Did You Know?

The Nurse-Family Partnership (NFP) program is a leading example of how intervening very early in life can bring many long-term benefits. This intensive home-visiting program focuses on young first-time mothers-to-be who are coping with socio-economic disadvantage. It begins in early pregnancy and continues until children reach age two, and can produce life-changing benefits. A recent paper — by researchers from the Children’s Health Policy Centre and published in the Canadian Medical Association Journal OPEN — suggests some encouraging results. In a randomized controlled trial in BC, NFP led to reduced prenatal cannabis use, and in smokers it led to modest reductions in cigarette use. As a result, it is thought that NFP may hold promise for reducing some types of prenatal substance use in disadvantaged populations.

This is a good time to remember that reducing inequality in society has been shown to reduce maltreatment of children. In particular, policies that redistribute wealth to ensure that more children have their basic needs met can contribute to reducing important problems such as child maltreatment. For more information on preventing and treating child maltreatment, see Vol. 3, No. 2 of the Children’s Mental Health Research Quarterly.

When a child has depression, families should have easy access to effective psychosocial treatments such as Cognitive-Behavioural Therapy. Interpersonal Therapy can also be effective. Then, if medication is needed, fluoxetine is the first choice, given robust research evidence supporting its use. For more information, see Vol. 11, No. 4 of the Children’s Mental Health Research Quarterly.

Spanking can harm children, for example, leading to physical injuries as well as emotional and behavioural problems. Spanking is also ineffective at changing children’s behaviour. Spanking and other forms of physical punishment should therefore not be used. For more information, see Vol. 9, No. 1 of the Children’s Mental Health Research Quarterly.

How do you persuade busy young mothers to participate in a scientific trial that’s going to last more than two years? The BC Healthy Connections Project achieved this goal by using a number of strategies. These included:

• Offering to perform research interviews on weekends and evenings.
• Changing the type of contact to suit the needs of participants who were aged 14–24 years.
• Making texting the preferred style of contact.
• Personalizing the connection by showing appreciation and conveying genuine interest.

Many of the 739 participants said they enjoyed contributing to research and having their voices heard, through the survey data. They especially appreciated being able to feel that someone was listening and was interested in their lives.

The trial, which started in 2011, was designed as a scientific evaluation of the Nurse-Family Partnership, a landmark US program focusing on children born to girls and young women who are facing disadvantages such as low income. The program starts early — in pregnancy, before children are even born — and involves intensive home visits from public health nurses.

For more information on how the BC Healthy Connections Project maintained its impressive participation rates, see the team’s paper recently published in Trials.

In October, which is ADHD Awareness Month in Canada and around the world, it’s worth remembering the many young people who are frequently labeled as “problem children” rather than children with a medical problem. Research evidence supports the use of three medications — methylphenidate, dextroamphetamine and atomoxetine — for children with ADHD. Careful use of these medications can reduce children’s symptoms and improve their quality of life. For more information, see Vol. 11, No. 1 of the Children’s Mental Health Research Quarterly.

Childhood obesity has more than just physical health implications. Obese children often have higher rates of depression, anxiety and eating Yet steps can be taken to prevent childhood obesity — including restricting food and beverage advertisements that exploit children, and implementing policies that make healthy foods more available and affordable. For more information, see Vol. 4, No. 1 of the Children’s Mental Health Research Quarterly.

World Mental Health Day occurs Oct. 10. To mark this important day, the Children’s Health Policy Centre notes that comprehensive public health strategy is the most effective way to address children’s mental health in BC and in Canada. This strategy includes addressing social determinants, promoting healthy development for all children, preventing disorders in children at risk, providing effective treatments for all children with disorders and monitoring population outcomes. For more information, see Vol. 1, No. 1 of the Children’s Mental Health Research Quarterly.

September 30, 2020 marks Orange Shirt Day, in recognition of the harm the residential school system did to Indigenous children. It is a time worth remembering that effective interventions for mental health issues can also be culturally relevant. For example, a Cognitive-Behavioural Therapy (CBT) program was adapted to reflect the local culture in a remote Indigenous community in Ontario, with local practitioners receiving training and support to use the program. The adapted program succeeded, suggesting that local cultural values can be embedded within well-researched interventions such as CBT. For more information, see Vol. 10, No. 3, page 7 of the Children’s Mental Health Research Quarterly.

It looks as though research efforts by the BC Healthy Connections Project team have paid off.

When the team began a research trial— involving 739 young mothers and their 731 children — researchers knew it would be a challenge to keep participants fully involved for the two-and-a-half years.

But interview completion rates were high for the five follow-up interviews: ranging from 80 to 91% across pregnancy and through until the children reached age two years.

As well, 99% of participants allowed the team to have access to official provincial data on their children’s wellbeing.

The trial, which started in 2011, was designed as a scientific evaluation of the Nurse-Family Partnership, a landmark US program focusing on children born to girls and young women who are facing disadvantages such as low income. The program starts early — in pregnancy, before children are even born — and involves intensive home visits from public health nurses.

For more information on the study team’s participation strategies, see their paper in Trials.