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, 9 (11), e030709

Fit for School Study Protocol: Early Child Growth, Health Behaviours, Nutrition, Cardiometabolic Risk and Developmental Determinants of a Child's School Readiness, a Prospective Cohort

Collaborators, Affiliations

Fit for School Study Protocol: Early Child Growth, Health Behaviours, Nutrition, Cardiometabolic Risk and Developmental Determinants of a Child's School Readiness, a Prospective Cohort

Catherine S Birken et al. BMJ Open.

Abstract

Introduction: School readiness is a multidimensional construct that includes cognitive, behavioural and emotional aspects of a child's development. School readiness is strongly associated with a child's future school success and well-being. The Early Development Instrument (EDI) is a reliable and valid teacher-completed tool for assessing school readiness in children at kindergarten age. A substantial knowledge gap exists in understanding how early child growth, health behaviours, nutrition, cardiometabolic risk and development impact school readiness. The primary objective was to determine if growth patterns, measured by body mass index trajectories in healthy children aged 0-5 years, are associated with school readiness at ages 4-6 years (kindergarten age). Secondary objectives were to determine if other health trajectories, including health behaviours, nutrition, cardiometabolic risk and development, are associated with school readiness at ages 4-6 years. This paper presents the Fit for School Study protocol.

Methods and analysis: This is an ongoing prospective cohort study. Parents of children enrolled in the The Applied Health Research Group for Kids (TARGet Kids!) practice-based research network are invited to participate in the Fit for School Study. Child growth, health behaviours, nutrition, cardiometabolic risk and development data are collected annually at health supervision visits and linked to EDI data collected by schools. The primary and secondary analyses will use a two-stage process: (1) latent class growth models will be used to first determine trajectory groups, and (2) generalised linear mixed models will be used to examine the relationship between exposures and EDI results.

Ethics and dissemination: The research ethics boards at The Hospital for Sick Children, Unity Health Toronto and McMaster University approved this study, and research ethics approval was obtained from each school board with a student participating in the study. The findings will be presented locally, nationally and internationally and will be published in peer-reviewed journals.

Trial registration number: NCT01869530.

Keywords: EDI; body mass index; brain development; early development instrument; kindergarten; school readiness.

Conflict of interest statement

Competing interests: JLM received an unrestricted research grant for a completed investigator-initiated study from the Dairy Farmers of Canada (2011–2012) and Ddrops provided non-financial support (vitamin D supplements) for an investigator-initiated study on vitamin D and respiratory tract infections (2011–2015). PP received unrestricted research grants for completed investigator-initiated studies from Danone Institute of Canada (2002–2004 and 2006–2009), Dairy Farmers of Ontario (2008–2010) and Mead Johnson Nutrition provided non-financial support (Fer-In-Sol liquid iron supplement) (2011–2017) for an ongoing investigator-initiated trial of iron deficiency in young children that was funded by Canadian Institutes of Health Research (FRN # 115059). CBi received a research grant from the Centre for Addiction and Mental Health Foundation (CAMH 2017-2020). CBo reports previously receiving a grant for a completed investigator-initiated study from the SickKids Centre for Health Active Kids (CHAK) (2015–2016) involving the development and validation of a risk stratification tool to identify young asymptomatic children at risk of iron deficiency. These agencies had no role in the design, collection, analyses or interpretation of the results of this study or in the preparation, review or approval of the manuscript. All other authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The process of Fit for School Study recruitment and data collection. Note: the alternative stream was developed to avoid asking the teachers to complete the EDI twice. *, school board, school name and teacher’s name; **, date of birth, sex and postal code; ***, EDI collected by all SK teachers in publicly funded school districts in Ontario during provincial implementation years (3-year cycles). EDI, Early Development Instrument; JK, junior kindergarten or year 1; OCCS, Offord Centre for Child Studies; SK, senior kindergarten or year 2.

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References

    1. Brown RS, Parekh G. The intersection of disability, achievement, and equity: a system review of special education in the TDSB. Toronto, Ontario, Canada: Toronto District School Board, 2013.
    1. Constante K. Strong roots, bright futures: the promise of education and early human development. An interview with Fraser mustard. Ontario Ministry of Education 2010;111:1–8.
    1. Guttmann A, Manuel D, Dick PT, et al. Volume matters: physician practice characteristics and immunization coverage among young children insured through a universal health plan. Pediatrics 2006;117:595–602. 10.1542/peds.2004-2784 - DOI - PubMed
    1. Janus M, Offord DR. Development and psychometric properties of the early development instrument (EDI): a measure of children's school readiness. Can J Behav Sci 2007;39:1–22. 10.1037/cjbs2007001 - DOI
    1. Janus M, Gaskin A. School readiness. Encyclopedia of quality of life research. New York: Springer, 2014.

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