Document Type


Degree Name

Master of Arts (MA)




Faculty of Science

First Advisor

Geoffrey Nelson

Advisor Role

Thesis Supervisor


The purpose of this research was to examine issues relevant to best practices for preschooler mental health prevention policy so as to inform future prevention policy. Data were gathered through the examination of two preschool prevention programs, Ontario Early Years Centres (OEYCs) and Healthy Babies, Healthy Children (HBHC). These prevention programs were examined with respect to four major issues: (a) the ideology and origins of the program, (b) theoretical underpinnings, (c) research base, and (d) implementation and adaptation issues. To explore these four issues, qualitative methods were used in the form of document reviews (two documents for the Early Years Centres and two documents for the Healthy Babies, Healthy Children) and key informant interviews (seven informants for the Early Years Centres and six informants for Healthy Babies, Healthy Children). The main finding regarding the ideology and origins of the Early Years Centres and Healthy Babies, Healthy Children is that a mixture of values related to both personal well-being and collective well-being was used in the framing of both the problem(s) and solution(s). Furthermore, informants indicated that centres were created by the government in response to both timing (an influx of federal funding for programs for preschool children) and the influences of key people. A key finding regarding the theoretical underpinnings of both programs is that brain-based development theories were used to explain how the quality of early sensory stimulation during critical early periods influences the brain’s ability to develop properly. The centres were used improve the quality of stimulation for preschool children by assisting parents and children through the use of centre-based programs, whereas Healthy Babies, Healthy Children programs used primarily family-based programs. Findings for the research base were based on evaluations conducted on both programs. While the evaluation reports suggest encouraging conclusions regarding the effectiveness and efficiency of both programs, the methodologies used in the evaluations of both programs have major limitations. As for best practices with regard to the Early Years Centres and Healthy Babies, Healthy Children, key informants noted the lack of comprehensiveness, accessibility, follow-up assessments, and theoretical basis of the programs and the issues of insufficient dosage of the interventions. Cultural sensitivity was deemed by informants to be a strong aspect of both programs. Key informants also noted that centres are struggling to provide consistent programming across Ontario. Additionally, the Healthy Babies, Healthy Children program’s home visitation services lack intensity and may not be effective because this program uses lay home visitors in its primary approach to home visitation. Findings regarding implementation and adaptation for the centres include a clear message from informants that the ease of implementation was dependent on whether the centre began in a pre-established organization. Additionally, key informants asserted that the extent of community ownership and adaptation varied from centre-to-centre across Ontario. The implementation and adaptation issues faced by Healthy Babies, Healthy Children are evidenced in the lack of pilot projects the program undertook before it was implemented province-wide. This approach led to implementation that was not based in teachings from research evidence or community-based knowledge. While informants commended HBHC’s ability to adapt to the community’s needs, the community’s sense of ownership of the program is still questionable. The findings of this research have implications for improving preschool mental health prevention policy in all four categories. These implications include: (a) more thorough framing of the problem(s) and solution(s), (b) a deeper understanding of the research base upon which the greatest program impacts can be achieved, and (c) the need for pilot projects before province-wide implementation.

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