Journal of Public Health and Nursing (JPHN) Vol.
No.
July 2025, pp.
DEVELOPMENT OF DIGITAL COMIC STRIP MEDIA ON
CONVENTIONAL AND ELECTRIC CIGARETTE CONTROL WITH
THE ADDIE MODEL
Ni Made Padma Batiari1.
I Desak Ketut Dewi Satiawati Kurnianingsih1, 2.
Kadek Sri Ariyanti1 1 Kartini Bali Health Polytechnic.
Jalan Piranha Nomor 2.
Denpasar and 80223.
Denpasar 2 Center for Public Health Innovation.
Faculty of Medicine.
Udayana University.
Bali.
Indonesia * Ni Made Padma Batiari.
Politeknik Kesehatan Kartini Bali.
Jalan Pulau Bungin Gang Vi Nomor 8.
Denpasar and 80222.
Denpasar Email: padmabatiari@gmail.
ABSTRACT
Many traditional smokers are switching to electronic cigarettes or becoming dual users due to the perception that e-cigarettes can helps reduce addiction and are less harmful.
The use of pictorial health warning on cigarette packs is not sufficient to educate adolescents on the health risks of smoking, prompting the need for more accessible and appealing informational media to change adolescent smoking habits.
In response, researchers aim to develop digital comic as an innovative health promotion tool to shed light on the risk associated with traditional and electric cigarettes.
This research is a type of development research called research and development (R&D).
The model used in this research is analysis, design, development, implementation, and evaluation or the ADDIE approach developed by Robert Maribe Branch .
This study involved material experts, media experts, facilitators, and a limited population of adolescents to be able to make an assessment regarding the feasibility of the media developed by researchers.
The results of the feasibility test of innovative media in the form of digital comic strips about dangers of conventional cigarettes and electronic cigarettes involving material experts, media experts, and adolescents as a whole media can be categorized as very feasible with an average of 83.
Digital comic strips can be an alternative to innovative health promotion media to approach adolescents, especially groups of elementary and junior high school students, to increase their knowledge of the dangers and impact of smoking behaviour.
Keywords: Comic digital.
health promotion.
INTRODUCTION
Smoking is one of the most significant public health problems faced by countries around the world.
Smoking habits are often seen in junior and senior high school students because this is a transition period from childhood to adulthood .
During this period, individuals experience physical and psychological development and change.
Thus, adolescents tend to be emotionally unstable, resistant, anxious, and eager to experiment and explore.
Teenagers who like trying new things are more likely to develop a smoking habit .
Technological advances greatly affect all aspects of peopleAos lives, including changes in individual lifestyles.
These conditions have also encouraged the emergence of electronic cigarettes, or vapes, which are currently popular among adolescents and have become part of their lifestyle .
Many conventional and beginner smokers are switching Journal homepage: https://journal.
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Journal of Public Health and Nursing (JPHN) to electric cigarettes or becoming dual smokers because electric cigarettes are considered less risky and can eliminate addiction .
The World Health Organization (WHO) report in 2020 found that 22.
3% of the total population in the world uses tobacco, including 36.
7% of men and 7.
8% women .
More than 80% of the total 3.
1 million tobacco users worldwide live in countries with low and middle economic levels.
Tobacco users have an impact on the economic condition of the family, because there is a tendency that smokers prioritize spending to buy cigarettes compared to the fullfillment of proper food and shelter .
Indonesia is the third country with the highest number of smokers in the world .
million smoker.
after China .
million smoker.
and India .
million smoker.
Data from the Indonesia Health Survey (HIS) in 2023 showed that the proportion of electronic smokers in the population aged Ou10 years in Bali Province .
5%) was higher than the national proportion .
2%) .
In relation to these data, a study found that the second largest age group as active smokers, namely the general group of 15-24 years .
5%) including 64.
7% of men and 2.
3% of women .
Health education can be carried out with various methods and media .
Media in health education is used to facilitate the delivery of health messages to targets .
connection with this, it is important for researchers to develop an innovative media of health promotion about the dangers and effects of conventional cigarettes and electronic cigarettes in the form of digital comics.
Comics are media that are simple, clear, and easy to understand .
Comics are usually developed by containing image or characters .
that act out a story and are modified with writing as an explanation of the subject matter, so comics also have appeal .
Comic also help in conveying messages and information that is easily accepted, does not seem patronising and can increase reading interest .
Health promotion with adolescents targets will be more communicative with the use of comic media that contains elements of entertainment and visual message.
The use of digital comic media aims to facilitate adolescentsAo access to information about the dangers and impacts of conventional cigarettes and electronic cigarettes easily.
METHODS
The type of this research is development research called research and development (R&D).
Methodologically, this research is at the level 4 stage, which is researching and testing in creating new products.
The model used in this research is analysis, design, development, implementation, and evaluation or the ADDIE Approach developed by Robert Maribe Branch .
This research was conducted at the UPTD PUSKESMAS II Work Area of the North Denpasar District Health Office.
The implementation of this research will be carried out for six months, namely June to November 2024.
This study involved material experts, media experts, facilitators and a limited population of adolescents to be able to make and assessment regarding the feasibility of the media developed by researchers.
Researchers used a questionnaire data collection method with a questionnaire instrument equipped with statements that could assess the feasibility of the developed health promotion media.
In this study, researchers conducted data analysis by calculating score of each categorized indicators to conclude the feasibility of the health promotion media developed Journal homepage: https://journal.
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Journal of Public Health and Nursing (JPHN) by researchers.
This was done at the same time to test the credibility oh the data through the involvement of several material and media experts who had been selected .
RESULT
Researchers conducted several stages in the process of developing innovative media in the form of digital comics about the dangers of smoking both conventional cigarettes and electronic cigarettes.
The first stage, planning begins with observations and interviews with health promotion program holders related to the availability of media used in conducting education related to conveying information about the dangers of smoking.
The results of the observation obtained several conventional media used in health promotion activities about the dangers of smoking, such as stickers, leaflets, and posters.
Figure 1 Conventional Health Promotion Media .
Based on the result of observations and interviews conducted by the researcher, the researcher made developments by paying attention to the following points:
Table 1.
Aspects of Innovative Media Development Development Aspect Description Material Media Make an outline of the material/topic of the comic to be developed Determine the character of the character Make a simple conversation Selecting several supporting images to explain the material/conversation Designing digital comics related to the dangers of conventional and electric cigarettes with Canva.
Designing the display with appropriate Arranging conversation balloons according to the characters that have been determined Researchers developed innovative media using the Canva application in accordance with the aspects describe in Table 1.
The concept used in the development of this media is the concept of a more concise comic trip with short and light stories.
The following are the Journal homepage: https://journal.
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Journal of Public Health and Nursing (JPHN) results of the development of digital strips comic media with the title AuMyths & FactsAy Conventional Cigarettes vs Electronic Cigarettes .
Figure 2.
Digital Comis Strip Cover Figure 3.
Digital Comic Strip Content Researchers conducted feasibility testing on three groups, namely material experts, media experts, and youth groups.
Feasibility testing on material experts assessed 11 aspects/indicators related to:
The suitability of the conversation with educational material .
Suitability of media contest with the characteristic of the respondent .
Suitability of the way the material is delivered with the development of respondents .
Providing opportunities for independent thinking .
The attractiveness of the title .
The attractiveness of the delivery of message content in the media .
The conciseness of the media presentation of the material .
The correctness of the content of the material .
Clarity of material content .
Depth and breadth of material .
Language suitability with EYD.
Researcher involved three material experts who came from practitioners, members of the Tobacco Control Support Centre (TSCS) IAKMI organization, and health promotion lecturers from different institutions with researchers.
The material expert gave score on Journal homepage: https://journal.
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Journal of Public Health and Nursing (JPHN) each aspect related to the comic strip media developed by researcher.
The result of filling out the questionnaire, then analysed and tabulated by the research, so as to get the following result:
Table 2.
Tabulation of Media Feasibility Test by Material Expert
Aspect
Total Score
Max Score
Percentage (%) Criteria
91,67
Very feasible Very feasible Feasible 83,33 Very feasible Feasible Feasible Feasible 83,33 Very feasible Clarity of material content
Very feasible Depth and breadth of material Feasible Language suitability with EYD
Feasible Total
82,58
Very feasible The suitability of the conversation with educational material Suitability of media contest with the characteristic of the respondent Suitability of the way the material is delivered with the development of Providing opportunities for independent thinking The attractiveness of the title The attractiveness of the delivery of message content in the media The conciseness of the media presentation of the material The correctness of the content of the The result of the media feasibility test by material expert concluded that digital comic strip media is an innovative health promotion media that is very feasible to use in delivering health information related to the dangers of conventional cigarettes and electric Some aspects that need improvement, namely related to the suitability of the delivery of material with the development of respondents, the attractiveness of the title, the attractiveness of the delivery of message content in the media, the orderliness of the presentation of the material, the depth and breadth of the material, and the suitability of language with EYD.
Feasibility testing on media expert was carried out assess 13 aspects/indicators, consisting of:
The accuracy of the background with the material .
Accuracy of layout proportions .
Accuracy of font selection for easy reading .
The accuracy of the font size to make it easy to read .
Accuracy of text colour to make it easy to read .
Image composition .
Image size Journal homepage: https://journal.
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Image display quality .
Accuracy of conversation with the message conveyed .
The attractiveness of the digital comic display .
Media durability .
Compatibility with users .
Flexibility The following are the results of the analysis of the media expert assessment based on the 13 aspects/indicators above:
Table 3.
Tabulation of Media Feasibility Test by Media Expert
Aspect
Total Score
Max Score
Percentage (%) Criteria
The accuracy of the background with the material Feasible Accuracy of layout proportions 91,67 Very feasible 83,33 Very feasible 83,33 Very feasible 83,33 Very feasible Image composition 91,67 Very feasible Image size
91,67
Very feasible Image display quality Feasible 91,67 Very feasible 83,33 Very feasible 91,67 Very feasible Compatibility with users 83,33 Very feasible Flexibility Very feasible Total
86,54
Very feasible Accuracy of font selection for easy The accuracy of the font size to make it easy to read Accuracy of text colour to make it easy to read Accuracy of conversation with the message conveyed The attractiveness of the digital comic Media durability Table 3 shows that the results of the feasibility test form media expert can be concluded to be categorized as very feasible, but there are two aspects that need to be improved, namely related to aspect of background accuracy with material and image display quality.
Researchers also tested the feasibility of digital comic strip media on 10 adolescents who were included in the youthAos POSYANDU.
There are 8 aspects/indicators assessed by adolescents to categorize the feasibility of digital comic strip media, namely:
The attractiveness of comic media .
Ease of understanding the material .
Systematic of the material presented .
Use of language in the media Journal homepage: https://journal.
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Attractiveness of appearance .
hape and colo.
Clarity of story and material content .
Ease of use .
Ease of management The following are the result of the analysis of adolescentsAo assessment of digital comic strip media based on the 8 aspects/indicators above:
Table 4.
Tabulation of Media Feasibility Test by Media Expert Aspect Total Score Max Score Percentage (%) Criteria The attractiveness of comic media Very feasible Ease of understanding the material Very feasible Systematic of the material presented Feasible Use of language in the media Very feasible Attractiveness of appearance .
hape and colou.
Feasible Clarity of story and material content
Very feasible Ease of use Feasible Ease of management Feasible Total
82,18
Very feasible Table 4 show that the results of the feasibility test from adolescents can be concluded to be categorized as very feasible, but there are four aspects in the feasible category that need to be improved, namely related to the systematic aspects of the material presented, the attractiveness of the appearance .
hape and colou.
, ease of use, and ease of DISCUSSION Comic in general are visual media that are in great demand by the public, including adolescents, while the public in general considers comics to be something that is humorous, suspenseful, builds curiosity that can bring readers to the background situation told .
Digital comics are also digital education media in the form of images, symbols, stories with certain characters that can provide information or message content with text information as an explanation .
The feasibility test process carried out in this innovative media development research involving media and material experts is an effort to get a product that can increase adolescentsAo interest and awareness regarding the topic of the dangers of smoking .
CONCLUSION
The conclusions of this research are as follows:
The process of developing innovative media in the form of digital comic strips about the dangers of conventional cigarettes and electric cigarettes war carried out by researchers with the stage of analysis, development, design, implementation, and Journal homepage: https://journal.
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Journal of Public Health and Nursing (JPHN) The analysis process was carried out by interviewing health promotion officers and observation, the development and design stage were carried out by planning the design and using the Canva application.
The implementation and evaluation stages are carried out by feasibility testing.
Researchers conducted a feasibility test of innovative media in the form of digital comic strips about the dangers of conventional cigarettes and electric cigarettes by involving material expert, media expert, and adolescents.
The result as a whole media can be categorized as very feasible.
Researchers recommend that digital comic strip can be an innovative alternative health promotion media to approach adolescents, especially groups of elementary and junior high school students, to increase their understanding of the dangers and impacts of smoking behaviour.
Acknowledgments Researchers would like to thank to Kartini Bali Foundation and Kartini Bali Health Polytechnic for providing material and non-material support, as well as all experts and adolescents who have volunteered in this study.
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