What is Fitwits?
Over the past two years our team has started to understand and define a method that has effectively integrated schools, doctors’ offices, and family centered community activities, providing them with affordable, easy to use health communications and services. Much of our time has been spent actively coordinating efforts in schools, doctor’s offices and family centered activities in the community to turn healthy lifestyle knowledge into action.
Send us an email at contact@fitwits.org
Research
Fitwits Program creates and integrates resources for healthy living at the intersection of families, schools, and community health services.
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.
The Fitwits School program is centered on the Fitwits and Nitwits personas, 34 engaging food- and snack-based cartoon characters. The Fitwits epitomize healthy foods and desirable lifestyle choices, including physical activities and active hobbies; the Nitwits typify unhealthy food choices and undesirable lifestyle decisions. “Character cards” are illustrated with a Fitwit or Nitwit and present simple fat and sugar scales and easily understood Fitwits ratings. Some cards include a simple recipe that reinforces use of the hand guide to measure portion sizes.
In the second phase, Fitwits MD flash cards are an office tool specifically designed to help doctors engage 9- to12-year-olds and their families during well child care visits. Tools and games are necessary to break down the barriers to effective discussion between doctors and families about childhood obesity. Barriers to healthy weight discussions during well child sessions 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.
Three East End family health clinics offices currently employ, Fitwits MD, a tool designed for office discussion of obesity during a well-child check-up. The Fitwits MD format and language provide an effective and entertaining basis for conversation about obesity with early adolescents, caregivers, and health care providers alike.
Physicians who used the Fitwits MD tool reported feeling: (a) more competent and comfortable to provide obesity prevention, nutrition, exercise, and portion health education to 9-12 year olds and their families; and (b) fewer barriers to discussing obesity prevention, nutrition, exercise, and portion health education to 9-12 year olds and their families.
Fitwits Zones and Fitwits Champions
The last phase of the program will design a “Fitwits Zone” created in local community centers to engage families in healthy lifestyle activities. The Fitwits Zone integrates and expands the Fitwits services developed for school interventions and the family health clinic intervention to engage parents and families.
In previous Fitwits programs, local champions in schools and the physician office played a critical in recruiting people for the Fitwits program and ensuring high level of program participation. For the Fitwit Zone community center interventions, we will recruit Fitwits Champions (e.g., parents and guardians), from the local community that are active, engaged, and willing to have a leadership role in spreading Fitwits to other parents and families in the community.
Fitwits is based on a preventive approach through communications about a healthy lifestyle. The Fitwits Zone is a natural extension that integrates the interventions throughout the community to provide a consistent message to children and parents across three settings: elementary school, health clinic office, and community-family interventions. Children and families with various learning styles and levels of comprehension are engaged the Fitwits multi-media presentations, games, and conversation scaffolds.
PAPERS: UNDER REVIEW
MCGAFFEY, ANN, K. HUGHES, S. FIDLER, F. D’AMICO, M. STALTER. “Can Elvis Pretzley and the
Fitwits Improve Knowledge of Obesity, Nutrition, Exercise, and Portions in Fifth Graders?”
Submitted to Journal of Pediatrics. May 2009.
PUBLISHED PAPERS
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.
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.
Workshops
PLAYGROUND: PARTICIPATORY DESIGN ACTIVITIES. HOW DOES IT ALL WORK?
DIS: Design of Interactive Systems 2006, State College, PA. June 2006.
Co-led with Ellen Ayoob.
Conference presentations
FITWITS: USING GAMES TO LEARN ABOUT PORTION, NUTRITION, AND HEALTH CHOICES
42nd Society of Teachers of Family Medicine (STFM) Annual Conference. Denver, CO. May 2009.
Presentation co-authored with Susan Fidler, MD, Ann McGaffey, MD, and Kristin Hughes.
FITWITS: USING GAMES TO LEARN ABOUT PORTION, NUTRITION, AND HEALTH CHOICES 2008 Society of Teachers of Family Medicine Northeast Region Meeting. Baltimore, MD. November 2008. Presentation co-authored with Susan Fidler, MD, Ann McGaffey, MD., and Kristin Hughes.
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.
Poster Presentations FITWITS: TEACHING 5TH GRADERS ABOUT PORTION SIZES Pennsylvania Academy of Family Physicians. Skytop, PA. March 2009. Co-authored with Jill Haltigan, MD, Kristen Scopaz, MD, Kristin Hughes, and Ann McGaffey, MD.
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.
Who are we?
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. We would also like to thank the St. Margaret Foundation and the Allegheny County Medical Society for funding the evaluation of Fitwits MD.
Our Team
Kristin Hughes is an Associate Professor in the School of Design Carnegie Mellon University. Recurring themes in her research and professional practice focus on utilizing design methods as a catalyst for community and civic engagement. She is currently looking at the design of products that allow participants agency over their own learning space. They are invited as co-creators in the design process, a process that they may eventually engage and sustain on their own. Most recently, this question has led her to explore game design, examining learning processes and ways that play spaces provide a powerful platform for uninhibited learning. Other projects include Click! Urban Adventure, an interactive role-playing game designed to immerse middle school girls in discipline-specific science, technology, engineering and mathematics activities. Hughes also collaborates on explanatoids (www.explanatoids.org), an interdisciplinary project funded by the National Science Foundation.
Ann McGaffey, MD is Medical Director of the UPMC St. Margaret Bloomfield Garfield Family Health Center and a faculty member of the UPMC St. Margaret Family Medicine Residency Program. Dr. McGaffey coordinates school health partnerships with five local elementary schools and The Neighborhood Academy. This collaboration pairs two institutions (education and medicine/health care) to address community and public health concerns relatively early in the lives of children.
Susan K. Fidler, MD, joined the Fitwits team as a third year resident, UPMC St. Margaret Family Medicine Residency Program, resident at the Bloomfield-Garfield FHC. Sue graduate of Penn State (Hershey) College of Medicine. Dr. Fidler paired her strong graduate school interest in nutrition and exercise with the introduction of a Fitwits one hour class for the Pittsburgh Montessori 5th grade in May 2007. She has recently moved to Philadelphia and is a Primary Care Sports Medicine Fellow" at Jefferson University.
Nathan Mazur is a graduate of The Art Institute of Pittsburgh. His skills include cartooning, animation, illustration, graphic design and web design. His work has been described as everything from cute and funny, to somewhat unnerving. He's done work for Disney Television, American Greetings, Carnegie Mellon University and numerous smaller companies, film makers, and individuals. Examples of his work can be found at www.scaredofbees.com.
Peter Scupelli, Ph.D. is a designer and a researcher. He is a visiting instructor in the Human Computer Interaction Institute at Carnegie Mellon University. As a design researcher, he uses human centered design methods to uncover people’s wants, needs, and desires in the context of use. He focuses on problems with broader reach than individual products and seeks design solutions – whether a product, service, or environment – that are integrated into a designed system. Peter joined the Fitwits team in September 2009. He is researching obesity prevention in the five levels of the socio-ecological framework (i.e., individual, interpersonal, organizational, community, and public policy). His Ph.D. dissertation in human computer interaction focused on how the architecture of the built environment around schedule displays support coordination. He has a master’s degree in interaction design from the School of Design at Carnegie Mellon University, and an architecture degree from the Universita' di Genova in Italy. He collaborated with the architecture collaborative A12 and Udo Noll on “Parole,” an online architecture glossary project. Parole was exhibited at the Architecture Biennial of Venice, PS1 MOMA (New York), the São Paulo Contemporary Art Biennial, and other places.
Frank J. D’Amico, PhD, Professor Department of Mathematics and Computer Science Duquesne University. He is the Director of Biostatistics and the Associate Director of Research in the UPMC St. Margaret Family Medicine Residency Program.
Diane Abatemarco, PhD, MSW, Assistant Professor of Public Health is the Co-Director of the Institute for Evaluation Science in Community Health, Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh. Her primary areas of expertise include evaluation research methods, survey research methods and behavioral epidemiology. Dr. Abatemarco and her Co-PI Dr. Stephen Kairys are developing a proposal to implement Practicing Safety on a national sample of pediatric practices. The work has been highlighted recently as an AHRQ Innovation.
Megan Montag, is a registered dietitian. She graduated from the University of Pittsburgh in 2005 with a Bachelor's Degree in Clinical Dietetics and Nutrition. In 2007, she received her Masters Degree in Health Education and Promotion from East Carolina University. She has a certificate of training in pediatric and childhood weight management.
Laura Macbeth, MPH, Laura graduated from the University of Pittsburgh, Graduate School of Public Health, Behavioral and Community Health Sciences. She also has her Certificate of Health Education Specialist. Laura is on the evaluation team for Fitwits. Her role is Fitwits Champion for the three UPMC St. Margaret Family Health Centers: New Kensington Lawrenceville, and Bloomfield Garfield. Each of the health centers has their own Champion who keeps staff informed about Fitwits, collects the data, and generally makes sure that each child who comes in to the health centers has the opportunity to participate in Fitwits. Laura addresses problems and concerns, along with helping each of the site Champions to implement Fitwits MD. She is excited to be working on such a fun exciting program and to have the opportunity to affect children’s lives now and in the future.
Dahlia Rao currently lives in Ann Arbor and coordinates an arts-outreach program called Detroit Connections, based in the School of Art & Design and the University of Michigan. Rao received a degree in Arts in Education at Harvard and later worked as the Studio Educator/Atelierista at the Cyert Center for Early Education. During the summer and fall of 2006, Rao collaborated with Prof. Hughes to begin the development of the Fitwits program. Rao participated in all aspects of the design process, with special focus on the research and presentation of its educational content.
Margaret Gibson, MD, second year resident, elected Co-Chief Resident, UPMC St. Margaret Family Medicine Residency Program, resident at the New Kensington FHC, and graduate of University of Pittsburgh School of Medicine. Dr. Gibson has been integral to the introduction of Fitwits at Fort Pitt ALA School and Pittsburgh Montessori Elementary School. She is now a sports medicine fellow.
Emily Welsh, MSW, former Family Health Coordinator, bridging and tracking the programs of the school health partnerships, the UPMC St. Margaret Family Medicine residents and fellows, and the students, faculty, and staff at our partnership schools. Ms. Welsh has effectively brought case management to school and after school children and improved coordination of scheduling between residents, teachers and classrooms. She is currently in NYC getting her Masters degree in teaching.
Collaborators
CMU School of Design
Caryn Audenried, Amy Chang, Chris Chen, Melissa Dolin, Courtney Gooch, Maria Kim, James Liu, Raelynn Miles, Kelly May Nash, Caitlin Osbahr, Jung Yeun Paek, Jennifer Lynne Shirey, Ruqian Zhou
UPMC St. Margaret Bloomfield Garfield Family Health Center
Children’s Hospital of Pittsburgh: Weight Management and Wellness Center
Goutham Rao, MD, CM, Megan McQuaide, RD, Lindsey Detwiler, RD
UPMC St. Margaret Family Medicine Residency Program: Stacey L. Brown, MD,. Jill E. Haltigan, MD, Michelle N. Stalter, DO, Kristen A. Scopaz, MD
Allegheny County Health Department, Joan Procopio, RD LDN, Darija Neureuter Wiswell, RD
Elementary Schools: Fort Pitt ALA, Woolslair, Arsenal, Pittsburgh Montessori and Urban League Charter of Pittsburgh School: 5th graders, principals, and teachers, a big thank you!
The Bloomfield Garfield Corporation
Pittsburgh Public Schools: Janet Yuhasz, MEd, Coordinator of Health Services
Parents from East Liberty
Josh Franzos, photographer, www.manwithcamera.com
Judy Dodd, MS, RD, LDN, Giant Eagle Corporate Nutritionist and University of Pittsburgh School of Health and Rehabilitation Sciences
Carnegie Mellon University
Department of English: Three week, final project, taught Spring 2008 by Necia Werner to help in the development of the instructional manual for Citylife. Students: Melissa Dolin, Nisha Phatak, Ida Lomibao, Anand Durvasala, Brianna Allen, Gabriella Moskowicz, Sanyu Kyeyune, Eugene Kang, Felix Park, Gates Winkler, Emily Newman, Helen Park, Rob Perrone, Cody Vild
H & SS Information Systems: Senior project course taught Fall 2008 by Randy Weinberg to help develop the backend technology for the Fitwits web site. Students: Steve Hillenius, Chang Liu, Victoria Yew, Hans Schweit