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Development and Evaluation of Prenatal Education for Environmental Health Behavior Using Cartoon Comics

카툰 코믹스를 이용한 환경적 건강행위 산전교육 개발과 평가

  • Kim, Hyun Kyoung (Department of Nursing, Kongju National University) ;
  • Kim, Hee Kyung (Department of Nursing, Kongju National University) ;
  • Kim, Mirim (Division of Cartoon & Animation, Kongju National University) ;
  • Park, Seohwa (Division of Cartoon & Animation, Kongju National University)
  • 김현경 (국립공주대학교 간호학과) ;
  • 김희경 (국립공주대학교 간호학과) ;
  • 김미림 (국립공주대학교 만화애니메이션학부) ;
  • 박서화 (국립공주대학교 만화애니메이션학부)
  • Received : 2021.05.12
  • Accepted : 2021.07.07
  • Published : 2021.08.31

Abstract

Purpose: This study aimed to develop and examine the effects of a prenatal program on environmental health behavior using cartoon comics among Korean pregnant women. Methods: This study used a non-equivalent control group pre-test/post-test design. The program used cartoon comics to explore environmental health behaviors during pregnancy. The program consisted of the following four components: environmental toxicants during pregnancy, avoiding particulate matter during pregnancy, environmental toxicants during baby care, and making a healthy environment for children. In total, 35 pregnant women participated in the study: 18 in the experimental group and 17 in the control group. Data collection and program adaptation were conducted between November 3, 2020 and January 19, 2021. The effect of the prenatal education program was evaluated by t-test and repeated measures ANOVA. Results: Learning experience (t = - 2.35, p = .025), feasibility (t = - 2.46, p = .019), satisfaction (t = - 2.23, p = .032) were higher in the experimental group than in the control group in the first post-test. Feasibility (t = - 2.40, p = .022) was higher in the experimental group than in the control group in the second post-test. Repeated-measures ANOVA showed significant interactions between time and group in environmental susceptibility (F = 9.31, p < .001), self-efficacy (F = 3.60, p = .033), and community behavior (F = 5.41, p = .007). Conclusion: This study demonstrates the need for a prenatal education program to promote environmental health perceptions and behavior during pregnancy. We suggest a prenatal class adopting the creative cartoon comics to promote the maternal environmental health behaviors.

Keywords

Acknowledgement

This study was supported the National Research Foundation of Korea (NRF) grant funded by the Korea government (MIST) (No. 2020R1F1A1048449).

References

  1. Grussu P, Quatraro RM, Jorizzo GJ. Supporting perinatal women in the context of the COVID-19 emergency: Can web-based antenatal education classes make it possible? Journal of Reproductive and Infant Psychology. 2020;38(5):471-473. https://doi.org/10.1080/02646838.2020.1834261
  2. Fryer K, Delgado A, Foti T, Reid CN, Marshall J. Implementation of obstetric telehealth during COVID-19 and beyond. Maternal and Child Health Journal. 2020;24(9):1104-1110. https://doi.org/10.1007/s10995-020-02967-7
  3. Davis-Floyd R, Gutschow K, Schwartz DA. Pregnancy, birth and the COVID-19 pandemic in the United States. Medical Anthropology. 2020;39(5):413-427. https://doi.org/10.1080/01459740.2020.1761804
  4. Statistics Korea. Population census; vital statistics [Internet]. Daejeon: Statistics Korea; c2019 [cited 2020 Mar 16]. Available from: http://kosis.kr/eng/statisticsList/statisticsListIndex.do?menuId=M_01_01&vwcd=MT_ETITLE&parmTabId=M_01_01&statId=1962001&themaId=#A_4.2.
  5. Jeong GH, Kim HK, Kim YH, Kim SH, Lee SH, Kim KW. Development of an instrument to assess the quality of childbirth care from the mother's perspective. Journal of Korean Academy of Nursing. 2018;48(1):38-49. https://doi.org/10.4040/jkan.2018.48.1.38
  6. Wu H, Sun W, Huang X, Yu S, Wang H, Bi X, et al. Online antenatal care during the COVID-19 pandemic: Opportunities and challenges. Journal of Medical Internet Research. 2020;22(7):e19916. https://doi.org/10.2196/19916
  7. Jeong GH, Kim HK. Pro-environmental health behaviour and educational needs among pregnant women: A cross-sectional survey. Journal of Advanced Nursing. 2020;76(7):1638-1646. https://doi.org/10.1111/jan.14346
  8. National Environmental Health Association (NEHA). Definitions of environmental health [Internet]. Denver: NEHA; c2020-2021 [cited 2021 Mar 31]. Available from: https://www.neha.org/about-neha/definitions-environmental-health.
  9. Sunyach C, Antonelli B, Tardieu S, Marcot M, Perrin J, Bretelle F. Environmental health in perinatal and early childhood: Awareness, representation, knowledge and practice of Southern France perinatal health professionals. International Journal of Environmental Research and Public Health. 2018;15(10):2259. https://doi.org/10.3390/ijerph15102259
  10. Osanan GC, Vidarte MFE, Ludmir J. Do not forget our pregnant women during the COVID-19 pandemic. Women & Health. 2020;60(9):959-962. https://doi.org/10.1080/03630242.2020.1789264
  11. Sontag JM, Barnes SR. The visual framing of graphics when used in preventative health digital news packages: Exploring the use of a narrative structure as the message infrastructure. Journal of Visual Communication in Medicine. 2017:40(3);109-119. https://doi.org/10.1080/17453054.2017.1366824
  12. Jamal SNB, Ibrahim NHB, Surif JB. Concept cartoon in problem-based learning: A systematic literature review analysis. Journal of Technology and Science Education. 2019;9(1):51-58. https://doi.org/10.3926/jotse.542
  13. Shin DS, Kim DH, Park JS, Jang HG, Chung MS. Evaluation of anatomy comic strips for further production and applications. Anatomy and Cell Biology. 2013;46(3):210-216. https://doi.org/10.5115/acb.2013.46.3.210
  14. Bieri FA, Yuan LP, Li YS, He YK, Bedford A, Li RS, et al. Development of an educational cartoon to prevent worm infections in Chinese schoolchildren. Infectious Diseases of Poverty. 2013;2(1):29. https://doi.org/10.1186/2049-9957-2-29
  15. Rogers RW. Cognitive and physiological processes in fear appeals and attitude change: A revised theory of protection motivation. In: Cacioppo JT, Petty RE, editors. Social Psychophysiology: A Sourcebook. New York (NY): Guilford Press; 1983. p. 153-176.
  16. Salazar LF, Crosby RA, Noar SM, Schipani-McLaughlin AM, DiClemente RJ. Models based on perceived threat and fear appeals. In: DiClemente RJ, Salazar LF, Crosby RA, editors. Health Behavior Theory for Public Health: Principles, Foundations, and Applications. 2nd ed. Burlington (MA): Jones & Bartlett Learning; 2019. p. 73-93.
  17. Ashford MT, Olander EK, Ayers S. Computer- or web-based interventions for perinatal mental health: A systematic review. Journal of Affective Disorders. 2016;197:134-146. https://doi.org/10.1016/j.jad.2016.02.057
  18. Mello S, Hovick SR. Predicting behaviors to reduce toxic chemical exposures among new and expectant mothers: The role of distal variables within the integrative model of behavioral prediction. Health Education & Behavior. 2016;43(6):705-715. https://doi.org/10.1177/1090198116637600
  19. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods. 2009;41(4):1149-1160. https://doi.org/10.3758/BRM.41.4.1149
  20. Durak G, Ataizi M. The ABC's of online course design according to Addie Model. Universal Journal of Educational Research. 2016;4(9):2084-2091. https://doi.org/10.13189/ujer.2016.040920
  21. Rouillon S, El Ouazzani H, Hardouin JB, Enjalbert L, Rabouan S, Migeot V, et al. How to educate pregnant women about endocrine disruptors? International Journal of Environmental Research and Public Health. 2020;17(6):2156. https://doi.org/10.3390/ijerph17062156
  22. Rosas LG, Trujillo C, Camacho J, Madrigal D, Bradman A, Eskenazi B. Acceptability of health information technology aimed at environmental health education in a prenatal clinic. Patient Education and Counseling. 2014;97(2):244-247. https://doi.org/10.1016/j.pec.2014.07.018
  23. Chae J, Kim HK. Birth cohort effects on maternal and child environmental health: A systematic review. Korean Journal of Women Health Nursing. 2021;27(1):27-39. https://doi.org/10.4069/kjwhn.2021.03.12
  24. Polit DF, Beck CT, Owen SV. Is the CVI an acceptable indicator of content validity? Appraisal and recommendations. Research in Nursing & Health. 2007;30(4):459-467. https://doi.org/10.1002/nur.20199
  25. Babikako HM, Neuhauser D, Katamba A, Mupere E. Patient satisfaction, feasibility and reliability of satisfaction questionnaire among patients with pulmonary tuberculosis in urban Uganda: A cross-sectional study. Health Research Policy and Systems. 2011;9:6. https://doi.org/10.1186/1478-4505-9-6
  26. Kim HK. Development and assessment of an instrument measuring environmental health perception and behavior toward reproductive health of female adolescents. Japan Journal of Nursing Science. 2020;17(3):e12347. https://doi.org/10.1111/jjns.12347
  27. Weinstein ND. The precaution adoption process. Health Psychology. 1988;7(4):355-386. https://doi.org/10.1037//0278-6133.7.4.355
  28. Miller MD, Valenti M, Schettler T, Tencza B. A multimedia e-book-a story of health: Filling a gap in environmental health literacy for health professionals. Environmental Health Perspectives. 2016;124(8):A133-A136. https://doi.org/10.1289/EHP222
  29. Glanz K, Rimer BK, Viswanath K. Health behavior and health education: Theory, research, and practice. 4th ed. San Francisco (CA): Jossey-Bass; 2008. p. 48-49.
  30. Barreda-Angeles M, Aleix-Guillaume S, Pereda-Banos A. An "empathy machine" or a "just-for-the-fun-of-it" machine? Effects of immersion in nonfiction 360-video stories on empathy and enjoyment. Cyberpsychology, Behavior and Social Networking. 2020;23(10):683-688. https://doi.org/10.1089/cyber.2019.0665
  31. Pell T, Eliot M, Chen A, Lanphear BP, Yolton K, Sathyanarayana S, et al. Parental concern about environmental chemical exposures and children's urinary concentrations of phthalates and phenols. The Journal of Pediatrics. 2017;186:138-144.e3. https://doi.org/10.1016/j.jpeds.2017.03.064
  32. Ozaki I, Watai I, Nishijima M, Saito N. Randomized controlled trial of web-based weight-loss intervention with human support for male workers under 40. Journal of Occupational Health. 2019;61(1):110-120. https://doi.org/10.1002/1348-9585.12037
  33. Ridsdale L, Wojewodka G, Robinson EJ, Noble AJ, Morgan M, Taylor SJC, et al. The effectiveness of a group self-management education course for adults with poorly controlled epilepsy, SMILE (UK): A randomized controlled trial. Epilepsia. 2018;59(5):1048-1061. https://doi.org/10.1111/epi.14073