Kristin Hughes, associate professor in Carnegie Mellon University’s School of Design, has partnered with Dr. Ann McGaffey of UPMC’s St. Margaret Family Health Centers, and several Pittsburgh Public Schools to create Fitwits, a three-part series of learning games that will be implemented in schools and hospitals.


Students here (and in next photo) play one of the card games designed as part of the FitWits program

Fitwits teaches children and families how to have healthy lifestyles in an educational and entertaining way. Hughes’ work is supported by a $195,000 grant from The Heinz Endowments, and is a collaboration between Carnegie Mellon, UPMC, and the Pittsburgh Public Schools. Fitwits is designed to help teachers, after-school specialists, and doctors to augment existing curricula with more comprehensive health and nutrition content through play.



Comments Dr. McGaffey, “We are so pleased to see Kristin’s work with the Fitwits and their opposite characters, the Nitwits . These games make understanding nutrition and healthy choices a lot easier for kids and their families at home, school, the grocery store—and the family doctor’s office, too. These are all important places in the lives of children and families and are interdependent for consistency of message.”

According to the US Surgeon General, about 17% of children and adolescents 2 to 19 years of age are overweight—over 12.5 million. These children are at far greater risk for numerous health consequences, including cardiovascular and joint problems, type 2 diabetes, and other chronic diseases. The most immediate consequence of being overweight as perceived by the children themselves is social discrimination, sometimes resulting in poor self-esteem and depression. In Pennsylvania alone the percentage of at-risk overweight and obese children is 35.1. It hits especially hard in economically and socially disadvantaged populations, whose children are often the most ill-prepared of all groups to make informed choices about nutrition and health.

Adds Dr. McGaffey, “We have continued to see declines in family meals that are home-prepared and nutritious, as well as declines in children’s and families’ overall levels of fitness. Schools have vanishing gym time. Families aren’t walking and exercising as much—and with the ever-increasing prevalence and easy access of fast food, doctors and others have been stymied. How do we send messages to kids and families that work?”


Children learn to use their hands to better understand portion control

Saint Margaret’s partners with five local elementary schools and The Neighborhood Academy to help teachers and parents educate preadolescent kids about healthy living. The classroom component of Fitwits helps teachers and students learn the vocabulary of health. They then can play five memory, matching and trivia games that teach about proper portion sizes and the food pyramid. Hughes is working on recess and gym games that get kids to exercise. A home component uses flash cards to teach parents how to keep their kids healthy. The flash cards are geared to make it easier to learn about healthy choices.

Hughes’ interest in this project originated in June 2006 as interdisciplinary discussions with designers with expertise in games, arts and education, and design research methods, along with doctors and teachers—discussions that explored the growing epidemic of childhood obesity and what they as individuals could do to help create change. Observing families at Pittsburgh’s Children’s Hospital Weight Management Clinic showed the team how communications with at-risk youths and their families often broke down. Says Hughes, “At the clinic we routinely observed that parents and children were handed a folder containing overly complex charts, contracts, and diagrams to assist them in their daily decisions with portion control and general nutrition. Unfortunately, the language and presentation of these materials inhibit their understanding, and thus adoption of the health recommendations, once they left the doctor’s office. “

The Fitwits program is a series of learning games imbedded with positive, educational health content regarding nutrition and physical activity for pre-adolescents. There are three main subsets of the Fitwits program: Games for Health, which are classroom games; Doctor’s Spaces—games that children can play in waiting rooms and patient care rooms; and Fitwits Healthperks!®—a community-based game with local businesses that reward consumers for healthy choices. Says Hughes, “The design of each component of the program allows participants to discuss important health issues, but also to be stewards of their own play experiences.” Adds Dr. Susan Fidler, a second year UPMC family practice resident, “The Fitwits games help doctors teach kids about portion, nutrition and fitness in a way that is both tangible and fun.”


Hughes plays Fitwits with students in pilot classrooms

The classroom component of Fitwits helps teachers and students learn the vocabulary of health. Students can play five memory, matching and trivia games that teach students about proper portion sizes and vocabulary. Hughes is working on recess and gym games that get students to exercise. Also, she is creating materials that explain the Pittsburgh Public School’s Wellness Policy to parents and students based on a policy from the Centers for Disease Control’s Coordinated School Health Program that stresses education and parent involvement. Hughes has also developed a series of games for children to play while waiting in doctors’ offices. Along with UPMC St. Margaret Family Practice residents, she is developing flash cards to teach parents how to keep their children healthy. The flash cards are aimed toward first-time parents, teenage parents and other parents to facilitate open discussions. Doctors can then use these games, flash cards and other materials to facilitate a conversation about health with their patients. Patients can also take the games home with them.

Fitwits will roll out to the Pittsburgh Public Schools in May of this year. “The games recognize healthy and unhealthy ingredients in foods and stress the importance of kid-appropriate portion sizes and amounts, which enables children to feel a sense of control no matter what meal they are provided with at home or in school,” Hughes said. “It is also designed to help facilitate conversations about health and health-related topics. Fitwits is really designed to be used by all kids, not just ‘healthy kids’ or ‘unhealthy kids.’”

Hughes’ previous research—explanatoids and click!, both of which target younger audiences, were influential in her work with Fitwits. Like explanatoids, which applies scientific principles and makes them understandable in everyday objects, Hughes comments “With Fitwits, we focused on how do we make kid-friendly material--how do we reach kids to help them make better decisions in everyday situations.” And like with click!, which used gaming scenarios to teach science and technology to 11 to 14 year old girls , Fitwits uses games to help children learn more about healthy eating.

Hughes will be teaching a course in the Fall 2008 semester called 51-320/51-820, Fitwits: Public Health Interventions.

Dr. McGaffey adds, “I really tremendously admire Kristin’s work and her managerial ability to coordinate such a broad project across so many different institutions. She’s really helped get everyone working in tandem.”

Read Carnegie Mellon’s press release about Fitwits

Posted on Apr 30, 2008