Background In an integrated care model, involving primary care providers (PCPs) and obesity specialists, telehealth may be useful for overcoming barriers to treating childhood obesity. Objective To conduct a pilot study comparing BMI changes between two arms: 1) PCP in-person clinic visits plus obesity specialist tele-visits (PCP visits + Specialist tele-visits) and 2) PCP in-person clinic visits only (PCP visits only), with ongoing tele-consultation between PCPs and obesity specialists for both arms. Methods Patients (N=40, 10–17 years, BMI ≥95th percentile) were randomized to Group 1 or 2. Both groups had PCP visits every 3 months for 12 months. Using a cross-over protocol, Group 1 had PCP visits + Specialist tele-visits during the first 6 months and PCP visits only during the second 6 months, and Group 2 followed the opposite sequence. Each of 12 tele-visits was conducted by a dietitian or psychologist with a patient and parent. Results Retention rates were 90% at 6 months and 80% at 12 months. BMI (z-score) decreased more for Group 1 (started with PCP visits + Specialist tele-visits) vs. Group 2 (started with PCP visits only) at 3 months (−0.11 vs. −0.05, P=0.049), following frequent tele-visits. At 6 months (primary outcome), BMI was lower than baseline within Group 1 (−0.11, P=0.0006) but not Group 2 (−0.06, P=0.08); however, decrease in BMI at 6 months did not differ between groups. After cross-over, BMI remained lower than baseline for Group 1 and dropped below baseline for Group 2. Conclusion An integrated care model utilizing telehealth holds promise for treating children with obesity.

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Background Childhood overweight and obesity (OWO) has become a major public concern worldwide including in Shanghai, one of the most developed areas of China. Understanding perceptions and challenges of tackling childhood OWO among caregivers of children is critical to provide services in need. Methods A qualitative descriptive study including in-depth interviews with seven parents and six focus group discussions with a total of 32 parents or grandparents of children zero to 6 years of age. Participants lived in three districts of Shanghai and indexed children included both those with OWO or non-OWO children. Data were analyzed using qualitative thematic analysis. Results Caregivers tended to underestimate children’s weight status, and to regard chubby children as a sign of good parental care. Some caregivers even suggested that there were positive effects of childhood overweight. Caregivers identified a number of challenges to prevention of OWO in children, including difficulties in controlling dietary intake or increasing children’s physical activities; discordant views between parents and grandparents, and barriers to accessing professional guidance. Caregivers desired more detailed advice regarding children’s nutrition intake and physical activity, and preferred online approaches. Conclusions Misconceptions regarding childhood overweight were found in caregivers of children in Shanghai. Professional guidance on childhood weight control for caregivers is desired via digital applications such as mobile phone applications and social media.

Objectives To develop and validate a web-based self-diagnostic questionnaire on school food service offer aimed at food service managers (FSMs) by: i) identifying relevant indicators of school food offer, developing a questionnaire and validating the concept using an expert panel, ii) validating the questions by comparing the food service manager’s responses with observations by dietitians, and iii) undergoing a qualitative evaluation of the tool through direct observation and short interviews. Design Mixed methods. Setting Quebec, Canada. Participants Nine experts validated the theoretical constructs and indicators on which the questionnaire was based. Inter-rater reliability tests were conducted with 39 food service managers, who then participated in interviews about platform functionality satisfaction. Twenty school stakeholders participated in the survey pertaining to their use of the personalised report. Results The questionnaire focused on the main school food service’s lunchtime offer and comprised 26 questions. The overall strength of agreement was good, and all questions’ strengths of agreement were fair to excellent except for one question. Qualitative data reached saturation and showed that navigation through the questionnaire was fluid. Improvements were suggested to increase user-friendliness and simplicity of both the platform and questionnaire. Results from the survey showed that all respondents were either satisfied or very satisfied with their personalised report. Conclusions We successfully developed and validated a web-based self-diagnostic questionnaire. The final version facilitates knowledge mobilisation with school stakeholders and offers a new opportunity for the assessment and surveillance of school food offer.