Effects of a diabetes-themed cartoon-based education on disease knowledge and physical activity among Japanese children: a preliminary randomized controlled trial

We examined whether cartoon-based diabetes education could enhance diabetes knowledge and physical activity among children. During the first visit, participants completed a diabetes knowledge test; accelerometers, which were worn, were distributed. During the second visit, participants were randomly assigned to the cartoon distribution or lecture attendance group. At 6 mo post-intervention, the children received the diabetes knowledge test and accelerometers via mail, completed them at home, and returned them. Thirty children participated, with a 100% follow-up rate. Changes in diabetes knowledge test scores or physical activity levels showed no significant between-group differences; however, both groups exhibited significant within-group improvements. In the diabetes knowledge test, the cartoon distribution and lecture attendance groups improved by 11 (19 [17, 22] to 30 [23, 35], p = 0.003) and 10 (17 [14, 23] to 28 [26, 32], p = 0.007) points, respectively. Physical activity significantly increased, with the cartoon distribution and lecture attendance groups gaining 1,427 ± 2,980 (6190 ± 2529 to 7617 ± 3315, p = 0.047) and 1,371 ± 2,659 (6640 ± 3056 to 8011 ± 3046, p = 0.037) steps/d, respectively. This pilot intervention revealed that diabetes-themed cartoons and lecture attendance were similarly effectiveness in improving diabetes knowledge and physical activity.