SELECTED PUBLICATIONS
Below is a list of selected publications by the CHART Lab team. For a complete list of Dr. Hasina Samji’s publications, please visit this link.
2025
- Development and validation of the youth development instrument (YDI): A comprehensive survey of adolescent health and well-being
Hasina Samji, Jorge A. Delgado-Ron, Kimberly A.Schonert-Reichl, Martin Guhn, David Long, Jenna Whitehead, Lauren Gorfinkle, Giulia De Arruda Maluf, Judy Wu, Julia Kaufmann, Jose M. del Casal, Jaqueline Maloney
Rationale: Strengths-based approaches are urgently needed to protect and promote adolescent well-being in the United States and Canada, where adolescent happiness and mental health rank among the lowest of the world’s wealthiest countries. Identifying protective and promotive factors for adolescent well-being is critical for guiding policy, public health, and education sector responses as adolescents face unprecedented challenges.
Objective: We examined the dimensionality and psychometric properties of the Youth Development Instrument (YDI), a comprehensive survey of adolescent health and well-being within a longitudinal well-being monitoring system. The YDI draws predominantly from existing, validated measures identified as fundamental to adolescent well-being.
Methods: We describe the survey creation process in consultation with adolescents, interdisciplinary experts, and partners in adolescent development, medicine, policy, psychology, psychiatry, education, and public health. We conducted psychometric analysis of the YDI pilot implementation among 2295 eleventh-grade students across 31 schools in British Columbia, Canada, in 2021. We examined each measure’s dimensionality and relationship with thriving, resilience, and prosocial orientation to assess their construct validity.
Results: Exploratory and confirmatory factor analyses demonstrated the uni-dimensionality of each measure. Most measures had good or excellent internal consistency (mean Cronbach’s α: 0.85) and demonstrated moderate or large magnitude correlations to thriving, resilience, and/or prosocial orientation and small correlations with family affluence as hypothesized. Correlation patterns aligned with theoretical literature.
Conclusion: The YDI is a comprehensive and psychometrically sound survey of adolescents’ well-being and protective and promotive factors. The YDI’s linkable nature also creates potential for measuring population-level mental health and wellbeing trajectories.
- Gender and sexual orientation differences in the relationship between social media use and disordered eating: Results from a serial cross-sectional youth survey from 2022 to 2024
Purpose: The COVID-19 pandemic associated with a sustained increase in youth online activity and a sharp increase in eating disorder-related hospitalizations. Social media use and its portrayal of unrealistic body types have been previously linked to poor body image and disordered eating (DE), particularly affecting girls, transgender and gender-expansive (TGE) individuals, and sexual minorities (SM). We aimed to assess the effects of time on social media on DE among youth in British Columbia (BC), Canada, across intersecting identities of gender and sexual orientation.
Methods: Our serial cross-sectional study used 2022-2024 data from the Youth Development Instrument, a population-level youth well-being survey conducted annually in British Columbia schools, primarily among Grade 11 students. Our exposure was self-reported time spent on social media, and our outcome was DE. We fitted linear and logistic regression models across strata of gender and sexual orientation. The adjustment set included age, number of adverse childhood experiences (ACEs) and protective childhood experiences (PCEs), and affluence. We also estimated the effect of abstaining from social media on DE scores.
Results: Among 35,067 youths, 8,256 (23.5%) experienced DE. This proportion was higher among transgender and gender-expansive participants (40.9%) and SM girls (43.3%) compared to cis-hetero girls (32.2%), SM boys (16.5%), and cis-hetero boys (9.2%). We found a dose-response relationship for all groups. Social media abstention reduced the counterfactual outcome score by 16.0% for cis-hetero girls, 16.3% for SM girls, 13.9% for SM boys, 11.6% for transgender and gender-expansive youth, and 7.5% for cis-hetero boys.
Discussion: Longer time spent on social media is significantly associated with increased odds of DE in youth, with the odds increasing progressively with higher levels of social media use, independent of income, age, adverse childhood experiences , and protective childhood experiences. Abstaining from social media may be protective against DE for all groups, but girls may benefit substantially more.
2024
- Supporting adolescent well-being at school: Integrating transformative social and emotional learning and trauma-informed education
Jacqueline E. Maloney, Jenna Whitehead, David Long, Julia Kaufmann, Eva Oberle, Kimberly A. Schonert-Reichl, Michelle Cianfrone, Alexander Gist, Hasina Samji
There is an urgent need to support the social and emotional well-being of adolescents with experiences of adversity and trauma. Adolescence is a critical period of development for promoting social and emotional competencies, which can prevent poor mental health and problematic substance use and promote thriving during challenging teenage years and beyond. Both transformative social and emotional learning (TSEL) and trauma-informed programs for schools (TIPS) have been identified as promising practices for supporting social and emotional well-being among young people with experiences of adversity. We propose a pragmatic theory of action for schools for implementing and evaluating initiatives that integrate TSEL and TIPS made up of three iterative components: awareness, assessment, and action. The TSEL + TIPS Theory of Action is illustrated by a case study of a cross-sectoral collaboration of government, schools, researchers, healthcare, and adolescents to implement TSEL and TIPS initiatives in British Columbia, Canada. The case study provides evidence for the feasibility of TSEL + TIPS Theory of Action and may serve as an example for other regions as experiences of adversity and poor mental health continue to rise among adolescents globally.
- Positive childhood experiences serve as protective factors for mental health in pandemic-era youth with adverse childhood experiences
Hasina Samji, David Long, Jillian Herring, Rachel Correia, Jacqueline Maloney
Background: While adverse childhood experiences (ACEs) predict poorer mental health across the life course, positive childhood experiences (PCEs) predict better mental health. It is unclear whether PCEs protect against poor mental health outcomes and promote mental well-being in pandemic-era adolescents with ACEs.
Methods: We examined the individual and joint contributions of ACEs and PCEs to mental health and well-being (MHW) in eleventh-grade British Columbian adolescents (N = 8864) during the fifth wave of COVID-19. We used a novel measure of ACEs that included community- and societal-level ACEs in addition to ACEs experienced at home to investigate the role of social and structural determinants of mental health in supporting the MHW of pandemic-era adolescents. A series of two-way ANCOVAs were conducted comparing MHW outcomes between adolescents with and without ACEs. Interaction effects were examined to investigate whether PCEs moderated the association between ACEs and MHW.
Results: Adolescents with no ACEs had significantly better MHW than those with one or more ACE. Having six or more PCEs was associated with better MHW in adolescents with and without ACEs. PCEs significantly moderated the association between ACEs and depression. Effect sizes were larger for PCEs than ACEs in relation to depression, mental well-being, and life satisfaction.
Conclusions: PCEs may protect against depression among adolescents with ACEs and promote MHW among all pandemic-era adolescents. These findings emphasize the importance of addressing social determinants of mental health to mitigate the impact of ACEs and promote PCEs as part of a public health approach to MHW.
2023
- Development and validation of a youth climate anxiety scale for the Youth Development Instrument survey
Judy Wu, David Long, Nada Hafez, Jacqueline Maloney, Yan Lim, Hasina Samji
Emerging terms in the literature such as climate anxiety describe heightened concern, fear, and anxiety related to the climate crisis. Recent efforts have attempted to develop and validate scales to measure climate anxiety; however, extant research is largely focused on adults. Consequently, it is unclear whether developed measures are appropriate for adolescent populations, despite disproportionate impacts of the climate crisis experienced by this age group. The purpose of this study was two-fold; first, we aimed to assess levels of climate concern among Canadian adolescents using the Youth Development Instrument (YDI), a population-level youth well-being survey administered in schools with students (ages 15–18). Secondly, we collaborated with adolescents to adapt an existing climate anxiety scale to be included in the YDI survey. We used survey results to validate the adapted scale for use with adolescents and assessed levels of climate anxiety within our sample. In consultation with adolescents, the 13-item Climate Change Anxiety Scale (CCAS) was adapted to create the Climate Change Anxiety Scale – Short-form (CCAS-S) which consists of four-items adapted from the original CCAS. A total of 2306 respondents were included in analyses. Most adolescents reported feeling climate change concern (75.8%). A smaller proportion reported experiences of climate anxiety (48.7%). Confirmatory factor analysis supported a one-factor structure for the CCAS-S, with high internal consistency (Cronbach’s alpha = 0.95) and good model fit with error co-variance. Findings from this study provide construct validity evidence and reliability for the use of the CCAS-S in adolescent populations.
- Original quantitative research - Access to mental health support, unmet need and preferences among adolescents during the first year of the COVID-19 pandemic
Lauren R. Gorfinkel, Gaelen Snell, David Long, Mari del Casal, Judy Wu, Kimberly Schonert-Reichl, Martin Guhn, and Hasina Samji
Introduction: The COVID-19 pandemic has had widespread effects on adolescent mental health. However, little is known about support-seeking, unmet need and preferences for mental health care among adolescents.
Methods: The Youth Development Instrument (YDI) is a school-administered survey of adolescents (N=1928, mean age=17.1, SD=0.3) across British Columbia, Canada. In this cohort, we assessed the characteristics of accessed mental health supports, prevalence of unmet need and preferences for in-person versus internet-based services.
Results: Overall, 40% of adolescents obtained support for mental health, while 41% experienced unmet need. The most commonly accessed supports were family doctors or pediatricians (23.1%) and adults at school (20.6%). The most preferred mode of mental health care was in-person counselling (72.4%), followed by chat-based services (15.0%), phone call (8.1%) and video call (4.4%). The adjusted prevalence of accessing support was elevated among adolescents with anxiety (adjusted prevalence ratio [aPR]=1.29, 95%CI:1.10–1.51), those who used alcohol (1.14, 1.01–1.29), gender minorities (1.28, 1.03–1.58) and sexual minorities (1.28, 1.03–1.45). The adjusted prevalence of unmet need was elevated among adolescents with depression (1.90, 1.67–2.18), those with anxiety (1.78, 1.56–2.03), females (1.43, 1.31–1.58), gender minorities (1.45, 1.23–1.70) and sexual minorities (1.15, 1.07–1.23).
Conclusion: Adolescents of gender or sexual minority status and those with anxiety were more likely than others to have discussed mental health concerns and also to have reported unmet need. The most common sources of support were primary health care providers and adults at school, while the most and least preferred modes of support were in-person and video call services, respectively.
2022
- Review: Mental health impacts of the COVID-19 pandemic on children and youth – a systematic review
Hasina Samji, Judy Wu, Amilya Ladak, Caralyn Vossen, Evelyn Stewart, Naomi Dove, David Long, Gaelen Snell
Background: The COVID-19 pandemic has posed an unprecedented threat to global mental health. Children and adolescents may be more susceptible to mental health impacts related to their vulnerable developmental stage, fear of infection, home confinement, suspension of regular school and extracurricular activities, physical distancing mandates, and larger scale threats such as global financial recessions and associated impacts. Our objective was to review existing evidence of the COVID-19 pandemic’s global impact on the mental health of children and adolescents <19 years of age and to identify personal and contextual factors that may enhance risk or confer protection in relation to mental health outcomes.
Methods: We conducted a search of peer-reviewed and preprint research published in English from January 1, 2020, to February 22, 2021. We included studies collecting primary data on COVID-19-related mental health impacts on children and adolescents. We graded the strength of included articles using the Oxford Centre for Evidence-Based Medicine rating scheme.
Results: Our search and review yielded 116 articles presenting data on a total of 127,923 children and adolescents; 50,984 child and adolescent proxy reports (e.g., parents, healthcare practitioners); and >3,000 chart reviews. A high prevalence of COVID-19-related fear was noted among children and adolescents, as well as more depressive and anxious symptoms compared with prepandemic estimates. Older adolescents, girls, and children and adolescents living with neurodiversities and/or chronic physical conditions were more likely to experience negative mental health outcomes. Many studies reported mental health deterioration among children and adolescents due to COVID-19 pandemic control measures. Physical exercise, access to entertainment, positive familial relationships, and social support were associated with better mental health outcomes.
Conclusions: This review highlights the urgent need for practitioners and policymakers to attend to and collaborate with children and adolescents, especially those in higher risk subgroups, to mitigate short- and long-term pandemic-associated mental health effects.