Co-development of a digital screening and intervention tool to improve lifestyle habits: focus group with parents and clinicians (Preprint)

BACKGROUND Chronic preventable diseases represent a major burden in Canada, often rooted in unhealthy behaviors established during childhood. Despite recommendations for routine screening, most children are not assessed due to clinical barriers. This study presents the early development of Project DISCO, a self-administered, digital pre-appointment tool to screen and support healthy lifestyle behaviors, including physical activity, sleep, nutrition, and screen time, in children aged 2 to 12 years. OBJECTIVE This study aimed to explore clinicians’ and parents’ needs and past experiences with health technology, integrate their insights into the development of a digital tool for promoting health behaviors, and evaluate the usability, relevance, and acceptability of this tool. METHODS Three semi-structured focus group and interview sessions were conducted with primary care clinicians and parents. Participants were recruited at the Groupe de Médecine de Famille Universitaire (GMF-U) Saint-Hubert using purposive and convenience sampling: clinicians were recruited internally, while parents of children aged 2-12 were invited via email sent by clinic staff. Data were analyzed using a combination of inductive and deductive approaches. Findings informed iterative refinements throughout the co-development of the digital tool for promoting healthy lifestyle behaviors in children. RESULTS A total of 8 participants took part in six discussions, including 5 parents of children aged 3-12 and 3 primary care clinicians. Hybrid thematic analysis identified six themes: (1) the potential of a digital tool to promote healthy habits in pediatrics; (2) implementation challenges and opportunities, including integration of the tool into clinical workflow; (3) adherence and engagement with the tool, with suggestions for reminders and involvement of nurses; (4) perceived limitations and improvement of screening tool, particularly the nutrition and sleep questionnaires; (5) feedback on the screening report and intervention, emphasizing clarity and actionable guidance; and (6) perceived clinical value and opportunity costs. Insights from these discussions guided refinements of the digital tool. CONCLUSIONS Findings support the tool’s relevance and inform its ongoing development. A feasibility study is planned prior to a randomized controlled trial.