Fitwits: Designed to help physicians start conversations with families about obesity

Doctors in the Pittsburgh, Pennsylvania area often have difficulty speaking with children and parents about childhood obesity issues for a number of reasons. They have limited time in well-child appointments, they perceive a lack of effectiveness of these talks, and these discussions can seem confrontational to children and parents. This paper describes the creation, testing, and implementation of Fitwits MD, a tool that can be used by physicians to facilitate these discussions. Building on prior work developed in the Fitwits School Program, we ran participatory design sessions with health care providers from family medicine and pediatric institutions. The activities included redefining often misused and confusing terminology, role-playing as 9- to 12-year-old patients, open conversations about the barriers to weight discussion with families, and the issues providers believe are most important to convey to patients. Doctors used the Fitwits School Program games as inspiration to generate new games that might help them during a well-child visit.

During these sessions, doctors realized the difficulties they had in finding a common language and overcoming time and other barriers that limit the desired content. Doctors needed a tool to facilitate comfort between doctors and patients and develop a structure that gives key messages and conversational opportunities. The result is Fitwits MD, a structured tool for office discussion of obesity during well-child care. The Fitwits MD framework and language provide a conversation that is gratifying to early adolescents, caregivers, and health care providers alike.