Eating disorders among international migrants: a systematic review and meta-analysis.

PURPOSE: Migrants may have elevated exposure to stressors, which can affect their physical and mental well-being. However, migrants often experience a healthy immigrant effect, the applicability of this phenomena to eating disorders is unknown. We aimed to synthesize the available literature and estimate a summary measure of prevalence odds ratio for eating disorders in migrant populations compared to local populations. METHODS: A literature search was conducted using MEDLINE, Embase, PsycINFO, and Web of Science with keywords on migration and eating disorders. Inclusion criteria involved using a validated eating disorder scale and having a comparator group. Two independent reviewers performed study screening and data extraction. The NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess risk of bias. Random-effects models of meta-analysis were applied to compare eating disorder prevalence between migrants and local populations. RESULTS: There were 10 studies included in our review (meta-analysis = 6, narrative synthesis = 4). Studies provided prevalence estimates for: any eating disorder, binge eating disorder, anorexia nervosa, and bulimia nervosa. Among studies with a diagnostic instrument, the pooled prevalence odds ratio (POR) between migrants and local populations for any eating disorder was 0.45 (95%CI: 0.35-0.59). However, a subgroup analysis of eating disorder instruments among studies using risk assessment tools demonstrated inconsistent findings, with both increases and decreases in prevalence. CONCLUSION: Migrants were found to have a lower prevalence of eating disorders compared to local populations, supporting the healthy immigrant hypothesis. However, this effect differs between diagnostic and risk assessment tools.

Women's perspectives on smartphone apps for fertility tracking and predicting conception: a mixed methods study.

BACKGROUND: Women use fertility tracking apps (FTAs) for conception purposes, but user perspectives on FTA use for conception are largely unknown. In collaboration with SPD Clearblue, this study explored: how women trying to conceive use FTAs; women's knowledge of their conception chances; and women's feelings towards a potential natural conception prediction app (NCPA). METHODS: A mixed methods design was used (online survey and phone interviews). Participants were women 18-40 years old actively trying to conceive. RESULTS: The survey received 154 responses and 24 interviews were conducted. Thematic analysis of interviews found that women consider several factors before trying to conceive (ex. age, financial and job security, stability of relationship, etc.) and may adopt lifestyle and behaviour changes when trying (ex. increasing exercise, smoking cessation, diet changes, etc.). Survey results indicated that nearly all respondents were aware of FTAs (n = 146, 94.8%), however, several other fertility and conception information sources were also used (ex. health care providers, online sources, family and friends, etc.). Nearly all respondents reported they would use an NCPA (n = 153, 99.4%). During interviews women had positive feelings towards such an app due to it offering new and individualised information, but worried the app could provide upsetting information. CONCLUSION: This research elaborates on women's uses of and interest in FTAs. Stakeholders should use this research to reflect on current conception experiences and possibilities for improvement through development of an NCPA. Future research should seek opinions from a more diverse sample of women to inform the development of an inclusive NCPA.

Depression, parenting and the COVID-19 pandemic in Canada: results from three nationally representative cross-sectional surveys.

OBJECTIVES: Depression is associated with problems in functioning in many aspects of life, including parenting. COVID-19 has increased risk factors for depression. We investigated the prevalence of depression among parents during the pandemic and the association with dysfunctional parenting. DESIGN: Canadian nationwide cross-sectional study. SETTING AND PARTICIPANTS: The 2020 and 2021 Surveys on COVID-19 and Mental Health (SCMH) and the Canadian Community Health Survey (CCHS) (2015‒2019). Responding sample sizes for parents were 3121 for the 2020-SCMH; 1574 for the 2021-SCMH and 6076 for the CCHS. PRIMARY OUTCOME MEASURES: All three surveys collected information on symptoms of major depressive disorder (MDD). The SCMH measured harsh parenting. RESULTS: Based on data from the 2021-SCMH collected during wave 3 of COVID-19, 14.4% of fathers and 21.2% of mothers screened positive for MDD. These prevalence estimates were similar to those from the 2020-SCMH during wave 2, but at least two times higher than pre-COVID-19 estimates from the CCHS. Multivariate analyses revealed a linear association between MDD and harsh parenting. COVID-19-related stressors were associated with harsh parenting. Among mothers, feeling lonely or isolated because of COVID-19 was a risk factor for harsh parenting; among fathers, being a front-line worker was a risk factor. Meditation was a protective factor for mothers. CONCLUSIONS: After years of stability, the prevalence of MDD increased substantially among Canadian parents during the pandemic. Ongoing monitoring is vital to determine if elevated levels of depression persist because chronic depression increases the likelihood of negative child outcomes. Programmes aimed at addressing depression and bolstering parenting skills are needed as families continue to face stressors associated with COVID-19.

Concerns about Household Violence during the COVID-19 Pandemic.

Evidence about how the pandemic affected household violence in Canada is mixed, but inarguably, the risk factors increased. This study used data from the 2020 Canadian Perspective Survey Series and the 2020 and 2021 Surveys of COVID-19 and Mental Health to examine the following: changes in the prevalence of concern about violence in individuals' own homes during the pandemic; the characteristics of those who expressed concern; and the prevalence of concerns for specific household members. Among Canadians, the prevalence of concern about violence in individuals' own homes decreased significantly between July and Fall 2020 (5.8% to 4.2%). Among women, the characteristics that were significantly associated with higher adjusted odds of concern about household violence included larger household size and lower household income. Lower education among women was associated with lower adjusted odds of concern. The associations with higher adjusted odds of concern among men included: being an immigrant, larger household size, and lower household income. From Fall 2020 to Spring 2021, the prevalence of concerns for oneself and for a child/children increased (1.7% to 2.5% and 1.0% to 2.5%, respectively), but concern for other adults in the household decreased (1.9% to 1.2%). Ongoing surveillance is needed to understand vulnerable populations' exposure to household violence and to inform policies and programs.

Symptoms of major depressive disorder during the COVID-19 pandemic: results from a representative sample of the Canadian population. / Symptômes du trouble dépressif majeur pendant la pandémie de COVID 19 : résultats obtenus à partir d'un échantillon représentatif de la population canadienne.

INTRODUCTION: Since the outbreak of COVID-19, numerous studies from around the world have reported declines in mental health. However, most of these studies were of low-to-moderate quality and many were based on convenience samples or used mental health measures with low validity, or both. Consequently, it has been difficult to draw conclusions. METHODS: Both the 2020 Survey on COVID-19 and Mental Health (SCMH) and the Canadian Community Health Survey (CCHS) (2015-2019) used the Patient Health Questionnaire-9 to screen for major depressive disorder (MDD) in adults aged 18 or older. The prevalence of MDD was compared between the SCMH and the CCHS. Risk and protective factors for MDD in the SCMH were examined using bivariate and logistic regression analyses. RESULTS: Based on SCMH data, 15.2% (95% CI: 14.2-16.2) of Canadians screened positive for MDD. The prevalence of MDD was more than two times higher in the SCMH (during COVID-19) than in the CCHS (predating COVID-19). In bivariate analysis, Canadians reporting five or more COVID-19-related risk factors were close to 30 times more likely to have MDD than those reporting no risk factors. Mastery and a sense of community belonging were protective factors for MDD. CONCLUSION: After remaining stable for two decades, the prevalence of depression among Canadians increased substantially with the onset of COVID-19. Ongoing monitoring of this common condition associated with major morbidity is vital to determine if elevated levels of MDD persist as we progress through and beyond future waves of COVID-19.