P2.J189: Healthy Nutrition Counseling With a Side of Joy: Use of an Innovative Tool to Support Pediatricians and Families

Background: Developing healthy eating behaviors in early childhood is an important strategy to help prevent future obesity and support overall child health. Given the frequency of their interactions with families of children ≤5 years of age, pediatricians are often first and trusted messengers about food and feeding. Conversations about healthy foods can be fraught with negativity and difficult for pediatricians to incorporate in ways that resonate with families. This abstract describes evaluation results for the Eatable Alphabet program, offered to 2 cohorts of pediatricians (Cohort 1= 72; Cohort 2=69) between 2021-2022. The program provided each participant with 60 copies of an innovative counseling resource, Eatable Alphabet Kitchen Activity Cards (Figure 1) for distribution to children aged 2-5 years, along with access to provider education and other supportive resources.

Methods: A brief, anonymous post-program survey was administered at the conclusion of Cohorts 1 and 2. In June 2023, in-depth interviews were conducted with 4 pediatricians (2 Cohort 1; 2 Cohort 2) who responded to an invitation to participate, to gather additional information on the program and its potential impacts. Interviews, conducted virtually by an external evaluator, lasted ~30 minutes and followed a semi-structured discussion guide. Transcripts, generated from interview recordings, were content analyzed for key and recurrent themes. Each interview participant received a $35 e-gift card incentive.

Results: Within post-program surveys (response rates: Cohort 1=39%; Cohort 2=70%), >95% respondents reported that the Eatable Alphabet cards helped the delivery of age-appropriate nutrition counseling; 100% agreed that cards were easy to integrate into clinical care. During in-depth interviews, participants reported positive experiences incorporating the Eatable Alphabet cards into nutrition-related counseling. Pediatricians noted that the variety of foods represented on the cards offered healthcare professionals and families new ideas for healthy foods and child-friendly food preparation, celebrated cultural diversity in food preferences, and encouraged selective eaters to broaden their palates. Multiple pediatricians used the word “joy” to describe their experiences using this counseling tool. Several noted shifts in mindset and new strategies for counseling families (Figure 2). When program supplies were depleted, however, cost prohibited most from continuing Eatable Alphabet deck distribution.

Conclusion: At a time when the COVID-19 pandemic introduced a panoply of new challenges for pediatric practices and many family education resources have “gone digital,” pediatricians found success, joy, and broadened perspectives, by using an innovative tool to support often difficult conversations with young children and families around food and nutrition. Limitations include the relatively small number of in-depth interviews, incomplete survey response rates, and a lack of available feedback from children/families. Findings from post-program surveys and participant interviews can inform opportunities for future program enhancement and resource development.