AimTo describe a community‐specific and culturally coherent approach to youth mental health services in a small and remote northern Indigenous community in Canada's Northwest Territories, under the framework of ACCESS Open Minds (ACCESS OM), a pan‐Canadian youth mental health research and evaluation network.MethodsAs 1 of the 14 Canadian communities participating in a 5‐year, federally funded service transformation and evaluation project, the arctic Inuit community of Ulukhaktok has undertaken culturally relevant adjustments in their delivery of youth mental wellness services and related community wellness initiatives. These enhancement activities highlight connections to culture and traditional skills, honour youth‐ and community‐expressed desires to incorporate Inuvialuit‐specific approaches to wellness, and strengthen the support systems to improve access to mainstream mental healthcare, when needed. The adaptation of a Lay Health Worker model from Global Mental Health to the local circumstances resulting in creation of lay community health workers is central to this approach in meeting contextual needs.ResultsCommunity leaders identified key activities for sustainable change, including human capital development, authentic collaboration and diversified engagement strategies. Building around five ACCESS OM objectives, the local site team in Ulukhaktok has identified its youth programming and mental wellness service gaps through an ongoing process of community mapping.ConclusionsInformation from service providers, youth and other community members demonstrates attuning of the ACCESS OM framework to Inuit paradigms in Ulukhaktok. It could prove to be a sustainable prototype for delivering youth mental health services in other communities in the Inuvialuit Settlement Region and possibly across the entire Inuit Nunangat. It needs, however, to be further supported by easier access to specialized mental health services when needed.

In response to new and exacerbated challenges imposed by the COVID-19 pandemic, Indigenous children and youth in Canada have developed innovative and holistic solutions to amplify their voices, continue cultural engagement and combat social isolation for themselves and their communities as a whole. In this analysis, we have selected three Indigenous philosophical tenets as an ethical orientation for discussion of how the COVID-19 pandemic is impacting the well-being of Indigenous young people. The guiding values of interconnected relationships, holism and Indigenous-informed restorative justice help us interpret existing pandemic-specific literature and identify, define and prioritize considerations of child and youth well-being from an Indigenous-centred worldview. This analysis can (a) help inform future pandemic measures affecting Indigenous young people and (b) foster similar considerations for Indigenous communities in other regions of the world.

Many Indigenous communities view children as sacred gifts deserving of love and respect, and as the ones who will carry their collective ways of life forward. However, Indigenous young people within Canada face disproportionate challenges to their health and well-being, partly a result of ongoing colonial practices within professional services. In response to the Truth and Reconciliation Commission’s Calls to Action regarding improvements to professional education and training, our team conducted an international scoping review which identified that Indigenous pedagogy is rarely included in curricular development. We completed this scoping review’s consultation phase in two Anishinabeg communities. In this consultation, we posed the following questions: What are Anishinaabe perspectives on and experiences of child-focused professional practices? How are child-focused professionals currently prepared to work with young Anishinabeg peoples? How should they be prepared? Participants highlighted the importance of professionals learning Indigenous history and Anishinaabe culture, having field-based education, and engaging children with hands-on activities. Professionals encountered little to no Indigenous-focused content in their formal education, with most exposure occurring in continuing education settings. Our results suggest Indigenous ways of knowing can and should be honored in child-focused professional education, thereby supporting the development of effective and culturally-safe relationships between professionals and Indigenous peoples.

Background Background: Antibiotic resistance is a major public health concern. A modifiable intervention is outpatient antibiotic stewardship. The goal of this study was to review the electronic health records (EHR) of children diagnosed with community acquired pneumonia (CAP) to compare patients who received non-guideline concordant therapy with those prescribed recommended therapy. Methods Methods: This was a retrospective chart review of 300 children (6 months to 6 years old) with an outpatient diagnosis of CAP between July 2017 and June 2019. 45 Children’s Hospital of Pittsburgh (CHP) and UPMC Children’s Community Pediatrics (CCP) practices were included. CHP practices are academic-based with trainees involved in visits, while CCP practices do not include trainees. First-line recommended therapy was defined as amoxicillin, second-line therapy as azithromycin or amoxicillin-clavulanate, and all other prescriptions were defined as other. Patients prescribed first-line therapy were compared to patients with second-line therapy or other. If first-line therapy was not prescribed, the EHR was manually reviewed for justification. If drug allergy was listed, the medication allergy and type of reaction were recorded. Results Results: In this study the minority of children (43%) were prescribed first-line therapy. This group was younger (57 vs. 63 months of age), more likely to be Non-white (80%), and seen at the CHP locations than those prescribed non-guideline concordant therapy. The average symptom duration was shorter, heart rate and respiratory rate were higher and the presence of fever was more common in the first-line therapy group. Justification for non-guideline therapy was most often reported as to provide coverage for atypical organisms. The most common drug allergy recorded was amoxicillin, and urticaria with unknown timing was the most common type of reaction. Demographics Comparison Results Justification for Second-line / Other Therapy and Drug Allergy Results Conclusion This project observed a high proportion of children being prescribed non-guideline concordant therapy for a diagnosis of CAP. Age, race, practice location, and severity of illness measures showed a statistically significant difference between groups. This study highlights the importance of education which reviews the current guidelines and the most likely pathogens for children with CAP. Disclosures All Authors: No reported disclosures