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Review
. 2022 Mar;52(3):e13642.
doi: 10.1111/eci.13642. Epub 2021 Jun 30.

The use of comics to promote health awareness: A template using nonalcoholic fatty liver disease

Mireia Alemany-Pagès  1   2 , Anabela Marisa Azul  1   3 , João Ramalho-Santos  1   4
Affiliations
Review

The use of comics to promote health awareness: A template using nonalcoholic fatty liver disease

Mireia Alemany-Pagès et al. Eur J Clin Invest. 2022 Mar.

Abstract

Nonalcoholic fatty liver disease (NAFLD) constitutes a major threat to public health systems worldwide on account of its widespread prevalence and increasing incidence. More effective tools to raise awareness and increase health communication are therefore needed. Comics may constitute an effective language for this purpose, given the permanence, adaptability and ability of this form of communication to convey complex information, using both visual components and the creation of narrative involvement, thus promoting both awareness and health-conscious behaviours. Importantly, this process requires careful preparation in terms of selecting both the key biomedical concepts to be conveyed, as well as a graphical style and appropriate characters and a narrative arc with which a target audience can identify with. Here we provide a brief introduction to the use of comics in health communication and propose a possible roadmap for the development of comic-based tools for diverse conditions, using the context of NAFLD.

Keywords: NAFLD; biomedical knowledge; comics; health communication.

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Conflict of interest statement

None of the authors have potential conflicts of interest to be disclosed.

Figures

FIGURE 1
FIGURE 1
Schematic representation of the stages of liver disease discussed in the text, including both gross liver morphology (above), as well as cellular damage (below), including fat deposition, inflammation and fibrosis. Adapted from the comic ‘A Healthy Liver Will Always Deliver!’ illustrated by Rui Tavares
FIGURE 2
FIGURE 2
Link between fat depositions in the liver and human behaviour, in both NAFLD (symbolically represented on the left) and alcohol consumption‐triggered alcoholic fatty liver disease—AFLD (right). The idea behind this type of representations is to connect well‐known and relatable human behaviour with consequences at the cellular/physiological level, that most patients are unaware of. Excerpt from the comic ‘A Healthy Liver Will Always Deliver!’ illustrated by Rui Tavares
FIGURE 3
FIGURE 3
Flow chart of the steps involved in the development of a health communication comic. This table elaborates on the content selection and structure‐building processes that we undertook for the creation of the narrative ‘A Healthy Liver Will Always Deliver!’ and that could serve as a possible roadmap for the development of comics‐based tools for diverse conditions. See text for details
FIGURE 4
FIGURE 4
The self‐management and prevention of NAFLD involve behaviour changes in lifestyle, that should be simple, easy to understand from both personal and scientific/clinical standpoints, and implementable. In this case, a positive role model T2DM patient (as both a benign authority figure and potential agent of change with personal experience in metabolic disorders) advises her unaware great‐niece on nutritional issues, representing the importance of early‐life commitment to a healthy lifestyle. Excerpt from the comic ‘A Healthy Liver Will Always Deliver!’ illustrated by Rui Tavares, see text for discussion on character roles
See this image and copyright information in PMC

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