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
1 month 2 months 4 months 6 months 9 months
12 months 15 months 18 months
2 years
3 years
4 years
5 years
6+ years
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
?RegionalNational
LocalRegional 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