A1.2 What Gets Counted Counts_Catherine Birken

TARGet Kids! Practice Based Primary Care Research Network Catherine S Birken MD, MSc, FRCPC

CFPC Conflict of Interest

Disclosure of Commercial Support Presenter Disclosure Presenters: Catherine Birken, Richard Birtwhislte, Irfan Dhalla, Ruth Sanderson, Mari Teitelbaum, Karen Tu Relationships with commercial interests: • • • •

Grants/Research Support: None Speakers Bureau/Honoraria: None Consulting Fees: None Other: None

CFPC CoI Templates: Slide 1

Faculty/Presenter Disclosure • Presenter: Catherine Birken • Relationships with commercial interests: – None

Practice Based Research Network www.targetkids.ca

Practice Embedded Data Collection Primary Healthcare Practice Age newborn to 5 years

Questionnaires

Height, weight, BMI waist circumference, blood pressure, head circumference, parent BMI

A research assistant trained in phlebotomy is embedded in each practice site

DATA MANAGEMENT SYSTEM Applied Health Research Centre Secure web-based data management using Medidata RAVE™ software

LABORATORY SERVICES Mount Sinai Services Laboratory tests

Village Park Paediatrics Dr. Eddy Lau Dr. Brian Chisamore Dr. Sharon Naymark Tarandeep Malhi (RA)

Clairhurst Paediatrics Dr. Michael Peer Dr. Sheila Jacobson Dr. Carolyn Taylor Subitha Rajakumaran (RA)

Danforth Paediatrics A Dr. Patricia Neelands Dr. Janet Saunderson Dr. Anh Do Laurie Thompson (RA)

Humber Paediatrics Dr Peter Wong Dr Robert Lau Dr Barbara Smiltnieks Dr Keewai Fung Dr Michael Dorey

Research Leads: Dr. Patricia Parkin Dr. Catherine Birken Dr. Jonathon Maguire

LABORATORY SERVICES Mount Sinai Services Dr. Azar Azad

Research Managers/Coordinators: Kanthi Kavikondala Matthew D’Ascanio

Steering Committee: Dr. Mark Feldman Dr. Moshe Ipp Dr. Brian Chisamore Dr. Tony Barozzino

Danforth Paediatrics B Dr. Marty Perlmutar Dr. Karoon Danayan Dr. Alana Rosenthal Juela Sejdo (RA)

St Michael’s Hospital Pediatric Ambulatory Clinic Dr. Tony Barozzino Dr. Michael Sgro Dr. Sloane Freeman Tonya D’Amour (RA)

St Michael’s Hospital 410 Sherbourne Family Medicine Clinic Dr. Susan Shepherd Nadia Kabir (RA)

DATA MANAGEMENT

Applied Health Research Centre Dr. Muhammad Mamdani Magda Melo Kevin Thorpe Dr. Gerald Lebovic Yang Chen

St Michael’s Hospital 80 Bond Street Family Medicine Clinic Dr. Nav Persaud Richa Kukkar (RA)

Growth and Health Behaviours

A Platform for Surveillance of Growth and Behaviour Trajectories

Time

Building Linkages

Instrument Schedule NHQ 0 weeks

NS

IBQ

ECBQ

CBQ

NDDS

ITC

PSI

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1 month 2 months 4 months 6 months 9 months

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12 months 15 months 18 months

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2 years

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3 years

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4 years

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5 years

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6+ years

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   

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randomize

A Platform for Randomized Trials

Group A Group B

Baseline Characteristics of TARGet Kids! Cohort Demographics Child’s age, months 0 - < 1 years 1 - < 3 years 3 - < 6 years Child’s sex, male Mother’s place of birth In Canada Outside of Canada Missing Child Health Child’s zBMI Underweight (z < -1) Normal weight (-1≥ z ≤1) Overweight (1> z ≤2) Obese (z > 2) Missing Breastfeeding duration, months 0 – 6 months 6 – 12 months 12 – 24 months 24 months + Never Missing

Total (N = 5062) Frequency (N, %) Median (Range) 25 (0.2 – 72) 511 (10.1) 2441 (48.3) 2110 (41.7) 2646 (52.3) 3144 (62.1) 1707 (33.7) 211 (4.2) 0.1 (-4.7 – 6.2) 681 (13.5) 3143 (62.1) 708 (14.0) 225 (4.4) 305 (6.0) 10 (0 – 48) 901 (17.8) 2274 (44.9) 1103 (21.8) 149 (2.9) 353 (7.0) 282 (5.6)

Cardiovascular risk associated with eating behaviours during early childhood CMAJ, 2013

Intervention: 10 minute ‘doc talk’ at 3 year old visit  reduce screen time  remove screen from bedroom  turn off TV during meals

Approaches to Data Collection Characteristics

Canadian Health Measures Survey

Electronic Medical Records

Practice Based Research Network

Representative

National

?RegionalNational

LocalRegional National

Sample size

Small

Large

Large

Age

Excludes 0-3

All who attends

All recruited

Design

Cross-sectional

Longitudinal

Longitudinal

Measure Health outcomes

Yes

Limited

Yes

Evaluate Interventions

Limited

Health system Interventions

Trials

Health behaviours

Yes

Limited

Yes

•

TARGet Kids! Summary • Large sample young children • Embedded data collection and knowledge translation • Platform for Surveillance and Trials • Scale up to sentinal sites • Complements other data sources

Practice Based Research Network www.targetkids.ca