Shared decision-making (SDM) is a best practice for delivering high-quality, patient-centered care when there are multiple options from which to choose. A patient decision aid (PDA) to promote SDM for the treatment of adolescent severe obesity was piloted among 12–17-year-olds (n = 31) from six pediatric weight management programs within the Childhood Obesity Multi Program Analysis and Study System (COMPASS). Medical providers used a brochure that described indications, risks, and benefits of intensive lifestyle management alone versus bariatric surgery plus lifestyle. Immediately after, patients/families completed a survey. Patient/family perceptions of provider effort to promote understanding of health issues, to listen to what mattered most to them, and to include what mattered most to them in choosing next steps averaged 8.6, 8.8, and 8.7, respectively (0 = no effort, 9 = every effort). Nearly all (96%) reported knowing the risks/benefits of each treatment option and feeling clear about which risks/benefits mattered most to them. Most (93%) reported having enough support/advice to make a choice, and 89% felt sure about what the best choice was. Providers largely found the PDA to be feasible and acceptable. This pilot will guide a more rigorous study to determine the PDA’s effectiveness to support decision-making for adolescent severe obesity treatment.

We recently demonstrated that small prizes given for a “Power Plate” (plain fat-free milk, entrée, fruit and vegetable) can be used in an elementary school cafeteria to increase healthful food selection by over 300%. The purpose of this study was to measure changes in food waste when the Power Plate (PP) program is implemented. The PP intervention was conducted at an inner-city elementary school. Emoticons were placed next to the preferred foods and children were given a small prize if they selected the PP. Data were obtained by observation and cash register receipts. The trays of 111 students before the intervention and 96 after were examined for content and waste. PP selection increased from 2% to 73% (P < .001). There was no significant change in waste. We conclude that small prizes as an incentive for better food selection does not lead to an increase food waste.