Cheryl L. Currie

Adolescent Use of Prescription Drugs to Get High in Canada

Objective: To present epidemiologic information on adolescent use of prescription drugs to get high, and not for medical purposes, in Canada. Methods: Data were obtained from 44 344 adolescents in grades 7 to 12 living across Canadas 10 provinces who completed the Youth Smoking Survey in 2008/2009. Results: Nationally, 5.9% of adolescents in grades 7 to 12 reported the use of prescription drugs to get high in the past 12 months in 2008/2009. Females were more likely to report use of pain relievers, sedatives, or tranquilizers to get high, while males were more likely to report the use of prescription stimulants for this purpose. The use of prescription drugs to get high was elevated among older youth, those living in British Columbia, and those who identified as First Nations, Métis, or Inuit. School connectedness was associated with a reduction in this form of prescription drug misuse for all adolescents; however, this protective effect was particularly strong for Aboriginal youth, and may be an important preventative factor for this population. Conclusions: Use of prescription drugs to get high was prevalent among adolescents in Canada in 2008/2009. Findings highlight the need for clinicians to include questions about prescription drugs when screening adolescents for substance abuse in Canada. Findings also highlight the need for evidence-informed strategies to reduce prescription drug misuse among Aboriginal youth living outside First Nations communities in Canada. The results of this study suggest school connectedness may be a particularly important target for these interventions.

Racial Discrimination Experienced by Aboriginal University Students in Canada

Objectives: Racial discrimination is an established life course social determinant of health associated with adverse psychological outcomes among minority populations. However, little is known about the extent to which Aboriginal people in Canada may experience racial discrimination and consequent adverse psychological effects. This study sought to measure the extent to which Aboriginal university students living in an urban area of Canada experienced racism, to triangulate this evidence with US data and qualitative findings, and to examine the impact of these experiences on mental health. Methods: Data for this mixed method study were collected via in-person surveys with a volunteer sample of Aboriginal university students (n = 60) living in a mid-sized city in central Canada in 2008–2009. Results: Results indicate Aboriginal university students experienced more frequent racism across a greater number of life situations than African- and Latino-American adults in the United States. Student reactions to these experiences were symptomatic of what has been termed racial battle fatigue in the United States. Students who considered themselves traditional or cultural Aboriginal persons were significantly more likely to experience discrimination. Conclusions: Results underline the need for policies aimed at reducing racism directed at Aboriginal people in urban areas and the growth of services to help Aboriginal people cope with these experiences. Results highlight the need for further research to determine the potential pathogenic consequences of racial discrimination for Aboriginal people in Canada.

Illicit and prescription drug problems among urban Aboriginal adults in Canada: the role of traditional culture in protection and resilience.

Illicit and prescription drug use disorders are two to four times more prevalent among Aboriginal peoples in North America than the general population. Research suggests Aboriginal cultural participation may be protective against substance use problems in rural and remote Aboriginal communities. As Aboriginal peoples continue to urbanize rapidly around the globe, the role traditional Aboriginal beliefs and practices may play in reducing or even preventing substance use problems in cities is becoming increasingly relevant, and is the focus of the present study. Mainstream acculturation was also examined. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Associations were analysed using two sets of bootstrapped linear regression models adjusted for confounders with continuous illicit and prescription drug problem scores as outcomes. Psychological mechanisms that may explain why traditional culture is protective for Aboriginal peoples were examined using the cross-products of coefficients mediation method. The extent to which culture served as a resilience factor was examined via interaction testing. Results indicate Aboriginal enculturation was a protective factor associated with reduced 12-month illicit drug problems and 12-month prescription drug problems among Aboriginal adults in an urban setting. Increased self-esteem partially explained why cultural participation was protective. Cultural participation also promoted resilience by reducing the effects of high school incompletion on drug problems. In contrast, mainstream acculturation was not associated with illicit drug problems and served as a risk factor for prescription drug problems in this urban sample. Findings encourage the growth of programs and services that support Aboriginal peoples who strive to maintain their cultural traditions within cities, and further studies that examine how Aboriginal cultural practices and beliefs may promote and protect Aboriginal health in an urban environment.

Epidemiology of adolescent Salvia divinorum use in Canada

BACKGROUND Salvia divinorum is a potent, naturally occurring hallucinogen gaining popularity as a recreational drug in North America. To date, detailed epidemiologic information about the use of this substance among adolescents living outside the United States has been limited. This study provides information on the prevalence and correlates of Salvia divinorum use among adolesecents in Canada using a nationally representative sample. METHODS Data were obtained from a representative sample of 42,179 Canadian adolescents aged 12-17 years living across all 10 provinces who completed the Youth Smoking Survey in 2008-09. RESULTS Overall, 3.8% of adolescents reported using Salvia in the past year and 6.2% had used the substance in their lifetime. A conservative estimate suggests 23.2% of youth were repeat users. Salvia use was highest among youth in British Columbia and Quebec. Comparatively, the prevalence of 12-month Salvia use was higher than 12-month cocaine and amphetamine use but lower than 12-month ecstasy, cannabis, and other hallucinogen use. Correlates of Salvia use included older age, male gender, high available spending money, binge drinking, illicit drug use and smoking in fully adjusted models. Findings suggest low self-esteem may be an important correlate specific to the use of this substance among youth. CONCLUSIONS Salvia divinorum use is prevalent among Canadian adolescents. Salvia may be a significant public health issue in Canada given it is readily available, under limited regulation, and little is known about the abuse liability of the substance, interactions with other substances, and potential complications from use.

Sedentary behavior among adults: The role of community belonging.

Sedentary behavior is a modifiable determinant of health. Little is known about the ways in which contextual factors may influence this behavior. The objectives of this study were to: (1) examine the association between community belonging and adult sedentary behavior during leisure; (2) determine if this association was explained by perceived health. Data were derived from the 2010 Canadian Community Health Survey (N = 11,494 adults). Multinomial regression models and 99% confidence intervals were used to examine associations between sense of community belonging and sedentary behavior, adjusting for sociodemographic variables and perceived health. On average, adults were sedentary for 20–24 h per week during leisure. More than a third of the sample reported low sedentary behavior (≤ 19 h a week). In a fully adjusted model participants who were female, in middle adulthood, married, and/or living in higher income households were less sedentary during leisure. Adults with a strong sense of community belonging were also significantly less sedentary during leisure; this association remained significant after adjustment for perceived mental and overall health. Most efforts to address sedentary behavior have focused on individual-level interventions. The present finding highlights the role that larger contextual factors may play in sedentary behavior. Sense of community belonging is a contextual determinant of health that may serve as a useful target for interventions designed to reduce adult sedentary behavior during leisure.

Looking further upstream to prevent fetal alcohol spectrum disorder in Canada

Half of all pregnancies in Canada are unintended. Whether a pregnancy is intended or unintended has a bearing on the risk of prenatal alcohol exposure. Research indicates that women who experience an unintended pregnancy are significantly more likely to consume alcohol while pregnant. Most fetal alcohol spectrum disorder (FASD) prevention frameworks in Canada have adopted a mid-stream approach focused on preventing alcohol consumption among women who are already pregnant. Yet there is a second approach, further upstream, that is rarely discussed as an FASD prevention tool in this country - preventing unintended pregnancy itself. Improving access to long-acting reversible contraceptives for women and girls who are experiencing cost and access barriers to these methods could do much to stem the incidence of FASD and the prohibitive health and social costs associated with this disorder in Canada.RésuméLa moitié des grossesses au Canada sont non désirées. Qu’une grossesse soit voulue ou non a une incidence sur le risque d’exposition prénatale à l’alcool. Des études ont montré que les femmes qui vivent une grossesse non désirée sont de manière significative plus susceptibles de consommer de l’alcool lorsqu’elles sont enceintes. La plupart des cadres de prévention du trouble du spectre de l’alcoolisation fœtale (TSAF) au Canada emploient une approche à mi-parcours, qui vise à prévenir la consommation d’alcool des femmes déjà enceintes. Pourtant, il existe une deuxième approche, plus en amont, dont on discute rarement en tant qu’outil de prévention du TSAF dans ce pays: prévenir les grossesses non désirées. Le fait d’améliorer l’accès aux contraceptifs réversibles et à longue durée d’action pour les femmes et les filles qui n’ont pas les moyens de s’en procurer ou qui n’y ont pas accès contribuerait beaucoup à réduire l’incidence du TSAF et les coûts sanitaires et sociaux associés à ce trouble au Canada.

Short-term changes in daily movement behaviour influence salivary C-reactive protein in healthy women

This study assessed the effect of changing daily movement behaviour on C-reactive protein (CRP) measured in saliva. Two groups of women either reduced daily movement or increased physical activity for 10 days. Salivary CRP increased by 31% in the sedentary group (0.378 ± 0.596 to 0.487 ± 0.793 μg·L-1) and decreased by 22% in the active group (0.414 ± 0.640 to 0.259 ± 0.284 μg·L-1). These results suggest short-term changes in daily movement behaviour can affect salivary CRP, a marker of systemic inflammation.

Fitness Equipment in Public Parks: Frequency of Use and Community Perceptions in a Small Urban Centre

BACKGROUND Providing freely accessible exercise facilities may increase physical activity at a population level. An increasingly popular strategy is outdoor fitness equipment in urban parks. Few studies have evaluated the effectiveness of this intervention in smaller cities. This study examined fitness equipment use, perceived effectiveness, and ways to increase use in a city of 100,000 people in 2015. METHODS Two parks with fitness equipment and 4 without were directly observed. Interviews with 139 adults in active parks or living nearby were also conducted. RESULTS Only 2.7% of adult park users used the fitness equipment over 100 hours of observation across 3 seasons. In contrast, 22.3% of adults interviewed reported monthly or more use of the equipment, highlighting the limitations of self-report methods. Adults interviewed perceived the equipment as potentially beneficial and suggested strategies to increase public use, including increased advertising, the introduction of programming to teach and encourage use, improved equipment quality, and improved maintenance of the equipment and surrounding area. CONCLUSIONS In a low density city, park fitness equipment may not be an effective public health practice without additional efforts to market, introduce programming, and maintain these sites.

Community Belonging and Sedentary Behaviour Among Métis Canadians: A Gendered Analysis

Study Purpose: Framed by intersectionality theory, this study examined how gender and sense of community belonging interact to influence sedentary behaviour during leisure among Metis adults in Canada. Methods: Data were obtained from 1,169 Metis adults who completed the Canadian Community Health Survey in 2012. Weighted linear regression models examined associations between sedentary behaviour and community belonging stratified by gender, adjusting for confounders. Results: Male gender, younger age, physical activity, and increased socioeconomic status were associated with less sedentary behaviour among Metis adults. Metis men with a very strong sense of community belonging spent 3.6 fewer hours per week engaged in sedentary pursuits during leisure than Metis men who reported a very weak sense of community belonging. Conversely, Metis women with a very strong sense of community belonging spent 1 additional hour per week engaged in sedentary pursuits during leisure than Metis women who reported a very weak sense of community belonging. These associations remained significant after adjustment for sociodemographic covariates and perceived mental health and overall health, suggesting other factors were influencing these differences. Conclusions: A strong sense of community belonging among Metis men may reduce sedentary behaviour during leisure by as much as 30 minutes per day, which may be clinically significant. Increased community belonging among Metis women was associated with increased sedentary behaviour. These findings suggest that interactions between community belonging and gender should be considered when developing interventions to reduce leisure sedentary behaviour among Metis adults in Canada.