CHEO success in CIHR’s latest Project Grant competition

Ottawa — March 11, 2021 — The Canadian Institutes of Health Research has awarded CHEO researchers more than $1.2M in the fall 2020 Project Grant competition, supporting discoveries that help provide the best life for every child and youth.

CHEO is celebrating the achievements of our researchers, four of whom were successfully funded of seven applications submitted in the last CIHR Project Grant competition. These funds will allow research teams to make significant strides in their research in areas such as anaphylaxis, mental health, vaping and gestational weight in pregnancy. The applications of Drs. Waleed Alqurashi and Gary Goldfield ranked first and second on their respective panels. Drs. Daniel Corsi and Yanfang (Mary) Guo were recognized as Early Career Investigators.

“Congratulations our researchers and their teams,” said Dr. Jason Berman, VP of Research at CHEO, and CEO and Scientific Director of the CHEO Research Institute. “We are very proud of their achievements and look forward to seeing the impact their work will have on the children, youth and families we serve at CHEO.”

Our 4 awardees and their projects

Dr. Waleed Alqurashi (Co-PIs: Amy Plint, CHEO; Marcus S Shaker, Dartmouth-Hitchcock Medical Center, Lebanon, USA) was awarded $726,749 over 3 years for the project Canadian Anaphylaxis Network-Predicting Recurrence after Emergency Presentation for Allergic REactions (CAN-PREPARE)

Food allergy impacts 50% of Canadian households and up to 80% of severe allergic reactions in children are triggered by food. In Canada, approximately every 10 minutes, someone visits an Emergency Room (ER) for food-induced allergic reaction. In the event of an allergic reaction, treatment guidelines recommend that children be transported by an ambulance to an ER for observation, even if symptoms are mild or have stopped. The rationale behind the need for observation in the ER is that some patients are at risk of delayed reactions which can be life-threatening. The delayed allergic reaction consists of a return of symptoms after a period in which patients seem to recover from the first reaction successfully. Unfortunately, research data on the frequency, timing, severity and predictors of delayed allergic reactions are very limited. As a result, many children are also admitted to the hospital or observed in the ER for long hours to increase the chance of detecting delayed reactions. Canadian families described feelings of ambiguity about the severity of a reaction and hesitance to treat with epinephrine along with perceptions that ER visits often involve a long post-treatment wait time. The unpredictability of reactions and anticipation of ER visits can have a significant psychosocial impact on children and their caregivers. In fact, surveys of Canadian families showed that almost half of respondents described their anxiety level as 8 out of 10 or higher. The main objective of this study is to determine which combination of risk factors identify children with allergic reactions who are at risk of developing delayed reactions. From this knowledge, we can develop appropriate guidelines so that children at high risk are monitored appropriately, whereas those at no or low risk can be discharged from the ER once they became asymptomatic. These guidelines will be highly beneficial to our community and to the health-care system.

Dr. Gary Goldfield (Co-PI:  Christopher G Davis, Carleton University) was awarded $340,424 over 4 years for the project Effects of Reducing Social Media Use on Emotional Distress in Youth

Anxiety and depression affect large numbers of youth. Social media use (SMU) is also prevalent among youth. This is concerning given high social media use is related to feelings of anxiety, depression, and loneliness, which may be due to unfavorable social comparisons that arise with SMU. A study done in adults found reducing social media use resulted in less emotional distress, but no studies have been done in youth. This study will test whether reducing social media use is an effective way to reduce feelings of anxiety, depression and other symptoms in youth who are already experiencing emotional distress. We will also explore whether sex, gender or social comparisons influence the impact that the intervention has on emotional distress. We plan to recruit 216 youth aged 12-17 years who are on the waiting list for outpatient mental health services at a local children's hospital. Each participant will have an equal chance (like flipping a coin) of being assigned to the intervention group (108 youth) or to the control group (108 youth). The intervention group will receive an educational handout on tips for reducing SMU and will be required to limit SMU to 1-hour per day. Participants in the control group will receive the same educational handout but will have no limits put on their SMU. All participants will monitor their SMU daily on their smartphones and send us screenshots of their daily use. We will measure participants' symptoms of emotional distress using questionnaires that will be completed before the program, after 4 weeks of intervention and again after 8 and 12 weeks to see if youth in the intervention group show greater reductions in emotional distress compared to those in the control group. This study may be the first to show that reducing social media use is an effective way to reduce emotional distress in a vulnerable group of youth waiting for mental health services. If this study is successful, findings would suggest that reducing social media use should be included in the treatment of distressed youth.

Dr. Daniel Corsi (Co-PI: Adam M Lippert, University of Colorado, Denver) was awarded $100,000 for one year from a Priority Announcement (Population and Public Health - Early Career Investigator) for the project Vaping in Canada: Investigating the geographic distribution and sociodemographic correlates of e-cigarette use

How common is vaping among Canadians? Does e-cigarette use vary by province and between communities? What community risks are associated with vaping? Do rates of vaping differ across areas with higher or lower poverty, inequality, and tobacco use rates? Despite the availability of data to answer these questions, there remain many knowledge gaps related to vaping across Canada's diverse communities, particularly among youth and marginalized populations. Inconsistencies in Provincial and Territorial policies and regulations related to the sale and marketing of vaping products have resulted in considerable variations in the geography and patterns of vaping use across Canadian communities. The popularity and availability of e-cigarettes and other vaping products in Canada have increased steadily over the past decade. Increases have been most notable in younger populations, and this is concerning given that we now know vaping to be associated with many significant health risks. A better understanding of regional, demographic and social patterns associated with vaping in Canada is essential to help target prevention and harm reduction efforts, and to revise policies. We will use existing data from national health surveys to examine patterns of vaping across Canada and Canadian communities, as well as the impact of policies and regulations on vaping use. From our findings, we will develop a detailed online data atlas of vaping product use across Canada for use by health-care providers, policy planners, researchers and the public.

Dr. Yanfang (Mary) Guo (Co-PI: Darine El-Chaar, Ottawa Hospital Research Institute) was awarded $75,000 for one year from a Priority Announcement (Data Analysis Using Existing Databases and Cohorts) for the project Gestational weight loss in obese women and risk for adverse perinatal outcomes: a population-based retrospective cohort study

Currently almost 20% of Canadian women enter pregnancy with a BMI in the obese range. Appropriate weight gain during pregnancy helps to improve outcomes for both mothers and their babies in women of all weights, including obese women. Due to limited and controversial findings of current studies, there is no tailoring of weight gain recommendations during pregnancy by severity of obesity. Although weight loss during pregnancy is not recommended, it has been shown that 5-8% of obese women in general, and up to 15% of women with extreme obesity, reported intentional weight loss during pregnancy. Given that a clinical trial of weight loss during pregnancy is not ethical, a high-quality observational study is greatly needed to explore potential harms of intentional weight loss during pregnancy for mothers and their babies. Our study will use Ontario birth registry data to examine the impact of weight loss during pregnancy on a wide range of adverse maternal and infant outcomes among obese women, divided into more precise obesity classes. Our study will overcome limitations of previous studies and fill research gaps by investigating dose-response effects of weight loss during pregnancy on perinatal outcomes. The study findings will inform prenatal counselling, help guide weight management during pregnancy and improve the quality of care for obese women. The current study will provide relevant, contemporary evidence of short-term perinatal outcomes of intentional gestational weight loss among obese women. Future research is needed to create optimal weight gain trajectories specific to obese women, based on their severity of obesity.

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