Isabella Romano - Academia.edu (original) (raw)

Papers by Isabella Romano

Research paper thumbnail of Evaluating the Associations Between Exposure to Tobacco Interventions During Inpatient Treatment and Substance Use Outcomes: Findings From a Natural Experiment

Journal of Addiction Medicine

Objective: In this study, we took advantage of a natural experiment that occurred within a substa... more Objective: In this study, we took advantage of a natural experiment that occurred within a substance use disorders (SUD) treatment setting which first saw the implementation of an evidence-based practice (EBP) for tobacco cessation, followed by the implementation of a tobacco-free policy (TFP) that included a campus-wide tobacco ban. We sought to examine how implementation of the EBP and TFP was associated with substances use outcomes, in addition to tobacco use, up to 3-months posttreatment. Methods: Data were collected from patients in a substance use disorders treatment program at baseline, discharge, 1-, and 3-months posttreatment. Using a quasi-experimental design and generalized estimating equations, we modelled how patients’ (N = 480) exposure to one of 3 interventions (1: treatment as usual [TAU], 2: EBP, and 3: EBP + TFP) was associated with overall abstinence from tobacco, alcohol, and other substances over time. Measures of tobacco use frequency, amount, and quit attempts...

Research paper thumbnail of Navigating Newcomers’ Food Transitions in the COVID-19 Pandemic: A developmental evaluation of a community-based program

Research Square (Research Square), Dec 13, 2022

Refugee newcomers almost invariably face "food" culture shock and are at greater risk of food ins... more Refugee newcomers almost invariably face "food" culture shock and are at greater risk of food insecurity due to slow-to-evolve institutions. Community programs can help boost refugee newcomer con dence through knowledge exchange during intercultural culinary experiences. The originally proposed program was "Breaking Down the Walls (BDTW)-Building Integration and Cultural Appreciation through Shared Food Experiences with Refugee Newcomers". With the restrictions set in place due to the COVID-19 pandemic, adaptations were made to the BDTW program. Speci cally, the program's scope was greatly reduced and the program itself shifted to a virtual environment. The nal deliverables for this program included: 1) a framework/guide for conducting intercultural cooking events; and 2) an Online cultural brokerage training tool to help users to grasp some of the food-related challenges faced by newcomers to Canada. To best identify the challenges, successes, and e cacy of conducting community-based research, the team adopted a Developmental Evaluation approach, which is often used in complex settings and evolving scenarios such as the COVID-19 pandemic. The themes which emerged from interviews with participants were further distilled into broader areas of the COVID-19 pandemic, collaboration, and equity. Programs like BDTW have the potential to create infrastructure for newcomer nutrition programming that is integrated and streamlined as a long-term intervention. This type of programming would help shift care practices from sporadically addressing health/nutrition and settlement issues as they arise to a system that proactively anticipates nutritional needs from day one, ultimately promoting long-term health and mental wellbeing among newcomer populations.

Research paper thumbnail of Weight control intentions and mental health among Canadian adolescents: a gender-based analysis of students in the COMPASS study

Health Promotion and Chronic Disease Prevention in Canada

Introduction Little is known about gender differences in associations between weight control inte... more Introduction Little is known about gender differences in associations between weight control intentions and mental health in adolescents. Our objective was to examine these associations in a large sample of adolescent girls and boys. Methods Using data from Year 6 (2017–18) of the COMPASS study (n = 57 324), we performed a series of multivariable linear regressions to examine whether weight control intentions (gain, lose, stay the same, no intention) were associated with depression, anxiety and self-concept, while adjusting for relevant covariates including body mass index. Models were stratified by self-reported gender. Results Compared to those with no intentions, girls who intended to lose weight reported higher symptoms of depression (B = 0.52, p lt;0.001)andanxiety(B=0.41,plt; 0.001) and anxiety (B = 0.41, p lt;0.001)andanxiety(B=0.41,plt; 0.001) and poorer self-concept (B = 2.06, p lt;0.001).Girlswhointendedtogainweightalsoreportedhighersymptomsofdepression(B=0.54,plt; 0.001). Girls who intended to gain weight also reported higher symptoms of depression (B = 0.54, p lt;0.001).Girlswhointendedtogainweightalsoreportedhighersymptomsofdepression(B=0.54,plt; 0.001), anxiety (B = 0.50, p $lt; 0.001) ...

Research paper thumbnail of Risky cannabis use is associated with varying modes of cannabis consumption: Gender differences among Canadian high school students

Drug and Alcohol Dependence Reports

Research paper thumbnail of Perceptions of and adherence to early COVID-19-related restrictions and associations with substance use among youth in Canada

Health Promotion and Chronic Disease Prevention in Canada

Introduction As a largely social behaviour, substance use may have decreased for some youth overa... more Introduction As a largely social behaviour, substance use may have decreased for some youth overall in Canada during the COVID-19 pandemic; however, continued use may indicate nonadherence to pandemic-related restrictions and social distancing measures. In a sample of Canadian adolescents (aged 12–19 years), our objective was to examine how substance use (cannabis, binge drinking, cigarettes, vaping) is associated with perceptions of, and adherence to, early COVID-19-related public health measures, taking into consideration sociodemographic factors. Methods Cross-sectional data were retrieved from online data collected during Year 8 of the COMPASS school-based study, during the early months of the COVID-19 pandemic (May–July 2020) in British Columbia, Ontario and Quebec. We fitted two models using generalized estimating equations to examine how substance use was associated with separate measures of (1) perceptions of, and (2) adherence to early COVID-19 restrictions. Results In our ...

Research paper thumbnail of Perceptions et respect des premières restrictions liées à la COVID-19 et associations avec la consommation de substances chez les jeunes au Canada

Promotion de la santé et prévention des maladies chroniques au Canada

Introduction Dans la mesure où la consommation de substances est un comportement principalement s... more Introduction Dans la mesure où la consommation de substances est un comportement principalement social, elle est susceptible d’avoir diminué chez certains jeunes partout au Canada pendant la pandémie de COVID-19, et le maintien d’une consommation est susceptible d’indiquer un non-respect des restrictions liées à la pandémie et des mesures de distanciation physique. Notre objectif était d’analyser, dans un échantillon composé d’adolescents canadiens (de 12 à 19 ans), la manière dont la consommation de substances (cannabis, consommation excessive d’alcool, cigarettes, produits de vapotage) est associée aux perceptions et au respect des premières mesures de santé publique liées à la COVID-19, en tenant compte de facteurs sociodémographiques. Méthodologie Des données transversales ont été extraites des données en ligne recueillies au cours de la huitième année de l’étude réalisée en milieu scolaire COMPASS, pendant les premiers mois de la pandémie de COVID-19 (mai à juillet 2020) en Col...

Research paper thumbnail of A scoping review of school-level risk and protective factors of youth cannabis use: An application of the socio-ecological model

Research paper thumbnail of Additional file 1 of Bi-directional relationships between physical activity and mental health among a large sample of Canadian youth: a sex-stratified analysis of students in the COMPASS study

Additional file 1: Supplementary Table A. Logistic regression model predicting likelihood of miss... more Additional file 1: Supplementary Table A. Logistic regression model predicting likelihood of missing outcome data among adolescents who participated in the 2017–18 and 2018–19 school years of the COMPASS Study in Alberta, British Columbia, Ontario, and Quebec.

Research paper thumbnail of Physical-mental multimorbidity in children and youth: a scoping review

BMJ Open, 2021

ObjectiveEfforts to describe the current state of research are needed to advance the field of phy... more ObjectiveEfforts to describe the current state of research are needed to advance the field of physical-mental multimorbidity (ie, the co-occurrence of at least one physical illness and at least one mental disorder) among children and youth. Our objective was to systematically explore the breadth of physical-mental multimorbidity research in children and youth and to provide an overview of existing literature topics.DesignScoping review.MethodsWe conducted a systematic search of four key databases: PubMed, EMBASE, PsycINFO and Scopus as well as a thorough scan of relevant grey literature. We included studies of any research design, published in English, referring to physical-mental multimorbidity among children and youth aged ≤18 years. Studies were screened for eligibility and data were extracted, charted and summarised narratively by research focus. Critical appraisal was employed using the modified Quality Index (QI).ResultsWe included 431 studies and 2 sources of grey literature....

Research paper thumbnail of Multimorbidity in children and youth: a scoping review protocol

Research paper thumbnail of Changes in cannabis use modes among Canadian youth across recreational cannabis legalization: Data from the COMPASS prospective cohort study

Addictive Behaviors, 2021

INTRODUCTION Canadian youth consume cannabis in multiple ways, including by smoking, vaping, and ... more INTRODUCTION Canadian youth consume cannabis in multiple ways, including by smoking, vaping, and eating or drinking. Existing evidence suggests that these behaviours may change after law liberalization, though data regarding youth are scarce. We investigated changes in cannabis modes of use and associated factors across the federal legalization of recreational cannabis use for adults in Canada, among a large sample of underage youth before alternative products were made legally available. METHODS Data were available from 2953 longitudinally linked Canadian high school students who reported on their cannabis use during the 2017/2018 and 2018/2019 school years. We explored whether students maintained a single or multiple cannabis use mode(s), contracted, or expanded the number of modes used. We then used generalized estimating equations to analyse associations of baseline characteristics with use mode trajectory. RESULTS Expansion of cannabis use modes (42.3%) was more common than maintenance of a single mode (31.3%), maintenance of multiple modes (14.3%), or reduction (12.1%). Students who maintained multiple modes were significantly more likely to have high amounts of weekly spending money (AOR 1.68), to binge drink (AOR 2.25) or vape (AOR 1.99), to use cannabis regularly (AOR 2.67), and to endorse more symptoms of depression (AOR 1.06). School support for quitting tobacco, drug, or alcohol use appeared to have no effect. CONCLUSIONS Multi-modal cannabis use increased among Canadian youth in our sample. Its association with other substance use and depressive symptoms may indicate clustering of additional harms. Screening for this use pattern may assist in identifying high-risk substance use and should be considered in the design of harm reduction programming.

Research paper thumbnail of Psychometric evaluation of the treatment entry questionnaire to assess extrinsic motivation for inpatient addiction treatment

Drug and Alcohol Dependence Reports, 2021

Research paper thumbnail of Intentions en matière de contrôle du poids et santé mentale chez les adolescents canadiens : analyse comparative entre les sexes chez les élèves participant à l’étude COMPASS

Promotion de la santé et prévention des maladies chroniques au Canada, 2021

Introduction Les différences entre les genres en lien avec les intentions de contrôle du poids et... more Introduction Les différences entre les genres en lien avec les intentions de contrôle du poids et la santé mentale des adolescents sont peu connues. Notre objectif était d’examiner ces associations au sein d’un vaste échantillon d’adolescents et d’adolescentes. Méthodologie En utilisant les données de l’année 6 (2017-2018) de l’étude COMPASS (n = 57 324), nous avons procédé à une série de régressions linéaires multivariables pour déterminer si les intentions de contrôle du poids (gain de poids, perte de poids, maintien du poids, aucune intention) étaient associées à la dépression, à l’anxiété et à l’image de soi, tout en tenant compte de covariables pertinentes, dont l’indice de masse corporelle. Les modèles ont été stratifiés en fonction du genre autodéclaré. Résultats Par rapport aux filles sans intention en matière de contrôle du poids, les filles ayant l’intention de perdre du poids ont fait état de symptômes plus importants de dépression (B = 0,52, p $lt; 0,001) et d’anxiété (B...

Research paper thumbnail of Substance-related coping behaviours among youth during the early months of the COVID-19 pandemic

Addictive Behaviors Reports, 2021

As impacts of the COVID-19 pandemic continue to unfold, research is needed to understand how scho... more As impacts of the COVID-19 pandemic continue to unfold, research is needed to understand how school-aged youth are coping with COVID-19-related changes and disruptions to daily life. Among a sample of Canadian youth, our objective was to examine the mental health factors associated with using substances to cope with COVID-19-related changes, taking account of expected sex differences. Methods: We used online data collected from 7150 students in the COMPASS study, during the early months of the COVID-19 pandemic (May-July 2020) in British Columbia, Ontario, and Quebec, Canada. We specified a sexstratified, generalized linear mixed model to estimate the likelihood of engagement in substance-related coping behaviours, while testing for the effects of students' mental health, individual characteristics, and school neighborhood characteristics. Results: Twelve percent of students (13.4% of females, 9.9% of males) in our sample reported using cannabis, alcohol, cigarettes, and/or vaping to help cope with COVID-19-related changes. Regardless of sex, students with greater depressive symptoms were more likely to engage in substance-related coping (aOR Female = 1.04, 95 %CI [1.01-1.07]; aOR Male = 1.06, 95 %CI[1.013-1.11]). Among females, better psychosocial wellbeing was protective against engagement in substance related-coping (aOR = 0.96, 95 %CI[0.94-0.98]), controlling for current substance use. Conclusions: Canadian school-aged youth with generally poor mental health may be more likely to have engaged in substance use to help cope with COVID-19-related changes during the first wave of the pandemic, and female youth may be at disproportionate risk of engaging in the behaviour. Ongoing evaluation of the impacts of COVID-19 on youth health is required.

Research paper thumbnail of Measurement Invariance of the GAD-7 and CESD-R-10 Among Adolescents in Canada

Journal of Pediatric Psychology, 2021

Objective The primary objective of our study was to assess measurement invariance (by grade and s... more Objective The primary objective of our study was to assess measurement invariance (by grade and sex) of the 7-item Generalized Anxiety Disorder (GAD-7) and 10-item Center for Epidemiologic Studies Depression Revised (CESD-R-10) scales in a sample of adolescents in Canada. If measurement invariance was demonstrated, our secondary objective was to estimate differences in scale scores across these subgroups. Methods We used data from 59,052 adolescents in Year 7 (2018–19) of the COMPASS school-based study. Measurement invariance was tested within a multigroup confirmatory factor analysis framework. Differences in scale scores were estimated using mixed linear regression which accounted for school-level clustering and adjusted for relevant confounders. Results Both the GAD-7 and CESD-R-10 demonstrated strict measurement invariance by sex and grade in our sample. Mean scale scores were higher among adolescents in grade 12 compared to grade 9 (βGAD-7 = 0.91, p < .001; βCESD-R-10 = 0.99...

Research paper thumbnail of Bi-directional relationships between physical activity and mental health among a large sample of Canadian youth: a sex-stratified analysis of students in the COMPASS study

International Journal of Behavioral Nutrition and Physical Activity, 2021

Objective The aim of this research was to examine the bidirectional association between self-repo... more 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 anxie...

Research paper thumbnail of Evaluating the short-term impact of a tobacco-free policy in an inpatient addiction treatment setting

Journal of Substance Abuse Treatment, 2019

Tobacco use is highly prevalent within addiction treatment settings, despite the potential benefi... more Tobacco use is highly prevalent within addiction treatment settings, despite the potential benefits that cessation may provide to patients' psychosocial functioning and overall sobriety. Moreover, tobacco cessation is often insufficiently addressed in addiction treatment programs, although evidence suggests that tobacco control policies, such as access to evidence-based treatment or tobacco-free policies, may be effective. The objective of our study was to evaluate the impact of the implementation of these two tobacco control policies in an inpatient addiction treatment centre. Methods: Using a 3-group quasi-experimental design, we examined how the implementation of the Ottawa Model for Smoking Cessation (OMSC) and a subsequent campus-wide tobacco ban influenced patients' overall smoking status, frequency, amount used per day, and quit attempts during treatment, compared to usual care. Participants (N = 397) responded to a comprehensive questionnaire upon admission and discharge from an addiction treatment program. We used generalized linear mixed modelling to measure changes over time while accounting for relevant sociodemographic covariates. Results: Patients exposed to a more comprehensive tobacco control environment (i.e., the OMSC, plus complete tobacco ban) were over 80% less likely to report having used tobacco during treatment, compared to patients exposed to usual care (AOR = 0.17, 95% CI [0.05-0.63]). Receiving treatment in this setting also contributed to a 35% decrease in the average number of days patients used tobacco compared to usual care (AOR = 0.65, 95% CI [0.53-0.98]), and a 27% decrease in the average number of cigarettes used per day compared to usual care (AOR = 0.73, 95% CI [0.58-0.93]). Conclusion: Comprehensive tobacco control policy interventions within inpatient addiction treatment hospitals promote tobacco cessation. Such interventions should include a combination of evidence-based treatment for patients and environmental restrictions to discourage tobacco use. The results of our study suggest that, within inpatient addiction treatment settings, use of the OMSC in combination with a campus-wide tobacco ban may be more effective than usual care or the OMSC alone.

Research paper thumbnail of Psychological and Behavioural Correlates of Cannabis use among Canadian Secondary School Students: Findings from the COMPASS Study

Canadian Journal of Addiction, 2019

Objectives: The aim of this study was to investigate the sociodemographic, behavioural, and psych... more 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 hi...

Research paper thumbnail of High School Bullying and Mental Disorder: an Examination of the Association with Flourishing and Emotional Regulation

International Journal of Bullying Prevention, 2019

Bullying behaviours are shown to be associated with symptoms of affective disorder; however, ther... more Bullying behaviours are shown to be associated with symptoms of affective disorder; however, there is limited evidence of these associations in a Canadian high school context. We sought to examine the relationship between psychosocial characteristics of high school youth, their bullying involvement, and their self-reported symptoms of anxiety and depression. Logistic regression was conducted using data from year 5 of the COMPASS Study, a large behavioural health survey of Canadian students in grades 9 to 12. Data were used from 6,585 students who participated in a pilot test introducing a new Mental Health-Module (MH-M). One third of students in our sample reported clinically-relevant symptoms of anxiety, and over 40% reported symptoms of depression. Approximately 20% of students reported involvement in bullying as victims, perpetrators, or victim-perpetrators. Overall, being involved in bullying as a victim or victim-perpetrator was associated with increased likelihood of anxiety and depression, but this was not observed for perpetration. Measures of mental wellbeing and emotional regulation skills were also significantly associated with clinically relevant symptoms of anxiety and depression among students in our sample, and were shown to partially mediate the relationship between bullying and mental disorder. Further research is needed to investigate the protective effects of positive mental wellbeing and socio-emotional skills on mental disorder, within high school bullying contexts. School-based prevention efforts that aim to foster emotional intelligence and improve flourishing among youth may be most effective in addressing the psychological burdens of bullying involvement.

Research paper thumbnail of Psychological correlates and binge drinking behaviours among Canadian youth: a cross-sectional analysis of the mental health pilot data from the COMPASS study

BMJ Open, 2019

ObjectiveThe objective of this study was to examine associations between depression, anxiety and ... more 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 Scal...

Research paper thumbnail of Evaluating the Associations Between Exposure to Tobacco Interventions During Inpatient Treatment and Substance Use Outcomes: Findings From a Natural Experiment

Journal of Addiction Medicine

Objective: In this study, we took advantage of a natural experiment that occurred within a substa... more Objective: In this study, we took advantage of a natural experiment that occurred within a substance use disorders (SUD) treatment setting which first saw the implementation of an evidence-based practice (EBP) for tobacco cessation, followed by the implementation of a tobacco-free policy (TFP) that included a campus-wide tobacco ban. We sought to examine how implementation of the EBP and TFP was associated with substances use outcomes, in addition to tobacco use, up to 3-months posttreatment. Methods: Data were collected from patients in a substance use disorders treatment program at baseline, discharge, 1-, and 3-months posttreatment. Using a quasi-experimental design and generalized estimating equations, we modelled how patients’ (N = 480) exposure to one of 3 interventions (1: treatment as usual [TAU], 2: EBP, and 3: EBP + TFP) was associated with overall abstinence from tobacco, alcohol, and other substances over time. Measures of tobacco use frequency, amount, and quit attempts...

Research paper thumbnail of Navigating Newcomers’ Food Transitions in the COVID-19 Pandemic: A developmental evaluation of a community-based program

Research Square (Research Square), Dec 13, 2022

Refugee newcomers almost invariably face "food" culture shock and are at greater risk of food ins... more Refugee newcomers almost invariably face "food" culture shock and are at greater risk of food insecurity due to slow-to-evolve institutions. Community programs can help boost refugee newcomer con dence through knowledge exchange during intercultural culinary experiences. The originally proposed program was "Breaking Down the Walls (BDTW)-Building Integration and Cultural Appreciation through Shared Food Experiences with Refugee Newcomers". With the restrictions set in place due to the COVID-19 pandemic, adaptations were made to the BDTW program. Speci cally, the program's scope was greatly reduced and the program itself shifted to a virtual environment. The nal deliverables for this program included: 1) a framework/guide for conducting intercultural cooking events; and 2) an Online cultural brokerage training tool to help users to grasp some of the food-related challenges faced by newcomers to Canada. To best identify the challenges, successes, and e cacy of conducting community-based research, the team adopted a Developmental Evaluation approach, which is often used in complex settings and evolving scenarios such as the COVID-19 pandemic. The themes which emerged from interviews with participants were further distilled into broader areas of the COVID-19 pandemic, collaboration, and equity. Programs like BDTW have the potential to create infrastructure for newcomer nutrition programming that is integrated and streamlined as a long-term intervention. This type of programming would help shift care practices from sporadically addressing health/nutrition and settlement issues as they arise to a system that proactively anticipates nutritional needs from day one, ultimately promoting long-term health and mental wellbeing among newcomer populations.

Research paper thumbnail of Weight control intentions and mental health among Canadian adolescents: a gender-based analysis of students in the COMPASS study

Health Promotion and Chronic Disease Prevention in Canada

Introduction Little is known about gender differences in associations between weight control inte... more Introduction Little is known about gender differences in associations between weight control intentions and mental health in adolescents. Our objective was to examine these associations in a large sample of adolescent girls and boys. Methods Using data from Year 6 (2017–18) of the COMPASS study (n = 57 324), we performed a series of multivariable linear regressions to examine whether weight control intentions (gain, lose, stay the same, no intention) were associated with depression, anxiety and self-concept, while adjusting for relevant covariates including body mass index. Models were stratified by self-reported gender. Results Compared to those with no intentions, girls who intended to lose weight reported higher symptoms of depression (B = 0.52, p lt;0.001)andanxiety(B=0.41,plt; 0.001) and anxiety (B = 0.41, p lt;0.001)andanxiety(B=0.41,plt; 0.001) and poorer self-concept (B = 2.06, p lt;0.001).Girlswhointendedtogainweightalsoreportedhighersymptomsofdepression(B=0.54,plt; 0.001). Girls who intended to gain weight also reported higher symptoms of depression (B = 0.54, p lt;0.001).Girlswhointendedtogainweightalsoreportedhighersymptomsofdepression(B=0.54,plt; 0.001), anxiety (B = 0.50, p $lt; 0.001) ...

Research paper thumbnail of Risky cannabis use is associated with varying modes of cannabis consumption: Gender differences among Canadian high school students

Drug and Alcohol Dependence Reports

Research paper thumbnail of Perceptions of and adherence to early COVID-19-related restrictions and associations with substance use among youth in Canada

Health Promotion and Chronic Disease Prevention in Canada

Introduction As a largely social behaviour, substance use may have decreased for some youth overa... more Introduction As a largely social behaviour, substance use may have decreased for some youth overall in Canada during the COVID-19 pandemic; however, continued use may indicate nonadherence to pandemic-related restrictions and social distancing measures. In a sample of Canadian adolescents (aged 12–19 years), our objective was to examine how substance use (cannabis, binge drinking, cigarettes, vaping) is associated with perceptions of, and adherence to, early COVID-19-related public health measures, taking into consideration sociodemographic factors. Methods Cross-sectional data were retrieved from online data collected during Year 8 of the COMPASS school-based study, during the early months of the COVID-19 pandemic (May–July 2020) in British Columbia, Ontario and Quebec. We fitted two models using generalized estimating equations to examine how substance use was associated with separate measures of (1) perceptions of, and (2) adherence to early COVID-19 restrictions. Results In our ...

Research paper thumbnail of Perceptions et respect des premières restrictions liées à la COVID-19 et associations avec la consommation de substances chez les jeunes au Canada

Promotion de la santé et prévention des maladies chroniques au Canada

Introduction Dans la mesure où la consommation de substances est un comportement principalement s... more Introduction Dans la mesure où la consommation de substances est un comportement principalement social, elle est susceptible d’avoir diminué chez certains jeunes partout au Canada pendant la pandémie de COVID-19, et le maintien d’une consommation est susceptible d’indiquer un non-respect des restrictions liées à la pandémie et des mesures de distanciation physique. Notre objectif était d’analyser, dans un échantillon composé d’adolescents canadiens (de 12 à 19 ans), la manière dont la consommation de substances (cannabis, consommation excessive d’alcool, cigarettes, produits de vapotage) est associée aux perceptions et au respect des premières mesures de santé publique liées à la COVID-19, en tenant compte de facteurs sociodémographiques. Méthodologie Des données transversales ont été extraites des données en ligne recueillies au cours de la huitième année de l’étude réalisée en milieu scolaire COMPASS, pendant les premiers mois de la pandémie de COVID-19 (mai à juillet 2020) en Col...

Research paper thumbnail of A scoping review of school-level risk and protective factors of youth cannabis use: An application of the socio-ecological model

Research paper thumbnail of Additional file 1 of Bi-directional relationships between physical activity and mental health among a large sample of Canadian youth: a sex-stratified analysis of students in the COMPASS study

Additional file 1: Supplementary Table A. Logistic regression model predicting likelihood of miss... more Additional file 1: Supplementary Table A. Logistic regression model predicting likelihood of missing outcome data among adolescents who participated in the 2017–18 and 2018–19 school years of the COMPASS Study in Alberta, British Columbia, Ontario, and Quebec.

Research paper thumbnail of Physical-mental multimorbidity in children and youth: a scoping review

BMJ Open, 2021

ObjectiveEfforts to describe the current state of research are needed to advance the field of phy... more ObjectiveEfforts to describe the current state of research are needed to advance the field of physical-mental multimorbidity (ie, the co-occurrence of at least one physical illness and at least one mental disorder) among children and youth. Our objective was to systematically explore the breadth of physical-mental multimorbidity research in children and youth and to provide an overview of existing literature topics.DesignScoping review.MethodsWe conducted a systematic search of four key databases: PubMed, EMBASE, PsycINFO and Scopus as well as a thorough scan of relevant grey literature. We included studies of any research design, published in English, referring to physical-mental multimorbidity among children and youth aged ≤18 years. Studies were screened for eligibility and data were extracted, charted and summarised narratively by research focus. Critical appraisal was employed using the modified Quality Index (QI).ResultsWe included 431 studies and 2 sources of grey literature....

Research paper thumbnail of Multimorbidity in children and youth: a scoping review protocol

Research paper thumbnail of Changes in cannabis use modes among Canadian youth across recreational cannabis legalization: Data from the COMPASS prospective cohort study

Addictive Behaviors, 2021

INTRODUCTION Canadian youth consume cannabis in multiple ways, including by smoking, vaping, and ... more INTRODUCTION Canadian youth consume cannabis in multiple ways, including by smoking, vaping, and eating or drinking. Existing evidence suggests that these behaviours may change after law liberalization, though data regarding youth are scarce. We investigated changes in cannabis modes of use and associated factors across the federal legalization of recreational cannabis use for adults in Canada, among a large sample of underage youth before alternative products were made legally available. METHODS Data were available from 2953 longitudinally linked Canadian high school students who reported on their cannabis use during the 2017/2018 and 2018/2019 school years. We explored whether students maintained a single or multiple cannabis use mode(s), contracted, or expanded the number of modes used. We then used generalized estimating equations to analyse associations of baseline characteristics with use mode trajectory. RESULTS Expansion of cannabis use modes (42.3%) was more common than maintenance of a single mode (31.3%), maintenance of multiple modes (14.3%), or reduction (12.1%). Students who maintained multiple modes were significantly more likely to have high amounts of weekly spending money (AOR 1.68), to binge drink (AOR 2.25) or vape (AOR 1.99), to use cannabis regularly (AOR 2.67), and to endorse more symptoms of depression (AOR 1.06). School support for quitting tobacco, drug, or alcohol use appeared to have no effect. CONCLUSIONS Multi-modal cannabis use increased among Canadian youth in our sample. Its association with other substance use and depressive symptoms may indicate clustering of additional harms. Screening for this use pattern may assist in identifying high-risk substance use and should be considered in the design of harm reduction programming.

Research paper thumbnail of Psychometric evaluation of the treatment entry questionnaire to assess extrinsic motivation for inpatient addiction treatment

Drug and Alcohol Dependence Reports, 2021

Research paper thumbnail of Intentions en matière de contrôle du poids et santé mentale chez les adolescents canadiens : analyse comparative entre les sexes chez les élèves participant à l’étude COMPASS

Promotion de la santé et prévention des maladies chroniques au Canada, 2021

Introduction Les différences entre les genres en lien avec les intentions de contrôle du poids et... more Introduction Les différences entre les genres en lien avec les intentions de contrôle du poids et la santé mentale des adolescents sont peu connues. Notre objectif était d’examiner ces associations au sein d’un vaste échantillon d’adolescents et d’adolescentes. Méthodologie En utilisant les données de l’année 6 (2017-2018) de l’étude COMPASS (n = 57 324), nous avons procédé à une série de régressions linéaires multivariables pour déterminer si les intentions de contrôle du poids (gain de poids, perte de poids, maintien du poids, aucune intention) étaient associées à la dépression, à l’anxiété et à l’image de soi, tout en tenant compte de covariables pertinentes, dont l’indice de masse corporelle. Les modèles ont été stratifiés en fonction du genre autodéclaré. Résultats Par rapport aux filles sans intention en matière de contrôle du poids, les filles ayant l’intention de perdre du poids ont fait état de symptômes plus importants de dépression (B = 0,52, p $lt; 0,001) et d’anxiété (B...

Research paper thumbnail of Substance-related coping behaviours among youth during the early months of the COVID-19 pandemic

Addictive Behaviors Reports, 2021

As impacts of the COVID-19 pandemic continue to unfold, research is needed to understand how scho... more As impacts of the COVID-19 pandemic continue to unfold, research is needed to understand how school-aged youth are coping with COVID-19-related changes and disruptions to daily life. Among a sample of Canadian youth, our objective was to examine the mental health factors associated with using substances to cope with COVID-19-related changes, taking account of expected sex differences. Methods: We used online data collected from 7150 students in the COMPASS study, during the early months of the COVID-19 pandemic (May-July 2020) in British Columbia, Ontario, and Quebec, Canada. We specified a sexstratified, generalized linear mixed model to estimate the likelihood of engagement in substance-related coping behaviours, while testing for the effects of students' mental health, individual characteristics, and school neighborhood characteristics. Results: Twelve percent of students (13.4% of females, 9.9% of males) in our sample reported using cannabis, alcohol, cigarettes, and/or vaping to help cope with COVID-19-related changes. Regardless of sex, students with greater depressive symptoms were more likely to engage in substance-related coping (aOR Female = 1.04, 95 %CI [1.01-1.07]; aOR Male = 1.06, 95 %CI[1.013-1.11]). Among females, better psychosocial wellbeing was protective against engagement in substance related-coping (aOR = 0.96, 95 %CI[0.94-0.98]), controlling for current substance use. Conclusions: Canadian school-aged youth with generally poor mental health may be more likely to have engaged in substance use to help cope with COVID-19-related changes during the first wave of the pandemic, and female youth may be at disproportionate risk of engaging in the behaviour. Ongoing evaluation of the impacts of COVID-19 on youth health is required.

Research paper thumbnail of Measurement Invariance of the GAD-7 and CESD-R-10 Among Adolescents in Canada

Journal of Pediatric Psychology, 2021

Objective The primary objective of our study was to assess measurement invariance (by grade and s... more Objective The primary objective of our study was to assess measurement invariance (by grade and sex) of the 7-item Generalized Anxiety Disorder (GAD-7) and 10-item Center for Epidemiologic Studies Depression Revised (CESD-R-10) scales in a sample of adolescents in Canada. If measurement invariance was demonstrated, our secondary objective was to estimate differences in scale scores across these subgroups. Methods We used data from 59,052 adolescents in Year 7 (2018–19) of the COMPASS school-based study. Measurement invariance was tested within a multigroup confirmatory factor analysis framework. Differences in scale scores were estimated using mixed linear regression which accounted for school-level clustering and adjusted for relevant confounders. Results Both the GAD-7 and CESD-R-10 demonstrated strict measurement invariance by sex and grade in our sample. Mean scale scores were higher among adolescents in grade 12 compared to grade 9 (βGAD-7 = 0.91, p < .001; βCESD-R-10 = 0.99...

Research paper thumbnail of Bi-directional relationships between physical activity and mental health among a large sample of Canadian youth: a sex-stratified analysis of students in the COMPASS study

International Journal of Behavioral Nutrition and Physical Activity, 2021

Objective The aim of this research was to examine the bidirectional association between self-repo... more 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 anxie...

Research paper thumbnail of Evaluating the short-term impact of a tobacco-free policy in an inpatient addiction treatment setting

Journal of Substance Abuse Treatment, 2019

Tobacco use is highly prevalent within addiction treatment settings, despite the potential benefi... more Tobacco use is highly prevalent within addiction treatment settings, despite the potential benefits that cessation may provide to patients' psychosocial functioning and overall sobriety. Moreover, tobacco cessation is often insufficiently addressed in addiction treatment programs, although evidence suggests that tobacco control policies, such as access to evidence-based treatment or tobacco-free policies, may be effective. The objective of our study was to evaluate the impact of the implementation of these two tobacco control policies in an inpatient addiction treatment centre. Methods: Using a 3-group quasi-experimental design, we examined how the implementation of the Ottawa Model for Smoking Cessation (OMSC) and a subsequent campus-wide tobacco ban influenced patients' overall smoking status, frequency, amount used per day, and quit attempts during treatment, compared to usual care. Participants (N = 397) responded to a comprehensive questionnaire upon admission and discharge from an addiction treatment program. We used generalized linear mixed modelling to measure changes over time while accounting for relevant sociodemographic covariates. Results: Patients exposed to a more comprehensive tobacco control environment (i.e., the OMSC, plus complete tobacco ban) were over 80% less likely to report having used tobacco during treatment, compared to patients exposed to usual care (AOR = 0.17, 95% CI [0.05-0.63]). Receiving treatment in this setting also contributed to a 35% decrease in the average number of days patients used tobacco compared to usual care (AOR = 0.65, 95% CI [0.53-0.98]), and a 27% decrease in the average number of cigarettes used per day compared to usual care (AOR = 0.73, 95% CI [0.58-0.93]). Conclusion: Comprehensive tobacco control policy interventions within inpatient addiction treatment hospitals promote tobacco cessation. Such interventions should include a combination of evidence-based treatment for patients and environmental restrictions to discourage tobacco use. The results of our study suggest that, within inpatient addiction treatment settings, use of the OMSC in combination with a campus-wide tobacco ban may be more effective than usual care or the OMSC alone.

Research paper thumbnail of Psychological and Behavioural Correlates of Cannabis use among Canadian Secondary School Students: Findings from the COMPASS Study

Canadian Journal of Addiction, 2019

Objectives: The aim of this study was to investigate the sociodemographic, behavioural, and psych... more 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 hi...

Research paper thumbnail of High School Bullying and Mental Disorder: an Examination of the Association with Flourishing and Emotional Regulation

International Journal of Bullying Prevention, 2019

Bullying behaviours are shown to be associated with symptoms of affective disorder; however, ther... more Bullying behaviours are shown to be associated with symptoms of affective disorder; however, there is limited evidence of these associations in a Canadian high school context. We sought to examine the relationship between psychosocial characteristics of high school youth, their bullying involvement, and their self-reported symptoms of anxiety and depression. Logistic regression was conducted using data from year 5 of the COMPASS Study, a large behavioural health survey of Canadian students in grades 9 to 12. Data were used from 6,585 students who participated in a pilot test introducing a new Mental Health-Module (MH-M). One third of students in our sample reported clinically-relevant symptoms of anxiety, and over 40% reported symptoms of depression. Approximately 20% of students reported involvement in bullying as victims, perpetrators, or victim-perpetrators. Overall, being involved in bullying as a victim or victim-perpetrator was associated with increased likelihood of anxiety and depression, but this was not observed for perpetration. Measures of mental wellbeing and emotional regulation skills were also significantly associated with clinically relevant symptoms of anxiety and depression among students in our sample, and were shown to partially mediate the relationship between bullying and mental disorder. Further research is needed to investigate the protective effects of positive mental wellbeing and socio-emotional skills on mental disorder, within high school bullying contexts. School-based prevention efforts that aim to foster emotional intelligence and improve flourishing among youth may be most effective in addressing the psychological burdens of bullying involvement.

Research paper thumbnail of Psychological correlates and binge drinking behaviours among Canadian youth: a cross-sectional analysis of the mental health pilot data from the COMPASS study

BMJ Open, 2019

ObjectiveThe objective of this study was to examine associations between depression, anxiety and ... more 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 Scal...