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Background: Combining patient-generated health data and digital health platforms may improve patient experience and population health, mitigate rising health care costs, reduce clinician burnout, and enable health equity. However, lack of trust may be a notable barrier to the data-sharing required by such platforms. Understanding sociodemographic, health, and personal characteristics will enable developers and implementers of such technologies to consider these in their technical design requirements. Objective: This study aims to understand relationships between sociodemographic characteristics of caregivers of children or adolescents and trust in and willingness to use digital platforms to store and share personal health information for clinical care and research. Methods: This study used a mixed methods approach, including surveys of caregivers of youth aged <18 years living in Canada or the United States and youth aged 16 to 17 years living in Canada, as well as web-based bulletin board discussions to further explore topics of trust in data sharing. Sociodemographic and survey data were tabulated and explored using proportional odds ordinal regression models. Comments from web-based group discussions were analyzed thematically using a coding approach to identify issues important to the participants. Results: Survey data from 1128 caregivers (female participants: n=549, 48.7%; 36-50 years old: n=660, 58.5%; Canadian: n=603, 53.5%; urban population: n=494, 43.8%) were collected, of which 685 (60.7%) completed all questions. Data from 173 youth (female participants: n=73, 42.2%; urban population: n=94, 54.3%) were collected, of which 129 (74.6%) completed all questions, and data were available for analysis. Furthermore, among 40 participants, 23 (58%) caregivers contributed to the web-based discussion boards. Related to trust, living in a rural area (vs urban; odds ratio [OR] 0.66, 95% CI 0.46-0.95) resulted in lower concern for data privacy and security, while having an undergraduate (OR 1.82, 95% CI 1.30-2.55) or graduate degree (vs secondary or trade school; OR 2.50, 95% CI 1.68-3.73) resulted in higher levels of concern. Living with a chronic disease (OR 1.81, 95% CI 1.35-2.44) increased levels of concern regarding data privacy and security. Interestingly, those with chronic disease were more willing to use digital platforms for clinical care and share personal health information for not-for-profit research. Caregivers were most concerned about data breaches involving data from their children but also highlighted that digital platforms would allow for better coordination of care for their children. Conclusions: Our research confirms the willingness of caregivers and youth to use digital platforms for both clinical care delivery and research and suggests that the value of a digital platform may outweigh the risks of its use. Engagement of end users in co-designing such platforms has the potential to enhance digital trust. However, digital trust varies across sociodemographic groups; therefore, diverse end user engagement is necessary when designing digital applications. [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]