title: Can Elvis Pretzley and the Fitwits improve knowledge of obesity, nutrition, exercise, and portions in fifth graders?
abstract: OBJECTIVE
  To determine the effectiveness of an educational intervention, created with a human-centered design approach, on children's knowledge and beliefs related to obesity and nutrition.
  
  
  METHODS
  Pre-post intervention: we evaluated fifth graders (aged 9-12) from five urban schools using a survey instrument at 1 week before intervention, immediately after intervention, and 1 week later after intervention.
  
  
  METHODS
  Of 189 fifth graders enrolled in the schools, 165 consented students (87.3%) completed baseline data. We obtained immediate post-intervention data from 94% of them and 1-week post-intervention data from 88%.
  
  
  RESULTS
  Of the 14 instrument questions that covered items under obesity, disease, nutrition, portion sizes, and exercise, 11 showed significant improvements in the percentage of correct answers. The children's knowledge in specific areas, including the meaning of the term 'obesity' and portion sizes, increased dramatically. Participatory design, child-inspired characters, hand-based portions, traditional games, and attention to reception by the students resulted in an engaging presentation.
  
  
  CONCLUSIONS
  Simplified health vocabulary and multiple modes of presentation resulted in accessible and understandable health education regarding obesity, nutrition, exercise, and portion size. This study yields compelling evidence that the Fitwits tools are an effective method to promote knowledge about obesity. Future studies are needed to determine whether this knowledge can affect health outcomes.
authors.affiliation: UPMC St Margaret Family Medicine Residency Program, University of Pittsburgh Medical Center, Pittsburgh, PA M01 RR023940, USA. mcgaffeyal@upmc.edu
authors.forename: A
authors.initials: A
authors.lastname: McGaffey
authors.forename: K
authors.initials: K
authors.lastname: Hughes
authors.forename: S K
authors.initials: SK
authors.lastname: Fidler
authors.forename: F J
authors.initials: FJ
authors.lastname: D'Amico
authors.forename: M N
authors.initials: MN
authors.lastname: Stalter
mesh_terms: D015992:Body Mass Index; D002648:Child; D005260:Female; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D008297:Male; D009765:Obesity / Q000517:prevention & control* / Q000523:psychology*; D040242:Risk Reduction Behavior; D012574:Schools; D013334:Students / Q000523:psychology