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Article ; Online: Closing the loop: From system-based data to evidence-influenced policy and practice.

Katz, Alan / Brownell, Marni / Enns, Jennifer E / Nickel, Nathan C

International journal of population data science

2022 Volume 6, Issue 3, Page(s) 1701

Abstract: For more than 30 years, the Manitoba Centre for Health Policy has been conducting research and evaluation to provide timely and critical evidence to answer real-world policy questions. Our experienced team of research scientists, analysts and other staff ...

Abstract	For more than 30 years, the Manitoba Centre for Health Policy has been conducting research and evaluation to provide timely and critical evidence to answer real-world policy questions. Our experienced team of research scientists, analysts and other staff work extensively with policy-makers at the macro, meso and micro levels of government to support evidence-informed policy and program development in an effort to ensure that policy initiatives provide the greatest benefit possible to individuals and society as a whole. Using the widely recognized whole-population Manitoba Population Research Data Repository, which comprises approximately 100 different datasets from multiple sectors, we employ sophisticated and state-of-the-art research methods and data science technologies, and then translate the results into meaningful insights or recommendations for policy-makers. Our long and productive history of working with policy-makers has taught us much about making our research relevant to policy-makers. In this article, we outline some examples of how research evidence has been used to influence policy in Manitoba, and the key lessons we have learned about what makes relationships between researchers and policy-makers work. In essence, policy-makers have supported the growth of the Repository over the last 30 years, because researchers have "closed the loop" by sharing valuable and policy-relevant research results with them. This ability to inform policies, programs and service delivery with scientific evidence continues to benefit individuals, communities and our society as a whole.
MeSH term(s)	Administrative Personnel ; Health Policy ; Humans ; Manitoba ; Policy Making ; Research Personnel
Language	English
Publishing date	2022-02-25
Publishing country	Wales
Document type	Journal Article
ISSN	2399-4908
ISSN (online)	2399-4908
DOI	10.23889/ijpds.v7i1.1701
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Article ; Online: Neighbourhood-level socioeconomic status and prevalence of teacher-reported health disorders among Canadian kindergarten children.

Janus, Magdalena / Brownell, Marni / Reid-Westoby, Caroline / Pottruff, Molly / Forer, Barry / Guhn, Martin / Duku, Eric

Frontiers in public health

2024 Volume 11, Page(s) 1295195

Abstract: Background: The evidence on the association between neighborhood-level socioeconomic status (SES) and health disorders in young children is scarce. This study examined the prevalence of health disorders in Canadian kindergarten (5-6 years old) children ... ...

Abstract	Background: The evidence on the association between neighborhood-level socioeconomic status (SES) and health disorders in young children is scarce. This study examined the prevalence of health disorders in Canadian kindergarten (5-6 years old) children in relation to neighborhood SES in 12/13 Canadian jurisdictions. Methods: Data on child development at school entry for an eligible 1,372,980 children out of the total population of 1,435,428 children from 2004 to 2020, collected using the Early Development Instrument (EDI), were linked with neighborhood sociodemographic data from the 2006 Canadian Census and the 2005 Taxfiler for 2,058 neighborhoods. We examined the relationship using linear regressions. Children's HD included special needs, functional impairments limiting a child's ability to participate in classroom activities, and diagnosed conditions. Results: The neighborhood prevalence of health disorders across Canada ranged from 1.8 to 46.6%, with a national average of 17.3%. The combined prevalence of health disorders was 16.4%, as 225,711 children were identified as having at least one health disorder. Results of an unadjusted linear regression showed a significant association between neighborhood-level SES and prevalence of health disorders ( Conclusion: Our study demonstrated that the prevalence of health disorders among kindergarten children was higher in lower SES neighborhoods and varied by jurisdiction in Canada, which has implications for practice and resource allocation.
MeSH term(s)	Child ; Humans ; Child, Preschool ; Prevalence ; Child Development ; Social Class ; Schools ; Ontario
Language	English
Publishing date	2024-01-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2023.1295195
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Article: Developmental health of Canadian kindergarten children with teacher-reported asthma between 2010 and 2015: A population-level cross-sectional study.

Janus, Magdalena / Reid-Westoby, Caroline / Pottruff, Molly / Schneeweiss, Michelle / Hu, George / Brownell, Marni

Preventive medicine reports

2023 Volume 37, Page(s) 102525

Abstract: Asthma can impact children's quality of life. It is unclear how asthma is associated with the developmental health (i.e. a broad range of skills and abilities associated with growth and development) of young children at school entry. The goals of this ... ...

Abstract	Asthma can impact children's quality of life. It is unclear how asthma is associated with the developmental health (i.e. a broad range of skills and abilities associated with growth and development) of young children at school entry. The goals of this cross-sectional, population-level study were to: (1) investigate the association between teacher-reported asthma and children's concurrent indicators of developmental health (developmental vulnerability); and (2) explore whether school absences and functional impairments modified this association. Participants were a Canadian population-based sample of 564 582 kindergarten children
Language	English
Publishing date	2023-11-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2785569-7
ISSN	2211-3355
ISSN	2211-3355
DOI	10.1016/j.pmedr.2023.102525
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Article ; Online: Ensuring Indigenous participation in research on the health and well-being of Indigenous Peoples.

Katz, Alan / Brownell, Marni

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

2019 Volume 191, Issue 25, Page(s) E714

MeSH term(s)	Child ; Female ; Humans ; Indigenous Peoples ; Manitoba ; Mothers ; Pregnancy ; Prenatal Care ; Retrospective Studies
Language	English
Publishing date	2019-06-24
Publishing country	Canada
Document type	Letter ; Comment
ZDB-ID	215506-0
ISSN	1488-2329 ; 0008-4409 ; 0820-3946
ISSN (online)	1488-2329
ISSN	0008-4409 ; 0820-3946
DOI	10.1503/cmaj.72120
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Article ; Online: Reducing child mortality in high-income countries: where to from here?

Brownell, Marni / Enns, Jennifer

Lancet (London, England)

2018 Volume 391, Issue 10134, Page(s) 1968–1969

MeSH term(s)	Child ; Child Mortality ; Developed Countries ; Developing Countries ; Humans ; Income ; Infant Mortality
Language	English
Publishing date	2018-05-03
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(18)30938-3
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Article ; Online: Screening for intimate partner violence in the early postpartum period: Maternal and child health and social outcomes from birth to 5-years post-delivery.

Taillieu, Tamara L / Brownridge, Douglas A / Brownell, Marni

Child abuse & neglect

2020 Volume 111, Page(s) 104865

Abstract: Background: Intimate partner violence (IPV) during pregnancy is a substantial public health concern, yet little is known about the developmental trajectory of these women and their children after birth.: Objective: The objective was to examine ... ...

Abstract	Background: Intimate partner violence (IPV) during pregnancy is a substantial public health concern, yet little is known about the developmental trajectory of these women and their children after birth. Objective: The objective was to examine maternal and child health as well as social outcomes from birth to 5-years post-delivery associated with a positive (vs. negative) maternal IPV screen around the time of delivery. Participants and setting: Manitoban women giving birth to a live singleton infant from January 1, 2003 to December 31, 2006 were followed from birth to 5-years post-delivery (analytic sample: N = 40,051). Methods: Administrative databases from the Manitoba Centre for Health Policy provided data for the study. Descriptive statistics and logistic regression were used to examine relationships between IPV screen response around the time of birth (i.e., current, or history of, violence between parenting partners) with maternal and child health as well as social outcomes. Results: Women screening positive for IPV had increased odds of diagnosed mood/anxiety disorders, personality disorders, substance use disorders, diabetes, respiratory morbidity, and intentional/non-intentional injury hospitalizations (adjusted odds ratio [AOR] range 1.81-5.59, p < .01). Children of women screening positive for IPV had increased odds of diagnosed attention deficit-hyperactivity disorder, lower respiratory infections, and injury hospitalizations (AOR range 1.53-2.00, p < .01), child welfare organization contact (AOR = 8.84, p < .01), and of being more developmentally vulnerable at kindergarten across domains of functioning (AOR range 1.69-1.93, p < .01) than children of mothers screening negative for IPV. Conclusion: A positive IPV screen was associated with poorer maternal and child health, increased child and family services contact, and children being more developmentally vulnerable in the 5-years after delivery.
MeSH term(s)	Brain Abscess ; Child Health ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Intimate Partner Violence/statistics & numerical data ; Male ; Postpartum Period/physiology ; Pregnancy ; Social Participation
Language	English
Publishing date	2020-12-16
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	799143-5
ISSN	1873-7757 ; 0145-2134
ISSN (online)	1873-7757
ISSN	0145-2134
DOI	10.1016/j.chiabu.2020.104865
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Article: Do Patterns of Early Disease Severity Predict Grade 12 Academic Achievement in Youths With Childhood-Onset Chronic Rheumatic Diseases?

Lim, Lily S H / Ekuma, Okechukwu / Marrie, Ruth A / Brownell, Marni / Peschken, Christine A / Hitchon, Carol A / Gerhold, Kerstin / Lix, Lisa M

The Journal of rheumatology

2023 Volume 50, Issue 9, Page(s) 1165–1172

Abstract: Objective: To test the association of early disease severity with grade 12 standards test performance in individuals with childhood-onset chronic rheumatic diseases (ChildCRDs), including juvenile arthritis and systemic autoimmune rheumatic diseases.: ...

Abstract	Objective: To test the association of early disease severity with grade 12 standards test performance in individuals with childhood-onset chronic rheumatic diseases (ChildCRDs), including juvenile arthritis and systemic autoimmune rheumatic diseases. Methods: We used linked provincial administrative data to identify patients with ChildCRDs born between 1979 and 1998 in Manitoba, Canada. Primary outcomes were Language and Arts Achievement Index (LAI) scores and Math Achievement Index (MAI) scores from grade 12 standards test results as well as enrollment data. The secondary outcome was enrollment in grade 12 by 17 years of age. Latent class trajectory analysis identified disease severity groups using physician visits following diagnosis. Multivariable linear regression tested the association of disease severity groups with LAI and MAI scores, and logistic regression tested the association of disease severity with age-appropriate enrollment, after adjusting for sociodemographic factors and psychiatric morbidities. Results: The study cohort included 541 patients, 70.1% of whom were female. A 3-class trajectory model provided the best fit; it classified 9.7% of patients as having severe disease, 54.5% as having moderate disease, and 35.8% as having mild disease. After covariate adjustment, severe disease was associated with poorer LAI and MAI scores but not with age-appropriate enrollment. Conclusion: Among patients with ChildCRDs, those with severe disease performed more poorly on grade 12 standards tests, independent of sociodemographic and psychiatric risk factors. Clinicians should work with educators and policy makers to advocate for supports to improve educational outcomes of patients with ChildCRDs.
MeSH term(s)	Humans ; Child ; Female ; Adolescent ; Male ; Academic Success ; Rheumatic Diseases/epidemiology ; Morbidity ; Achievement ; Patient Acuity
Language	English
Publishing date	2023-02-01
Publishing country	Canada
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	194928-7
ISSN	1499-2752 ; 0315-162X
ISSN (online)	1499-2752
ISSN	0315-162X
DOI	10.3899/jrheum.220656
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Article ; Online: Acute health care use among children during the first 2.5 years of the COVID-19 pandemic in Ontario, Canada: a population-based repeated cross-sectional study.

Iskander, Carina / Stukel, Therese A / Diong, Christina / Guan, Jun / Saunders, Natasha / Cohen, Eyal / Brownell, Marni / Mahar, Alyson / Shulman, Rayzel / Gandhi, Sima / Guttmann, Astrid

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

2024 Volume 196, Issue 1, Page(s) E1–E13

Abstract: Background: The effects of the decline in health care use at the start of the COVID-19 pandemic on the health of children are unclear. We sought to estimate changes in rates of severe and potentially preventable health outcomes among children during the ...

Abstract	Background: The effects of the decline in health care use at the start of the COVID-19 pandemic on the health of children are unclear. We sought to estimate changes in rates of severe and potentially preventable health outcomes among children during the pandemic. Methods: We conducted a repeated cross-sectional study of children aged 0-17 years using linked population health administrative and disease registry data from January 2017 through August 2022 in Ontario, Canada. We compared observed rates of emergency department visits and hospital admissions during the pandemic to predicted rates based on the 3 years preceding the pandemic. We evaluated outcomes among children and neonates overall, among children with chronic health conditions and among children with specific diseases sensitive to delays in care. Results: All acute care use for children decreased immediately at the onset of the pandemic, reaching its lowest rate in April 2020 for emergency department visits (adjusted relative rate [RR] 0.28, 95% confidence interval [CI] 0.28-0.29) and hospital admissions (adjusted RR 0.43, 95% CI 0.42-0.44). These decreases were sustained until September 2021 and May 2022, respectively. During the pandemic overall, rates of all-cause mortality, admissions for ambulatory care-sensitive conditions, newborn readmissions or emergency department visits or hospital admissions among children with chronic health conditions did not exceed predicted rates. However, after declining significantly between March and May 2020, new presentations of diabetes mellitus increased significantly during most of 2021 (peak adjusted RR 1.49, 95% CI 1.28-1.74 in July 2021) and much of 2022. Among these children, presentations for diabetic ketoacidosis were significantly higher than expected during the pandemic overall (adjusted RR 1.14, 95% CI 1.00-1.30). We observed similar time trends for new presentations of cancer, but we observed no excess presentations of severe cancer overall (adjusted RR 0.91, 95% CI 0.62-1.34). Interpretation: In the first 30 months of the pandemic, disruptions to care were associated with important delays in new diagnoses of diabetes but not with other acute presentations of select preventable conditions or with mortality. Mitigation strategies in future pandemics or other health system disruptions should include education campaigns around important symptoms in children that require medical attention.
MeSH term(s)	Child ; Infant, Newborn ; Humans ; COVID-19/epidemiology ; Pandemics ; Ontario/epidemiology ; Cross-Sectional Studies ; Emergency Service, Hospital ; Neoplasms ; Delivery of Health Care
Language	English
Publishing date	2024-01-15
Publishing country	Canada
Document type	Journal Article
ZDB-ID	215506-0
ISSN	1488-2329 ; 0008-4409 ; 0820-3946
ISSN (online)	1488-2329
ISSN	0008-4409 ; 0820-3946
DOI	10.1503/cmaj.221726
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Article ; Online: Screening for partner violence in the early postpartum period: are we missing families most at risk of experiencing violence?

Taillieu, Tamara L / Brownridge, Douglas A / Brownell, Marni

Canadian journal of public health = Revue canadienne de sante publique

2019 Volume 111, Issue 2, Page(s) 286–296

Abstract: Objectives: In Manitoba, government policy is for public health nurses to screen families with newborns within 1-week post-discharge for risk factors associated with poor child developmental health. The purpose of this study was to compare the ... ...

Abstract	Objectives: In Manitoba, government policy is for public health nurses to screen families with newborns within 1-week post-discharge for risk factors associated with poor child developmental health. The purpose of this study was to compare the characteristics of families who are screened for intimate partner violence (IPV) with families without a documented response to an IPV screen item. This information can be used to help identify and target families in need of support whose needs are not being met within the current system. Methods: Manitoban women giving birth to a live singleton in the province from January 1, 2003 to December 31, 2006 were included in the analyses (N = 52,710). Data were part of a larger research study following these families for several years to examine longer-term developmental outcomes. Administrative databases from the Manitoba Centre for Health Policy provided data for the study. Descriptive statistics and logistic regression were used to examine relationships between IPV screen status and socio-demographic covariates and birth outcomes. Results: In the study population, 66.7% of the sample were screened for IPV. Women less than 20 years of age, not in married or common-law unions, and living in lower income areas were less likely to have a documented response to the IPV screen item. A low number of prenatal care visits, prenatal mental health problems, and prenatal substance use, as well as premature and low birthweight delivery, were associated with a decreased likelihood of having a documented response to the IPV screen item. Conclusion: Incorporating violence screening into routine prenatal and postnatal care, rather than only screening women after birth, may help to better identify families with unmet needs and ensure more timely referrals to positive strengths-based supports and services.
MeSH term(s)	Adult ; Female ; Health Policy ; Humans ; Intimate Partner Violence ; Manitoba ; Mass Screening ; Nurses, Public Health ; Postpartum Period ; Risk Assessment ; Young Adult
Language	English
Publishing date	2019-11-19
Publishing country	Switzerland
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	417262-0
ISSN	1920-7476 ; 0008-4263
ISSN (online)	1920-7476
ISSN	0008-4263
DOI	10.17269/s41997-019-00266-5
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Article ; Online: The Mental Health of First Nations Children in Manitoba: A Population-Based Retrospective Cohort Study Using Linked Administrative Data: La santé mentale des enfants des Premières Nations au Manitoba : une étude de cohorte rétrospective dans la population, à l'aide de données administratives liées.

Chartier, Mariette J / Brownell, Marni / Star, Leona / Murdock, Nora / Campbell, Rhonda / Phillips-Beck, Wanda / Horton, Mabel / Meade, Chelsey / Au, Wendy / Schultz, Jennifer / Bowes, John-Michael / Cochrane, Brooke

Canadian journal of psychiatry. Revue canadienne de psychiatrie

2024 , Page(s) 7067437241226998

Abstract: Objective: First Nations children face a greater risk of experiencing mental disorders than other children from the general population because of family and societal factors, yet there is little research examining their mental health. This study ... ...

Abstract	Objective: First Nations children face a greater risk of experiencing mental disorders than other children from the general population because of family and societal factors, yet there is little research examining their mental health. This study compares diagnosed mental disorders and suicidal behaviours of First Nations children living on-reserve and off-reserve to all other children living in Manitoba. Method: The research team, which included First Nations and non-First Nations researchers, utilized population-based administrative data that linked de-identified individual-level records from the 2016 First Nations Research File to health and social information for children living in Manitoba. Adjusted rates and rate ratios of mental disorders and suicide behaviours were calculated using a generalized linear modelling approach to compare First Nations children ( Results: Compared with all other children, First Nations children had a higher prevalence of schizophrenia (adjusted rate ratio (aRR): 4.42, 95% confidence interval (CI), 3.36 to 5.82), attention-deficit hyperactivity disorder (ADHD; aRR: 1.21, 95% CI, 1.09 to 1.33), substance use disorders (aRR: 5.19; 95% CI, 4.25 to 6.33), hospitalizations for suicide attempts (aRR: 6.96; 95% CI, 4.36 to 11.13) and suicide deaths (aRR: 10.63; 95% CI, 7.08 to 15.95). The prevalence of ADHD and mood/anxiety disorders was significantly higher for First Nations children living off-reserve compared with on-reserve; in contrast, hospitalization rates for suicide attempts were twice as high on-reserve than off-reserve. When the comparison cohort was restricted to only other children in low-income areas, a higher prevalence of almost all disorders remained for First Nations children. Conclusion: Large disparities were found in mental health indicators between First Nations children and other children in Manitoba, demonstrating that considerable work is required to improve the mental well-being of First Nations children. Equitable access to culturally safe services is urgently needed and these services should be self-determined, planned, and implemented by First Nations people.
Language	English
Publishing date	2024-02-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	304227-3
ISSN	1497-0015 ; 0008-4824 ; 0706-7437
ISSN (online)	1497-0015
ISSN	0008-4824 ; 0706-7437
DOI	10.1177/07067437241226998
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