A muti-informant national survey on the impact of COVID-19 on mental health symptoms of parent-child dyads in Canada.

The COVID-19 pandemic negatively impacted the mental health of children, youth, and their families which must be addressed and prevented in future public health crises. Our objective was to measure how self-reported mental health symptoms of children/youth and their parents evolved during COVID-19 and to identify associated factors for children/youth and their parents including sources accessed for information on mental health. We conducted a nationally representative, multi-informant cross-sectional survey administered online to collect data from April to May 2022 across 10 Canadian provinces among dyads of children (11-14 years) or youth (15-18 years) and a parent (> 18 years). Self-report questions on mental health were based on The Partnership for Maternal, Newborn & Child Health and the World Health Organization of the United Nations H6+ Technical Working Group on Adolescent Health and Well-Being consensus framework and the Coronavirus Health and Impact Survey. McNemar's test and the test of homogeneity of stratum effects were used to assess differences between children-parent and youth-parent dyads, and interaction by stratification factors, respectively. Among 933 dyads (N = 1866), 349 (37.4%) parents were aged 35-44 years and 485 (52.0%) parents were women; 227 (47.0%) children and 204 (45.3%) youth were girls; 174 (18.6%) dyads had resided in Canada < 10 years. Anxiety and irritability were reported most frequently among child (44, 9.1%; 37, 7.7%) and parent (82, 17.0%; 67, 13.9%) dyads, as well as among youth (44, 9.8%; 35, 7.8%) and parent (68, 15.1%; 49, 10.9%) dyads; children and youth were significantly less likely to report worsened anxiety (p < 0.001, p = 0.006, respectively) or inattention (p < 0.001, p = 0.028, respectively) compared to parents. Dyads who reported financial or housing instability or identified as living with a disability more frequently reported worsened mental health. Children (96, 57.1%), youth (113, 62.5%), and their parents (253, 62.5%; 239, 62.6%, respectively) most frequently accessed the internet for mental health information. This cross-national survey contextualizes pandemic-related changes to self-reported mental health symptoms of children, youth, and families.

BENEFITS AND FEASIBILITY OF A DEDICATED HEAD AND NECK CANCER PROGRAM AT A COMMUNITY CANCER CENTER

With patients seeking care closer to home, community cancer centers must meet the demands of caring for complex cancer patients with limited resources. A need was identified within the Radiation Oncology Center at our Community Cancer Center to provide comprehensive care for Head and Neck Cancer patients. This initiative required buy-in and devoted time from Hospital teams (Registered Dietitian (RD), Inpatient Speech Pathologists (SP)) for implementation. Full multidisciplinary support services were implemented in September 2019. A retrospective review of Head and Neck patients referred to Radiation Oncology, Stage 1 & 2, receiving concurrent chemoradiation from March 2019 to August 2021 was performed to evaluate patient outcomes prior to and after implementation (N=18). Processes implemented included dedicated education sessions provided by the Radiation Oncology RN at time of consultation regarding the importance and benefit of SP and RD services during their cancer treatment. Referrals were then placed to each specialty. Patient education continued at each weekly Radiation visit to aid in overall compliance. Multidisciplinary communication took place via EMR communication, as well as during newly initiated Head and Neck Chart Rounds. Of the 18 patients, four patients were treated prior to implementation (January to August 2019). 3 of the 4 (75%) patients required a Radiation treatment break related to unmet nutrition needs, zero (0%) patients met with a RD and 2 (50%) patients underwent SP Evaluation. Two (50%) patients required PEG tube placement. Nine patients were treated after initiative implementation. Zero patients required a Radiation treatment break related to unmet nutrition needs, 4 (44%) patients met with a RD and 8 patients (89%) underwent SP Evaluation. Three (33%) patients required PEG tube placement. Not only did we see a significant decrease in treatment breaks due to unmet nutritional needs, but with the incorporation of this initiative, our team was able to streamline ambulatory PEG tube placement to avoid unnecessary hospitalizations, with 50% admitted for PEG placement prior to initiative and 0% requiring a hospital stay following implementation. In conclusion, the implementation of a dedicated head and neck program is feasible at a community hospital when appropriate resources are available to ensure positive patient outcomes and preserve hospital resources. Barriers identified during our initiative included availability of hospital team members (RD services during COVID-19 peaks) and patients opting to forgo additional visits with multidisciplinary team members.

Strategies to mitigate the impact of the COVID-19 pandemic on child and youth well-being: a scoping review protocol.

INTRODUCTION: Children and youth are often more vulnerable than adults to emotional impacts of trauma. Wide-ranging negative effects (eg, social isolation, lack of physical activity) of the COVID-19 pandemic on children and youth are well established. This scoping review will identify, describe and categorise strategies taken to mitigate potentially deleterious impacts of the COVID-19 pandemic on children, youth and their families. METHODS AND ANALYSIS: We will conduct a scoping review following the Arksey-O'Malley five-stage scoping review method and the Scoping Review Methods Manual by the Joanna Briggs Institute. Well-being will be operationalised according to pre-established domains (health and nutrition, connectedness, safety and support, learning and competence, and agency and resilience). Articles in all languages for this review will be identified in CINAHL, Cochrane CENTRAL Register of Controlled Trials, EMBASE, ERIC, Education Research Complete, MEDLINE and APA PsycINFO. The search strategy will be restricted to articles published on or after 1 December 2019. We will include primary empirical and non-empirical methodologies, excluding protocols, reports, opinions and editorials, to identify new data for a broad range of strategies to mitigate potentially deleterious impacts of the COVID-19 pandemic on child and youth well-being. Two reviewers will calibrate screening criteria and the data abstraction form and will independently screen records and abstract data. Data synthesis will be performed according to the convergent integrated approach described by the Joanna Briggs Institute. ETHICS AND DISSEMINATION: Ethical approval is not applicable as this review will be conducted on published data. Findings of this study will be disseminated at national and international conferences and will inform our pan-Canadian multidisciplinary team of researchers, public, health professionals and knowledge users to codesign and pilot test a digital psychoeducational health tool-an interactive, web-based tool to help Canadian youth and their families address poor mental well-being resulting from and persisting beyond the COVID-19 pandemic.