IMPACT (Immunization Monitoring Program, ACTive) is a pediatric national active surveillance network based in 13 pediatric hospitals, and is administered by the CPS. It tracks adverse events following immunization (AEFIs), as well as the frequency and severity of selected infections that are—or will be—vaccine preventable. POPCORN funding will leverage existing IMPACT funding, derived primarily from PHAC, and supplemented by other funds for specific projects.

CPSP (Canadian Paediatric Surveillance Program) is another Canadian Paediatric Society (CPS) program that performs ongoing, systematic collection of data through pediatric provider surveys, to determine burden of disease (not limited to infections) and assess interventions to prevent the occurrence of a disorder. These data are then available to guide health policymakers, as demonstrated for COVID-19.

CIRN (Canadian Immunization Research Network) is a CIHR-funded network of networks that serves as a primary source of vaccine data to inform public health decision-making about immunization programs in Canada. CIRN’s niche is at the interface of clinical research, surveillance and epidemiology, and public health program evaluation. CIRN’s primary focus is the evaluation of late-stage vaccine program implementation. Through the Canadian National Vaccine Safety (CANVAS) Network and the Special Immunization Clinic (SIC) Network, AEFIs are monitored and studied in collaboration with international programs. CANVAS captures self-reported symptoms among vaccinees, including chest pain, fever, neurological symptoms. The SIC Network studies outcomes of patients revaccinated following AEFIs.

PICNIC (Paediatric Investigators Collaborative Network on Infections in Canada) is a less-formalized pediatric infectious diseases network that conducts studies, including those on COVID-19, across 15 pediatric hospitals in Canada.

The Pediatric Inpatient Research Network (PIRN) was established in 2019 to improve the evidence base and outcomes for hospitalized children in General Pediatric settings. This research network is based in all 17 academic pediatric hospitals across Canada and four large Ontario community hospitals. PIRN’s mission includes working with children and families to generate evidence and building research capacity through mentorship and collaboration. The network conducts multi-centre, patient-oriented research to serve patients and families, clinicians, researchers, and health system decision-makers.

The Pediatric Emergency Research Canada (PERC) Network was established in 1995 by a group of Pediatric Emergency Medicine (PEM) clinician investigators with the aim of conducting research designed to improve outcomes in children requiring ED care. The network spans across 15 Canadian children’s hospitals. The network’s goals are:

-Create new knowledge through research involving clinical and epidemiological studies in PEM;

-Mentor new investigators and fellows in developing research projects;

-Promote PEM as an academic discipline with its own research agenda; and

-Pool the expertise of researchers and develop cohesiveness between PEM centres.

-PERC currently includes 195 members from various disciplines and specialties.

The Canadian Critical Care Trials Group (CCCTG) was created in 1989 to improve the care of adult and pediatric critically ill patients through investigator-initiated research, and to provide a national forum for continuing education about research methods. Dr. Patricia Fontela is a pediatric intensivist and chair of the CCCTG Pediatric Group. The CCCTG Pediatric Group includes critical care professionals in all 17 PICUs across Canada, including 62 multidisciplinary pediatric critical care researchers and 28 research coordinators. Collectively, CCCTG leads innovative, multidisciplinary, patient-centred research that is anchored in rigorous methods.

Dr. Nicole Basta is an associate professor of Epidemiology and Canada Research Chair in Infectious Disease Prevention (Tier 2) at McGill University. The EpiBioMed Pillar will serve critical, cross-cutting roles within POPCORN. It will provide epidemiological, biostatistical and methodological expertise to all POPCORN researchers and project teams, aligning the methods implemented across the network.

The Women & Children's Health Research Institute (WCHRI, University of Alberta) is the Data Coordinating Centre (DCC) where the common REDCap database for all proposed projects will be built with harmonization of variables. WCHRI will be responsible for data management, data quality checks, data analysis, and data storage (letter of collaboration). Study participants will receive a unique participant ID that will be used across all POPCORN studies to capture core data variables throughout their entire hospital and post-discharge trajectory. In parallel, under the lead of Dr. Patricia Fontela and Dr. Elodie Portales-Casamar, Dr. Isabel Fortier’s team at Maelstrom will be responsible for the harmonization of variables and the creation of a core COVID-19 data module with its metadata catalogue. The POPCORN Data Governance structure will be jointly developed by the Governance Committee and members of the Data Governance, EpiBioMed, and Biobank pillars. It will be based on:

Ongoing collaboration between Canadian pediatric research networks, patient and family partners, public health, and stakeholders;
EDI+I;
Centralized research coordination; and
Research process efficiency.

POPCORN will establish systems at each site to take advantage of residual samples (respiratory swabs, Broncho alveolar lavage fluid, serum/plasma, etc.) from POPCORN cohort patients whenever possible. It will also collect dedicated samples for virologic (e.g., variant typing) and immunologic assays, using methods that optimize the preservation and yield of analytes for current and future studies. The group will harmonize the sharing of prospectively collected pediatric samples, building on the infrastructure and processes of the biobanking infrastructure that already exists at several of the POPCORN sites.

Biobanks
The British Columbia Children’s Hospital Biobank: Vancouver, BC
The Alberta Children’s Hospital BioCORE: Calgary, AB
The McMaster Clinical Research Laboratory and Biobank: Hamilton, ON
The SickKids Central Biobank: Toronto, ON
The CHU Sainte-Justine Institutional Mother-Child Biobank: Montreal, QC

POPCORN leverages the established Knowledge Mobilization (KM) infrastructure and expertise within the Translating Emergency Knowledge for Kids (TREKK) Network. Dr. Olivier Drouin leads the KM Pilar and will work with the coordinating centre, PE, EDI+I teams to ensure principles of integrated Knowledge Translation are woven throughout all activities of POPCORN. Communities of knowledge users (e.g., patient partners and government decision-makers), researchers, healthcare providers, and industry will be engaged regularly to:

• ensure objectives of POPCORN activities align with end-users’ needs, to help with the uptake of findings on a rolling basis.

• involve end-users in project design, delivery and dissemination strategies.

• develop user-informed resources to mobilize knowledge in both French and English.

• embed evaluation within the resource development process and monitor website/social media metrics to evaluate reach.

The KM Pillar will also develop a comprehensive KM plans targeting four main audiences:

1) parents/families

2) healthcare professionals

3) scientists and academics

4) public health organizations, government, and other stakeholders who develop policies and best practices for healthcare services and delivery.

Findings and resources will be disseminated through several means including:

• a rapid results webpage to share the latest research results in formats informed by end-users.

• an evidence-based social media strategy.

• established communication channels (e.g., newsletters, parent magazines/organizations, community organizations, education sessions, webinars, podcasts, websites).

• policy briefs and meetings with public health decision-makers.

• traditional academic outputs (publications and conference presentations).

Products created through POPCORN have the potential to impact millions of families by democratizing research results, making them easily accessible to support healthcare decisions that impact the healthcare and outcomes of children and youth during future pandemics.

Knowledge transfer is woven through the entire POPCORN process, from identifying key questions, to co-designing projects and receiving data and summaries on an ongoing basis. Dr. Robert Strang, Chief Medical Officer of Health (CMOH) for Nova Scotia, we will be able to understand the needs from provinces and territories (Council of CMOHs), aiming to support CMOHs in their decisions. In her role at the federal level, Dr. Eleni Galanis (PHAC) will ensure that proposed projects are not duplicates of others. Dr. Marina Salvadori (co-applicant and medical specialist on COVID-19 at PHAC) and Dr. Robyn Harrison (current vice-chair of NAC) will ensure liaison and integrated knowledge transfer with PHAC.

The EDI+I vision for POPCORN, driven by Dr. Patricia Li, is to gain an understanding of the structural and social determinants of health that are associated with COVID-19 infection and vaccination consequences, by taking a perspective that intersects all projects. The diverse research team will achieve this with the following strategies:

Community-based interface and engagement;

Harmonized data collection on health equity measures; and

Applying an intersectional lens in qualitative interviews to engage youth and caregivers to better understand their experiences with COVID.

POPCORN’s patient engagement strategy will ensure that patient and family involvement are integrated in all three levels of the network and across all eight pillars. The patient and family engagement initiative will be led by Dr. Francine Buchanan and supported by Dr. Carrie Costello, The team will work to:

Ensure patient engagement is implemented across POPCORN pillars and research projects;

Education, mentoring and organizational support is provided for researchers and patient and family partners to engage in meaningful and positive ways;

Ensure there is consistent and diverse patient and family partner representation within the network; and

Embed evaluation within the patient engagement to inform continuous improvement initiatives.

POPCORN is committed to providing mentorship and training to its investigators and trainees through its mentorship and training stream, which is led by Dr. Evelyn Constantin, with the collaboration of Dr. Susan Samuel (CCHCSP/ENRICH director), and is supported by co-applicants from all participating networks. POPCORN will develop a specific mentorship and training stream that leverages the close affiliations and already established child health mentorship and training programs. To achieve this vision, our strategies and our main objectives will be to:

Develop POPCORN-specific educational resources for mentorship and training, based on a POPCORN-specific needs assessment exercise;

Harmonize the mentorship and training programs across POPCORN pillars and develop a national POPCORN platform for investigators and trainees;

Create a national POPCORN-specific repository of national mentors and mentees, with pairing of mentor and mentee dyads (matching ECRs) and trainees to more senior investigators); and

Engage with established POPCORN-affiliated national programs, such as ENRICH for the formal ECR training and mentorship program. POPCORN will support two ECRs for a two-year ENRICH program enrolment (CCHCSP’s newly CIHR-funded health research training platform).

All 16 POPCORN sites are already members of the Maternal Infant Child & Youth Research Network (MICYRN), a federal not-for-profit, charitable organization founded in 2006 to build capacity for high-quality applied health research. MICYRN will serve as the centralized infrastructure to coordinate the national child health research networks within POPCORN. A key role of MICYRN will be to liaise with pillar leads, project leads, patient engagement coordinators, and collaborators to ensure POPCORN‘s aims are achieved. MICYRN will also be responsible for assisting in the sustainability of POPCORN, seeking ongoing funding opportunities, and developing processes for streamlined research, including contracts, ethics, and data linkages.