SMH – St. Michael’s Hospital Medical Services Association
SMH-20-041 – COVID-19 Study of Children and Families: Reducing the risk and severity of COVID-19 in Canadian Children and Parents
As Canada and the world continue to lift COVID-19 restrictions, now is an opportune time to evaluate the impact of these changes on children and families. The World Health Organization recommends that governments seeking to relax physical distancing measures do so through two complementary approaches: 1) breaking chains of transmission through testing, isolating, and treating and 2) monitoring disease circulation through surveillance and serological surveys. To support this approach, we have leveraged Canada’s largest primary care research network, TARGet Kids!, to provide high-quality, real-time data to monitor, quantify and characterize COVID-19 infection among children and parents. We are currently measuring the cumulative incidence of new infections and previous COVID-19 exposure through serological testing so that we can understand transmission dynamics, risk factors for infection and healthcare utilization. We also aim to understand unintended consequences from physical isolation policies on child emotional, behavioural and mental health, as well as parent mental health and stress. We are conducting a prospective cohort study with 1200 parents and children aged 0-16 years of age participating in TARGeT Kids!. Baseline characteristics including age, sex, birth weight, ethnicity, income, anthropometrics, and physical and mental health status have already been collected through the TARGet Kids! study. Since April 2020, parents have provided frequent measures about compliance with public health measures (including social distancing, staying at home, and avoiding contact with others) as well as health services utilization (e.g. emergency department visits, hospitalizations). We have assessed emotional, behavioral,and mental health problems including COVID-19 related stress among children and parents. We have found that lockdowns and school closures were associated with higher compliance with physical distancing measures but that compliance generally decreased over time. Compliance was higher for children than parents and lower among families who were essential workers, unemployed or apartment dwelling. We have also found that higher compliance with physical distancing measures was associated with lower physical activity, higher screen time and worse mental health scores among children. Results from this ongoing study will provide high-quality, evidence to inform new policies aimed at disrupting under recognized chains of transmission while minimizing unintended harms from social distancing policies. Numerous hurdles have already been overcome including recruiting 1200 children over the first year of the study. Findings from this study, including predictors of adherence to public health preventive measures and the impact of these measures on children and families’ wellbeing have been published in the Canadian Journal of Public Health, European Child & Adolescent Psychiatry, and Research Involvement and Engagement. Our multidisciplinary team will continue to share study results with policy makers and professional societies including the Canadian Pediatric Society, Public Health Ontario, and the Ontario Ministries of Health and Education.
Public Health Measures and Society
Primary Project Lead for Contact
Dr. Jonathon Maguire