Depression symptoms and night eating in young adulthood.

PURPOSE: We estimated cross-sectional and longitudinal associations between depression symptoms and night eating in young adults. METHODS: Data were drawn from a longitudinal investigation of students age 12-13 years at inception in 1999-2000, in Montreal, Canada. Depression symptoms were measured with the Depressive Symptoms Scale (DSS) 20 times from age 12 to 17, and with the Major Depression Inventory (MDI) post-high school at ages 20 and 24. Night eating was measured at age 24. The association between depression symptoms and night eating was estimated in multivariable logistic regression models adjusted for sex, age and mother university-educated. RESULTS: 9% of 829 participants (n = 77) reported night eating. In cross-sectional analysis, the adjusted odds ratio (OR) estimate for MDI scores (range 0-50) was 1.04 (1.01, 1.07). In longitudinal analyses, the OR estimates were 1.75 (1.20, 2.55) for DSS scores (range 1-4) and 1.03 (1.002, 1.06) for the MDI. CONCLUSIONS: Depression symptoms are associated with night eating in young adults cross-sectionally and possibly longitudinally. Treatment of depression symptoms may be important in preventing night eating, a core symptom of the Night Eating Syndrome. LEVEL OF EVIDENCE: Level III, cohort analytic study.

Parental Cannabis Use Is Associated with Cannabis Initiation and Use in Offspring.

OBJECTIVES: To assess, before legalization in Canada, whether parental cannabis use is associated with initiation of use in adolescent offspring or with use in young-adult offspring. STUDY DESIGN: Data were available in 2 longitudinal studies in Montréal, Canada. In AdoQuest, 1048 parents with children in grade 6 reported past-year cannabis use. Cannabis initiation among offspring was measured in grade 7, 9, and/or 11. In the Nicotine Dependence in Teens study, cannabis use data were available for 584 participants (mean age 24 years) and their parents (ie, 542 offspring-mother pairs, 438 offspring-father pairs). The association between parental and offspring cannabis use was estimated using multivariable logistic regression in both studies. RESULTS: In AdoQuest, grade 6 never-users were 1.8 times more likely to initiate cannabis during high school if their parents reported past-year use. In the Nicotine Dependence in Teens study, the aORs (95% CI) for past-year cannabis use among adult offspring were not different for "mother uses cannabis" (2.8 [1.4-5.8]) or "father uses cannabis" (2.1 [1.2-3.8]). Participants with 1 or 2 cannabis-using parents were 1.7 and 7.1 times more likely to use cannabis, respectively, than participants with non-using parents. CONCLUSIONS: To enable informed decision-making about their own cannabis use, parents need to be aware that children of cannabis users are more likely to use cannabis in adolescence and young adulthood.

A Tool to Identify Adolescents at Risk of Cigarette Smoking Initiation.

: media-1vid110.1542/5828318368001PEDS-VA_2017-3701Video Abstract OBJECTIVES: To describe the development of a prognostic tool to identify adolescents at risk for transitioning from never to ever smoking in the next year. METHODS: Data were drawn from the Nicotine Dependence in Teens study, a longitudinal investigation of adolescents (1999 to present). A total of 1294 students initially age 12 to 13 years were recruited from seventh-grade classes in 10 high schools in Montreal. Self-report questionnaire data were collected every 3 months during the 10-month school year over 5 years (1999-2005) until participants completed high school (n = 20 cycles). Prognostic variables for inclusion in the multivariable analyses were selected from 58 candidate predictors describing sociodemographic characteristics, smoking habits of family and friends, lifestyle factors, personality traits, and mental health. Cigarette smoking initiation was defined as taking even 1 puff on a cigarette for the first time, as measured in a 3-month recall of cigarette use completed in each cycle. RESULTS: The cumulative incidence of cigarette smoking initiation was 16.3%. Data were partitioned into a training set for model-building and a testing set to evaluate the performance of the model. The final model included 12 variables (age, 4 worry or stress-related items, 1 depression-related item, 2 self-esteem items, and 4 alcohol- or tobacco-related variables). The model yielded a c-statistic of 0.77 and had good calibration. CONCLUSIONS: This short prognostic tool, which can be incorporated into busy clinical practice, was used to accurately identify adolescents at risk for cigarette smoking initiation.

Social disparities in children's exposure to secondhand smoke in privately owned vehicles.

INTRODUCTION: Secondhand smoke (SHS) can quickly attain high concentrations in cars, posing health risks to passengers and especially to children. This paper assesses whether there are social disparities in children's exposure to SHS in privately owned vehicles. METHODS: On weekday mornings and afternoons from September to November 2011, trained observers were stationed at 100 selected street intersections in Montreal, Canada. For each car transporting at least one passenger aged 0-15 years travelling through the intersection, observers recorded the estimated age of the youngest child in the car, whether any occupant was smoking and the licence plate number of the car. Licence plate numbers were linked to an area material deprivation index based on the postal code of the neighbourhood in which the car was registered. RESULTS: Smoking was observed in 0.7% of 20 922 cars transporting children. There was an apparent dose-response in the association between area material deprivation level and children's exposure to SHS in cars. Children travelling in cars registered in the most disadvantaged areas of Montreal were more likely to be exposed to SHS than children travelling in cars registered in the most advantaged areas (unadjusted OR=3.46, 95% CI 1.99 to 6.01). CONCLUSIONS: This study revealed social disparities in children's exposure to SHS in privately owned vehicles.

Mapping Collaborative Relations among Canada's Chronic Disease Prevention Organizations.

In the field of chronic disease prevention (CDP), collaborations between organizations provide a vital framework for intersectoral engagement and exchanges of knowledge, expertise and resources. However, little is known about how the structures of preventive health systems actually articulate with CDP capacity and outcomes. Drawing upon data from the Public Health Organizational Capacity Study - a repeat census of all public health organizations in Canada - we used social network analysis to map and examine interorganizational collaborative relationships in the Canadian preventive health system. The network of relationships obtained through our study shows that provincial boundaries remain a major factor influencing collaborative patterns. Not only are collaborations scarce on the interprovincial level but they are also mostly limited to links with federal and multi-provincial organizations. Given this finding, federal or multi-provincial organizations that occupy central bridging positions in the Canadian CDP collaborative structure should serve as key players for shaping CDP practices in the country.

Public health strategies promoting physical activity and healthy eating in Canada: are we changing paradigms?

OBJECTIVES: To compare the extent to which Canadian public health organizations incorporated the Ottawa Charter for Health Promotion action areas in promoting physical activity and healthy eating in 2004 and 2010. METHODS: Data were available from repeat censuses of all regional, provincial, and national organizations with mandates to promote physical activity [n = 134 (2004); n = 118 (2010)] or healthy eating [n = 137 (2004); n = 130 (2010)]. Eleven strategies to promote these behaviors were grouped according to the five action areas. Descriptive analyses were conducted to document the level of involvement in each action area over time. RESULTS: The proportion of organizations promoting physical activity and "heavily involved" in creating supportive environments increased from 51 % (2004) to 70 % (2010). The proportion also increased for reorienting health services (29 % to 39 %). The proportion of organizations promoting healthy eating and "heavily involved" in building healthy public policy increased from 47 to 53 %. Individual skill building remained stable for physical activity but declined for healthy eating. CONCLUSIONS: While developing personal skills remains important in promoting physical activity and healthy eating in Canada, public health organizations increased involvement in structural-level strategies.

Association between organizational capacity and involvement in chronic disease prevention programming among Canadian public health organizations.

In the context of the emerging field of public health services and systems research, this study (i) tested a model of the relationships between public health organizational capacity (OC) for chronic disease prevention, its determinants (organizational supports for evaluation, partnership effectiveness) and one possible outcome of OC (involvement in core chronic disease prevention practices) and (ii) examined differences in the nature of these relationships among organizations operating in more and less facilitating external environments. OC was conceptualized as skills and resources/supports for chronic disease prevention programming. Data were from a census of 210 Canadian public health organizations with mandates for chronic disease prevention. The hypothesized relationships were tested using structural equation modeling. Overall, the results supported the model. Organizational supports for evaluation accounted for 33% of the variance in skills. Skills and resources/supports were directly and strongly related to involvement. Organizations operating within facilitating external contexts for chronic disease prevention had more effective partnerships, more resources/supports, stronger skills and greater involvement in core chronic disease prevention practices. Results also suggested that organizations functioning in less facilitating environments may not benefit as expected from partnerships. Empirical testing of this conceptual model helps develop a better understanding of public health OC.

Does level of tobacco control relate to smoking prevalence in Canada: a national survey of public health organizations.

OBJECTIVES: To describe levels of tobacco control "effort" in public health organizations across provinces, and to test the hypothesis that "effort" is associated with the prevalence of daily smoking. METHODS: Data were drawn from a national survey (Oct 2004-Apr 2005) of all public health organizations engaged in chronic disease prevention in Canada in 2004. We investigated the association between "effort" and decline in smoking prevalence (CTUMS, 1999-2009) across provinces in an ecologic study design. "Effort" was assessed using two indicators: percent of public health organizations engaged in tobacco control, and mean level of involvement in engaged organizations. RESULTS: Of 216 organizations, 88% had undertaken tobacco control activities in the three years prior to data collection and were categorized as "engaged". Level of involvement in tobacco control was highest in community-at-large settings; and it was generally higher for population- than for individual-level strategies. Nova Scotia reported higher levels of involvement than other provinces. There was substantial variability in "effort" across provinces. High-"effort" provinces (BC, NS, ON, QC) experienced, on average, improvement in the "change in smoking prevalence" score (1999 to 2009). CONCLUSION: The findings provide evidence that provincial tobacco control "effort" relates to declines in smoking prevalence. Given that smoking remains a critical public health issue, the kinds of data reported herein are needed to inform the debate on how best to invest in tobacco control infrastructure to combat the most important public health threat of our times.

A national survey of organizational transfer practices in chronic disease prevention in Canada.

Underuse of best practices in chronic disease prevention (CDP) represents missed opportunities to promote healthy living and prevent chronic disease. Better understanding of how CDP programs, practices and policies (PPPs) are transferred from 'resource' organizations that develop them to 'user' organizations that implement them is crucial. The objectives of this work were to develop psychometrically sound measures of transfer practices occurring within resource organizations; describe the use of these transfer practices and identify correlates of the transfer process. Cross-sectional data were collected in structured telephone interviews with the person most knowledgeable about PPP transfer in 77 Canadian organizations that develop PPPs. Independent correlates of transfer were identified using multiple linear regression. The transfer practices most commonly used included: identification of barriers to PPP adoption/implementation, tailoring transfer strategies and designing a transfer plan. Skill at planning/implementing transfer, external sources of funding specifically allocated for transfer, type of resource organization, attitude toward process of collaboration and user-centeredness were all positively associated with the transfer process. These factors represent possible targets for interventions to improve transfer of CDP PPPs.

Organizational capacity for chronic disease prevention: a survey of Canadian public health organizations.

BACKGROUND: There are no national data on levels of organizational capacity within the Canadian public health system to reduce the burden of chronic disease. METHODS: Cross-sectional data were collected in a national survey (October 2004 to April 2005) of all 216 national, provincial and regional-level organizations engaged in chronic disease prevention through primary prevention or healthy lifestyle promotion. Levels of organizational capacity (defined as skills and resources to implement chronic disease prevention programmes), potential determinants of organizational capacity and involvement in chronic disease prevention programming were compared in western, central and eastern Canada and across three types of organizations (formal public health organizations, non-governmental organizations and grouped organizations). RESULTS: Forty percent of organizations were located in Central Canada. Approximately 50% were formal public health organizations. Levels of skill and involvement were highest for activities that addressed tobacco control and healthy eating; lowest for stress management, social determinants of health and programme evaluation. The few notable differences in skill levels by provincial grouping favoured Central Canada. Resource adequacy was rated low across the country; but was lowest in eastern Canada and among formal public health organizations. Determinants of organizational capacity (organizational supports and partnerships) were highest in central Canada and among grouped organizations. CONCLUSION: These data provide an evidence base to identify strengths and gaps in organizational capacity and involvement in chronic disease prevention programming in the organizations that comprise the Canadian public health system.

Building the backbone for organisational research in public health systems: development of measures of organisational capacity for chronic disease prevention.

BACKGROUND: : Research to investigate levels of organisational capacity in public health systems to reduce the burden of chronic disease is challenged by the need for an integrative conceptual model and valid quantitative organisational level measures. OBJECTIVE: To develop measures of organisational capacity for chronic disease prevention/healthy lifestyle promotion (CDP/HLP), its determinants, and its outcomes, based on a new integrative conceptual model. METHODS: Items measuring each component of the model were developed or adapted from existing instruments, tested for content validity, and pilot tested. Cross sectional data were collected in a national telephone survey of all 216 national, provincial, and regional organisations that implement CDP/HLP programmes in Canada. Psychometric properties of the measures were tested using principal components analysis (PCA) and by examining inter-rater reliability. RESULTS: PCA based scales showed generally excellent internal consistency (Cronbach's alpha = 0.70 to 0.88). Reliability coefficients for selected measures were variable (weighted kappa(kappa(w)) = 0.11 to 0.77). Indicators of organisational determinants were generally positively correlated with organisational capacity (r(s) = 0.14-0.45, p<0.05). CONCLUSIONS: This study developed psychometrically sound measures of organisational capacity for CDP/HLP, its determinants, and its outcomes based on an integrative conceptual model. Such measures are needed to support evidence based decision making and investment in preventive health care systems.

The G8 Heart Health Projects Database: testing the compatibility of an Internet-based resource with health promotion planning processes.

This study examined the context and processes in which health promotion policy and program decisions are made to ensure that an Internet-based information system on heart health promotion programs provides appropriate information for decision makers' needs and is compatible with their decision-making processes. Five focus groups and six individual interviews were conducted with potential users of and contributors to the G8 Heart Health Projects Database. Results suggest that Internet-based systems such as this are seen as useful tools, but will only be used at certain critical points in program development and then, only when they meet several rigorous criteria. Systems must be completely credible and up-to-date, providing instant answers to complex questions about program design, implementation, and effectiveness, with adequate qualitative information for assessing contextual applicability. Participants also provided information about the conditions required if they were to submit project information to the system.