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In community-based research projects, needs assessments are one of the first steps to identify community priorities. Access-related issues often pose significant barriers to participation in research and evaluation for rural and remote communities, particularly Indigenous communities, which also have a complex relationship with academia due to a history of exploitation. To bridge this gap, work with Indigenous communities requires consistent and meaningful engagement. The prominence of digital devices (i.e., smartphones) offers an unparalleled opportunity for ethical and equitable engagement between researchers and communities across jurisdictions, particularly in remote communities. This paper presents a framework to guide needs assessments which embed digital platforms in partnership with Indigenous communities. Guided by this framework, a qualitative needs assessment was conducted with a subarctic Métis community in Saskatchewan, Canada. This project is governed by an Advisory Council comprised of Knowledge Keepers, Elders, and youth in the community. An environmental scan of relevant programs, three key informant interviews, and two focus groups (n = 4 in each) were conducted to systematically identify community priorities. Through discussions with the community, four priorities were identified: (1) the Coronavirus pandemic, (2) climate change impacts on the environment, (3) mental health and wellbeing, and (4) food security and sovereignty. Given the timing of the needs assessment, the community identified the Coronavirus pandemic as a key priority requiring digital initiatives. Recommendations for community-based needs assessments to conceptualize and implement digital infrastructure are put forward, with an emphasis on self-governance and data sovereignty.

Objective The aim of this research was to examine the bidirectional association between self-reported symptoms of mental disorder and physical activity among a large sample of Canadian secondary school students over time. Methods Linked survey data were obtained from 28,567 grade 9 to 12 students across Canada participating in two waves of the COMPASS Study (2017–18; 2018–19). Autoregressive cross-lagged models were run to examine the reciprocal relationships between self-reported moderate-to-vigorous physical activity (MVPA) and symptoms of depression (CESD-10) and anxiety (GAD-7). Models were stratified by gender, and accounted for grade, ethno-racial identity, and school-level clustering. Results Autoregressive associations show that neither symptoms of anxiety nor depression, at baseline, were predictive of mean MVPA at follow-up – consistent for the full sample and among both males and females. Higher MVPA among males at baseline was associated with lower symptoms of both anxiety (β = − 0.03, p  = 0.002) and depression (β = − 0.05, p  < 0.001) at follow-up. However, among females, higher MVPA at baseline was associated with greater symptoms of anxiety (β = 0.03, p  < 0.001), but not symptoms of depression (β = 0.01, p  = 0.073), at follow-up. Conclusion In our large sample of Canadian secondary school students, associations between physical activity and symptoms of mental disorder were not bi-directional, and these relationships differed in males and females. This study illustrates the complex nature of the relationship between physical activity and symptoms of mental disorder among youth. While results support the benefits of promoting physical activity among males to prevent or manage internalizing symptoms, the relationship among females warrants further investigation.

Background Physical activity behaviours are known to be highly correlated. Adolescents who participate in one type of physical activity (e.g., physical education) have a greater likelihood of participating in other physical activities (e.g., organized sports); however, little research has examined participation rates in various physical activity behaviours concurrently. This study identified longitudinal physical activity profiles among secondary school aged youth in Ontario, Canada. Methods We used data from the COMPASS Study, a school-based prospective cohort study of adolescents in Canada. Using a repeated measures latent class analysis, Ontario students who participated in grade 9 PE in 2015-16 were analysed through to 2018-19 ( n  = 1,917). Latent classes were defined by: PE participation, guideline adherence (≥ 60 min/day of moderate to vigorous activity over the last 7 days), and sport participation (varsity, community, and/or intramural). Multinomial logistic regression models were used to examine associations between latent class membership and student characteristics. Results Three distinct latent classes were identified for females and four were identified for males. These classes were: (1) Guidelines (high probability of guideline adherence; females: 44%; males: 16%), (2) PE & Sports (high probability of PE and sport participation; females: 33%; males: 43%), (3) Guidelines & Sports (high probability of guideline adherence and sport participation; females: 23%; males: 23%;), and (4) Inactive (low probability of all physical activity indicators; males: 18%). Strength training, sleep, and English grade were associated with class membership among females. Ethno-racial identity, weekly spending money, strength training, and English and math grades were associated with class membership among males. Conclusions Findings suggest that latent physical activity profiles differ by sex. Guideline adherence was the most common class among females, indicating high levels of independent physical activity, whereas PE & Sport participation was the most common class among males, indicating greater tendency towards organized activities. Additionally, a substantial number of male students were not engaging in any physical activity. Participation in both PE and sports did not necessarily lead to meeting physical activity guidelines, highlighting that these activities alone may not be providing sufficient levels of physical activity that align with current recommendations for Canadian youth.

The current public health crises we face, including communicable disease pandemics such as COVID-19, require cohesive societal efforts to address decision-making gaps in our health systems. Digital health platforms that leverage big data ethically from citizens can transform health systems by enabling real-time data collection, communication, and rapid responses. However, the lack of standardized and evidence-based methods to develop and implement digital health platforms currently limits their application. This study aims to apply mixed evaluation methods to assess the development of a rapid response COVID-19 digital health platform before public launch by engaging with the development and research team, which consists of interdisciplinary researchers (ie, key stakeholders). Using a developmental evaluation approach, this study conducted (1) a qualitative survey assessing digital health platform objectives, modifications, and challenges administered to 5 key members of the software development team and (2) a role-play pilot with 7 key stakeholders who simulated 8 real-world users, followed by a self-report survey, to evaluate the utility of the digital health platform for each of its objectives. Survey data were analyzed using an inductive thematic analysis approach. Postpilot test survey data were aggregated and synthesized by participant role. The digital health platform met original objectives and was expanded to accommodate the evolving needs of potential users and COVID-19 pandemic regulations. Key challenges noted by the development team included navigating changing government policies and supporting the data sovereignty of platform users. Strong team cohesion and problem-solving were essential in the overall success of program development. During the pilot test, participants reported positive experiences interacting with the platform and found its features relatively easy to use. Users in the community member role felt that the platform accurately reflected their risk of contracting COVID-19, but reported some challenges interacting with the interface. Those in the decision maker role found the data visualizations helpful for understanding complex information. Both participant groups highlighted the utility of a tutorial for future users. Evaluation of the digital health platform development process informed our decisions to integrate the research team more cohesively with the development team, a practice that is currently uncommon given the use of external technology vendors in health research. In the short term, the developmental evaluation resulted in shorter sprints, and the role-play exercise enabled improvements to the log-in process and user interface ahead of public deployment. In the long term, this exercise informed the decision to include a data scientist as part of both teams going forward to liaise with researchers throughout the development process. More interdisciplinarity was also integrated into the research process by providing health system training to computer programmers, a key factor in human-centered artificial intelligence development.

The rapid expansion of digital connectivity has provided youth with wide-ranging access to digital platforms for communication, entertainment, and education. In light of this profound shift, there have been growing concerns about online safety, data privacy, and cybersecurity. A critical factor influencing the ability of youth to responsibly navigate digital platforms is digital literacy. While digital literacy programs have been implemented in various regions worldwide, significant disparities remain not only in overall digital literacy levels, but also the assessment of digital literacy initiatives. To address these challenges, an environmental scan and literature review were conducted to identify existing digital literacy programs in Canada developed specifically for youth, as well as digital literacy assessment tools, respectively. The search encompassed peer-reviewed articles, organizational curricula, and assessment measures indexed in various databases and organization websites. The environmental scan identified 15 programs targeting key components of digital literacy such as data safety, cyberbullying, and digital media. The literature review identified 12 digital literacy assessment tools. Based on the findings, data were synthesized from shortlisted programs and assessment tools to inform the development of both a new digital literacy program and assessment tool to complement the youth-focused program. The new program focuses on four key components: (1) digital fluency, (2) digital privacy and safety, (3) ethics and empathy, and (4) consumer awareness. A 15-item assessment tool was also developed consisting of 4–5 questions specific to each program component. Given the growing importance of digital competencies, a youth-focused program and assessment tool are crucial for understanding and addressing digital literacy among this vulnerable cohort. This program's adaptability allows for customization across sociodemographic target groups, including culturally diverse and geographically remote communities—an aspect that has the potential to enhance digital literacy across settings. Implementing digital literacy programs can better prepare youth for an increasingly digital world, while minimizing potential risks associated with technology use.

Background To examine changes in hair cortisol concentrations (HCC) in children with chronic physical illness and identify patterns of association between HCC and mental comorbidity. Methods A sample of 50 children aged 6 to 16 years were recruited within six months of being diagnosed with a chronic physical illness. Data were collected via hair samples, structured interviews, and behavioral checklists. Results There was no change in HCC over six months. Baseline HCC was associated with internalizing—odds ratio (OR) = 1.29 (90% confidence interval (CI): 1.01–1.66)—and externalizing disorders—OR = 1.32 (90% CI: 1.07–1.64). Externalizing disorder at six months was associated with elevated baseline—OR = 1.25 (90% CI: 1.02–1.53)—and six-month HCC—OR = 1.25 (90% CI: 1.02–1.54). Associations between HCC and mental disorder weakened over time, and for internalizing disorders, changed direction (i.e., inverse association), albeit not significantly. Conclusion Results provide preliminary evidence that physiological stress, measured using HCC, may be implicated in the relationship between physical and mental illness, and these associations align with attenuated stress responses over time.

Introduction Children living with mental disorder are at risk for lower health-related quality of life (HRQoL) compared to their peers. While evidence suggests that cortisol dysregulation is implicated in the onset of mental disorder, the extent to which cortisol is associated with HRQoL is largely unknown. Further, it remains unknown how comorbid physical illness may alter this relationship. This study examined whether the presence of a comorbid physical illness moderated the association between hair cortisol concentration (HCC) and HRQoL among children with mental disorder. Methods One-hundred children (4-17 years) receiving care from a pediatric hospital were recruited. The Mini International Neuropsychiatric Interview was used to measure mental disorder and the KIDSCREEN-27 to assess HRQoL. Cortisol extracted from children's hair was assayed using high-sensitivity ELISA. Multiple regression analyses tested the association between HCC and HRQoL. Results Presence of a physical illness was found to moderate the relationship between HCC and HRQoL in the domain of peers and social support [comorbidity: β = −0.57 (−0.97, −0.17); no comorbidity: β = 0.22 (−0.11, 0.55)]. Conclusion The association between HCC and HRQoL in children with mental disorder is moderated by the presence of a physical illness, such that in children with comorbid physical and mental disorder, elevated HCC is associated with lower HRQoL. Approaches that reduce stress in these children may help promote optimal well-being. More research investigating physiological stress and psychosocial outcomes in children with mental disorder, particularly those with comorbid physical illness, is needed.

[This corrects the article DOI: 10.1371/journal.pone.0279282.].

Promoting wellbeing of persons with dementia and their families is a priority of research and practice. Engaging diverse partners, including persons with dementia and their families, to co-develop interventions promotes relevant and impactful solutions. We describe the process, output, and lessons learned from the dementia resources for eating, activity, and meaningful inclusion (DREAM) project, which co-developed tools/resources with persons with dementia, care partners, community service providers, health care professionals, and researchers with the aim of increasing supports for physical activity, healthy eating, and wellbeing of persons with dementia. Our process included: (1) Engaging and maintaining the DREAM Steering Team; (2) Setting and navigating ways of engagement; (3) Selecting the priority audience and content; (4) Drafting the toolkit; (5) Iterative co-development of tools and resources; (6) Usability testing; and (7) Implementation and evaluation. In virtual meetings, the DREAM Steering Team confirmed the toolkit audiences (primary: community service providers; secondary: persons with dementia and care partners) and identified and evolved content areas. An environmental scan identified few existing, high-quality resources aligned with content areas. The Steering Team, additional multi-perspective partners, and external contractors iteratively co-developed new tools/resources to meet gaps over a 4-month virtual process that included virtual meetings, email exchange of documents and feedback, and one-on-one calls by telephone or email. The final DREAM toolkit includes a website with seven learning modules (on the diversity of dementia, rights and inclusion of persons living with dementia, physical activity, healthy eating, dementia-inclusive practices), a learning manual, six videos, nine handouts, and four wallet cards ( www.dementiawellness.ca ). Our co-development participants rated the process highly in relation to the principles and enablers of authentic partnership even though all engagement was virtual. Through use of the co-developed DREAM toolkit, we anticipate community service providers will gain the knowledge and confidence needed to provide dementia-inclusive wellness programs and services that benefit persons with dementia and their families.

This study aimed to determine if secondary school students are meeting the new Canadian 24-Hour Movement Guidelines (24-MG), as well as each individual recommendation (physical activity; sleep; sedentary behavior) within the 24-MG, and which student-level characteristics predict meeting the 24-MG, both cross-sectionally and longitudinally. This study is the first to examine longitudinal changes in students meeting the 24-MG, as well as student-level characteristics that were predictive of favourable shifts in movement patterns. Cross-sectional data were obtained for 11,793 grade 9 students across Canada as part of the COMPASS study. Of this sample, 3713 students provided linked follow-up data from grade 9 to grade 12. The probability of meeting the guidelines was modeled using two-level logistic regression analyses, adjusting for student-level co-variates and school clustering. Only 1.28% (p < 0.0001) of the sample met the overall 24-MG. Among grade 9 students, 35.9% (p < 0.0001), 50.8% (p < 0.0001), and 6.4% (p < 0.0001) were meeting the individual recommendations for physical activity, sleep, and screen time, respectively. Of those students, less than half were still meeting them by grade 12. Community sport participation was the only predictor of all three individual recommendations within the 24-MG. Longitudinal analyses found that community sport participation and parental support and encouragement were significantly associated with Grade 12 students starting to meet the physical activity and screen time recommendations, respectively, after having not met them in grade 9. Findings can be used to inform policy and public health practice, as well as to inform future research examining causal relationships between the variables.