The MCHRI brings together a group of internationally recognized child health research programs under a common umbrella, to share our experiences and to address these common themes of children and families with complicated lives. These groups bring significant research expertise in child and youth mental health, childhood disability, childhood cancer, obesity, exercise and nutrition, bone and muscle disorders, the economic costs of health care utilization and child maltreatment.
Together, we will approach child health research from new directions, seeking to understand and explore new issues and shed new light on challenges that have, until now, either not been recognized at all, or have been neglected. The MCHRI brings a fresh and innovative perspective to child and youth health, and expects to learn lessons that will ultimately benefit children and families everywhere and position the Institute as a world leader in child health research and treatment.
MCHRI will address conditions, themes and developmental stages simultaneously and in an integrated manner in its effort to discover new and innovative knowledge that is much less likely to be achieved by focusing only on specific conditions or themes.
The figure above demonstrates visually how various facets of MCHRI, including its goals, themes and research foci, are interconnected. Each condition can affect individuals at any stage of their lives across the many MCHRI themes. The figure illustrates diagrammatically how a number of aspects of the lives of children and families can be addressed thematically as elements of research programs, knowledge translation activities and therapeutic endeavours. Note as well that each theme is likely to be more or less applicable to every child with a ‘complicated life', and to their family.
Children with complicated lives and their families have many issues in common. The Institute will focus on cross-cutting research themes including:
Quality of Life
This dimension of child health is an area of increasing interest and at the same time confusion in the literature. McMaster child health researchers have made internationally recognized innovative contributions to the development and application of measures of quality of life in childhood cancer, childhood epilepsy, childhood disability and long-term neonatal follow-up. This emerging area of child health (and child health research) provides an excellent illustration of the way that the MCHRI can create a cross-cutting program of research that can become a resource for the nation.
The Institute will undertake to support researchers and their research programs through various funding mechanisms. Any individual supported by the Institute must be a member of the Institute and is expected to follow the guiding principles of the Institute. All research activities supported by the MCHRI, even with seed funding (when that becomes possible), will need to involve individuals from more than one of the MCHRI's federated members.
People's ‘participation' (engagement in life) is an aspect of the World Health Organization's International Classification of Functioning, Health and Disability (ICF) that needs to be developed and, again, is an area of special interest to child health practitioners and researchers at McMaster. This concept is of interest in childhood disability, diabetes, obesity, adolescent health and child and youth mental health.
Role of the Environment
A component of the ICF that is also attracting interest and attention, but about which there is as yet relatively little sound academic work, is identifying and measuring the role of ‘environment' in people's lives. For example, at McMaster there is expertise in ‘geomapping', in which health indicators can be plotted on maps to explore the distribution of these issues as a basis for further research and proposed interventions. Another component of ‘environment' is policy development at the political level, an area for which McMaster's child health expertise is frequently sought by provincial and national policy-makers.
Transition to Adulthood
Health and other professionals who work with youth with complicated lives share with parents a major concern about what happens to these children as they grow into adulthood. As the MCHRI develops there will be unique opportunities to cross-link health services researchers, parents, youth and practitioners to create and evaluate innovative transition programs, and then to ‘export' these widely across Canada and beyond.
Families’ lives are also ‘complicated’ by the realities of their children’s lives. We know, for example, that the physical and mental health of parents of these young people is significantly less good than that of comparable Canadian parents whose children are well. Chronic illness affects not only the child but also the family as a whole, often forcing many changes within the family. Researchers have illustrated how in these circumstances role relationship changes are often required, such as when one parent must stay at home to care for the child, forcing the family to survive on one income. Others have studied the family’s resilience and ability to mobilize resources to adapt and respond to the situation. It was found that families exhibiting warmth, cohesion, and stability appear to foster resilient children.