Locating longitudinal study participants 10 years after last contact: Contemporary approaches to sample retention.

AIMS: Despite their advantages, longitudinal studies often face high rates of attrition. This study documents the extensive efforts associated with retaining a longitudinal cohort last contacted 10 years earlier. METHOD: We examine the processes and outcomes of attempts to reach 1736 individuals who have been part of a multiwave study about growing up in Ontario, Canada. Contact methods include email, phone, text, social media, postal mail, announcements in newspapers, subway stations, and music streaming services. RESULTS: Challenges included a lack of consistent annual communication with participants, children moving out of the parental home, and changes in email addresses and phone numbers. The most effective contact method was phone; text messages and friend referrals were the least effective. Overall, 41.5% of the original sample was reached. Locating former research participants years later necessitated multiple and repeated contact attempts, and intensive human resources. CONCLUSION: Ten lessons for effective sample retention are discussed. In summary, reducing attrition depends on a comprehensive study design and an organized and flexible protocol that adapts to a study's ever-changing needs.

Cost-Savings Analysis of the Better Beginnings, Better Futures Community-Based Project for Young Children and Their Families: A 10-Year Follow-up.

This study examined the long-term cost-savings of the Better Beginnings, Better Futures (BBBF) initiative, a community-based early intervention project for young children living in socioeconomically disadvantaged neighborhoods during their transition to primary school. A quasi-experimental, longitudinal two-group design was used to compare costs and outcomes for children and families in three BBBF project neighborhoods (n = 401) and two comparison neighborhoods (n = 225). A cost-savings analysis was conducted using all project costs for providing up to 4 years of BBBF programs when children were in junior kindergarten (JK) (4 years old) to grade 2 (8 years old). Data on 19 government service cost measures were collected from the longitudinal research sample from the time the youth were in JK through to grade 12 (18 years old), 10 years after ending project participation. The average family incremental net savings to government of providing the BBBF project was $6331 in 2014 Canadian dollars. When the BBBF monetary return to government as a ratio of savings to costs was calculated, for every dollar invested by the government, a return of $2.50 per family was saved. Findings from this study have important implications for government investments in early interventions focused on a successful transition to primary school as well as parenting programs and community development initiatives in support of children's development.

The Better Beginnings, Better Futures project: findings from grade 3 to grade 9.

Although comprehensive and ecological approaches to early childhood prevention are commonly advocated, there are few examples of long-term follow-up of such programs. In this monograph, we investigate the medium- and long-term effects of an ecological, community-based prevention project for primary school children and families living in three economically disadvantaged neighborhoods in Ontario, Canada. The Better Beginnings, Better Futures (BBBF) project is one of the most ambitious Canadian research projects on the long-term impacts of early childhood prevention programming to date. Bronfenbrenner's ecological model of human development informed program planning, implementation, and evaluation. Using a quasi-experimental design, the BBBF longitudinal research study involved 601 children and their families who participated in BBBF programs when children were between 4 and 8 years old and 358 children and their families from sociodemographically matched comparison communities. We collected extensive child, parent, family, and community outcome data when children were in Grade 3 (age 8­9), Grade 6 (age 11­12), and Grade 9 (age 14­15). The BBBF mandate was to develop programs that would positively impact all areas of child's development; our findings reflect this ecological approach. We found marked positive effects in social and school functioning domains in Grades 6 and 9 and evidence of fewer emotional and behavioral problems in school across the three grades. Parents from BBBF sites reported greater feelings of social support and more positive ratings of marital satisfaction and general family functioning, especially at the Grade 9 follow-up. Positive neighborhood-level effects were also evident. Economic analyses at Grade 9 showed BBBF participation was associated with government savings of $912 per child. These findings provide evidence that an affordable, ecological, community-based prevention program can promote long-term development of children living in disadvantaged neighborhoods and produce monetary benefits to government as soon as 7 years after program completion.

Preventing mental disorders in children: a public health priority.

BACKGROUND: Mental disorders affect 14% of children, cause significant long-term disability and are arguably the leading health problems that Canadian children face after infancy. Treatment services alone cannot meet children's mental health needs. In addition to treatment, prevention programs hold potential to reduce the number of children with disorders in the population. Effective programs exist for preventing conduct, anxiety and depressive disorders, three of the most prevalent disorders in children. Therefore, we investigated the state of Canadian programs in comparison with prevention programs described in the literature for these three disorders. METHODS: We identified children's mental health and early child development (ECD) programs across Canada with national or provincial/territorial scope and significance and with potential relevance to mental health. We then interviewed policy-makers to determine which programs included goals related to mental health, and incorporated key features from programs known to be effective for preventing the three disorders of interest. RESULTS: No prevention programs specific to children's mental health were identified. However, 17 ECD programs incorporated generic goals related to mental health and incorporated key features seen in effective prevention programs. Only Ontario's Better Beginnings, Better Futures (BBBF) explicitly included mental health within its major program goals, incorporated multiple features seen in effective (conduct disorder) prevention programs and demonstrated positive child mental health outcomes. DISCUSSION: The lack of Canadian prevention programs specific to children's mental health is concerning. ECD programs have the potential to improve child mental health outcomes within their wider mandates. BBBF is an exemplar for such programs. However, new investments in implementing (and evaluating) programs that specifically aim to prevent mental disorders are required to improve the mental health of children in the population. Preventing children's mental disorders must be a Canadian public health priority.

Preventing mental disorders in children: a systematic review to inform policy-making.

BACKGROUND: At any given time, 14% of Canadian children experience clinically significant mental disorders, which frequently persist into adulthood. Canadian public policy has emphasized specialized treatment services, yet these services only reach 25% of children with disorders. Prevention programs hold potential to reduce the number of children with disorders in the population. To inform policy-making, we systematically reviewed the best available research evidence on programs for preventing conduct disorder (CD), anxiety and depression, three of the most prevalent mental disorders in children. METHODS: We systematically identified and reviewed randomized controlled trials (RCTs) on programs intended to prevent CD, anxiety and depression in children aged 0-18 years. RESULTS: Fifteen RCTs met selection criteria: nine (on eight programs) for preventing CD; one for anxiety; four (on three programs) for depression; and one for all three. Ten RCTs demonstrated significant reductions in child symptom and/or diagnostic measures at follow-up. The most noteworthy programs, for CD, targeted at-risk children in the early years using parent training (PT) or child social skills training (SST); for anxiety, employed universal cognitive-behavioural training (CBT) in school-age children; and for depression, targeted at-risk school-age children, also using CBT. Effect sizes for these noteworthy programs were modest but consequential. There were few Canadian studies and few that evaluated costs. DISCUSSION: Prevention programs are promising but replication RCTs are needed to determine effectiveness and cost-effectiveness in Canadian settings. Four program types should be priorities for replication: targeted PTand child SST for preventing CD in children's early years; and universal and targeted CBTfor preventing anxiety and depression in children's school-age years. Conducting RCTs through research-policy partnerships would enable implementation in realistic settings while ensuring rigorous evaluation. Prevention merits new policy and research investments as part of a comprehensive public health strategy to improve children's mental health in the population.

[The Better Beginnings, Better Futures Project: short-term effects on the children of Cornwall]. / Le projet << Partir d'un bon pas pour un avenir meilleur >>: ses effets à court terme auprès des enfants de Cornwall.

The Ontario Better Beginnings, Better Futures Project is a prevention project for young children and their families living in 8 disadvantaged neighbourhoods throughout the province. The Cornwall site of Better Beginnings, Better Futures ("Partir d'un bon pas pour un avenir meilleur"), the only francophone site of the project, has focused on children aged 4 to 8 in 4 francophone schools. This article presents the short-term effects of the programs on the children of Cornwall after 4 years of operation. Results showed a decrease in teacher ratings of behaviour problems and an increase in teacher ratings of prosocial behaviour. There was also a significant improvement in nutrition and health care. Finally, results showed a decrease in the number of students receiving special education services for learning disabilities or behavioural problems. However, results failed to show significant improvements in cognitive functioning or academic achievement.

The Better Beginnings, Better Futures Project: a universal, comprehensive, community-based prevention approach for primary school children and their families.

Evaluated a community-based, universal project designed to prevent emotional and behavioral problems and promote general development in young children, while also attempting to improve family and neighborhood characteristics, to link effectively with existing services, and to involve local residents in project development and implementation. The research involved 554 4-year-old children and their families living in 3 disadvantaged neighborhoods in Ontario, Canada. Longitudinal analyses of changes over the first 5 years of project operation indicated significant improvements in children's and parents' social-emotional functioning and physical health, parenting behaviors, and neighborhood and school characteristics. The findings from the Better Beginnings, Better Futures Project are encouraging and provide unique evidence for the extent to which a universal, comprehensive, community-based prevention strategy can promote the longer term development of young children, their families, and their neighborhoods.