Abstract— This paper describes the design and implementation of an interactive activity and food logging website for use by patients (obese children and teens) and their counselors at the Children’s Fitness Clinic at the University of Virginia. The system, GetFit, was designed to address patient retention problems, incomplete paper logs, lack of communication between patients and counselors between sessions, and the patients’ overall apathy towards participation. We used a systematic approach to develop GetFit. This lifecycle consisted of problem analysis, system design, construction, testing, and maintenance. Throughout the design process, there was an emphasis on usability testing and open communication with clients (CFC patients and counselors) in order to meet their needs. I. INTRODUCTION besity has become the leading cause of disease in America. Since 1970, the rate of children who are overweight or obese has risen to almost thirty-three percent [1]. The University of Virginia’s Children’s Fitness Clinic (CFC) in Charlottesville, Virginia was established in 2003 to address the growing number of obese children in the surrounding community. The CFC provides a six-month behavior modification program for children ages two to twenty-one at or above the 85 th percentile in Body Mass Index (BMI). As part of the program, patients (or their parents for very young patients) are asked to provide information about daily food intake and activity by filling out paper logs that are submitted to their counselors at monthly counseling sessions. This current system is not ideal because many of the patients do not fill out the logs out or forget them at home. Without this information counselors are less able to make informed recommendations to the patients about how to improve their situation. Furthermore, a Manuscript received April 4, 2011. This research was supported by a grant from Philip Morris USA, an Altria Company, (ALCS) to the University of Virginia. We are grateful for this important support. Its contents are solely the responsibility of the authors and are not meant to represent the official views of the sponsor. R. Eckardt, E. Carwile, M. Cassi, D. Hart, S. Hoffberg, J. Wang, & S. Guerlain are with the Department of Systems and Information Engineering at the University of Virginia, Charlottesville, VA 22904 USA (corresponding author S. Guerlain phone: 434-924-4438; fax: 434-982- 2972; e-mail: guerlain@virginia.edu). recent analysis showed that 39% of patients drop out of the program following their first visit, while only just under 15% of patients return for the recommended 7 visits to complete the program. Our objective was to improve the quality of patient- counselor interactions of the CFC by developing an interactive website, called GetFit that enables online daily entry of activities and food intake by patients, and counselor-patient interactions via private messaging through the site. We hypothesized that such a system would: 1. Increase patients’ interest to consistently and accurately report their daily food intake and activity 2. Increase the amount of information exchanged between patients and counselors between visits 3. Reduce “data gathering” and increase “counseling” activities during counseling sessions 4. Be seen as a feasible and useful alternative to paper logs 5. Cause patients to remain in the CFC counseling program longer II. BACKGROUND After meeting with the counselors to discuss the current system, we determined that the problems included patient retention, limited use of paper logs, and limited communication between monthly sessions. To address these problems, the new system needed to generate interest in the program, thereby encouraging patients to invest themselves in the program. The counselors expressed an interest in an electronic journal designed for children to track and classify their food intake, log physical activities (including number of steps taken each day), and record “screen time”. Screen time is defined as the amount of time a patient spends watching television, on the computer, playing video games, and using their cell phones. To address the communication issue, counselors wanted to be able to view patient input and contact patients between visits and enable patients to ask questions of counselors. We suggested adding the ability for patients to send short text messages to the site since people are not always at a computer but often have a phone with them. Since many children do not own “smart phones” the text messaging was simply envisioned as an ability for patients to send “self-reminders”, e.g., a brief description of Design of a Personalized Health Record Application to Support Food and Exercise Counseling for Overweight and Obese Children Robert Eckardt, Elizabeth Carwile, Matthew Cassi, Dominique Hart, Sara Hoffberg, Jianping Wang, Stephanie Guerlain Department of Systems and Information Engineering, University of Virginia O