Principal Investigator: Dr. Susan Phillips
Youth, anxiety, screen time and a whole lot more
Articles with titles like, "Have smartphones destroyed a generation?" (Atlantic 2017) tout the growing anxiety among youth and suggest that screen time is to blame. However, there is no evidence for this. I do have the sense that young patients are increasingly anxious and less able to cope. I have speculated as to whether parents trying to protect children from challenges are inadvertently diminishing their resilience. This has led to a series of linked studies, some ongoing, all with wonderful medical students and residents.
The first, a mixed methods assessment of youth and resilience, included interviews of 60 kids age 12-14, living in Kingston and northwestern Ontario, about stresses in their lives and how they managed these. I have never done such heartening research. The summary – the kids are alright. They had remarkable insight about their lives, stresses, and how to mitigate these. Whether by doing art, writing, team sports, or diversion, those with the most apparent life stressors often turned these into sources of strength.
A second study looked at social and emotional development among 4-6 year olds and found that although such development is central to future health, it is not really part of physicians' well child checks.
We are now assessing whether there has been any change in diagnoses of anxiety over the past 20 years. Preliminary results – the point prevalence of anxiety is higher among girls but has stayed relatively stable from the pre- to post-social media eras. There are some aberrations to this which we are still assessing.
Also ongoing is a study of whether adding some intervention to the well 4-6 year old check-up to address social and emotional development can be of benefit. We are doing the background work to develop an RCT to study this.
It might seem curious that all of this was precipitated by a previous study about healthy aging (IMIAS) that found that events across the life-course, and particularly in childhood, have an ongoing impact on health even among the elderly. And so, a study of aging became the springboard for a series of studies of childhood.
Some of the papers about this work include:
Phillips SP, Jiang M, Lakkadghatwala R, Wang, S. Assessing wellness in the well child check: what about social and emotional development? Can Fam Phys 2019, in press
Phillips SP, Swift SA, Reipas K, Zelek B. Adolescent Resilience Assessment in Person-centered Medical Care. International Journal of Person Centered Medicine 2016;6:289-97.
Phillips SP, King N, Michaelson V, Pickett W. Sex, drugs, risk and resilience. European J Publ Health 2018;0: doi:10.1093/eurpub/cky169.
Demetriou Y, Vondung C, Bucksch J, Schlund A, Schulze C, Knapp G, Coen SE, Puil L, Phillips SP, Reimers AK. Interventions on children’s and adolescents’ physical activity and sedentary behaviour: protocol for a systematic review from a sex/gender perspective. Systematic Reviews 2019; in press.
Gupta S, Bélanger E, Phillips SP. Low socioeconomic status but resilient: panacea or double trouble? John Henryism in the international IMIAS study of older adults. Journal of Cross-Cultural Gerontology 2018; 1-10: DOI 10.1007/s10823-018-9362-8
Lau Z, Guerra R, Barbosa JFS, Phillips SP. The impact of resilience on health in older adults: A cross-sectional analysis from the International Mobility in Aging Study (IMIAS). BMJ Open 2018; 8:e023779. doi:10.1136/ bmjopen-2018-023779.
Stewart JM, Auais M, Bélanger E, Phillips SP. Comparison of Self-Rated and Objective Successful Ageing in an International Cohort. Ageing and Society 2018;1-18 doi:10.1017/S0144686X17001489.
Phillips S, Auais M, Belanger E, Alvarado B, Zunzunegui MV. Early and current social and economic circumstances and resilience in older adults: findings from the longitudinal International Mobility in Aging Study (IMIAS). SSM Population Health 2016 http://dx.doi.org/10.1016/j.ssmph.2016.09.007.
Principal Investigator: Imaan Bayoumi
Co-Investigators: Mary Martin, Eva Purkey, Cornelia Borkhoff, Jonathan Maguire, Catherine Birken, Andrew Willan, Patricia Parkin
Child poverty remains a prevalent problem in Canada, affecting about one in five Canadian children and many more families are living under financial strain. Many families struggle to make ends meet and may be experiencing high levels of stress. Low income and high family stress can impact children’s social, emotional and behavioural development.
Because of the strong links between income and health, many professional organizations are encouraging healthcare providers to identify and address poverty, but little evidence exists regarding effective interventions. Social systems are complex and frequently difficult to navigate; therefore, many families may not be accessing all financially related benefits to which they are entitled. Our study will use a randomized controlled trial to test the effect of having a Community Support Worker work with families of children young children to identify unmet financially related social needs (like food, housing or energy insecurity) and help families navigate the social service system. The Community Support Worker will help families complete income tax, apply for benefits and community supports to which they are entitled. We will study the effect on child emotional and behavioural health, parent stress and depression and family income.
The pilot phase of this research has been awarded funding through the SEAMO Innovation Fund and Queen’s University Faculty of Health Sciences. The research team is led by Imaan Bayoumi and includes colleagues from the Hospital for Sick Children in Toronto.
Results from this research will fill a critical evidence gap regarding the impact of an income security intervention on important child and parent health outcomes, and will establish the role of non-health care providers in linking health and social systems. Effective income security interventions and improved emotional and behavioural health in this age group have the potential to establish a foundation for improved mental health trajectories and greater academic success, which in turn can positively influence health over the life course.