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Community-based screening and triage connecting First Nations children and youth to local supports: a cross-sectional
Nancy L Young1, Marnie M Anderson2, Mary Jo Wabano2
1Faculty of Medicine (Young), CHEO Research Institute, Ottawa, Ont.; ECHO Research Centre at Laurentian University (Young, Anderson, Usuba, Hawthorne, Denommee), Sudbury, Ont.; Naandwechige-Gamig Wikwemikong Health Centre (Wabano, Trudeau, Jacko, Mishibinijima), Wiikwemkoong Unceded Territory, Ont.; Ottawa Hospital Research Institute (Mallick, Momoli, Thavorn), Ottawa, Ont.; Hospital for Sick Children Research Institute (Szatmari), Toronto, Ont.; Whitefish River First Nation (McGregor), Ont.; First Peoples Wellness Circle (Restoule), Nipissing First Nation, Ont.; Université de Moncton (Roy-Charland), Moncton, NB; Occupational Science and Occupational Therapy (Barbic), Faculty of Medicine, The University of British Columbia, Vancouver, BC; Faculty of Medicine (Cudmore), University of Ottawa, Ottawa, Ont.; Ontario Institute for Studies in Education (Peltier), University of Toronto, Toronto, Ont.; Centre for Rural and Northern Health Research (Mian), Laurentian University, Sudbury, Ont.; Centre for Rural and Northern Health Research (Mushquash), Lakehead University, Thunder Bay, Ont.; Centre for Addiction and Mental Health (Linklater), Toronto, Ont.; Black Dog Institute (Boydell), Randwick, NSW, Australia; Wikwemikong Health Centre (Kaboni, Neganegijig), Nadmadwin Mental Health Clinic, Wiikwemkoong Unceded Territory, Ont.; Wikwemikong Health Centre (Djeletovic, Wassengeso, Recollet, Roy), Wiikwemkoong Unceded Territory, Ont.; Northern Ontario School of Medicine University (Mushquash, Cudmore), Thunder Bay/Sudbury, Ont. nyoung@cheo.on.ca.
Background:
First Nations children in Canada experience health inequities. We aimed to determine whether a self-report health app identified children's needs for support earlier in their illness than would typically occur.
Methods:
Children (aged 8 to 18 yr) were recruited from a rural First Nation community. Children completed the Aaniish Naa Gegii: the Children's Health and Well-being Measure (ACHWM) and then met with a local mental health worker who determined their risk status. ACHWM Emotional Quadrant Scores (EQS) were compared between 3 groups of children: healthy peers (HP) who were not at risk, those with newly identified needs (NIN) who were at risk and not previously identified, and a typical treatment (TT) group who were at risk and already receiving support.
Results:
We included 227 children (57.1% girls), and the mean age was 12.9 (standard deviation [SD] 2.9) years. The 134 children in the HP group had a mean EQS of 80.1 (SD 11.25), the 35 children in the NIN group had a mean EQS of 67.2 (SD 13.27) and the 58 children in the TT group had a mean EQS of 66.2 (SD 16.30). The HP group had significantly better EQS than the NIN and TT groups (p < 0.001). The EQS did not differ between the NIN and TT groups (p = 0.8).
Interpretation:
The ACHWM screening process identified needs for support among 35 children, and the associated triage process connected them to local services; the similarity of EQS in the NIN and TT groups highlights the value of community screening to optimize access to services. Future research will examine the impact of this process over the subsequent year in these groups.
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