The Research Chair in Community Social Pediatrics aims to promote academic excellence in research on the social determinants of health specific to the development of children and adolescents living in vulnerable conditions.
Children and adolescents living in economically and socially vulnerable conditions are overrepresented among those with behavioral, developmental and learning difficulties in Quebec. To address the problems facing youth in several disadvantaged neighborhoods across the province, Dr Gilles Julien developed the Community Social Pediatrics (CSP) model integrating different individualized interventions for youth and their families. The model was inspired by the ecobiodevelopmental framework that guides various interventions for children exposed to economic and social poverty.
The framework accounts for the impact of such adversity on a child’s developmental trajectory and refers to ‘toxic stress’ as a result of prolonged activation of biological responses to stress due a sustained exposure to adverse experiences in early childhood. Early exposure to adverse experiences can also affect the natural coping capacities needed to face later challenges. Although the CSP model is widely implemented in various communities across the province, it has not yet been evaluated with respect to its long-term effects.
Within the objectives of the research chair, a research program is planned to explore four main research questions: (1) To what extent the living conditions of the youth who benefit from the CSP model change following exposure to CSP interventions? (2) To what extent the youths’ developmental trajectories, externalized and internalized symptoms, as well as overall health outcomes change following exposure to CSP interventions? (3) How are CSP intervention characteristics linked to the effect sizes that will be obtained? (4) What are the individual and environmental factors that modulate the relationship between intervention characteristics and their impact on youth?
The research program consists of two phases: a pilot study, which is underway, and a larger-scale study whose design will be informed by the pilot’s findings. The pilot study using a pre-post intervention design was launched in 2018 and is conducted in collaboration with Dr Julien’s Foundation and 8 CSP centers across the Quebec province. The study aims to recruit 100 families (children aged 0-12 years and their parents) newly enrolled in the 8 CSP centers. Participants will be assessed at baseline and 6 months later on various measures including child functioning and development as well as parental skills and perceived support. This proof of concept study has four main objectives: (1) To assess the acceptability of proposed measures by the families receiving services from CSP centers; (2) To assess the effect of the interventions offered in CSP centers on two intermediary outcome measures (youth externalized symptoms and parental stress); (3) To understand the link between intervention characteristics and the two intermediary outcome measures; and (4) To inform the design and implementation of a larger-scale study.
