ObjectivesMethodologically, to assess the feasibility of participant recruitment and retention, as well as missing data in studying mental disorder among children newly diagnosed with chronic physical conditions (ie, multimorbidity). Substantively, to examine the prevalence of multimorbidity, identify sociodemographic correlates and model the influence of multimorbidity on changes in child quality of life and parental psychosocial outcomes over a 6-month follow-up.DesignProspective pilot study.SettingTwo children’s tertiary-care hospitals.ParticipantsChildren aged 6–16 years diagnosed in the past 6 months with one of the following: asthma, diabetes, epilepsy, food allergy or juvenile arthritis, and their parents.Outcome measuresResponse, participation and retention rates. Child mental disorder using the Mini International Neuropsychiatric Interview at baseline and 6 months. Child quality of life, parental symptoms of stress, anxiety and depression, and family functioning. All outcomes were parent reported.ResultsResponse, participation and retention rates were 90%, 83% and 88%, respectively. Of the 50 children enrolled in the study, the prevalence of multimorbidity was 58% at baseline and 42% at 6 months. No sociodemographic characteristics were associated with multimorbidity. Multimorbidity at baseline was associated with declines over 6 months in the following quality of life domains: physical well-being, β=−4.82 (–8.47, –1.17); psychological well-being, β=−4.10 (–7.62, –0.58) and school environment, β=−4.17 (–8.18, –0.16). There was no association with parental psychosocial outcomes over time.ConclusionsPreliminary evidence suggests that mental disorder in children with a physical condition is very common and has a negative impact on quality of life over time. Based on the strong response rate and minimal attrition, our approach to study child multimorbidity appears feasible and suggests that multimorbidity is an important concern for families. Methodological and substantive findings from this pilot study have been used to implement a larger, more definitive study of child multimorbidity, which should lead to important clinical implications.

OBJECTIVES: We investigated the extent to which a sample of Ontario and Alberta secondary schools are being compliant with their respective provincial nutrition policies, in terms of the food and beverages sold in vending machines. METHODS:This observational study used objective data on drinks and snacks from vending machines, collected over three years of the COMPASS study (2012/2013-2014/2015 school years). Drink (e.g., sugar-containing carbonated/non-carbonated soft drinks, sports drinks, etc.) and snack (e.g., chips, crackers, etc.) data were coded by number of units available, price, and location of vending machine(s) in the school. Univariate and bivariate analyses were undertaken using R version 3.2.3. In order to assess policy compliancy over time, nutritional information of products in vending machines was compared to nutrition standards set out in P/PM 150 in Ontario, and those set out in the Alberta Nutrition Guidelines for Children and Youth (2012) in Alberta.RESULTS: Results reveal a decline over time in the proportion of schools selling sugar-containing carbonated soft drinks (9% in 2012/2013 vs. 3% in 2014/2015), crackers (26% vs. 17%) and cake products (12% vs. 5%) in vending machines, and inconsistent changes in the proportion selling chips (53%, 67% and 65% over the three school years). Conversely, results highlight increases in the proportion of vending machines selling chocolate bars (7% vs. 13%) and cookies (21% vs. 40%) between the 2012/2013 and 2014/2015 school years.CONCLUSION: Nutritional standard policies were not adhered to in the majority of schools with respect to vending machines. There is a need for investment in formal monitoring and evaluation of school policies, and the provision of information and tools to support nutrition policy implementation.KEY WORDS: School nutrition; policy implementation; school health; built environment La traduction du résumé se trouve à la fin de l'article.

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Objective: The objective of this research was to determine the school and community characteristics associated with milk and milk alternative (MMA) consumption by Canadian youth. Methods: We analyzed self-reported data from 50,058 Canadian students participating in the 2017-2018 wave of the COMPASS survey. We used logistic and linear regression analyses to identify school- and community-level factors associated with students meeting the MMA guidelines, and factors associated with daily number of MMA servings consumed, respectively. Results: Student-level factors were more strongly associated with MMA consumption than school- and community-level factors. Students who attended schools that provided staff with nutrition training consumed fewer daily servings of MMAs and were less likely to meet MMA guidelines. Students attending schools that received healthy eating grants were more likely to meet MMA guidelines, whereas students attending schools that sold flavored milk in their vending machines were less likely to meet MMA guidelines. Conclusion: Our findings suggest that student-level factors have a stronger association with MMA consumption than school or community factors. Additional research is needed to understand how factors associated with MMA consumption may influence behaviours over time, and how changes to Canada's food guide may impact youth eating habits.

ObjectiveThe objective of this study was to examine associations between depression, anxiety and binge drinking among a large sample of Canadian youth, while testing the moderating effect of flourishing. This research uses data from the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, Sedentary Behaviour (COMPASS) study (2012–2021) with a large sample size collecting data on youth health behaviours within Canadian secondary schools.DesignCross-sectionalSetting14 secondary schools across Ontario and British Columbia, Canada.ParticipantsA sample of grade 9–12 students (n=6570) who participated in the Mental Health pilot of the COMPASS studyPrimary and secondary outcome measuresSelf-reported questionnaires assessed student binge drinking behaviours (5≥drinks), symptoms of depression (Center for Epidemiologic Studies Depression Scale (Revised)−10 scores≥10) and anxiety (Generalised Anxiety Disorder 7-item Scale scores≥10), and flourishing (Diener’s Flourishing Scale: 8–40).ResultsIn our sample of 6570 students, 37.0% of students reported binge drinking in the last year, and 41.4% and 31.7% of students report clinically-relevant symptoms of depression and anxiety, respectively. Anxiety (adjusted OR (AOR): 0.57, (99% CI 0.15 to 2.22)) and depression (AOR: 1.98, (99% CI 0.76 to 5.13)) symptoms were not found to be associated with binge drinking and we did not detect any moderating role of flourishing. Rather, factors that were associated with increased odds of binge drinking included sports team participation (AOR: 1.67, (99% CI 1.37 to 2.03)) and use of other substances (tobacco (AOR: 3.00, (99% CI 2.12 to 4.25)) and cannabis (AOR: 7.76, (99% CI 6.36 to 9.46))). Similar associations were found for frequency of binge drinking.ConclusionsConsistent with existing literature, binge drinking behaviours were problematic, as well as clinically-relevant symptoms of depression and anxiety. However, mental health problems and well-being may not be responsible for explaining patterns of binge drinking in youth. Targeted intervention efforts towards student athletes and concurrent substance users are necessary for addressing binge drinking in youth populations.

Objectives: The aim of this study was to investigate the sociodemographic, behavioural, and psychological characteristics of students who reported using cannabis in the school-year preceding cannabis legalization in Canada. Methods: Data were derived from 36,884 students attending 122 schools that participated in year 6 (2017–2018) of the COMPASS Study, a large, prospective cohort study that administers questionnaires annually in high schools across Canada. Multilevel logistic regression models were used to estimate the odds of past-year cannabis use among students. Predictor variables used in the models included indicators of mental health and disorder, other substance use, movement, and students’ sociodemographic characteristics. We tested the moderating effects of polysubstance use with interactions between binge-drinking, cigarette use, and e-cigarette use. Results: One in 4 students reported past-year cannabis use. Factors associated with higher odds of cannabis use included higher grade, more spending money, identifying as indigenous, use of other substances (binge-drinking, cigarettes, e-cigarettes, and opioid use), presence of depressive symptoms, and greater emotional dysregulation. Factors associated with lower odds of cannabis use included increased flourishing, recreational screen time of <2 hours per day, and adequate sleep time of 8 or more hours per night. Significant interactions between concurrent use of other substances on cannabis use were detected. Conclusions: Cross-sectional results suggest that students reporting greater psychological wellbeing and engagement in healthy behaviours are less likely to use cannabis. Future longitudinal research should investigate these associations as protective factors, and how the identified correlates may influence changes in student cannabis use patterns postlegalization. Objectifs: Le but de cette étude était d’examiner les caractéristiques sociodémographiques, comportementales et psychologiques des élèves ayant déclaré avoir consommé du cannabis au cours de l’année scolaire précédant la légalisation du cannabis au Canada. Méthodes: Les données proviennent de 36 884 élèves de 122 écoles ayant participé à la 6e année (2017-2018) de l’étude COMPASS, une vaste étude de cohorte prospective qui administre des questionnaires chaque année dans les écoles secondaires du Canada. Des modèles de régression logistique à plusieurs niveaux ont été utilisés pour estimer les probabilités de consommation de cannabis au cours de la dernière année parmi les étudiants. Les variables prédictives utilisées dans les modèles comprenaient des indicateurs de la santé mentale et des troubles mentaux, de la consommation d’autres substances, des mouvements et des caractéristiques sociodémographiques des élèves. Nous avons testé les effets modérateurs de la consommation de polysomes avec les interactions entre consommation excessive d’alcool occasionnelle, usage de la cigarette et usage de la cigarette électronique. Résultats: Un étudiant sur quatre a déclaré avoir consommé du cannabis au cours de la dernière année. Les facteurs associés à des probabilités de consommation de cannabis plus élevées incluent une classe supérieure, davantage d’argent de poche, l’identification comme étant autochtone, la consommation d’autres substances (consommation excessive d’alcool occasionnelle, cigarettes, cigarettes électroniques et consommation d’opioïdes), la présence de symptômes dépressifs et une plus grande dysfonction émotionnelle. Les facteurs associés à une probabilité plus faible de consommation de cannabis incluaient une durée accrue d’un dépistage de moins de 2 heures par jour, et de sommeil suffisant de 8 heures ou plus par nuit. Des interactions significatives entre la consommation simultanée d’autres substances et la consommation de cannabis ont été détectées. Conclusions: Les résultats transversaux suggèrent que les étudiants qui déclarent un plus grand bien-être psychologique et un comportement plus sain sont moins susceptibles de consommer du cannabis. Les futures recherches longitudinales devraient examiner ces associations en tant que facteurs de protection et déterminer comment les corrélats identifiés peuvent influencer les changements dans les habitudes de consommation de cannabis des élèves après la légalisation.

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.