Study: Development of a novel screening and brief intervention to improve delivery of pediatric preventive care

Welcome to the web page for the questionnaire regarding the development of a screening and brief intervention tool to identify and promote healthy lifestyle habits in children. As the parent or guardian of a child aged 2 to 12 years old, you are being invited to participate in this study on their lifestyle habits.

Objective: The objective of this study is to develop a screening and brief intervention tool that allows to better identify and understand lifestyle habits (physical activity, nutrition, screen time and sleep) in children aged 2 to 12 years old. This screening tool will serve to facilitate a better

Participation: You will need approximately 15 minutes to complete the questionnaire. You are asked to respond to the questions to the best of your knowledge according to your experiences and your perceptions. There are no right or wrong answers.

Benefits: You will not derive any immediate benefit from participating in this study. However, by responding to the questionnaire, you will be providing essential information to the child’s doctor, as well as other health professionals to contribute to better interventions to promote healthy habits. If you indicate on the questionnaire that you are interested in receiving information or in discussing these lifestyle habits with the child’s doctor, you will receive support in the adoption of healthy lifestyle habits, which could have a positive impact on the health of the child.

Risks and disadvantages: the time you spend answering the questionnaire and the possible discomfort associated with sharing the child’s health behaviours. The information in this study will be collected and transmitted electronically. As with all electronic data, there is a risk of data loss or theft.

Confidentiality: Participation in this study is voluntary and your responses are personal and confidential. The results of the questionnaire will be sent only to the child’s physician and to the research team, and will be added to the child’s medical file. The members of the research team will have access to the information collected, which will be deidentified so that the research team can use your responses in their study without them being linked to you, nor being able to determine to whom the responses belong. The researchers are part of Dr. Olivier Drouin’s research lab at the Sainte-Justine University Hospital Centre. All the measures will be taken (deidentification of participant data, collection and storage of data on a private, password protected server) to ensure the confidentiality of participants. Questionnaire responses will be kept for a period of five years, after the end of the project, after which they will be destroyed. Consent. By responding to this questionnaire, you are consenting to participate in this study. You are completely free to refuse to participate in this project and you may decide at any time to stop responding to questions. If you decide to not participate, this decision will not have any negative consequences on you or the child’s medical care.

This study has been approved and will be followed by the research ethics committee of the CISSS Montérégie-Centre. Additionally, we will ensure to submit the project for evaluation should there be any revisions or modifications to the research protocol or to the consent form. If you wish to contact this committee, you may communicate with the coordinator at 450-466-5000, ext. 3894.

Contacts: For any questions, you may contact:

Principal investigator: Dr. Olivier Drouin

Telephone: (514) 345-4931 extension: 4226

Email: Dr. Olivier Drouin

Complaints and quality services Ombudsman of the CISSS Montérégie-Centre:

Telephone: (450) 466-5434

Acknowledgments. Thank you for your participation and your precious time. Your answers are important.

Do you consent to participate in this study?