Comic book moms are nutrition heroes to guide migrant family health

The cartoon moms are like real-life moms in Latino farm workers' families, who are concerned about the growing obesity problem among young children, says Jill Kilanowski, assistant professor at the Frances Payne Bolton School of Nursing at Case Western Reserve University.

As part of several research projects, Kilanowski studied over 200 children on farms near Fremont, Willard, Urbana and Tipp City in Ohio and South Haven, Michigan.

Kilanowski has been studying children from migrant camps for three years as part of the "Dietary Intake and Nutritional Education (DINE) for Latino Migrant Farmworkers." The study is part of a National Institute of Health-funded Center of Excellence Self-Management Advancement through Research and Translation (SMART) at the CWRU nursing school.

The researcher set out to find a way to get the message about having a healthy lifestyle across to the migrant children -- of whom some 41 percent are overweight or obese. That number is more than double the national average for the children between the ages of 2 and 19 according to the 2003-2004 National Health and Nutrition Examination Survey.

Playing a role in changing lifestyles are moms, who traditionally cook the meals in Latino families.

"This comic is about making changes for the whole family," Kilanowski said.

The comic offers tips about exercising and making such small changes as switching from the popular lardo (animal fat) to using healthier cooking oils like canola oil. It talks about increasing vegetables, using whole grains, decreasing television time, playing outside more, looking at food portions, eating breakfast and more family meals.

When Kilanowski met with the mothers on the farms, she showed them pamphlets, DVDs and other forms of health literature available to families through schools or health clinics. For families on the move, and with few computers, the DVD was inadequate.

"The mothers told me they wanted reading materials with primary colors to use as a teaching tool for their small children as well as a colorful story line and pictures," Kilanowski said. "They wanted something they could carry in their purses and read to children while waiting at the health clinic or other places."

One thing the mothers agreed upon is comic books are popular in Mexico. Those chats became the beginning of the bilingual Small Changes Big Results. Kilanowski and a team of artists from the Columbus College of Art and Design produced it.

Once the idea of the comic book was decided, Kilanowski went through catalogues and magazines clipping pictures of people and clothes that could serve as models for the characters that she felt the children and mothers could relate to.

Kilanowski then enlisted the expertise of artists and designers from the Columbus College of Art and Design in illustrating and creating the images for the health materials. Richard Aschenbrand, art director; Yuko Smith, illustrator; and David Bennett, production manager, contributed to the production of the new comic.

The comic's story starts in English. If the comic is flipped to the back, the story is in Spanish for non-English speaking parents to read to their children. The story line follows a conversation between the mothers about how to make healthy changes with teachings from a migrant clinic nurse practitioner.