Efficacy of a food safety comic book on knowledge and self-reported behavior for persons living with AIDS

Assessing Existing Food Safety Resources with United Kingdom-Based Chemotherapy Patients and Family Caregivers for Future Learning Purposes

ABSTRACT

Because the incidence of foodborne infection is more prevalent among cancer patients and the domestic kitchen is a contributor to foodborne infection, appropriate domestic food safety practices are needed to safeguard this at-risk population. Although patients are aware of the increased risk of infection, previous self-reported data indicate potential food safety malpractices among patients and family caregivers, thus suggesting the need for targeted food safety information. However, existing United Kingdom resources provide inconsistent and insufficient food safety information. Involvement of intended end users in the cocreation of interventions increases potential effectiveness. Qualitative data were collated from in-depth interviews and a focus group with United Kingdom chemotherapy patients and family caregivers (n = 35) to determine perceptions and preferences for food safety information by evaluating existing food safety resources from international providers (n = 12). Although participants liked digital interventions (e.g., Web sites and videos), traditional paper-based leaflets were perceived as the most beneficial because they could be referred to on repeated occasions. Despite the drawbacks associated with some resources, combining approaches in a multiresource intervention was favored by patients and family caregivers. Ensuring patients are not overwhelmed with excessive information was important. Short, logical, engaging, educational, and entertaining information to evoke an interest in the topic was preferred. Utilization of graphics to supplement descriptive information may enhance comprehensibility. Interventions need to be appropriate for patients and caregivers, and delivery by trusted health care professionals may enhance the credibility of the message. Preferred approaches to facilitate targeted food safety communication were identified, and these findings can be utilized to cocreate targeted food safety interventions for chemotherapy patients and family caregivers.

HIGHLIGHTS

Emotional experiences of reading health educational manga encouraging behavioral changes: a non-randomized controlled trial

OBJECTIVE

Educational health manga are used to promote health behavior change. This study thus seeks to achieve the following objectives: identify the emotional experience of reading educational health manga, understand the effects of facilitating the psychological mediators of behavior change through emotional experiences, and compare the effectiveness of educational health manga with conventional materials.

DESIGN

A non-randomized controlled trial with six conditions was conducted. Target behaviors were physical activity and healthy diet. Individuals aged 20-69 years (n = 1,680) were assigned three manga intervention conditions and three control conditions (visual image-based, narrative text, and general text material).

MAIN OUTCOME MEASURES

Participants were asked about their emotional experience while reading either intervention material or control material and its perceived positive influence on enhancing psychological mediators.

RESULTS

Four factors relevant to emotional experiences were identified: risk perception, familiarity, satisfaction, and realism. Emotional experience strongly predicted the psychological mediators of behavior change. Analysis of differences among the six conditions revealed that exposure to educational health manga led to greater satisfaction and increased knowledge. Participants assigned manga conditions experienced superior emotional experiences and outcomes.

CONCLUSIONS

Those assigned manga conditions experienced superior emotional experiences and outcomes. The efficacy of educational health manga in encouraging psychological mediators of change was confirmed.Trial registration: UMIN Japan identifier: UMIN000034369.

Empirical Evaluation of Rainbow Reflections: A Comic Book Anthology on Body Image for Queer Men

Gay, bisexual, and queer (GBQ) men are at higher risk of negative body image. As having a negative body image is related to negative mood, sexual, and health outcomes, identifying and providing community-friendly tools for GBQ men is important. This paper describes the creation and evaluation of Rainbow Reflections, a comic anthology developed to promote awareness of and communication about body image. Rainbow Reflections includes comics from 38 trans- and cis-GBQ artists who drew inspiration from personal narratives based on pre-determined themes in the empirical literature and interactive inserts based on evidence-based practice. To evaluate Rainbow Reflections, 167 trans- and cis-GBQ men completed pre-post measures before/after viewing a selection of comics and responded to an open-ended question about their experience. Overall, participants rated the comic book positively, with a majority (61.1%) indicating that they would recommend the book to a friend. After viewing the comics, participants reported greater comfort with initiating conversations about body image, greater satisfaction with their bodies, and reported higher estimates of how common body image concerns are for queer men. Themes that emerged from open-ended responses included participants reflecting on personal struggles (~ 30%), relating with the stories of others (~ 22%), reflecting on the standards of queer men (~ 18%), recognizing cis-privilege (~ 11%), reflecting on others' struggles (~ 9%), negative feedback about the comics (~ 7%), and balancing masculine and feminine (~ 3%). Results of the study provide preliminary evidence for Rainbow Reflections as an effective community-friendly tool to promote awareness of and communication about body image for GBQ men.

Agricultural Safety Comic Book for Latinx Migrant Families: Development and Evaluation

INTRODUCTION

Comic books and graphic novels have been used in health education. The youth of migrant and seasonal agricultural workers are highly vulnerable to the health hazards associated with agricultural work and the migrant workers' itinerant home environment.

METHOD

The purpose of the study was to create a bilingual, culturally specific educational comic book to inform families of safety issues in youth hand-harvesting agricultural work and provide anticipatory guidance safety tips for agricultural work camp residence. In a mixed-methods design, a multistate and multidisciplinary team used focus groups to obtain the voice of potential users regarding the strengths and weaknesses of the comic book prototype and scales on satisfaction, helpfulness, and usability.

RESULTS

Focus group participants contributed constructive criticism to modify the prototype. Quantitative surveys found the comic book to be satisfactory, helpful, and highly usable.

DISCUSSION

This report describes the steps in the creation of the comic book that can be used for health promotion education.

Real-life food-safety behavior and incidence of foodborne infections in solid organ transplant recipients

Food-safety measures are recommended in solid organ transplant (SOT) recipients. However, the actual adherence of patients in a real-life setting and the impact on the incidence of foodborne infections remain largely unexplored. We performed a survey among SOT recipients followed at our institution, aiming to evaluate their food-safety behavior. We assessed the incidence of microbiologically proven foodborne infections by chart review. One hundred ninety-seven SOT recipients (kidney = 117, lung = 35, liver = 29, and heart = 16) participated in the survey. Overall, 17.7% of the participants observed all food-safety recommendations (22.0% avoided food at risk of contamination while 67.9% applied hygiene recommendations). Patients within the first year after transplantation (odds ratio [OR] 5.42; P = .001) and females (OR 4.67; P = .001) followed food-safety recommendations more closely. Although the majority of SOT recipients felt concerned and actively sought information on food safety (68%-70%), only 27% were able to recognize all risks of foodborne infection in hypothetical scenarios. Incidence of proven foodborne infections was 17.9% (95% confidence interval 9.9%-30.9%) 5 years after transplantation. Importantly, foodborne infections occurred exclusively among patients not following food-safety recommendations. In summary, most SOT recipients eat foods that make them at risk of foodborne infections. Our results indicate that there is room for improvement in patient education, particularly later after transplantation, and reinforce current food-safety recommendations.

Effectiveness of a health intervention based on WHO food safety manual in Iran

BACKGROUND

Food safety manual was developed by the World Health Organization (WHO) to train professionals to reduce the burden of foodborne diseases as a global strategy. The present pioneering research aimed to explore the effectiveness of an intervention based on the manual of five keys to safer food by WHO in enhancing the knowledge, attitude and behavior of Iranian Female Community Health Volunteers (FCHVs).

METHODS

In the present quasi-experimental research, FCHVs (n = 125) were selected and assigned to two groups, an intervention and a control. A modified version of the questionnaire based on WHO manual was used to measure knowledge, attitude and behavior of the sample. The questionnaire was first completed at the outset of the study (pre-test) and then once again in 2 months of the intervention (post-test). Face and content validity of the questionnaire was tested and confirmed. Cronbach's alpha was used to test the reliability of the questionnaire along with the test-retest method of testing reliability. The data entered SPSS16 for statistical analysis. To this aim, Chi-squared test, dependent and independent samples T-test, ANOVA and ANCOVA were run. Partial population attributable risks were calculated and corresponding 95% confidence intervals (95% CIs) were estimated using a bootstrap method.

RESULTS

The two groups showed no statistically significant difference in the pretest (p > .05). In the post-test, the mean scores for all variables was higher in the intervention group than the control, and this difference between the two research groups was statistically significant (p < .001). When the volunteers were adjusted for age and experience in healthcare centers, the mean scores were significantly higher in the intervention group than the control (p < .001).

CONCLUSION

It was revealed in the present study that the educational intervention based on five keys to food safety manual by WHO managed to improve participants' knowledge, attitude and behavior. Translation of the target guideline in future can be a great help to researchers in prospective research.

TRIAL REGISTRATION

Retrospectively registered: Iranian Registry of Clinical Trials IRCT20160822029485N4, at 2020-03-16.

Use of health promotion manga to encourage physical activity and healthy eating in Japanese patients with metabolic syndrome: a case study

Background

The present case study investigated the feasibility of using manga (Japanese-style comic books) to promote physical activity and healthy eating behavior in Japanese patients with metabolic syndrome.

Methods

A one-arm pre-post intervention was conducted in a Japanese suburban community. Twenty participants with a diagnosis of metabolic syndrome were recruited via health checkups. Health promotion manga were developed by the researcher, a publishing specialist, and a professional illustrator. We measured participants' self-reported physical activity, eating behavior, and psychological readiness to change toward engaging in healthy behavior.

Results

At 1 month after the intervention there were no significant differences in physical activity scores, but small positive changes in vigorous (R²  = 0.02) and moderate (R²  = 0.01) physical activity scores were observed. Total healthy eating behavior scores were significantly improved (p < 0.05, R²  = 0.47). In addition, participants reported positive change in psychological readiness, such as increased intention to engage in healthy behavior, enhanced self-efficacy, and benefits of using manga.

Conclusions

This study demonstrates that manga interventions have potential to encourage healthy eating in patients with metabolic syndrome.