Grant: Partnerships for Health System Improvement (PHSI)

While the link between childhood conduct problems and increased medical service usage in adulthood has been established in the literature, there is little knowledge on the mechanisms that could explain this association. It is unclear whether differences in medical service usage between adults with and without histories of conduct problems are already present in early to middle childhood, whether they gradually grow during adolescence, or if they fluctuate over time. We also have little information on risk/protective factors and sex differences that may be associated with variations in patterns of medical service usage and costs among youth with and without conduct problems. This information is nevertheless essential for planning effective services for youth with conduct problems. This study has three objectives. The first objective is to establish trajectories of medical service usage and costs between childhood and adolescence of boys and girls with and without conduct problems. A second objective is to identify risk and protective factors associated with variations in these trajectories. Finally, a third objective is to translate research findings into new and relevant knowledge for clinicians working with vulnerable youth with conduct problems, and their families. These questions will be examined by incorporating data on medical service usage provided by the Régie de l'assurance maladie du Québec, which is the public single-payer medicare provider in Québec, and information on self-reported health into an ongoing longitudinal study of 748 boys and girls with and without conduct problems who have been followed for the past seven years. Knowledge generated from this project will help inform services within our health sector partner, by identifying specific time periods and intervention targets where intensifying preventive efforts might yield positive results in terms of deflecting negative health trajectories that lead to increased medical service usage.