What is Fitwits?

Fitwits is an obesity prevention and health literacy research project that uses games and character-driven narratives to transform unhealthy lifestyles into healthy ones. The Fitwits project operates in schools, physician offices, community centers, and homes in several Pittsburgh area neighborhoods (including Lawrenceville, Wilkinsburg and McKeesport).

Since 2007, Fitwits projects have engaged children, parents, teachers, school administrators, physicians, and community leaders in the design process to work towards healthy changes at the personal, family, organizational, and policy levels.

To kids, Fitwits is an engaging, hands-on, educational experience to learn basic health information about obesity told through the voice of fun cartoon characters, the Fitwits and the Nitwits.

To parents, Fitwits is a non-threatening and easy to use approach to talking about health at home.

To educators, Fitwits is a series of tools to help integrate health learning into the classroom and school environment.

To doctors, Fitwits is a tool proven to reduce barriers with patients when discussing obesity and obesity-related diseases.

Fitwits is a collaborative research project designed by Carnegie Mellon University School of Design and UPMC Saint Margaret Family Health Centers. We are funded by the Heinz Endowments.

Send us an email at contact@fitwits.org

Fitwits functions not only as an easy-to-use educational tool, but also as a program with the ability to bridge the gaps in nutrition education and awareness. It is multi-use, and reflects recent thinking within obesity education, echoing calls for “an ecological model,” wherein a strong emphasis is placed on the confluence of family, community, and society in public health interventions. The program addresses the problem of obesity reduction via a simultaneous three-pronged approach between the individuals’ school, community, and doctors’ office environments (insert diagram).

Simply put, the Fitwits program

• Creates and delivers clear and effective educational services about health in schools, homes and communities.
• Improves attitudes, behavior and knowledge around food and nutrition.
• Increases health literacy, awareness and behavior among individuals and groups.
• Prepares children, youth, and their families to adopt healthy practices to achieve their full potential in life.
• Offers a thriving, replicable service network to address the obesity epidemic.

Currently, the Fitwits School Program is used in fifth grade classrooms in five urban schools affiliated with a school health partnership. This partnership pairs family medicine resident physicians with schools to provide health promotion and education. The fifth graders are racially diverse and primarily live in low-to-mid socioeconomic urban families.

In doctors’ offices, the Fitwits MD flash cards provide physicians with an office tool specifically designed to help doctors engage 9- to12-year-olds and their families during Well Child visits. Tools and games break down the barriers to effective discussion between doctors and families about childhood obesity. These barriers include: time pressure, hesitation to discuss obesity, confusion about body mass index (BMI) growth charts and other messages, family reluctance to recognize the problem, and the lack of an effective strategy.

Most recently we are working on developing “Fitwits Zones.” We have created Fitwits Zones in local community centers and schools to engage families in healthy lifestyle activities. While the school and family health clinic interventions occur once per student and/or patient, the Fitwits Zones engage parents and families over longer periods of time.

In the Fall of 2010, Fitwits teamed up with a charter school in McKeesport to engage 122 families in the six-month long Fitwits game challenge called “I am Fitwits”. The school environment can be a strong proponent of healthy behavior change. Based on a system of incentives, rewards, and competition, the positive changes we have seen through six months of playing the game are undeniable.

Since the game started, several new initiatives in the McKeesport school and the surrounding community have taken off. These include:

• A new salad bar now serving students and staff at lunch. Whole Foods donated the unit and the fresh produce is made possible through Eat ‘n Park’s “LifeSmiles” initiative. In a school where 90% of students qualify for the free lunch program, this is an important supplement to the school lunch.
• Teachers creatively integrating lessons about health into their curriculum, including creative endeavors such as newsletters and radio shows about healthy living in pursuit of “Fitwits cash”.
• A new school garden taking root. Thanks to parent volunteers, the Fifth grade teachers and students, Grow Pittsburgh, the City of McKeesport and seeds donated by Seeds for Peace, a vacant lot next to the school has become an outdoor learning experience for the whole school.

To find out what we're up to, please contact us: 412-268-6937 or contact@fitwits.org.

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Published Papers

MCGAFFEY A, ABATEMARCO DJ, JEWELL IK, FIDLER SK, HUGHES K. Fitwits MD™: An Office-Based Tool and Games for Conversations about Obesity with 9- to 12-Year-Old Children. Journal of the American Board of Family Medicine November-December 2011; 24(6):768-71.

 

MCGAFFEY A, HUGHES K, FIDLER SK, D'AMICO FJ, STALTER MN. Can Elvis Pretzley and the Fitwits improve knowledge of obesity, nutrition, exercise, and portions in fifth graders? International Journal of Obesity (Lond) 2010; 34(7): 1134-42.

HUGHES, KRISTIN AND DAHLIA RAO. “Making, Co-creating and Testing Games: Learning about Nutrition through Play – Fitwits,” Published in the conference proceedings for FLUX: Design Education in a Changing World. Capetown, South Africa. October 2007.

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Invited Conference Speaking Engagements
HUGHES K. Social Innovation and Fitwits: Ten Lessons Learned. American Industrial Design Association (AIGA), Pivot Design Conference. Phoenix, Arizona. October 2011.

HUGHES K. Fitwits: A Case Study. Let’s Move Pittsburgh: Feeding the Spirit, Phipps Conservatory and Botanical Gardens, Pittsburgh, PA. October 2011.

 

HUGHES K. Using Design Thinking to Help Reverse Childhood Obesity: The Fitwits Program. Mayo Clinic’s Transform 2011–Designing Solutions. Inspiring Health. Rochester, Minnesota. September 2011.

 

Peer Reviewed Conference Presentations
SCUPELLI P, HUGHES K. Socio-ecological service design: integrated
services for individuals, families, organizations, and communities. International Service Design Conference, San Francisco, CA. October 2011

 

WISLO V, HALTIGAN J, SCOPAZ K. The sustained use of the Fitwits office tool: Equipping residency-based physicians to discuss childhood obesity with preadolescents. Resident research in progress presentation. 2011 Family Medicine Education Consortium (FMEC) Northeast Region Meeting, Danvers, October 2011.

 

WISLO V, HALTIGAN J, SCOPAZ K, MCGAFFEY A. Preparing residency-based physicians to discuss childhood obesity with preadolescents: Baseline results, "The Sustained Use of the Fitwits Office Tool" Best Research Presentation, Resident Category. Pennsylvania Academy of Family Physicians Research Day. State College, PA, March 2011.

 

HUGHES K, SCUPELLI P, FIDLER S, MCGAFFEY A. Think, Make, Evaluate, (Evolve): Designing participatory tools to better understand how to help physicians communicate with families about obesity. A case study in sustainable co-design. Challenges and Opportunities for Design Research, Education and Practice in the XXI Century. LeNS Conference, Bangalore, India, October 2010.

 

FITWITS: USING GAMES TO LEARN ABOUT PORTION, NUTRITION, AND HEALTH CHOICES 42nd Society of Teachers of Family Medicine (STFM) Annual Conference. Presentation co-authored with Susan Fidler, MD, Ann McGaffey, MD, and Kristin Hughes. Denver, CO. May 2009.

 

THINK, MAKE, EVALUATE: DESIGNING PARTICIPATORY TOOLS WITH CHILDREN, FOR CHILDREN. Social Studies: Educating Designers in a Connected World, American Institute of Graphic Arts (AIGA) Conference. Baltimore, MD. October 2008.

 

DESIGNING MEANINGFUL PLAY: A CASE STUDY INVOLVING QUEEN OF WHEAT & ELVIS PRETZLEY. Meaningful Play 2008 Conference. East Lansing, MI. October 2008.

 

CREATING TOOLS AND SERVICES THAT ENGAGE SCHOOLS, FAMILIES AND HEALTHCARE PROVIDERS TO CONSIDER AND DISCUSS HEALTH, NUTRITION AND PHYSICAL ACTIVITY. Service Design Conference.. Co-authored with Kristin Hughes, Ann McGaffey, MD, and Susan Fidler, MD. Amsterdam, The Netherlands. November 2008

 

Invited Presentations

IDENTIFYING DESIGN OPPORTUNITIES WITHIN COMMUNITIES Hughes, Kristin, University of Cincinnati, School of Design, Cincinnati, OH. March 2009. Presented by invitation.

CO-DESIGNING WITH PHYSICIANS: OFFICE TOOLS THAT HELP FACILITATE BETTER CONVERSATIONS WITH PATIENTS, Hughes, Kristin, University of Cincinnati, School of Medicine, Cincinnati, OH. March 2009. Presented by invitation.

 

FITWITS: USING GAMES TO LEARN ABOUT HEALTH CHOICES, PORTION AND NUTRITION Pennsylvania Academy of Family Physicians Research Day. Best resident presentation. Co-authored with Susan Fidler, MD, Margaret Gibson, MD, Kristin Hughes, and Ann McGaffey, MD. Bedford Springs, PA. March 2008.

 

FITWITS: USING GAMES TO LEARN ABOUT PORTION, NUTRITION, AND HEALTH CHOICES 2008 Society of Teachers of Family Medicine Northeast Region Meeting. Presentation co-authored with Susan Fidler, MD, Ann McGaffey, MD., and Kristin Hughes. Baltimore, MD. November 2008.

Poster Presentations

THE SUSTAINED USE OF THE FITWITS OFFICE TOOL: EQUIPPING RESIDENCY-BASED PHYSICIANS TO DISCUSS CHILDHOOD OBESITY WITH PREADOLESCENTS. Poster, resident research in progress. 39th North American Primary Care Research Group (NAPCRG) Annual Meeting,. Valerie Wislo, MD, Ann McGaffey, MD, Kristen Scopaz, MD, Jill Haltigan, MD, Frank D'Amico, PhD, David Yuan, MD, Michael W. Bridges, PhD, Peter Scupelli, PhD, Kristin Hughes, MFA, Ilene Katz Jewell, MSHyg. Banff, Alberta, Canada. November 2011

 

FITWITS MD: AN INTERVENTION TO PREVENT CHILDHOOD OBESITY. American Academy of Health Behavior Meeting. Diane J. Abatemarco, PhD, MSW. Ann McGaffey, MD, Ilene Katz Jewell, MSHyg, Susan K. Fidler, MD, Kristin Hughes, MFA. Hilton Head, SC. March 2011.

PREPARING RESIDENCY-BASED PHYSICIANS TO DISCUSS CHILDHOOD OBESITY WITH PREADOLESCENTS: BASELINE RESULTS, “THE SUSTAINED USE OF THE FITWITS OFFICE TOOL.” Best resident presentation, 2011 Research Day, Pennsylvania Academy of Family Physicians. State College, PA. March 12, 2011. Wislo, Valerie, MD, Kristen Scopaz, MD, MD, and Jill Haltigan, MD. Acknowledgment David Yuan, MD, Ilene Katz Jewell, MSHyg, Frank D’Amico PhD, Peter Scupelli, PhD, Ann McGaffey, MD, Diane Abatemarco, PhD, Susan Fidler, MD, Kristin Hughes

RESIDENT PARTICIPATION IN FITWITS: IMPROVING COMMUNICATION WITH PARENTS AND CHILDREN REGARDING CHILDHOOD OBESITY. 2010 Family Medicine Education Consortium: NE Region Meeting, Co-authored with Valerie Wislo, MD, Adam Abdulally, MD, Stacey Brown, MD, Jill Haltigan, MD, Kristen Scopaz, MD, David Yuan, MD, et al. Hershey, PA. October 2010.

FITWITS MD: AN OFFICE GUIDE TO OBESITY COUNSELING FOR KIDS AND PARENTS. First Place award in the Resident and Fellows Poster Section, Pennsylvania Medical Society House of Delegates Annual Meeting, Co-authored with Adam Abdulally, MD, Jill Haltigan, MD, Ann McGaffey, MD, Kristin Hughes, and Susan Fidler, MD. Hershey, PA. October 2009.

FITWITS: TEACHING 5TH GRADERS ABOUT PORTION SIZES Pennsylvania Academy of Family Physicians Research Day. Co-authored with Jill Haltigan, MD, Kristen Scopaz, MD, Kristin Hughes, and Ann McGaffey, MD. Skytop, PA. March 2009.

CREATING TOOLS AND SERVICES THAT ENGAGE SCHOOLS, FAMILIES AND HEALTHCARE PROVIDERS TO CONSIDER AND DISCUSS HEALTH, NUTRITION AND PSYCHICAL ACTIVITY. Service Design Conference. Amsterdam, The Netherlands. November 2008. Co-authored with Kristin Hughes, Ann McGaffey, MD, and Susan Fidler, MD.

FITWITS: USING GAMES TO LEARN ABOUT HEALTH CHOICES, PORTION AND NUTRITION Pennsylvania Academy of Family Physicians. Bedford Springs, PA. March 2008. Co-authored with Susan Fidler, MD, Margaret Gibson, MD, Kristin Hughes, and Ann McGaffey, MD.