Comic book promotes prevention of fatty liver disease

Research coordinated by UC values scholarly communication and its impact

Lorena Caliman
15 january, 2021≈ 6 min read

To conduct scholarly communication rigorously and to assess its impact, bringing information to as many people as possible. Such activities are part of the work of a team from the Center for Neuroscience and Cell Biology (CNC) of the University of Coimbra, which has been promoting, through its investigations, communication strategies and prevention of non-alcoholic fatty liver disease (NAFLD). Recently, the group made available online a comic book that includes, besides the possibility of reading it, the participation of the public, to create awareness about the disease, and also to evaluate its effectiveness as a communication strategy for prevention.

The comic book is entitled 'Um Fígado Equilibrado É Meio Caminho Andado!' ('A Healthy Liver Will Always Deliver!'), and is signed by the PhD students of the Doctoral Program in Experimental Biology and Biomedicine (PDBEB) at UC, Mireia Alemany i Pagès (concept and history) and Rui Tavares (illustrations), in collaboration with their supervisors, João Ramalho-Santos (who developed the book's script) and Anabela Marisa Azul (editorial support in a participatory approach). João Ramalho-Santos and Anabela Marisa Azul are part of the coordination team of the international research project on fatty liver (Foie Gras project), which has 13 doctoral fellows from different countries. The PhD work of student Mireia Alemany i Pagès is one of them, and focuses exclusively on the scholarly communication of the NAFLD.

The production of the comic book resulted from an investigation by the Catalan student, co-authored with her supervisors and other researchers in the areas of Psychology, Sociology and Medicine, also counting with the participation of patients and their caregivers. The investigation was based on semi-sctructured interviews with Type 2 Diabetes Mellitus patients (T2DM), in order to understand the level of awareness of this population about fatty liver disease and its relationship with diabetes. The research results showed patients' low knowledge of fatty liver disease, and suggested that raising its awareness could facilitate the development of prevention programs and the promotion of lifestyle interventions. In addition, an important fact pointed out in the article published by the group - available in open access in BMC Public Health journal - is that about 70% of type 2 diabetes patients have non-alcoholic fatty liver.

With these data, the comic book was then produced from the life stories of the interviewed diabetics, also taking into account the doubts found among them; the book aggregates both scientific information that answers their curiosities and information considered important by their caregivers. The book also informs - in a way accessible to people of all ages - about the physiology of the liver, its functions and the characteristics of the disease, as well as ways to prevent and treat it.

The general public is also brought into the investigation through the way that the book is being disseminated. Available on the website, access to the book is preceded by a brief questionnaire that seeks to gather information about the population's knowledge about fatty liver disease; after reading the comic book, new questions are asked. The intention with the questions and answers is to generate data about the impact of the book as a scholarly communication strategy, to help building prevention and support programs - the impact of the initiative will be based on the responses to the survey. The goal then is to measure the effectiveness of the comic book as a way to raise public awareness about the disease, an evaluation that is unprecedented in the scope of scholarly communication.

For João Ramalho-Santos, this initiative is an example of bidirectional Participatory Science: “we try to create, disseminate and evaluate strategies that help the patients themselves to control their health and inform others”, he highlights. The researcher says that, from the beginning, the project was designed with these goals in mind: helping patients, informing, communicating and preventing. He also stresses the importance and the need to look at scholarly communication as a demanding area in itself, and not just an accessory activity. Regarding it, the researcher states that "if well implemented, it is fundamental to have greater and better true democratization of science, not only Open, but Participated and Critical".

All scientific publications related to research on the communication of fatty liver science will be made available on open access, says João Ramalho-Santos. The book itself, in addition to being already available online and open to participation through the questionnaire, will be published by Coimbra University Press and receive versions in the languages ​​of the other countries involved in the Foie Gras project. There is also the possibility of translation for anyone who wants to do so. "Only in this way we can fulfill the project's widest dissemination objectives”, says the biologist and professor at DCV.

About the Foie Gras project

The project involving the comic book 'A Healthy Liver Will Always Deliver!' is part of the European Advanced Training Network Foie Gras, coordinated by CNC and financed by the Horizon 2020 Program of the European Union with 3.2 million euros, inside the Marie Sklodowska-Curie Grant Agreement.

The project brings together 13 institutions from Portugal, Czech Republic, Italy, Poland, France, Germany and Spain, supporting the research of 13 PhD students in different topics related to the study of non-alcoholic fatty liver disease (NAFLD). In Portugal, in addition to the University of Coimbra, the Faculty of Pharmacy of the University of Lisbon, the University of Porto and the Protective Association of Diabetics of Portugal (APDP) also participate.

| Take part in it |

Access the questionnaire and the comic book 'A Healthy Liver Will Always Deliver!' - in Portuguese.

Learn more about the Foie Gras project.