Fight for Your Right to Fruit: Development of a Manga Comic Promoting Fruit Consumption in Youth

Innovative interventions addressing childhood obesity are needed to capture the attention of youth living in a multi-media environment. The purpose of this paper is to describe the qualitative study that was conducted to inform the development of an appealing manga comic (Japanese comic art) to promote fruit consumption in youth and the process of creating the comic. Seven focus groups and two interviews (N=28) were conducted with middle-school students to better understand such topics as enjoyable components of manga comics and important health concepts. Two researchers independently analyzed each transcript using ATLAS.ti. Inductive and deductive processes were used to identify codes (ideas emerging from text); similar codes were grouped into themes. Most frequently mentioned themes related to enjoyable components of manga comics were detailed graphics and artistic style of text used to convey sound effects. The majority said eating fruits and vegetables was the most important nutrition behavior for proper health. When asked about story ideas for a manga comic to encourage youth to be healthy, many responded with ideas involving comic characters who would consume fruit, then gain beneficial attributes. Others suggested highlighting more practical benefits, such as increased focus and energy. These findings informed the development of a 30-page manga comic promoting fruit consumption, with the aim of developing an appealing storyline and relatable characters for youth. Manga comics may be able to create an entertaining learning environment that has potential to promote positive dietary behaviors in youth.