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Background: Digital health apps are becoming increasingly available for people living with diabetes, yet data silos continue to exist. This requires health care providers (HCPs) and patients to use multiple digital platforms to access health data. Objective: In this study, we gathered the perspectives of caregivers of children and youths living with type 1 diabetes (T1D) and pediatric diabetes HCPs in the user-centered design of TrustSphere, a secure, single-point-of-access, integrative digital health platform. Methods: We distributed web-based surveys to caregivers of children and youths living with T1D and pediatric diabetes HCPs in British Columbia, Canada. Surveys were designed using ordinal scales and had free-text questions. Survey items assessed key challenges, perceptions about digital trust and security, and potential desirable features for a digital diabetes platform. Results: Similar challenges were identified between caregivers of children and youths living with T1D (n=99) and HCPs (n=49), including access to mental health support, integration of diabetes technology and device data, and the ability to collaborate on care plans with their diabetes team. Caregivers and HCPs identified potential features that directly addressed their challenges, such as more accessible diabetes data and diabetes care plans. Caregivers had more trust in sharing their child's data digitally than HCPs. Most caregivers and HCPs stated that an integrative platform for T1D would support collaborative patient care. Conclusions: Caregiver and HCP perspectives gathered in this study will inform the early prototype of an integrative digital health platform. This prototype will be presented and iterated upon through a series of usability testing sessions with caregivers and HCPs to ensure the platform meets end users' needs. [ABSTRACT FROM AUTHOR]

Background: Sustainable Childhood Obesity Prevention Through Community Engagement is an initiative that engages stakeholders across multiple sectors to promote the Live-5-2-1-0 message (5 vegetables and fruits, 2 hours at most of recreational screen time, 1 hour of physical activity, 0 sugar-sweetened beverages each day) and implement action to support healthy behaviors. As part of this initiative, an intervention using the Live 5-2- 1-0 Toolkit for family physicians (FPs) was piloted in two communities. This study aimed to identify barriers and aids to toolkit implementation, and to determine whether the toolkit improves physicians' capacity to promote healthy childhood behaviors. Methods: FPs completed preintervention and postintervention surveys and participated in semistructured interviews after implementation of the Live 5-2-1-0 Toolkit intervention. Implementation occurred sequentially in two communities and involved a total of 21 FPs in six primary care clinics. Descriptive statistics were used for quantitative data, and content analysis was used for qualitative data. Results: Of the 21 participating FPs, 14 completed the preintervention and the postintervention surveys (67%) and 7 completed the preintervention survey only (33%). FPs reported increased knowledge of medical evaluation of pediatric patients with obesity (from 14% preintervention to 36% postintervention), behavioral goal setting (from 36% to 93%), and motivational interviewing (from 57% to 79%). FPs' perceived efficacy in addressing the subject of weight improved (from 43% preintervention to 93% postintervention). Increases were also observed in routinely addressing nutrition (from 43% preintervention to 79% postintervention), physical activity (from 50% to 79%), screen time (from 14% to 64%), and sugar-sweetened beverage consumption (from 29% to 71%). As a result of toolkit implementation, 71% of FPs felt their patients were more aware of long-term complications related to lifestyle, 64% felt patients were more willing to set behavioral goals with providers, and 50% felt patients were more able to selfmanage issues related to lifestyle. The predominant barrier to implementation was lack of staff/clinic capacity to measure BMI; the most noted aid to implementation was access to ready-to-use Live 5-2-1-0 resources. Conclusions: The Live 5-2-1-0 Toolkit facilitated health promotion to pediatric patients in the primary care setting. Increasing routine BMI measurement in primary care remains challenging due to clinical capacity issues. Results of this pilot study will be used to refine the toolkit prior to wider dissemination across British Columbia. [ABSTRACT FROM AUTHOR]

Objectives: We describe the processes used in SCOPE, a community-based participatory research (CBPR) initiative, to achieve multisectoral engagement and collective action to prevent childhood obesity., Participants: SCOPE engages representatives from various sectors (local government, health, schools, recreation, local media, early childhood, community services) who influence the environments in which children live, learn and play., Setting: SCOPE has been implemented in three communities in British Columbia (BC)., Intervention: SCOPE (www.live5210.ca) is a multi-setting, multi-component initiative designed to enhance a community's capacity to create and deliver localized solutions to promote healthy weights among children. SCOPE, in partnership with a local organization, engages multiple stakeholders who plan and implement actions framed by a common evidence-based health message ('Live 5-2-1-0'). SCOPE's central team in Vancouver, BC facilitates alignment with provincial initiatives, knowledge translation and exchange (KTE) within and across communities, and the collection, analysis and reporting of shared data., Outcomes: Best practice processes that have emerged from SCOPE's experience align with the principles of CBPR and the five conditions of Collective Impact - a common agenda, mutually reinforcing action, continuous communication, a backbone organization and shared measurement. SCOPE has achieved sustainable practice change framed by a common agenda ('Live 5-2-1-0') leading to mutually reinforcing cross-sectoral action., Conclusion: A multi-pronged community-led childhood obesity prevention initiative can be achieved using CBPR principles and attending to the conditions for achieving collective impact.