Data were collected from a sample of secondary schools in Ontario, Canada across four years (2015/16-2018/19 [N[superscript 2015/16] = 65, N[superscript 2016/17] = 68, N[superscript 2017/18] = 61 and N2018/19 = 60]) as a part of the COMPASS study. School-level prevalence of cannabis and alcohol use between schools that did and did not prioritize student AODU as a health concern was examined. Ordinal mixed models examined whether student cannabis and alcohol use were associated with school prioritization of AODU. Chi-square tests examined changing health priorities among schools pre-post cannabis legalization. School priority ranking for AODU was mostly stable over time. While AODU was identified as an important health concern, most schools identified mental health as their first priority across the four years of the study. No significant changes to school AODU priorities were observed pre--post cannabis legalization nor was school prioritization of AODU associated with student cannabis and alcohol use behaviours. This study suggests that schools may benefit from guidance in identifying and addressing priority health concerns among their student population.

Background: The comprehensive school health (CSH) framework has four components: social and physical environment; partnerships and services; teaching and learning; and policy. This study examines associations between CSH and student physical activity (PA). Methods: Using 2015/2016 COMPASS study survey data of 37,397 students (grades 9-12) from 80 secondary schools in Ontario and Alberta, Canada, associations between school-level factors within CSH and student PA outcomes (weekly moderate-to-vigorous PA [MVPA] minutes and achieving the national PA recommendations of [greater than or equal to]60 min of MVPA daily, vigorous PA [greater than or equal to]3 days/week, strengthening activities [greater than or equal to]3 days/week) were analyzed using multilevel regression models stratified by gender and grade. Results: Factors within all four CSH components were associated with student PA. Four student subgroups were more likely to achieve the recommendations if their school had youth organization partnerships (Range of AORs:1.15-1.33, p <0.05) and female students were less likely if their school had low prioritization of PA (AOR = 0.77, 95% CI: [0.65-0.92]). Grade 9 students had higher MVPA when provided non-competitive PA opportunities ([beta] = 100.4, 95%CI: [30.0-170.9]). All student subgroups had better PA outcomes when schools provided access to equipment during non-instructional time. Conclusion: There is opportunity to improve student PA through CSH-guided interventions, but different strategies may be more effective for each gender/grade.

Previous research indicates that the disproportionate distribution of income within society is associated with aggression and violence. Although research has been conducted identifying the relationship between income inequality and bullying victimization and perpetration, little is known about possible mediators. We investigated the association between income inequality and bullying perpetration and victimization among adolescents participating in the Cannabis, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behavior (COMPASS) study. We identified whether school connectedness and psychosocial well-being mediated the relationship between income inequality and bullying behavior. This study used pooled cross-sectional data from 147,748 adolescents aged 13 to 18 from three waves (2015-2016, 2016-2017, 2017-2018) of the COMPASS study from 157 secondary schools in British Columbia, Alberta, Ontario, and Quebec (Canada). The Gini coefficient was calculated based on the school Census Divisions (CD) using the Canada 2016 Census and linked with student data. We used multilevel modeling to investigate the relationship between income inequality and self-reported bullying victimization and perpetration, while controlling for individual-, school-, and CD-level characteristics. A standard deviation increase in Gini coefficient was associated with increased odds for bullying victimization and perpetration. Findings were observed among girls; however, inequality was only associated with perpetration among boys. We identified social cohesion and psychosocial well-being as potential mediators. To counter the adverse effects of income inequality, school-based interventions designed to increase school connectedness and student psychosocial well-being should be implemented to protect against bullying.

Selection of appropriate study design and analytical methods is critical for producing robust research, as the design and analytical approach used can ultimately shape results and their interpretation. The objective of this research was to examine how findings from a large repeat cross-sectional data system compare to those from a sample of longitudinal data nested within the same data system, using milk and milk alternative consumption as a case study. Overall, the repeat cross-sectional and longitudinal findings were consistent, and this article highlights the strengths and limitations of both methodologies under examination. Application to social research and public health and policy are discussed.

Course grades, as an indicator of academic performance, are a primary academic concern at the secondary school level and have been associated with various aspects of mental health status. The purpose of this study is to simultaneously assess whether symptoms of mental illness (depression and anxiety) and mental well-being (psychosocial well-being) are associated with self-reported grades (in their primary language [English or French] and math courses) and education behaviors (school days missed due to health, truancy, and frequency of incomplete homework) in a sample of secondary school students across Canada (n = 57,394). Multivariate imputation by chained equations and multilevel proportional odds logistic regressions were used to assess associations between mental health scores, academic performance and education behaviors. Lower depression and higher psychosocial well-being scores were associated with better grade levels in both math and language courses, as well as better education behaviors. In turn, better education behaviors were associated with higher course grades. Depression scores and psychosocial well-being scores remained associated with higher grades after controlling for education behaviors, however the magnitude of association was diminished. Results indicate that the effects of mental health factors were partially attenuated by education behaviors, suggesting while reduced class attendance and poor homework adherence were associated with both academic outcomes and mental health, they do not account entirely for the association between lower grades and worse mental health.

Background: Few youth engage in sufficient daily moderate-to-vigorous physical activity (MVPA), and the likelihood of meeting guidelines declines through secondary school. Physical education (PE) can afford youth with opportunities for MVPA. Therefore, the purpose of this study was to investigate the impact of changes in PE enrollment on MVPA and MVPA guideline adherence in Ontario and Alberta secondary students. Methods: Linked survey data was used from 1514 students who participated in year 3 (2014/2015 baseline) and year 6 (2017/2018 follow-up) of the COMPASS Study. Regression models tested whether changes in PE enrollment predicted changes in self-reported MVPA (minutes) and MVPA guideline adherence from grade 9 (baseline) to grade 12 (follow-up), controlling for sports participation and sociodemographic variables. Results: Students who remained enrolled in PE in grade 12 reported a daily average of 30 minutes more MVPA. Among students meeting MVPA guidelines and enrolled in PE in grade 9, students not taking PE in the current term in grade 12 were less likely to continue to meet guidelines than students currently enrolled in PE (adjusted odds ratio 0.53; 95% confidence interval: 0.36, 0.78; p < .0013). Conclusions: Findings from this study could inform the future implementation of a mandatory PE credit for upper year secondary students.

Background: Adolescence coincides with the adoption of health behaviors that schools are not necessarily equipped to properly address. Collaboration between schools and external health services such as public health could fill gaps in addressing student health. Methods: The current study uses student- and school-level survey data from 59 nonprivate secondary schools in Ontario, Canada in year 6 (2017-2018) of the COMPASS study to examine barriers to improving student health, and analyze the effect of public health engagement on student health behaviors. Results: The majority of schools have received resources from their local public health unit, however, less than one third of schools were developing/implementing programs jointly, and 12% of schools reported no engagement. Students had higher odds of better overall mental health, of meeting screen time guidelines, and were less likely to bully others if public health units solved issues together with schools regarding these health behaviors. Conclusions: There is a notable lack of consistent public health engagement in schools participating in the COMPASS study despite a need for such services. Creating mechanisms to develop and strengthen effective partnerships between schools and external service providers such as public health might alleviate some barriers to implementing health interventions in Ontario secondary schools.