title: The Development and Refinement of an e-Health Screening, Brief Intervention, and Referral to Treatment for Parents to Prevent Childhood Obesity in Primary Care.
abstract: Nearly one-third of Canadian children can be categorized as overweight or obese. There is a growing interest in applying e-health approaches to prevent unhealthy weight gain in children, especially in settings that families access regularly. Our objective was to develop and refine an e-health screening, brief intervention, and referral to treatment (SBIRT) for parents to help prevent childhood obesity in primary care.
  
  
  
  Our SBIRT, titled the Resource Information Program for Parents on Lifestyle and Education (RIPPLE), was developed by our research team and an e-health intervention development company. RIPPLE was based on existing SBIRT models and contemporary literature on children's lifestyle behaviors. Refinements to RIPPLE were guided by feedback from five focus groups (6-10 participants per group) that documented perceptions of the SBIRT by participants (healthcare professionals [n = 20], parents [n = 10], and researchers and graduate trainees [n = 8]). Focus group commentaries were transcribed in real time using a court reporter. Data were analyzed thematically.
  
  
  
  Participants viewed RIPPLE as a practical, well-designed, and novel tool to facilitate the prevention of childhood obesity in primary care. However, they also perceived that RIPPLE may elicit negative reactions from some parents and suggested improvements to specific elements (e.g., weight-related terms).
  
  
  
  RIPPLE may enhance parents' awareness of children's weight status and motivation to change their children's lifestyle behaviors but should be improved prior to implementation. Findings from this research directly informed revisions to our SBIRT, which will undergo preliminary testing in a randomized controlled trial.
authors.affiliation: 1 Department of Pediatrics, University of Alberta , Edmonton, Alberta, Canada .
authors.forename: Jillian L S
authors.initials: JL
authors.lastname: Avis
authors.affiliation: 2 Faculty of Physical Education and Recreation, University of Alberta , Edmonton, Alberta, Canada .
authors.forename: Nicholas L
authors.initials: NL
authors.lastname: Holt
authors.affiliation: 3 School of Public Health, University of Alberta , Edmonton, Alberta, Canada .
authors.forename: Katerina
authors.initials: K
authors.lastname: Maximova
authors.affiliation: 4 Evolution Health Systems Inc., Toronto, Ontario, Canada .|5 Business School, University of Reading, Oxfordshire, United Kingdom .
authors.forename: Trevor
authors.initials: T
authors.lastname: van Mierlo
authors.affiliation: 4 Evolution Health Systems Inc., Toronto, Ontario, Canada .|5 Business School, University of Reading, Oxfordshire, United Kingdom .
authors.forename: Rachel
authors.initials: R
authors.lastname: Fournier
authors.affiliation: 6 Department of Medicine, University of Alberta , Edmonton, Alberta, Canada .
authors.forename: Raj
authors.initials: R
authors.lastname: Padwal
authors.affiliation: 7 Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta , Edmonton, Alberta, Canada .
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Cave
authors.affiliation: 8 Public Health and Wellness Branch , Health Services Division, Ministry of Health, Government of Alberta, Edmonton, Alberta, Canada .
authors.forename: Patricia
authors.initials: P
authors.lastname: Martz
authors.affiliation: 1 Department of Pediatrics, University of Alberta , Edmonton, Alberta, Canada .|9 Pediatric Centre for Weight and Health, Stollery Children's Hospital , Edmonton, Alberta, Canada .
authors.forename: Geoff D C
authors.initials: GD
authors.lastname: Ball
mesh_terms: D000293:Adolescent; D002170:Canada; D002648:Child; D004032:Diet; D015444:Exercise; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006266:Health Education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008019:Life Style; D008297:Male; D009042:Motivation; D010290:Parents / Q000193:education; D063766:Pediatric Obesity / Q000517:prevention & control*; D011320:Primary Health Care / Q000458:organization & administration*; D017216:Telemedicine / Q000458:organization & administration*
keywords: behavioral health; e-health; education; pediatrics