(PS6-B33) Assessing Medically Ill Youths’ Perceptions of a Brief Comic Book Activity to Deliver Evidence-based Skills During Inpatient Hospitalization

Youth hospitalized with medical illness and various forms of pain may experience psychiatric difficulties with anxiety, depression, social rejection and adjusting to their illness and its sequelae. They may also benefit from evidence-based interventions to assist with coping with pain and associated psychological distress. Inpatient medical stays often require creative methods for delivery of psychosocial interventions. Moreover, with rates of childhood psychiatric illness on the rise amidst the COVID-19 pandemic, creative, far-reaching therapeutic interventions are needed to respond effectively and efficiently to the current mental health crisis. One innovative format is comic books, which are receiving increasing attention for their potential as a medium for disseminating evidence-based care to youth. Prior research has indicated that comics may be a promising strategy to promote health behaviors, reduce anxiety and aggression, and promote resilience. 

SuperKids: Change the World (SK) takes the concept of comic books one step further by integrating cognitive-behavioral and acceptance-based strategies into an interactive activity book. SK aims to provide a youth-friendly approach to dealing with the difficult experiences associated with medical illnesses. SK content is based on real Bronx families and was developed collaboratively with the Montefiore Medical Center Psychiatry and Pediatrics teams and the team at PopCulture Hero Coalition. SK was illustrated by Wellington Alves and authored by psychologist, Dr. Janina Scarlet. SK features four diverse child characters experiencing real pain, fears, and sadness in relation to their illnesses. A group leader coaches the characters to practice various strategies (e.g., problem-solving, mindful breathing, coping self-talk) using super-hero language and narratives (e.g., superpowers, “origin stories,” “power-ups”). 

The current initial pilot study aimed to assess youth satisfaction with SK. In a single-arm design, the SK comic book was distributed to 55 youth ages 13-21 with medical illness during their inpatient stay at the Children’s Hospital at Montefiore. Attached to the comic book was a postcard with five questions regarding the likability, readability, and utility of SK using a 5-point Likert scale of “not at all” to “extremely” to assess how true each statement is. Qualitative data was also collected, featuring youths’ verbal feedback and suggestions about SK. 

Results indicate that youth perceived 1) SK extremely easy to read (M=4.51); 2) that the characters reminded them somewhat of themselves (M=2.95); 3) that the problems the kids in SK talked about reminded them a lot of the problems they have (M=3.09); 4) that the skills taught in SK were helpful “a lot” (M=3.93); and 5) that they believe SK can help kids when they are in the hospital “extremely” (M=4.52). Qualitatively, youth believed the comic book was better suited to a younger age and wished they could discuss or share the book with others. This study contributed to research promoting the use of an alternative intervention to teach evidence-based skills for coping with pain and adversity. The present research has implications for future interventions that can reach a large number of children and adolescents.