Matthew King

Gradients in risk for youth injury associated with multiple-risk behaviours: a study of 11,329 Canadian adolescents

This study used the Canadian version of the World Health Organization-Health Behaviour in School-Aged Children (WHO-HBSC) Survey to examine the role of multiple risk behaviours and other social factors in the etiology of medically attended youth injury. 11,329 Canadians aged 11-15 years completed the 1997-1998 WHO-HBSC, of which 4152 (36.7%) reported at least one medically attended injury. Multiple logistic regression analyses failed to identify an expected association between lower socio-economic status and risk for injury. Strong gradients in risk for injury were observed according to the numbers of multiple risk behaviours reported. Youth reporting the largest number (7) of risk behaviours experienced injury rates that were 4.11 times (95% CI: 3.04-5.55) higher than those reporting no high risk behaviours (adjusted odds ratios for 0-7 reported behaviours: 1.00, 1.13, 1.49, 1.79, 2.28, 2.54, 2.62, 4.11; p(trend) < 0.001). Similar gradients in risk were observed within subgroups of young people defined by grade, sex, and socio-economic level, and within restricted analyses of various injury types (recreational, sports, home, school injuries). The gradients were especially pronounced for severe injury types and among those reporting multiple injuries. The analyses suggest that multiple risk behaviours may play an important role in the social etiology of youth injury, but these same analyses provide little evidence for a socio-economic risk gradient. The findings in turn have implications for preventive interventions.

Youth injury data in the Canadian Hospitals Injury Reporting and Prevention Program: do they represent the Canadian experience?

Objective—Injuries to Canadian youth (11–15 years) identified from a population based health survey (World Health Organization—Health Behaviour in School-Aged Children Survey, or WHO-HBSC) were compared with youth injuries from a national, emergency department based surveillance system. Comparisons focused on external causes of injury, and examined whether similar rankings of injury patterns and hence priorities for intervention were identified by the different systems. Setting—The Canadian version of the WHO-HBSC was conducted in 1998. The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) is the national, emergency room based, surveillance program. Two hospitals involved in CHIRPP collectively provide population based data for Kingston, Ontario. Method—Numbers of injuries selected for study varied by data source: WHO-HBSC (n=3673); CHIRPP (n=20 133); Kingston CHIRPP (n=1944). WHO-HBSC and Kingston CHIRPP records were coded according to four variables in the draft International Classification of External Causes of Injury. Existing CHIRPP codes were available to compare Kingston and other CHIRPP data by five variables. Males and females in the three datasets were ranked according to the external causes. Data classified by source and sex were compared using Spearmans rank correlation statistic. Results—Rank orders of four variables describing external causes were remarkably similar between the WHO-HBSC and Kingston CHIRPP (ρ>0.78 p<0.004) for mechanism, object, location, and activity). The Kingston and other CHIRPP data were also similar (ρ>0.87; p<0.001) for the variables available to describe external causes of injury (including intent). Conclusion—The two subsets of the CHIRPP data and the WHO-HBSC data identified similar priorities for injury prevention among young people. These findings indicate that CHIRPP may be representative of general youth injury patterns in Canada. Our study provides a novel and practical model for the validation of injury surveillance programs.

Determinants of agricultural injury: a novel application of population health theory

Objectives (1) To apply novel population health theory to the modelling of injury experiences in one particular research context. (2) To enhance understanding of the conditions and practices that lead to farm injury. Design Prospective, cohort study conducted over 2 years (2007–09). Setting 50 rural municipalities in the Province of Saskatchewan, Canada. Subjects 5038 participants from 2169 Saskatchewan farms, contributing 10 092 person-years of follow-up. Main measures Individual exposure: self-reported times involved in farm work. Contextual factors: scaled measures describe socioeconomic, physical, and cultural farm environments. Outcome: time to first self-reported farm injury. Results 450 farm injuries were reported for 370 individuals on 338 farms over 2 years of follow-up. Times involved in farm work were strongly and consistently related to time to first injury event, with strong monotonic increases in risk observed between none, part-time, and full-time work hour categories. Relationships between farm work hours and time to first injury were not modified by the contextual factors. Respondents reporting high versus low levels of physical farm hazards at baseline experienced increased risks for farm injury on follow-up (HR 1.54; 95% CI 1.16 to 1.47). Conclusions Based on study findings, firm conclusions cannot be drawn about the application of population health theory to the study of farm injury aetiology. Injury prevention efforts should continue to focus on: (1) sound occupational health and safety practices associated with long work hours; (2) physical risks and hazards on farms.

Does the school performance variable used in the International Health Behavior in School-Aged Children (HBSC) Study reflect students' school grades?

BACKGROUND Given the pressure that educators and policy makers are under to achieve academic standards for students, understanding the relationship of academic success to various aspects of health is important. The international Health Behavior in School-Aged Children (HBSC) questionnaire, being used in 41 countries with different school and grading systems, has contained an item assessing perceived school performance (PSP) since 1986. Whereas the test-retest reliability of this item has been reported previously, we determined its convergent and discriminant validity. METHODS This cross-sectional study used anonymous self-report data from Austrian (N = 266), Norwegian (N = 240), and Canadian (N = 9,717) samples. Students were between 10 and 17 years old. PSP responses were compared to the self-reported average school grades in 6 subjects (Austria) or 8 subjects (Norway), respectively, or to a general, 5-category-based appraisal of most recent school grades (Canada). RESULTS Correlations between PSP and self-reported average school grade scores were between 0.51 and 0.65, representing large effect sizes. Differences between the median school grades in the 4 categories of the PSP item were statistically significant in all 3 samples. The PSP item showed predominantly small associations with some randomly selected HBSC items or scales designed to measure different concepts. CONCLUSIONS The PSP item seems to be a valid and useful question that can distinguish groups of respondents that get good grades at school from those that do not. The meaning of PSP may be context-specific and may have different connotations across student populations from different countries with different school systems.

Emotional health of Canadian and Finnish students with disabilities or chronic conditions

The purpose of this study was to investigate the dimensions of emotional health in two population-based groups (Finland and Canada) of adolescents (ages 13 and 15 years) who self-identify as having a disability or chronic condition, as conceptualized by the WHO International Classification of Functioning, Disability and Health. Data from the 2002 WHO Health Behaviour in School-aged Children survey were used to compare the prevalence of emotional health (items on feeling low, feeling nervous) within and between countries. Eighteen percent of the Canadian and Finnish samples indicated they had a long-time disability, illness or medical condition. Canadian adolescents with disability or chronic conditions felt low significantly more frequently than their classmates without disability or chronic conditions. In both countries, students with disabilities who had more than one functional difficulty were significantly more likely to report feeling low and nervous. These results illustrate that the severity of disability as measured by the number of functional difficulties, and not merely the presence of disability or chronic condition, or particular functional difficulties, may play an important role in the emotional health of adolescents. Health promotion programs may use this information to guide practice to support the emotional health of students with disabilities.

Perceptions of Parents, Mental Health, and School Among Canadian Adolescents from the Provinces and the Northern Territories

The authors examined whether perceptions of parents and personal mental health significantly influenced perceptions of school achievement and enjoyment in a large sample of Canadian adolescents. Responses from more than 10,000 Canadian adolescents in the Health Behaviour in School-Aged Children (HBSC) survey were used to create a Parental Support Index, a Mental Health Index, and a School Index. They found a significant, medium-sized effect between the parent index and the school index. They found a similar but smaller effect for mental health. The findings were consistent for adolescents across the 10 southern provinces. However, among adolescents from the two northern territories the Parental Support Index was not significant whereas demographic factors and mental health played a larger role in predicting scores on the School Index.

Parental involvement in children’s independent music lessons

ABSTRACT The purpose of the study was to examine types of parental involvement associated with independent music lessons. A self-report survey was designed to explore parent characteristics, parental goals, students’ musical progress, the teacher–student relationship, the practice environment, and parent behaviours during practice sessions. The extent to which the outcomes of enjoyment and progress could be predicted by parenting goals and values, time spent practising, teacher qualities, and student self-regulation was also examined. The survey was distributed through Canada’s Royal Conservatory, yielding 2583 surveys for analysis. Results indicated that parents were deeply invested in their children’s music lessons, as reflected in the years of commitment to music instruction, the thoughtful roles that they took in supporting their children’s evolution as self-regulating musicians, and the respect that they held for their children’s teachers. Evidence suggested that positive teacher–student relationships and parental involvement in practice sessions between lessons predicted student enjoyment of music and musical progress.

Student Experiences with Studio Instruction.

ABSTRACT The purpose of the study was to examine students’ experiences of independent music lessons, and to ascertain what factors predicted enjoyment and success, especially those predictors arising from self-regulation learning theory. A self-report survey was used to gather data on student demographics, practising habits, musical skills, achievements, and enjoyment. The survey was distributed through a Canadian conservatory system and other music schools in Canada, yielding 3920 surveys for analysis. Intrinsic motivation was the most salient predictor of enjoyment, persistence, and beliefs regarding musical self-efficacy for these highly engaged students. Additional contributing predictors for successful performance included focussing on aural abilities, motivation to acquire musical skills, and prior success at performing in public. The paper closes with a discussion of the role of intrinsic motivation for lifelong musicianship, as well as how future research might focus on broadening the student sample and on cross-validating student results with data from parents and teachers.

Characteristics of Independent Music Teachers.

ABSTRACT The purpose of the present study was to learn about the characteristics of independent music teachers, their beliefs about music teaching, and their studio practices. A self-report survey included questions about the teachers’ (a) background experiences, (b) pedagogical approaches, (c) use of digital technologies, and (d) professional development practices. Of the 1468 teachers responding to the survey, most predictably reported that a central activity was the study of repertoire from notated music. However, many of the teachers also reported teaching additional music components, such as playing by ear, composing, and improvising. Teachers described how parents supported their children’s music learning, and claimed that the greatest challenge for teachers was motivating students to practise. The responses to the use of digital technologies were widely varied. These teachers responding to the survey regularly availed themselves of professional development opportunities to advance both their musical knowledge and pedagogical practices.