Effects of a Diabetes-Themed Cartoon-Based Education on Disease Knowledge and Physical Activity Among Japanese Children - a Preliminary Randomized Controlled Trial

Sep 30, 2026

The study evaluated whether diabetes-themed cartoon-based education could strengthen disease knowledge and increase physical activity in children. Participants completed a baseline diabetes knowledge test and received accelerometers at the first visit. At the second visit, they were randomly assigned to a cartoon distribution group or a lecture attendance group. Six months later, knowledge tests and accelerometer data were collected at home by mail, with 30 children completing follow-up. Both groups improved within-group, while between-group changes were not significant.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Introduction

Background on pediatric diabetes

Need for accurate knowledge and self-management

Methods

Clinical Pediatric Endocrinology Vol.35 / No.1 January 2026 pp 74–84 Original Article Effects of a diabetes-themed cartoon-based education on disease knowledge and physical activity among Japanese children: a preliminary randomized controlled trial Yasuhiro Suzuki1–3 , Daichi Sugawara4 , Mika Oki5, 6 , Hirofumi Takahashi7 , Takaaki Matsuda8, 9 , Hiroaki Suzuki10 , Hitoshi Shimano2, 11–13 , Yasushi Hada14 , and Kenji Suzuki6 1Institute of Systems, Information and Engineering, University of Tsukuba, Tsukuba, Japan 2Department of Endocrinology and Metabolism, Institute of Medicine, University of Tsukuba, Tsukuba, Japan 3Biomedical Science and Engineering Research Center, Hakodate Medical Association Nursing and Rehabilitation Academy, Hakodate, Japan 4Institute of Human Sciences, University of Tsukuba, Tsukuba, Japan 5International Research Center for Neurointelligence (WPI-IRCN), UTIAS, The University of Tokyo, Tokyo, Japan 6Center for Cybernics Research, University of Tsukuba, Tsukuba, Japan 7Nutrition Department, University of Tsukuba Hospital, Tsukuba, Japan 8Tsukuba Clinical Research and Development Organization (T-CReDO), University of Tsukuba, Tsukuba, Japan 9Department of Endocrinology and Metabolism, University of Tsukuba Hospital, Tsukuba, Japan 10Department of Food and Health Sciences, Institute of Human Life Sciences, Jissen Women’s University, Tokyo, Japan 11Japan Agency for Medical Research and Development-Core Research for Evolutional Science and Technology (AMED-CREST), Tokyo, Japan 12Life Science Center of Tsukuba Advanced Research Alliance (TARA), University of Tsukuba, Tsukuba, Japan 13International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan 14Department of Rehabilitation Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan Highlights ● Cartoon based educational intervention is as effective as lecture-based educational intervention. ● Diabetes education via cartoons and educational lectures increase physical activity. ● Cartoons aimed at disease awareness are associated with psychological stress. Received: July 6, 2025 Accepted: October 6, 2025 Advanced Epub: October 16, 2025 Corresponding Author: Yasuhiro Suzuki, Ph.D., RPT, Institute of Systems, Information and Engineering, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan [E-mail: minaminagasaki2007@yahoo.co.jp](E-mail: minaminagasaki2007@yahoo.co.jp) This is an open-access article distributed under the terms of the Creative Commons Attribution NonCommercial No Derivatives (by-nc-nd) License <[http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/)> . Copyright© 2026 by The Japanese Society for Pediatric Endocrinology Clin Pediatr Endocrinol 75 Abstract. 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 = 0.0

FAQs

What was the main purpose of this trial?

To determine whether diabetes-themed cartoon-based education improves children’s diabetes knowledge and physical activity.

How were participants assigned to groups?

At the second visit, participants were randomly assigned to receive diabetes-themed cartoons or to attend lectures.

Did cartoons outperform lectures in improving outcomes?

No. Changes between the cartoon and lecture groups showed no significant differences, although both groups had significant within-group improvements.

Sep 30, 2026

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