<p>DK! Utilization.</p>

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.引言 美国儿童超重与肥胖（OW/OB）流行态势对边缘化背景儿童的影响尤为突出，尤其是那些缺乏经济资源或支持以参与循证干预措施的儿童。此外，医疗保健系统难以公平地提供此类干预服务。为填补这一空白，本研究评估了Dynamo Kids!（DK!）的实施科学结局——这是一款面向6至12岁超重/肥胖儿童家庭的新型基层医疗导向电子健康（eHealth）干预方案。 材料与方法 DK! 由德克萨斯州达拉斯市的一家大型安全网医疗体系开发。来自3家不同诊所的10名医疗服务提供者被要求向581个家中有6至12岁超重/肥胖儿童的家庭提供DK!干预服务。本研究以目标、效果、采纳、实施维持（Reach, Effectiveness, Adoption, Implementation Maintenance，RE-AIM）框架为指导，通过8种不同的定性与定量数据源，对2020年8月至2021年4月期间开展的DK!试点项目的实施科学结局进行评估。 结果 基于此前已发表的研究结果——该结果显示家庭营养与体力活动评分有所提升，儿童BMI95百分位值有所下降，本研究共招募了来自安全网医疗实践场景的46个家庭与10名背景多元的医疗服务提供者，他们普遍自我报告在超重与肥胖诊疗相关的知识、技能与自我效能方面均有所提升。多数家长对DK!干预方案表示满意，该平台的用户使用时长存在较大差异，3个月内平均总使用时长为2小时24分钟，且在定性访谈中认可其以患者为中心的照护模式。家庭与医疗服务提供者均普遍认为DK!方案具有重要价值、值得信赖、定制化且易于获取，并对该干预方案表示支持。 讨论 DK!在初始试点场景中取得了有限的成功，医疗保健系统与患者家庭均对该方案的延续与推广表示强力支持。未来研究应吸纳用户的优化建议，并考虑在新型冠状病毒肺炎疫情场景之外设置对照组，以对比干预结局。