Ethics approval and consent to participate
The study was approved by the Research Ethics Board of The Hospital for Sick Children (SickKids), the Western Institutional Review Board and the Institutional Review Boards of each participating institution. All research was performed in accordance with the Declaration of Helsinki. Agreement to be an institutional adaptation team member at a participating institution was considered consent to participate. For patient participation in the trial, informed written consent was obtained from participants and from the parents/legal guardians of minors (age specified by each institution).