Table 3.

Summary of user testing results.

Themes	Key findings	Sample quotes
Risk profile
Purpose	Visually show patients and their families their health status and change that needs to occur to improve overall health	“I would definitely review their BMI…. I would review the risk at the top there based on what information was given.” “So that's reducing that risk at the top…that's helpful so you can show them…you're doing so many minutes of moderate and vigorous activity now, but if you upped it to X number…could show how they could get their health back into the green zone.”
Usefulness	Ability to change risk factors and see change in overall risk Inclusion of patient's current physical activity and food intake behaviors Add clarity to risk factor definitions (e.g., define overall risk, tried smoking, blood pressure)	“These questions [food intake] are pretty good. Those are very specific. ‘Do you eat 2 or more fruits a day?' I think that's pretty good.” “It's very abstract when you do it on a growth chart…the color coding makes more sense, and for us, seeing that 99th makes more sense. Being able to toggle and get it to the yellow, we could say ‘so and so would only need to gain however many inches and stay this weight to get to a healthier BMI.' And that makes sense.”
Usability	Display of risk factors that are otherwise diffuse in the patient's chart Color coding easy to interpret Easy to navigate Nice to be able to turn off risk factors if data is not available Add ability to see previous visit risk factor data	“I like the visual aspect of it…so it's taking all of this information and showing you the overall risk. I think this would be fun…. I think kids and adolescents would like this a lot…it's really helpful for them to see what you're talking about and interact with it…it's easy to click through…we can move through it fairly quickly.” “These are numbers that we don't always have. It looks like we can turn it off.”
Behavior change recommendations
Purpose	Help patient's set individualized, achievable goals	“We could show them the screen and have them pick a couple things they want to work on….I would focus on the greens more than the yellows or the reds.”
Usefulness	Patient-centered content (e.g., food intake goals tailored based on what patient identified as problem areas) Goals are progressive, achievable and easy to understand Helpful for providers who lack knowledge/comfort to develop goals Providers may only have time to discuss the most pressing needs Amend content of recommended food lists	“I like that this populates in based on the questions that they've answered because it's almost like targeting some of their behaviors as opposed to me…telling them things to do…that might get some more buy-in from the families.” “I would love to address every single thing, but I know every single family gets really overwhelmed really fast…so I would probably just pick one of those to do.”
Usability	Organized and user friendly Add ability for provider to modify goals (e.g., add a “write-in” box) or select specific goals to target	“I love that there's examples of foods in here and it's more simplistic in the way it's organized. We have handouts we can add in through the EHR but it's in paragraph form. No kid is going to sit there and read it. So this is actually much more user friendly.”
Selection of activities
Purpose	Help patients select specific activities they enjoy to provide specificity and tailor recommendations to help patients be active	“If they already enjoy something that they don't do very much, that would be a great way to encourage something that they already do. I think that goes back to the sense of self.” “This can help guide us because we're doing this along with the patient….I like this for sure.”
Usefulness	Inclusion of diverse activities (including family-oriented activities) Activities in each activity-level (light, moderate, vigorous) Tool enhances current practice Suggested that activities are culturally appropriate (e.g., feasible in our region)	“Some kids have trouble finding ideas of things they like to do that count as physical activity so it's nice to have things they can choose.” “If the whole family will do these things, that is really, really helpful…go for a walk as a family two times a week…something like that so that. the teen doesn't feel like it's all on them.” “This is so much more detail oriented because we usually say ‘go for a walk. Track your steps on a phone.' This adds more variety of things that they can choose that may be more appealing…this may be more geared to them picking a couple things to attempt even if they haven't done it before.”
Usability	Ability to select activities tailored to each patient Add a “write-in” box to add an activity	“I love that you can tailor the activities and let them pick what they would be willing to do. I think that's awesome.”
Community resource map
Purpose	Add resources near where the patient lives to recommendations and eliminate the need for providers to search for resources	“I think that is one of the coolest things…I never know where anyone lives. They'll tell me their address and I'll be like ‘I don't know where that is.' ‘Where is the WIC office?' ‘I have no idea.' I think that is so great.”
Usefulness	Types of resources included are useful for behavior change Display of resources near the patient's home Inclusion of directions to the resource (by foot, car or public transportation) Eliminates provider need to conduct an online search of resources to offer to patients Add online/internet resources (e.g., dancing games, mindfulness apps)	“If you're trying to prescribe them to get active, knowing that they have a park or a basketball court or something close to them would be helpful.” “I think it's great that the locations are listed like this and they can see how far it is from home.” “We spend a little bit of time in going to websites for families, like printing out a page from a website…that would be nice to have in one place… I love that resources part.”
Usability	Automatic inclusion in the prescription eliminates burden. Make clear what types of resources are included	“…Here you have the categories and maybe next to it, if there could be a category that was color coded or something. I could see that being helpful. It can be hard from the name to tell if it's a farmers market or food pantry or a grocery store.” “It [resources] would be helpful and it would be something that our office staff doesn't have to do because it's automated.”
Prescription
Purpose	Provide patients a firm, detailed plan with community resources to review after the visit	“I think that's really awesome. It definitely gives a firm plan, but it also gives ways for them to get there and resources to help too.”
Usefulness	Design and layout provides clear goals for patients The addition of educational material (e.g., serving size information, tips for being active) Make changes to increase likelihood that patients read this resource (e.g., re-order material, shorten) Amend language to increase patient autonomy	“I think this is great with the green, yellow, red. That's enough of a distinction.” “The question in my mind is how do we reach those patients that don't read a lot of things?…This is longer, if there's one thing they can focus on it's diet, often…so maybe if the food part was up higher that could help.” “The ‘we've suggested some goals for you' doesn't sound like much of a partnership…when it comes from the patient they're going to be more likely to buy in when they think it's their idea. So something…together we try to develop some sort of goals for healthy changes.”
Usability	Electronic delivery to patient (not from provider's email). Be sure information sent is secure. Add way for patient to access resource map from home	“We have a little bit of trouble with emailing because it would come from my email. Not every provider is feeling like they want to send an email to all their patients.”