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Paediatrics
Protocol
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
  1. Catherine S Birken1,2,3,4,5,
  2. Jessica A Omand2,
  3. Kim M Nurse1,
  4. Cornelia M Borkhoff1,2,3,
  5. Christine Koroshegyi2,
  6. Gerald Lebovic3,6,
  7. Jonathon L Maguire3,4,5,6,7,
  8. Muhammad Mamdani3,6,7,8,
  9. Patricia C Parkin1,2,3,4,
  10. Janis Randall Simpson9,
  11. Mark S Tremblay10,11,
  12. Eric Duku12,
  13. Caroline Reid-Westoby12,
  14. Magdalena Janus12
  15. on behalf of the TARGet Kids! Collaboration
    1. 1Division of Paediatric Medicine and the Paediatric Outcomes Research Team (PORT), Hospital for Sick Children, Toronto, Ontario, Canada
    2. 2Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
    3. 3Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
    4. 4Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
    5. 5Department of Nutritional Sciences, Faculty of Medicine, Universtiy of Toronto, Toronto, Ontario, Canada
    6. 6The HUB Health Research Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
    7. 7Department of Paediatrics, St. Michael's Hospital, Toronto, Ontario, Canada
    8. 8Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
    9. 9Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
    10. 10Healthy Active Living and Obesity Research, Children's Hospital of Eastern Ontario Research Institute, Healthy Active Living and Obesity Research, Ottawa, Ontario, Canada
    11. 11Department of Paediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
    12. 12The Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
    1. Correspondence to Dr Jessica A Omand; jessica.omand{at}sickkids.ca

    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.

    • school readiness
    • body mass index
    • kindergarten
    • early development instrument
    • EDI
    • brain development

    This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

    https://doi.org/10.1136/bmjopen-2019-030709

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      Footnotes

      • Collaborators *TARGet Kids! collaborators: coleads: Catherine S. Birken, Jonathon L. Maguire; advisory committee: Ronald Cohn, Eddy Lau, Andreas Laupacis, Patricia C. Parkin, Michael Salter, Peter Szatmari, Shannon Weir; science review and management committees: Laura N. Anderson, Cornelia M. Borkhoff, Charles Keown-Stoneman, Christine Kowal, Dalah Mason; site investigators: Murtala Abdurrahman, Kelly Anderson, Gordon Arbess, Jillian Baker, Tony Barozzino, Sylvie Bergeron, Dimple Bhagat, Gary Bloch, Joey Bonifacio, Ashna Bowry, Caroline Calpin, Douglas Campbell, Sohail Cheema, Elaine Cheng, Brian Chisamore, Evelyn Constantin, Karoon Danayan, Paul Das, Mary Beth Derocher, Anh Do, Kathleen Doukas, Anne Egger, Allison Farber, Amy Freedman, Sloane Freeman, Sharon Gazeley, Charlie Guiang, Dan Ha, Curtis Handford, Laura Hanson, Leah Harrington, Sheila Jacobson, Lukasz Jagiello, Gwen Jansz, Paul Kadar, Florence Kim, Tara Kiran, Holly Knowles, Bruce Kwok, Sheila Lakhoo, Margarita Lam-Antoniades, Eddy Lau, Denis Leduc, Fok-Han Leung, Alan Li, Patricia Li, Jessica Malach, Roy Male, Vashti Mascoll, Aleks Meret, Elise Mok, Rosemary Moodie, Maya Nader, Katherine Nash, Sharon Naymark, James Owen, Michael Peer, Kifi Pena, Marty Perlmutar, Navindra Persaud, Andrew Pinto, Michelle Porepa, Vikky Qi, Nasreen Ramji, Noor Ramji, Danyaal Raza, Alana Rosenthal, Katherine Rouleau, Caroline Ruderman, Janet Saunderson, Vanna Schiralli, Michael Sgro, Hafiz Shuja, Susan Shepherd, Barbara Smiltnieks, Cinntha Srikanthan, Carolyn Taylor, Stephen Treherne, Suzanne Turner, Fatima Uddin, Meta van den Heuvel, Joanne Vaughan, Thea Weisdorf, Sheila Wijayasinghe, Peter Wong, John Yaremko, Ethel Ying, Elizabeth Young, Michael Zajdman; research team: Farnaz Bazeghi, Vincent Bouchard, Marivic Bustos, Charmaine Camacho, Dharma Dalwadi, Christine Koroshegyi, Tarandeep Malhi, Sharon Thadani, Julia Thompson, Laurie Thompson; project team: Mary Aglipay, Imaan Bayoumi, Sarah Carsley, Katherine Cost, Karen Eny, Theresa Kim, Laura Kinlin, Jessica Omand, Shelley Vanderhout, Leigh Vanderloo; Applied Health Research Centre: Christopher Allen, Bryan Boodhoo, Olivia Chan, David W.H. Dai, Judith Hall, Peter Juni, Gerald Lebovic, Karen Pope, Kevin Thorpe; Mount Sinai Services Laboratory: Rita Kandel, Michelle Rodrigues, Hilde Vandenberghe. Offord Centre for Child Studies Collaboration: principal investigator: Magdalena Janus; coinvestigator: Eric Duku; research team: Caroline Reid-Westoby, Patricia Raso, Amanda Offord.

      • Contributors CSB, JAO, KMN, CMB and MJ conducted the literature search. CSB and MJ designed the research study. CSB, CK, GL, JLM, MM, PCP, JRS, MST, ED and CR-W helped to refine the study design. CSB, JAO, KMN, CMB and MJ drafted the manuscript. All authors read and approved the final manuscript.

      • Funding This work was supported by the Canadian Institutes of Health Research (CIHR) grant number 133 585.

      • 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.

      • Patient consent for publication Not required.

      • Provenance and peer review Not commissioned; externally peer reviewed.