Implementation science evaluation of an eHealth pediatric primary-care overweight and obesity intervention using the
Joshua S Yudkin1, Rebecca M Jungbauer2, Marlyn A Allicock3
1School of Public Health, Texas A&M University, College Station, Texas, United States of America.
Insights
Dynamo Kids! (DK!) is a novel eHealth intervention for childhood overweight and obesity (OW/OB). The pilot showed promise in improving family knowledge and self-efficacy, with high satisfaction, though usage varied.
Area of Science:
- Implementation science
- Pediatric health
- Digital health interventions
Background:
- Childhood overweight and obesity (OW/OB) disproportionately affects marginalized communities.
- Healthcare systems face challenges in delivering equitable interventions.
- There is a need for accessible, evidence-based solutions for pediatric OW/OB.
Purpose of the Study:
- To evaluate the implementation science outcomes of Dynamo Kids! (DK!), a primary-care-based eHealth intervention for pediatric OW/OB.
- To assess the reach, effectiveness, adoption, and maintenance of the DK! intervention.
- To gather user feedback for future improvements.
Main Methods:
- Pilot study of the DK! eHealth intervention in a safety-net hospital system.
- Intervention offered to 581 families with children aged 6-12 with OW/OB.
- Evaluation guided by the RE-AIM framework using eight qualitative and quantitative data sources.
Main Results:
- Engaged 46 families and 10 providers from diverse backgrounds.
- Participants reported improved knowledge, skills, and self-efficacy in managing OW/OB.
- High parent satisfaction with DK!, with average website use of 2 hours 24 minutes over three months.
Conclusions:
- DK! showed limited success in its initial setting but demonstrated strong support for continuation.
- Families and providers found DK! important, trustworthy, tailored, and accessible.
- Future research should incorporate user recommendations and compare outcomes to a control group post-pandemic.
Introduction:
The childhood overweight and obesity (OW/OB) epidemic in the United States disproportionately affects children from marginalized backgrounds, particularly those who lack the financial resources or support to engage in evidence-based interventions. Moreover, healthcare systems struggle to deliver these interventions equitably. To address this gap, this study evaluated the implementation science outcomes of Dynamo Kids! (DK!), a novel primary-care-based eHealth intervention intended for families with children ages 6-12 with OW/OB.
Materials And Methods:
DK! was developed within a major safety-net hospital system in Dallas, TX. Ten providers in three different clinics were instructed to offer DK! to 581 families with children ages 6-12 with OW/OB. Guided by the Reach, Effectiveness, Adoption, Implementation Maintenance (RE-AIM) framework, we evaluated the implementation science outcomes of the DK! pilot conducted between August 2020 and April 2021, using eight different data sources-both qualitative and quantitative.
Results:
Building on previously published findings that demonstrated an increase in Family Nutrition Physical Activity score and a decrease in child%BMIp95, this study engaged 46 families and ten providers with diverse backgrounds in a safety-net practice who, generally, self-reported improved knowledge, skills, and self-efficacy in treating overweight and obesity. Most parents were satisfied with the DK! intervention, using the website with high variability, on average for two hours 24 minutes of total user time over three months and endorsed the patient-centered care in qualitative interviews. Both families and providers generally found DK! to be important, trustworthy, tailored, and accessible and endorsed the DK! intervention.
Discussion:
DK! demonstrated limited success in its initial setting, with strong support for its continuation and expansion from both the healthcare system and patient families. Future studies should incorporate user recommendations and consider comparing outcomes to a control group beyond the context of the COVID-19 pandemic.
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