Evaluating the Medium of Comics for Providing Information on Adult Immunizations

Theoretical Background and research questions/hypothesis: Providing comprehensive, easily readable healthcare information in a format that encourages reading is an ongoing challenge. Past evidence supports the use of visual and textual elements in providing information to consumers. One of the most popular yet understudied and underutilized forms of health communication media that combines visual images with text is – comics. This feasibility study compared the effects of two vaccine information flyers – a CDC flyer and a flyer designed in comic format on participants: (a) attitude towards the vaccine information flyer; (b) perceived informativeness of the vaccine information flyer; (c) intention to seek more information about adult immunizations after viewing the flyer; and (d) intention to get immunized after viewing the flyer.

Methods: A between-group, randomized trial was used. Adults (age ≥18 years) at an ambulatory care center were randomly assigned either the CDC or comic flyer. They were asked to respond to survey items developed to measure the outcome variables. Items were measured using a 7-point semantic differential scale. Exploratory factor analysis and Cronbach’s alpha was conducted. Independent-samples t-test was used for comparisons.

Results: A total of 265 usable surveys (CDC: n = 132 vs Comic: n = 133) were analyzed. Compared to the CDC flyer (M_CDC = 5.08; SD_CDC = 1.23), the comic flyer (M_Comic = 5.70, SD_Comic = 1.14) had a statistical significant effect on participant’s overall attitude towards the flyer (t = -4.173; df = 263; p=0.0004).  Also, compared to the CDC flyer (M_CDC = 5.80; SD_CDC = 1.11], the comic flyer (M_Comic = 6.10, SD_Comic = 1.03) had a statistical significant effect on participant’s perceived informativeness of the flyer (t = -2.283; df = 263; p=0.02). Flyer type did not have any statistical significant effect on intention-related variables. Significantly more participants reported there was a “very good-to-good” chance that they would pick and read the comic flyer (89.5%) compared to the CDC flyer (74.3%). Also, more participants who viewed the comic flyer (68.5%) reported taking “short-to-very short” amount of time to read the flyer compared to the amount of time taken by participants who read CDC flyer (55.3%).

Conclusions:  The study findings showed that the comic flyer was positively evaluated compared to the CDC flyer. These findings could provide a new direction for developing educational materials about adult immunizations.

Implications for research and/or practice: Healthcare agencies are involved in developing patient educational materials to effectively communicate important health issues to help people lead healthier lives in their communities. In this situation, research needs to be conducted in identifying an appropriate medium for patient education materials. The medium of comics is increasing in popularity. It is a medium with a language that can be understood by millions and across all age groups. The positive study findings would help fill the literature gap of identifying methods for improving public health communications and would open up a new venue for tailoring health messages (messages for either service or product) targeted towards specific or general populations.