Barriers and Facilitators to Implementation of a Child Care Center-Based Produce Delivery Program.

BACKGROUND: Regular consumption of produce is a challenge for families with young children in low food access areas. OBJECTIVE: A community partnership formed to evaluate feasibility of and interest in a child care center-based program for produce delivery from an online grocery vendor. METHODS: Surveys were collected from caregivers across three child care centers, including produce program participants. Descriptive statistics summarize household characteristics and participants' experience with the program. RESULTS: Challenges related to online payment and difficulty planning delivery times led to implementation of a modified intervention. Survey results revealed factors related to food access and storage that may impact interest and feasibility of online grocery in some communities. CONCLUSIONS: Online grocery vendors may increase accessibility to fresh produce for families, but barriers to their use still exist. Trusted community partners such as child care centers may offer some of the resources needed for success.

Obesity Applications in Smartphones: Development and Use of an Evaluation Tool.

INTRODUCTION: Rates of obesity amongst children and teens in the United States have tripled since the 1970s, and 18.5% are now considered obese. With smartphone use among children and teens becoming the norm, smartphone applications may be a cost-effective solution to support patients and families motivated to change lifestyle behaviors and reduce obesity. The purpose of this quality-improvement project was (1) to develop an app evaluation tool and star rating system based on scientific evidence and current clinical practice guidelines in managing childhood obesity, and (2) to determine whether an in-service training can increase provider knowledge and efficacy in the use of smartphone apps in managing childhood obesity. METHODS: An app evaluation tool (Ped-WHAT) was developed that includes evidence-based behavior modification strategies (BMS) and the American Academy of Pediatrics (AAP) guidelines for healthy weight management in pediatrics. Apps were given a rating based on the number of these criteria included in the app. An educational in-service training was developed to assist health care providers in using the app evaluation tool with patients. This training was tested with providers working in a pediatric weight management clinic. Pre- and post-training surveys were administered. Results were analyzed using t tests to assess differences. RESULTS: Sixteen commercially available apps were evaluated using the Ped-WHAT tool. Those that included the greatest number of BMS and AAP criteria received the highest rating on a 0-5 scale. Statistically significant improvements in provider knowledge and confidence were found after the in-service training. DISCUSSION: In this current digital environment, commercially available weight management apps should undergo evaluation by health care providers to ensure that they follow the standard of care and current practice guidelines/recommendations.