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Objectives: Cartoons, comics, and caricatures have been incorporated in health education. This trial aimed to evaluate the effectiveness of caricature‑based breastfeeding education at improving breastfeeding knowledge, attitudes, self‑efficacy, and practice among pregnant women. Materials and Methods: A randomized controlled clinical trial was carried out at Riyadh First Health Cluster in Saudi Arabia. A total of 85 pregnant women were randomly assigned to the intervention group (n = 41) or the control group (n = 44). The intervention was two caricature-based versus one standard online lecture in breastfeeding. The participants were followed up for 3 months postpartum. The primary outcome was full breastfeeding (predominant and exclusive breastfeeding) by the time infants were 3 months old. The secondary outcomes were prenatal and postnatal breastfeeding self‑efficacy, Iowa Infant Feeding Attitude Scale (IIFAS) scores, and satisfaction with the education. Results: The participants were mostly Saudi (97.6% vs. 90.9%) and housewives (79% vs. 86.4%) for the intervention and control groups, respectively. The full breastfeeding rate at 3 months postpartum was 32.5% for the intervention and 31.6% for the control (P = 0.808; 95% confidence interval 0.539–1.965; relative risk = 1.029). Prenatal breastfeeding, postnatal self‑efficacy, and IIFAS scores were compared between the intervention and control groups; no statistically significant difference was found (P > 0.05). In both arms of the study, participants’ experiences with the health education were satisfactory. Conclusion: Caricature use in antenatal breastfeeding education was a pleasant experience, but its effect on self‑efficacy, attitudes, and behavior could not be determined from this trial. Large‑scale, multi‑center, multi‑component research is recommended. [ABSTRACT FROM AUTHOR]

Background: Cerebrovascular accident dramatically impacts patients' lives. However, this chronic disease could be managed by boosting self-care and following healthy behaviors. Accordingly, this trial sought to specify the impact of a training program established on the theory of planned behavior on the self-care of clients with this condition. Materials and Methods: This trial was performed on 80 clients, who were selected using a random numbers table and divided into two equal groups to receive either usual care alone or usual care plus a training program based on the theory of planned behavior (five in-hospital individual sessions for 5 weeks and weekly phone follow-ups for 2 months after discharge). Self-care and the dimensions of the theory of planned behavior were investigated at baseline and 2 months after the last in-hospital session using the standardized Shah version of the modified Barthel index and a researcher-made questionnaire, respectively. Results: The mean score of self-care was significantly higher in the experimental arm at the posttest (Mann--Whitney = 506.00, p = 0.005). Also, the increase in mean change of self-care from baseline to posttest was significantly more in the experimental arm (t78 = -6.6, p < 0.001). Such findings were also found for all dimensions of the theory of planned behavior. Conclusions: Based on results, nurses and health policymakers can incorporate training based on the theory of planned behavior into routine care programs for patients with cerebrovascular accident to boost their self-care. The implemented intervention also could be reproduced in other contexts. Hence, further trials are requested to specify the sustainability of the findings. [ABSTRACT FROM AUTHOR]