Adolescent Health Lab

Research & Current Projects

In our lab we are interested in factors that increase risk and provide protection during pre-adolescence and adolescent development. Our work integrates research on both normative and atypical developmental trajectories with the goal of understanding how we can support healthy development and intervene during critical transitions to reduce risk. Please see below for our current research projects:

Towards a Framework for Disseminating Evidence-Based Preventative Interventions (EBPIs) to Promote Wellness and Mental Health in Children and Youth.

Funding Agency: Social Sciences and Humanities Research Council

Reducing Risk and Promoting Health Among Vulnerable Teens and their Families in the Context of COVID-19: A Multisite National and International Implementation and Evaluation Study

Principle Investigators: Dr. Marlene M. Moretti

Canadian Institutes of Health Research (CIHR) Operating Grant: COVID-19 Mental Health & Substance Use Service Needs and Delivery

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Addressing the mental health consequences of COVID-19 is critical, especially as there are significant and longstanding gaps in the availability and accessibility of mental health services for youth. COVID-19 exacerbates this shortage and potential long-term impacts that will follow. eConnect Online offers a highly promising strategy to mitigate the immediate and long-term mental health impacts of COVID-19 for families nationally and internationally. Like Connect, it is sensitive and flexible to cultural, gender, economic, and other diversities related to parenting practices, family and social dynamics, and expectations about youth behaviour, while also retaining the core therapeutic components underlyning Connect’s success. This project engages an established and highly skilled network of clinical researchers, community partners, mental health workers, agency and government stakeholders. The aim of this research is to evaluate the training, implementation, uptake, client fit, and mental health outcomes of eConnect Online for parents and caregivers of adolescents (ages 10-18) with serious behavioural and other mental health problems. Thus far, we’ve engaged researchers from around the world, including sites in Canada, Sweden, Italy, Australia, China, South Africa, and Mexico, and have trained over 200 facilitators in the delivery of eConnect Online and eConnect Online for Kinship & Foster, with more training sessions currently underway!

Supporting Kinship & Foster Parents Promotes Resilience and Wellbeing in Teens in Care: An Attachment and Trauma Informed Intervention

Principle Investigators: Dr. Marlene M. Moretti

Public Health Agency of Canada Mental Health Promotion Innovation Fund (MHP-IF)

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Adolescents in foster care are particularly at risk for social-emotional problems during adolescence and into adulthood. One of the most profound inequities experienced by all children placed in care is the disruption of their attachment relationships with primary caregivers, which is a critical protective factor when facing adversity. Extensive research shows that adolescents who lack a sense of connection and security with caring adults are at significant risk for a wide range of adverse outcomes; conversely, a sense of security in relationships is a powerful asset that buffers them against risk and promotes resilience, including strong emotion regulation skills (Allen & Miga, 2010; Allen, Porter, McFarland, McElhaney, & Marsh, 2007). Despite experiences of trauma and loss, children in care can develop secure attachment with their foster parents and this is reliably predicted by caregiver sensitivity (Gabler et al., 2014). The aim of the current project is to establish a strong foundation for implementation of Connect for Kinship and Foster Parents as the first step in determining its fit, feasibility, and effectiveness in sites across four provinces, especially in relation to cultural and gender diversity. The second aim of this study will be an evaluation of mental health clincians and practitioners’ experience of the Connect/Connect for Kinship & Foster Parents group facilitators. With respect to the virtual dissemination of Connect (eConnect Online for Kinship and Foster Parents), the intervention will be delivered in 2 formats: Version 1: Families will be recruited by local mental health agencies. In order to comply with social distancing guidelines, families will partake from their homes. Version 2: Similarly, families will be recruited by local mental health agencies who opt to partner with the host mental health agency to run the groups. The families recruited at each community will join the online group sessions from their respective local mental health agencies where a local coordinator will be present to manage risks and facilitate the running of the group sessions.

Past Projects

Strengthening Parent-Teen Relationships: Pathways to Improving Mental Health and Wellbeing of Aboriginal Youth and Caregivers

Principle Investigators: Dr. Marlene M. Moretti; Annette McComb

CIHR Team Grant: Pathways Implementation Research Team LOI

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The rate of suicide among Aboriginal youth is approximately five to six times that of non-Aboriginal youth. Extensive research has demonstrated that attachment security within the adolescent-caregiver relationship is associated with significantly lower levels of depression and suicidal ideation. The Connect Parent Group program is an attachment based intervention with demonstrated effectiveness that has been developed and evaluated in communities across British Columbia; however uptake has been more gradual among Aboriginal caregivers. Over the last 18 months, in collaboration with our partners in Aboriginal communities, we have held a series of focus groups and interviews with service providers, program facilitators, community leaders and caregivers living on-reserve and found that there was universal interest among those with whom we spoke to co-create an adapted version of the Connect program that would: strengthen attachment between caregivers and teens; honour the inherent strengths of Aboriginal caregivers; and respect traditional teachings related to parenting. This project of adaptation, implementation and evaluation of the Connect program for Aboriginal caregivers will move forward through four developmental phases. First, we will establish a Reflecting Team consisting of Aboriginal service providers, community members and leaders who will guide the process of adapting the program. Next we will work with the Reflecting Team to identify adaptations to the program and appropriate measures for evaluating the program that honour both Indigenous and Western ways of knowing. In phase three we will pilot the adapted program in at least six diverse Aboriginal communities representing urban and rural settings as well as on- and off-reserve communities. Finally, we will work with communities to identify barriers to program uptake and produce a detailed implementation plan that will support the future scale-up of the intervention in diverse Aboriginal communities. 

Effectiveness of a Relational Intervention in Reducing Violence and Victimization in At-risk Adolescent Girls and Boys

Principle Investigators: Dr. Marlene M. Moretti; Dr. Robert McMahon

CIHR Team Grant: Violence, Gender and Health

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Entry into adolescence is marked by profound biological and social relational changes for girls and boys. It is also a time when aggression and violence become a part of many young people’s lives. Physical aggression, social aggression (aggressive acts that harm social relationships, humiliate or demean others) and violence increase for girls and boys when they enter adolescence, peak in mid-adolescence and decline in adulthood. Victimization also rises for girls and boys. The social and economic burden of adolescent violence and aggression is extremely high. New prevention approaches are needed to support young adolescents at this critical turning point. Building on our 8 year longitudinal study of adolescent girls and boys at high risk for violence and aggression, we evaluate the efficacy of an attachment based program for vulnerable girls and boys just prior to their transition to secondary school, when problems tend to escalate. In this study, we examine how sex and gender intersect with social, psychological, genetic, and biological factors to determine intervention outcomes. The proposed research also explores sex and gender in relation to cultural diversity, violence and victimization, and takes steps to better understand the needs of girls and boys in the juvenile justice system.

Strengthening Parent-Teen Relationships to Reduce Risk and Enhance Healthy Development: A Sex and Gender Framework in Translating Research into Practice

Principle Investigators: Dr. Marlene M. Moretti, Dr. Robert McMahon

CIHR Operating Grant

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The social and economic costs of teen violence and aggression are substantial and rising. Despite recent progress, further research is needed to develop interventions for pre-teens and adolescents, particularly those at the highest level of risk. Few programs have addressed the relevance of gender differences in risk and protective factors, and important questions remain regarding the need for ‘gender sensitive’, ‘gender tailored’ or ‘gender specific’ programming. To be effective interventions must be research driven; based on established knowledge about risk and protective factors; and targeted to sensitive developmental transitions which present different risks for girls and boys. Programs that promote and strengthen relationships between youth and their parents offer considerable promise in enhancing healthy development, and reducing violence, aggression and related mental health and social problems. Building on our eight-year longitudinal study of adolescent girls and boys at high risk for violence, aggression, and poor social and mental health, we developed an attachment focused intervention designed to strengthen parent-teen relationships. The proposed research evaluates the short and long term effectiveness of this program for girls and boys; examines the role of risk and protective factors as determining treatment outcomes; and investigates shared and gender specific social, psychological, genetic and biological factors that underlie change in therapy.

Girls at Risk for Aggression and Antisocial Behaviour: Risk, Resilience and Developmental Trajectories

Principal Investigators: Dr. Marlene M. Moretti

Co-Investigators: Dr. Margaret Jackson, Dr. Candice Odgers, Dr. Dick Reppucci

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This research program builds on our longitudinal study of high-risk adolescent youth in Canada and the US obtained through under a CIHR New Emerging Team grant (Aggressive and violent girls: contributing factors, developmental course & intervention strategies) directed by Dr. Marlene Moretti and funded through the Institute of Sex, Gender and Health. The sample was strategically drawn to represent girls at the highest level of risk for engagement in aggression and antisocial behaviour from Canada and the US. A matched sample of adolescent boys was also recruited. Adolescents referred to a provincial centre mandated to serve youth with serious aggressive and antisocial behaviour and youth detained in custody centers were assessed at two time points using a comprehensive protocol that tapped information on behavioural patterns, family, peer and romantic partner life experiences including exposure to maltreatment and other forms of adversity, child mental health problems, social-relational functioning; social cognitive, school and intellectual functioning; self-regulatory capacity; and personality characteristics.

This research program extends our follow-up of these youth at three additional points across a five year period. Combined with existing data, this research will permit mapping of trajectories from early adolescence (age 13/14) to early adulthood (age 23/24). New waves of data collection assess a wider range of range of functional domains including adjustment in educational, vocational, romantic and parental roles. In addition, physical health outcomes will be evaluated. Both quantitative and qualitative methods are being used examine issues of cultural and social marginalization. Of particular interest is whether similar themes will emerge across girls of cultural minority status in Canada and the US; and whether experiences are shared across girls growing up in contexts characterized by varying levels of socioeconomic deprivation. This study will generate new findings on developmental trajectories among high-risk Canadian girls. It is the first comparative investigation of risk profiles and trajectories between Canadian and American girls.

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