Asthma affects more than 6 million children and leads to approximately 1.8 million visits to the emergency room annually in the United States, according to the Centers for Disease Control and Prevention.
In order to effectively manage asthma and help eliminate trips to the emergency room, physicians must identify the correct daily control and emergency rescue medications for their patients. However, educating young patients and their families is also critical.
“Patient education needs to be done at every visit,” Richard Moss, MD, professor of pediatrics, emeritus at Lucile Packard Children’s Hospital Stanford, recently told me. “This includes a review of the asthma symptoms, proper use of medications, written action plan, test results and educational handouts. The key is continuity of care and reiteration of important information at every visit.”
Last month, NBC News featured the work of an Illinois physician who has taken a non-traditional approach to patient education. Alex Thomas, MD, a cartoonist and pediatric allergist at the Center for Asthma and Allergy, created a multimedia asthma education program called Iggy and the Inhalers, which includes comic books, YouTube videos, posters, trading cards and stickers. I recently spoke with Thomas about this program and Booster Shot Comics, a partnership between Thomas and a health-communication specialist.
What motivated you to create the Iggy and the Inhalers comic book?
I started drawing Iggy characters when I was 11 years old. I grew up with asthma myself, so I drew as a way to understand my medications – turning them into superhero characters. My mom is an allergist, and she had a patient support group for kids with asthma. So I started drawing little comic strips about Iggy in the support group newsletter.
An interest in asthma and asthma education ultimately led me to go to medical school and become a pediatric allergist. When I was working on the pediatric wards, I noticed that a lot of kids were being admitted and readmitted to the hospital for asthma exacerbation due to confusion about their medications. So I eventually revisited my Iggy characters to create educational materials for physicians and patients, with the help of health communication specialist Gary Ashwal.
Can you describe the characters in Iggy and the Inhalers?
Iggy the Inhaler is the main character who teaches kids about the physiology of asthma. He has two teammates. One is Broncho the Bronchodilator, a rescue inhaler for quick relief of symptoms. The other partner is Coltron the Controller, a control inhaler that kids with persistent asthma need to take on a daily basis. There are also asthma trigger villains: Smokey Joe, Moldar, Pollenoid, Dust Mite, Roach and Hairy.
We wanted to create dynamic characters that embodied the mechanism of the medications that they represent, so kids can intuitively understand how the medications actually work. When kids look at a rescue inhaler, they imagine Broncho loosening the muscle bands around the airway because he’s a cowboy with a lasso. Whereas when they look at a control inhaler, they imagine Coltron decreasing inflammation inside the airways using his fire extinguisher arm.
How have families responded to Iggy the Inhaler?
It has been very effective.
There was one family that really stuck with me. A mother came with a 3-year-old son for an initial visit with a bag full of medications prescribed by an emergency room physician and subsequently doctors in urgent care. They were frazzled and overwhelmed, and the child was still coughing. I had them watch the basic Iggy video, while the Mom flipped through the comic book. When we talked afterwards, she said she finally understood the basic differences between the medications. She was very relieved and they went home with the Iggy stickers, comic book and trading cards.
The next week, the family returned for a follow-up. The son specifically asked to watch the Iggy video. He was reciting the words, wanting to play it again and again like an Elmo video. He was responding to the characters and the live actions in the video on how to use an inhaler. Since then, he’s done great. Every time I see him, he asks for more Iggy stickers.
What other projects is Booster Shot Comics working on?
We have plans for future issues of the Iggy comics and animated videos that will cover more specific topics on asthma and allergies, such as how to eliminate allergy triggers from the home. We are also working with physicians at the Children’s Hospital of Wisconsin to turn discharge instructions for a concussion into a comic book, as well as a comic book to teach kids and their parents how to treat pain.
Jennifer Huber, PhD, is a science writer with extensive technical communications experience as an academic research scientist, freelance science journalist, and writing instructor.
Previously: Tips from a child on managing asthma, Text message about asthma could help children breathe easier, Cancer Ninja fights patient misinformation, one cartoon at a time and Stanford alumnus writes children’s book to inspire next generation of curious minds
Video by Booster Shot Media