Development and validation of an educational comic book on healthy eating in early childhood.

Abstract

The objective of this study was to develop and validate an educational comic book designed to promote healthy eating among caregivers of young children. The study was conducted in four phases: (1) literature review and script development; (2) creation of the initial version of the comic book, including illustrations, layout and design, and calculation of the Flesch Readability Index (FI); (3) expert validation of the initial version and calculation of the Content Validity Index (CVI); and (4) adaptation of the comic book based on expert suggestions, recalculation of the FI, and pilot testing (CVI) with a lay population. A total of 64 volunteers participated in the validation process, including 14 expert judges and 50 caregivers responsible for feeding children aged 0 to 5 years. Statistical analysis included descriptive measures and inferential testing using the Wilcoxon signed-rank test. The FI score for the initial version was 85.0%, indicating a reading level classified as "easy to understand." After expert evaluation, the CVI reached 94%, reflecting high agreement among participants. In the revised version, the FI remained high at 84.7%, reinforcing the "easy to understand" reading level, while the CVI increased to 98% following the pilot test, demonstrating strong consensus among participants. A significant improvement in knowledge regarding healthy eating was observed after reading the comic book (p < 0.05). The comic book was validated for appearance, content and readability, showing a positive impact on caregivers' knowledge about healthy eating practices. It represents an accessible and effective resource that can be integrated into community-based nutrition education programmes.