Explore the vast range of titles available.

Background It has been proposed that adverse childhood experiences (ACEs) can put women at risk for mental illness in the pregnancy and postpartum periods. While some studies have found strong support for this proposition, others have found weak or no support. This study is a meta-analysis of the association between ACEs and maternal mental health to resolve between-study discrepancies, and to examine potential moderators of associations. Methods Three electronic databases (i.e., MEDLINE, Embase, and PsycINFO) were searched up to November 2018 by a health sciences librarian. A hand search was conducted in January 2020 and relevant studies were added. Included studies reported on associations between ACEs and maternal depression and/or anxiety in the perinatal period (pregnancy to 1-year postpartum). Pregnancy and postpartum outcomes were examined separately for both depression and anxiety. Random-effect meta-analyses were conducted. Moderator analyses were conducted using meta-regression. Study quality was evaluated using a 15-point scale. Results The initial search yielded 4646 non-duplicate records and full text review occurred for 196 articles. A total of 15 studies ( N = 7788) were included in the meta-analyses, of which 2 were also described narratively. Publication year ranged from 1998 to 2019. Mothers were approximately 28.93 years of age when they retrospectively reported on their ACEs. All studies had maternal self-report questionnaires for the mental health outcomes. Study quality ranged from 7 to 12. The pooled effect sizes between ACEs and prenatal ( N = 12; r = .19; 95% CI= .13, .24) and postpartum ( N = 7; r = .23; 95% CI = .06 to .39) depressive symptoms were significant. The pooled effect size between ACEs and prenatal anxiety was also significant ( N = 5; r = .14; 95% CI= .07, .21). Moderator analyses indicated that timing of depressive and anxiety symptoms may be important for understanding associations. Conclusions ACEs confer risk to maternal mental health, albeit effect sizes are small to moderate in magnitude. Trauma-informed approaches, as well as increased mental health support during and after pregnancy, may help to offset the relative risk of ACEs on maternal mental health.

According to recent federal data, the number of people experiencing homelessness in Canada increased by 20% from 2018 to 2022, with 10% of those who reported being unhoused in the Census also reporting being part of a family group. Homelessness among family groups appears to be on the rise as well. For example, City of Toronto data showed that shelter use by children younger than 16 years in Toronto increased from 8% in 2021 to 13% in 2024, with most children experiencing homelessness being younger than 10 years. Although most people experiencing homelessness in Canada are men, an analysis conducted by Statistics Canada in 2022 found that homelessness among women of childbearing age in Canada has increased. Here, Manoni-Millar and Racine discuss the disparities and risks that pregnant and parenting people experiencing homelessness face, and how to better support them and their children.

The aims of the current study were to examine the association between maternal adverse childhood experiences (ACEs) and antepartum health risks, and to investigate whether social support moderated this association. It was hypothesized that ACEs would be associated with antepartum health risks; however, social support in the prenatal period would buffer mothers from the deleterious consequences of ACEs. Data from 1994 women (mean age = 31 years) and their infants were collected from a longitudinal cohort recruited in health care offices in Alberta, Canada. Pregnant women completed questionnaires related to ACEs prior to the age of 18 and prenatal social support, and a health care professional assessed the mother’s antepartum health risk. ACEs included physical, emotional, and sexual abuse, exposure to domestic violence, as well as exposure to household dysfunction such as parental substance use, mental illness, or incarceration. Regression analyses demonstrated a positive association between ACEs and antepartum health risks. However, a significant interaction between maternal ACEs and social support was also observed. Specifically, women exposed to high ACEs and low social support in pregnancy had high antepartum health risks. However, among mothers who had high ACEs but also high levels of social support, there was no association between ACEs and antepartum health risk. A history of ACEs can place mothers at risk of antepartum health complications. However, a resiliency effect was observed: women with a history of ACEs were buffered from experiencing antepartum health risks if they reported high levels of social support in pregnancy.

Research suggests that nature promotes psychological and behavioral health among children. However, children living in low-income urban communities often have less access to green spaces compared to their counterparts living in high-income neighborhoods, and limited research has investigated the impact of nature on well-being and social connectedness in children experiencing marginalization. To address this gap, this mixed-methods study examined the impact of a one-week immersive nature camp on the well-being and social connectedness of 27 children aged 6–12 years referred to a community hub in Ottawa, Canada, for complex psychosocial difficulties. One week prior to and one week after the camp, caregivers completed a survey inquiring about their child’s personal well-being, social contact, loneliness, positive emotional state, and positive outlook. On the first and last days of the camp, children completed the same survey. Children also engaged in an audio-recorded focus group about their experience in the camp to inform the quantitative findings. Quantitative and qualitative responses were analyzed using paired samples t-tests and thematic analysis, respectively. Although not statistically significant, small to medium effect sizes for improved positive emotional state and positive outlook were reported by children ( p  =.26, d = 0.24; p  =.14, d = 0.31) and their caregivers ( p  =.12, d = 0.37; p  =.89, d = 0.03). Qualitative thematic analyses of focus groups revealed nine themes including making friends, acquiring new skills, and connecting with nature. Within the Canadian child health context, exposure to green spaces for children with complex psychological difficulties living in low-income urban communities may be associated with perceived enhancements in social connections and skills. Future research with larger sample sizes is needed.

Promoting youth mental health and well-being is a global concern. Administering social-emotional learning programs in contexts that are familiar to youth have the potential to increase mental well-being by helping youth develop fundamental coping skills that may contribute to their resilience. Implementing social-emotional learning programs in after-school settings is a unique opportunity to improve mental well-being skills in communities that face inequities. The study is a partnership between investigators at an academic mental health hospital and an after-school program embedded within economically and socially vulnerable neighborhoods in a large metropolitan city in Ontario, Canada. This 20-week covariate-constrained randomized controlled trial will test the feasibility and preliminary efficacy of the EMPOWER social-emotional learning curriculum for youth aged 11-14 years in an after-school program. Twenty sites will be randomized to an intervention group or no-intervention control. Program staff in the intervention arm will receive training on the manualized curriculum and weekly coaching sessions to build capacity and support implementation over the 16-week program. Program staff and youth across both intervention and no-intervention control groups will be asked to participate in baseline and post-intervention data collection where they may complete questionnaires about youth's social-emotional learning skills, global quality of functioning, and resilience skills. The no-intervention control group will carry on with their regular programming while the intervention group implements the 16-week social-emotional learning curriculum, after the collection of baseline data. Program staff in the intervention group will be asked to complete weekly fidelity measures and monthly feasibility, acceptability, and appropriateness of implementation scales. Parents/caregivers of youth in the intervention group will be asked to participate in a brief interview to report their observations of their children's social-emotional learning skills. Results from this pilot study will be disseminated in a peer-reviewed journal and at community and academic conferences.

Background Prospective cohorts may be vulnerable to bias due to attrition. Inverse probability weights have been proposed as a method to help mitigate this bias. The current study used the “All Our Families” longitudinal pregnancy cohort of 3351 maternal-infant pairs and aimed to develop inverse probability weights using logistic regression models to predict study continuation versus drop-out from baseline to the three-year data collection wave. Methods Two methods of variable selection took place. One method was a knowledge-based a priori variable selection approach, while the second used Least Absolute Shrinkage and Selection Operator (LASSO). The ability of each model to predict continuing participation through discrimination and calibration for both approaches were evaluated by examining area under the receiver operating curve (AUROC) and calibration plots, respectively. Stabilized inverse probability weights were generated using predicted probabilities. Weight performance was assessed using standardized differences of baseline characteristics for those who continue in study and those that do not, with and without weights (unadjusted estimates). Results The a priori and LASSO variable selection method prediction models had good and fair discrimination with AUROC of 0.69 (95% Confidence Interval [CI]: 0.67–0.71) and 0.73 (95% CI: 0.71–0.75), respectively. Calibration plots and non-significant Hosmer-Lemeshow Goodness of Fit Tests indicated that both the a priori (p = 0.329) and LASSO model (p = 0.242) were well-calibrated. Unweighted results indicated large (> 10%) standardized differences in 15 demographic variables (range: 11 − 29%), when comparing those who continued in the study with those that did not. Weights derived from the a priori and LASSO models reduced standardized differences relative to unadjusted estimates, with the largest differences of 13% and 5%, respectively. Additionally, when applying the same LASSO variable selection method to develop weights in future data collection waves, standardized differences remained below 10% for each demographic variable. Conclusion The LASSO variable selection approach produced robust weights that addressed non-response bias more than the knowledge-driven approach. These weights can be applied to analyses across multiple longitudinal waves of data collection to reduce bias.

Background The COVID-19 pandemic is an example of a global infectious disease outbreak that poses a threat to the well-being of children and youth (e.g., physical infection, psychological impacts). The consequences of challenges faced during COVID-19 may be longstanding and newly developed interventions are being deployed. We present a narrative synthesis of available evidence from the first 2 years of the COVID-19 pandemic on the feasibility, accessibility, and effects of interventions to improve well-being among children and youth to inform the development and refinement of interventions relevant to post-pandemic recovery. Methods Six databases were searched from inception to August 2022. A total of 5484 records were screened, 39 were reviewed in full text, and 19 studies were included. The definition of well-being and the five domains of well-being as defined by the Partnership for Maternal, Newborn & Child Health and the World Health Organization in collaboration with the United Nations H6 + Technical Working Group on Adolescent Health and Well-Being were used. Results Nineteen studies (74% randomized controlled trials) from 10 countries were identified, involving a total of 7492 children and youth (age range: 8.2–17.2 years; 27.8–75.2% males) and 954 parents that occurred during the COVID-19 pandemic (March 2020 to March 2021). Nearly all interventions ( n  = 18, 95%) targeted health and nutrition, followed by connectedness ( n  = 6, 32%), while fewer studies targeted agency and resilience ( n  = 5, 23%), learning and competence ( n  = 2, 11%), or safety and support ( n  = 1, 3%). Five interventions (26%) were self-guided while 13 interventions (68%) were guided synchronous by a trained professional, all of which targeted physical and mental health subdomains within health and nutrition; one intervention (5%) was unclear. Conclusions Studies deploying synchronous interventions most often reported improved well-being among children and youth largely in the domain of health and nutrition, specifically physical and mental health. Targeted approaches will be crucial to reach sub-groups of children and youth who are most at risk of negative well-being outcomes. Further research is needed to determine how interventions that best supported children and youth early in the pandemic are different from interventions that are required now as we enter into the post-pandemic phase.

Introduction Early child-caregiver attachment is foundational to mental health (MH). While prevention efforts often aim to improve attachment quality, clinicians frequently encounter infants and young children already exhibiting clinical symptoms of MH disorders. A comprehensive summary of attachment-based dyadic interventions for this population is lacking. This scoping review aims to address this gap. Methods We conducted a scoping review of CINAHL, MEDLINE, PsycINFO, Web of Science, Cochrane CENTRAL and hand-searched articles to identify and characterize dyadic, relationship-based interventions for children aged 0–6 years with clinical symptoms of MH disorders. Studies were screened for eligibility and included if they examined therapeutic modalities used in clinical populations beyond preventive approaches. Results Screening identified studies that evaluated several therapeutic modalities, e.g., Parent Child Interaction Therapy (PCIT), Early Pathways (EP), Watch, Wait, and Wonder, Parent-Infant Psychotherapy, and Video Feedback Interventions. PCIT and EP had the most published data, treated the largest number of participants, and demonstrated significant improvements in child or relational outcomes. However, most studies had small sample sizes and methodological limitations. Only a few interventions had been evaluated using rigorous designs such as randomized controlled trials. Conclusions Two interventions that had the most evidence were EP and PCIT, particularly for families affected by adverse social determinants of health. Both require further research to explore barriers for implementation (e.g., adaptability in multiple settings and cultures, lessen resources required for service delivery, etc.). Additional research is needed to strengthen the evidence base for dyadic, attachment-based treatments targeting clinical MH concerns in infants and young children.