STORIES ABOUT ALCOHOL DRINKING IN A QUILOMBOLA COMMUNITY: PARTICIPATORY METHODOLOGY FOR CREATING-VALIDATING A COMIC BOOK BY ADOLESCENTS¹

ABSTRACT

Objective:

describe the participatory methodology of adolescents in the creation-validation process of a comic book that addresses alcohol experimentation, and analyze the experiences of these adolescents that were portrayed in the comic book.

Method:

participatory, applied between 2015 and 2016, using the dynamics of creativity and sensitivity for comic books, of the creative sensitive method, in two groups of adolescents (G1 and G2), totaling 17 participants, aged from 10 to 17 years, all of them living in a Quilombola community in the north region of the state of Espírito Santo, Brazil. G1 participated in the creation of the comic book with content definition and production. G2 validated the experiential content of the comic book.

Results:

community info-geography and sociocultural information contributed to the creation of the scenery and characters; the narrative of boys (five) and girls (five) provided the storyboard script which a contracted designer changed into "A possible story." In the validation, boys (two) and girls (five) created the cultural identity with the plot, since alcohol is part of the everyday life of the community, stimulating experimentation among adolescents.

Conclusion:

the creation-validation methodology of a comic book about alcohol experimentation stimulated a critical thinking of adolescents who created and validated it.

DESCRIPTORS:
Educational and promotional materials; Adolescent; African continental ancestry group; Nursing; Methodology

RESUMO

Objetivo:

descrever a metodologia de participação de adolescentes no processo de criação-validação de uma história em quadrinhos que retrata a experimentação do álcool e analisar as experiências e vivências desses adolescentes que foram incorporadas às histórias em quadrinhos.

Método:

pesquisa participante, implementada entre 2015 e 2016, com a dinâmica de criatividade-sensibilidade "Almanaque" do método criativo-sensível, em dois grupos de adolescentes (G1 e G2), totalizando 17 participantes, entre 10 e 17 anos de idade. Todos residentes numa comunidade quilombola ao norte do Estado do Espírito Santo, Brasil. O G1 participou da criação da história em quadrinhos com o diagnóstico e a produção do seu conteúdo. O G2 validou o conteúdo vivencial e experiencial da história.

Resultados:

a infogeografia da comunidade e as informações socioculturais contribuíram para a criação do cenário e dos personagens; a narrativa de meninos (cinco) e meninas (cinco) forneceu o roteiro do storyboard transformado pelo designer contratado em "Uma história possível". Na validação, meninos (dois) e meninas (cinco) criaram identidade cultural com o enredo da história, pois o álcool integra-se ao cotidiano de vida da comunidade, estimulando a experimentação entre os adolescentes.

Conclusão:

a metodologia de criação-validação da história em quadrinhos, sobre o álcool estimulou a criticidade, tanto de quem a criou como de quem a validou.

DESCRITORES:
Materiais educativos e de divulgação; Adolescente; Grupo com ancestrais do continente africano; Enfermagem; Metodologia

RESUMEN

Objetivo:

describir la metodología de participación de adolescentes en el proceso de creación-validación de una historieta que retrata la experimentación del alcohol y analizar las experiencias y vivencias de esos adolescentes que fueron incorporadas a las historietas.

Método:

investigación participante implementada entre 2015 y 2016, con la dinámica de creatividad-sensibilidad "Almanaque" del método creativo-sensible, en dos grupos de adolescentes (G1 y G2), totalizando 17 participantes, entre 10 y 17 años de edad. Todos los residentes en una comunidad quilombola al norte del Estado del Espíritu Santo, Brazil. El G1 participó en la creación de la historieta con el diagnóstico y la producción de su contenido. El G2 validó el contenido vivencial y experiencial de la historia.

Resultados:

la info-geografía de la comunidad y las informaciones socioculturales contribuyeron a la creación del escenario y de los personajes; la narrativa de varones (cinco) y las mujeres (cinco) proporcionó el guion de la historia transformado por el diseñador contratado en "Una historia posible". En la validación, varones (dos) y mujeres (cinco) crearon identidad cultural con el enredo de la historia, pues el alcohol se integra al cotidiano de vida de la comunidad, estimulando la experimentación entre los adolescentes.

Conclusión:

la metodología de creación-validación del cómic, sobre el alcohol estimuló la criticidad, tanto de quien la creó y de la que la validó.

DESCRIPTORES:
Materiales educativos y de divulgación; Adolescente; Grupo de ascendencia continental africana; Enfermería; Metodología

INTRODUCTION

Alcohol is a low-cost product of wide social acceptance, easily available at parties, commercial facilities (stores, bars, supermarkets, and others), and at home. In this paper, we will use the terms "experience/experimentation" and "alcohol consumption" to designate alcohol drinking start time and frequency of use.^1-3

A study conducted in 2012 on alcohol experimentation and consumption among Brazilian adolescents, based on data from the Pesquisa Nacional de Saúde do Escolar (PENSE), reports that more than half of them, from both private and public schools, had experienced one or two shots of alcoholic drinks; 26.1% had consumed alcoholic drinks in the month prior to the survey, and 28.1% reported drunkenness. Those over 14 years of age experienced the first shot of alcoholic drinks between 12 and 13 years. As age increases, alcohol experimentation also increases, particularly among boys.¹ Data from this research did not analyze their ethnicity or place of residence, whether rural or urban area.

In this context, preventive nursing care, as part of total health care, should include the training of adolescents on self-care practices, health education, and production of educational materials, for example. However, a process of autonomy should be considered, involving dialogue and listening so that the decision-making on alcohol experimentation is conscious and not impulsive.

In the teenage phase, experimentation is inherent to the desire to learn about the world and with peers. However, the risks associated with the regular and continued consumption of alcoholic drinks can cause social, physical, and mental damages, which require collective and critical reflection, in the "I-you" relationship, focused on historical and sociocultural conditions. These assumptions are implied in a movement to (re)formulate health and health education practices for this target audience of many specificities.^1-2

The theme of alcohol in adolescence is little discussed in educational materials or presented with other subjects.^3-4 The content is usually more focused on adolescents living in urban areas, with the lifestyle of large cities, not taking into account their ethnicity, particularly disregarding black adolescents in public health issues. Scientific content and illustrations of these materials show more of the urban life^3-4 and do not involve the experiences of black adolescents living in rural areas whose daily life and history are unique to that place. Any material based on this logic does not favor the access of adolescents living in Quilombola communities to health information that considers ethnic/racial and geographical components and would allow them to create a reader identity with the characters, sceneries, and stories.

Quilombola communities are comprised of ethnic-racial groups according to self-attribution criteria. They were created as a form of resistance of black slaves to escape the historical oppression they suffered during the slavery period in Brazil. Quilombo is the basis of the physical, social, economic, and cultural reproduction of the collective, and the owners of these lands are remnants who ensure the physical, social, economic, and cultural reproduction of the community.⁵

Materials that show the view of the information producer, instead of producing knowledge, are cultural invaders, that is, they are the thinkers (not the invaded ones), based on their own values and references, imposing their word and silencing the invaded ones. They think for the other, not with the other. "The invader prescribes and the invaded ones just follow the prescription."^6:26-27 The creation of educational, interactive, and culturally non-invasive educational materials represents a great challenge to be addressed in public health policies. In this context, the Política Nacional de Saúde Integral da População Negra (National Policy of Integral Health of the Black Population) encourages, among other actions, the development of informative, communicational and educational materials on the health of this population, respecting the diverse knowledge and values, with the aim of socializing information and actions to promote the integral health of black people.⁷

The process of nursing care, within the scope of the policy of integral attention to the health of the black population, involves interpersonal relationships and is based on cooperation and mutual trust, from both the caregiver and the care receiver, developing from humanistic values and scientific knowledge.⁸ Considering care from this perspective requires new guidelines, proposals and methodologies of intervention through current methods to understand the subjective, biological, and sociocultural processes that are impacted by cultural invasion.

We understand that a comic book⁹ can be a powerful educational tool because it allows adolescents to reflect on social practices of experimentation and alcohol consumption in society, mediated by ludicity and critical thinking. Considering the above, this study analyzed the participation of black adolescents from a Quilombola community in the north region of the state of Espírito Santo in the construction of stories about alcohol drinking as a comic book. The objectives of this study were: to describe the participatory methodology of adolescents in the creation-validation process of a comic book that addresses alcohol experimentation, and analyze the experiences of the adolescents that were portrayed in the comic book.

METHOD

This is a participatory research^10-11 that used the Creative Sensitive Method (MCS) for arts-based group research.¹² While participatory research favors shared knowledge production, using the social reality of participants, the MCS values artistic expression to access human experience.^10-12 The active participation of adolescents in all stages of knowledge production and construction, focused on the stories and culture of adolescents from a Quilombola community, was associated with the playfulness and critique of creative and sensitive art to generate a new methodology for the production and validation of educational material in a comic book format by and for adolescents.

To complement the narratives, ethnographic records were adopted to show the world with greater clarity from the point of view of the participants. As a constant need for anthropological search, the concepts inherent to their "close experiences" were analyzed, with clarification and articulation of "distant experience" theoretically created to understand social life.¹³ On these occasions, the first author for eight days (including the weekend) spent 64 hours in the community between April and December 2015. The conversation with the nurse and the Community Health Agent (ACS), the family health team from the assigned area, community leadership, residents, and local school teachers, about the habits, stories, and legends of that social group were recorded in the field log of the study as an ethnographic note. This information helped create the characters of the story (info-biography) and the daily life (info-sociocultural aspect) in the comic books. In addition, the access to the community, the types of houses, churches, soccer field and school, the crops and animals were captured in the form of relevant pictures to build the scenery and scenes (info-geography) of the comic book.

The study was conducted in a Quilombola community, in the rural area, 44 kilometers from the municipality of São Mateus, in the north region of the state of Espírito Santo, Brazil, after approval of the Ethics Committee of the Escola de Enfermagem Anna Nery and the Instituto de Atenção Francisco de Assis (CEP EEAN/HESFA) of the Universidade Federal do Rio de Janeiro (protocol 856.682/2014).

The community leadership and the ACS distributed invitations to families with adolescents for meetings that took place on Sunday, when the first author presented the research proposal, which was also for the participation of adolescents. The content of the study terms (informed consent for parents/guardians and agreement for adolescents) was then read and explained.

When selecting the adolescents, the following inclusion criteria were adopted for two groups (G1 and G2) created at two distinct moments: attend elementary and/or middle school attendance in a public school located in the rural area; live in the Quilombola community; of either sex; aged 10 to 19 years, according to the World Health Organization (WHO), and with preserved cognitive and motor skills. Adolescents with acute diseases and chronic conditions, or not attending a public school in rural areas, and those living outside the Quilombola community were excluded. The adolescents who attended the meetings in March 2015 (G1) and October 2016 (G2) with their legal representatives, were placed in G1 and G2, respectively. G1 had ren adolescents (five girls and five boys), and G2 had seven (five girls and two boys).

Data generation was implemented in two of the three stages by G1, corresponding to the diagnosis and creation of the comic book; G2 was responsible for the general comic book validation in the third stage. The three stages were developed using the creativity and sensitivity dynamics of the MCS.¹²

The diagnostic stage was performed in two meetings whose minimum duration was 1 hour and 7 minutes, and maximum duration was 1 hour and 45 minutes. In the first meeting, G1 participated in the Dynamics of Creativity and Sensitivity (DCS) "Shortening Distances." After welcoming the participants, boys and girls elaborated the individual artistic production and answered the question for debate (QGD): "I am... I stay... I want..."At the end, each participant presented and discussed with the group what he/she had produced, synthesizing and validating the debate themes codified in the biographies of the characters in the comic book. These procedures helped raise the group awareness of the theme, created a group identity, and provided materials that subsequently inspired the comic book.

In the second meeting, the group participated in the DCS "Building My World" for the comic book, based on the following QGD: "Near my house, I see alcoholic drinks in..." With the material provided (Styrofoam boards, modeling paste, glue, scissors, and popsicle sticks) and several images (showing alcohol at parties, in bars, and at home) from the public domain of the Internet, G1 developed the individual artistic production, presenting and discussing it afterwards. The dynamics generated an image bank and narratives with the diagnosis of the alcohol scene in the social environment in which the participants live.

The second stage, creation of the comic book, started with the analysis of the thematic content¹⁴ of the written text corpus and images of the DCS and the ethnographic records. The first analysis corresponded to successive readings for material impregnation. In the second analysis, the materials were explored, encoding them through words, expressions, and text fragments linked with alcohol-related experiences. The text elements with common characteristics were grouped by theme (rural environment, sociocultural aspects, people, family members, what they drink, behavior). In the last stage, the various themes were reduced to only five, which were transformed into the storyboard "A possible story," which is part of the "Comic Book: Alcohol and Rites of Adolescents in a Quilombola Community." Also in this stage, scientific and legal bases were used to involve critiques and the experiential content of the adolescents, which were presented in the format of "curiosities", using direct language and short text.

In the storyboard,⁹the stories could be invented or based on everyday events, characterized by narration of facts with natural dialogue, through which the characters interact with words, gestures, and facial expressions. The speech is direct, in balloons, aided by legends and linguistic (onomatopoeic words, punctuation marks), paralinguistic (intensity of sounds, speed of pronunciation, and expression of emotions), and visual resources (pictorial figuration of emotions in the characters, balloons, and letters). To narrate the content of the story, a simplified and contemporary presentation was used, with few rules, to facilitate the work of illustrators and layout designers.¹⁵

The storyboard presented to G1 adolescents in the qualitative evaluation rounds of info-geographic (scenery), info-sociocultural (the story itself), and info-biographic (caricature) contents of the characters. Each version of the comic book, previously illustrated and designed by a professional contractor, was projected on multimedia equipment to be read by G2 adolescents, frame by frame. This group validated the material in the DCS "Shortening distances between what was produced and the comic book," with the following question for debate: "The characters are...the scenes are...the stories are..." No changes were proposed by the group. The whole meeting lasted 1 hour and 15 minutes.

The narratives of the participants were identified by the first letter of their names, followed by the gender (boy/girl) and age (in years).

RESULTS

The narratives of the stories of G1 adolescents inspired the production of the biographies of the comic book characters. They were boys and girls aged 10 to 14 years, from extended biparental, single parent, and nuclear families. All of them had consanguinity links (third and fourth-generation cousins and brothers) and they said they were Catholics or evangelicals. The students in the elementary school attended the multi-teacher school of the community; those who were in the middle school attended the Escola Família Agrícola. Two persons presented schooling level that was incompatible with their chronological ages, as they had failed and dropped out of school. The family income was less than four minimum wages (in March 2015 one minimum wage corresponded to R$788.00), whose income came from rural work and social benefits from the Sistema Único de Assistência Social (SUAS) (Family Allowance, Continued Provision Benefit) and rural retirement. After school, boys and girls played only after their school assignments, rural work, and helping around the house.

The following items describe the production-validation methodology of the storyboard of dialogic and interactive basis.

1. From diagnostic stage to comic book creation - a dialogic and participative process

The info-biography of the characters from the story was based on the characteristics of the participants, but a fictitious biographical character was maintained. The caricature of the characters preserved the sociocultural identity compatible with the lifestyle of the boys and girls, men and women, of the Quilombola community where they lived.

The scenery of the story (Figure 1) was created using the community info-geography, that is, a collection of images selected by the adolescents in the DCS "Constructing my world...," which express scenes of the life of a Quilombola rural community (house, crops, animals, bars, availability of alcoholic drinks(A); B) with photo-ethnography(B); C) to constitute the final version of the story scenery (C).

Figure 1
Process of comic book scenery creation. Rural Quilombola Community.

São Mateus, ES, Brazil, 2015

Chiumbo appears after combining scenes A and pictures B, a fictitious name chosen by G1 participants for the scenario of "A possible story" about alcohol and its effects on human behavior. In the story, Chiumbo is the name of a rural Quilombola community, located near the Cricaré river, in the municipality of São Mateus, in the north region of Espírito Santo, in Brazil. The access to the community is by an unpaved road, crossing the coconut plantation of a company that hires people from the community and also sponsors the only local soccer team. Conilon coffee, pepper, and many fruit trees are planted there to support the community as family farming.

The community has Catholic and Evangelical churches, a soccer field, a multi-teacher municipal public school, five bars that sell several alcoholic beverages, and houses.

Info-sociocultural data from the comic book emerged from narratives about lifestyles of adolescents and insertion in the context of families. Men and women buy fermented (beer) and distilled (cachaça) drinks to consume at home or at the bar near their homes.

Near my house there is a bar, which sells cachaça and beer. Men go there to drink and the women buy beer for the husbands to drink at home (L., boy, 10 years old). Near my house there are two bars (C. and Z.), where drinks are sold (J., girl, 13 years old).

Bars are places where friends meet to drink in a glass or directly from the bottle and get drunk walking around the community. Daily scenes show the experience of boys and girls with social drinking and that gather people, family members, and friends.

[...] At T.'s bar, several friends meet and drink (C., boy, 12 years old). [...] At the bars, there are bottles of alcoholic drinks and people drinking, there are also soft drinks (T., boy, 10 years old). At the bar, I see a man pouring his drink in a glass and some people drink from the bottle. There are a lot of people drinking at the bar and they leave the bar drunk (U., boy, 11 years old).

The analysis of these narratives led to the theme "behavior change with alcohol drinking," inspiring the creation of an adult character for the story, who regularly drinks alcohol and works in crops, which are the main source of income in family agriculture of the region, captured in the photo-ethnography of the first researcher. The main character of "A possible story" is Afro-descendent, married, and head of a nuclear family with six children. One of his habits is "to drink with friends or alone in bars near his house" after the rural work. Then he leaves the bar drunk, and walks the unpaved streets, stopping at the other bars farther from his house to continue drinking.

He is one person among many who get drunk in the community, and who can let alcohol change his life, especially the older people, who drink until they fall to the ground.

[...] Uncle C. has a bar that is not so close to my home. In Uncle M.'s bar, there is a sign that says: "Don't let alcohol change your life." Even so, I see several empty bottles of beer, drunk people... (T., boy, 11 years old)[...] The older people go from bar to bar drinking until they fall to the floor (G., boy, 13 years old). There are many people drinking at the bar and getting drunk (U., boy, 11 years old).

The behavior of drunken staggering adults who drink until they fall to the ground led to the development of a preliminary storyboard of "A possible story," which reproduces the speech of characters in a social and historical context. The organization and layout of the preliminary storyboard script defined the size of the production of the researchers and technical team in charge of story illustration and design. The characters, scenes, scenery, and narratives provided by the participants led to the construction of dialogical educational materials, interactively and culturally focused on their lives.

In one of the ethnographic immersions, a resident told the "Gameleira tree story," which was added to the DCS material to create the final argument of the comic book.

One night a man returned to the community from another nearby community. On the road there was a gameleira tree (the tree was said to be haunted, the people walked by and they heard voices, whispering, and many saw figures). That was the only road. There was a swamp, the gameleira tree, the road, and a very large white cashew tree. When the man was walking by, the road reversed and he ended up in the middle of Airi bushes and stayed there all night trying to get out of the bushes and find his way home. As the day was dawning, the sunshine lit up the road and the man finally found his way home. Then, he told everyone that the gameleira tree made the road disappear! (Ethnographic journal, local resident, 2015).

And so, the plot (scenes, scenery, characters, arguments, and narratives) was created for the comic book titled "A possible story" (Figure 2), still as a storyboard.

Figure 2
Arrangement of the preliminary storyboard for the comic book "A possible story" and sequence of narratives and images (A, B, C).

Version developed by professionals (D, frames 1 to 20). Rural Quilombola Community. São Mateus, ES, Brazil, 2015.

"Tukufu, a young man descending from slaves, married and father of six children, every day after working his land, where he lives and plants as a family farm, goes before the sun goes down, to a bar near his home to drink, relax, and meet friends. One day, he decided to go to another bar, and as he walked by the roots of a large gameleira tree, he stumbled, fell, and hit his head on a root, and was unconscious, falling asleep. During his deep sleep, he saw several images that made him rethink his life, his alcohol consumption and his family. He sought help to try to stop drinking."

The process of comic book development involved permanent dialogue, the illustrated storyboard coming and going for the appreciation of the adolescents, and changes whenever necessary. After the G1 participants read the storyboard and the text and image alterations made by the group, the material (A, B, and C) was delivered to a contractor (that converted it into D). Besides the image, the frames described actions, site, time, moments, and other information that guided the work of all of the professionals (Figure 3).

Figure 3
Fragments of the storyboard that is part of the comic book "Alcohol and Rites of Adolescents in a Quilombola Community."

São Mateus, ES, Brazil, 2016

After the characters presented the situation/problem, two curious facts about the effects of alcohol on people's behavior were inserted in the story, representing the translated scientific knowledge. CURIOUS FACT 1: Euphoria, relaxation, and pleasure plus loss of shyness and increased self-confidence are some initial effects of alcohol on people's bodies. CURIOUS FACT 2: With increased amount of alcohol, the movements become slower, uncoordinated, the person becomes sleepy and, if he keeps drinking, he can lose consciousness, fall into a coma, and die.

2. Validation of the comic book by peers

In the validation stage, the comic book was evaluated by other adolescents (G2), according to the cultural identification with the characters, the scenes and the narratives of the story. Regarding the characters, the adolescents found similarities between the story characters and the community people. Two participants reported the character reminded them of their grandfather.

Tukufu reminds me of my grandfather (EAN, girl, 11 years old) and (AMO, boy, 10 years old).

Others said that Tukufu reminds them of people who spend their life drinking, are always at the bar, and never go to church. Some of these people stopped drinking, but others continued forever. The info-geographical characteristics also helped create the identity of the character with the community, in addition to the sociocultural issues, as highlighted by three adolescents.

Tukufu reminds of some men who are always drinking here in the community, who are always at the bar and never go to church (ANS, boy, 12 years old). Tukufu reminds of some people from the community. Some have stopped drinking, but others continue (LTS, girl, 16 years old). Tukufu reminds of some people from the community, because of the alcohol consumption and the family farming (CTS, girl, 17 years old).

The rural environment portrayed in the scenes of the story represents the community where they live, as alcoholic drinks are sold at bars, a place where friends meet to drink every day, on weekends, and at parties.

In the countryside, with alcoholic drinks at bars and with friends (SNS, girl, 14 years old). The scenes are real situations of the community. It happens every day, more on weekends and at parties (ANS, boy, 12 years old). The scenes seem to show our community (EAN, girl, 11 years old and CTS, girl, 17 years old).

Regarding the story, they identified it as fiction, but very similar to the cases reported by older people in the community. It can be anyone who lives in the neighboring Quilombola community and does not think about the family when he starts drinking.

The story seems to tell what happened to a person from the neighboring community (KS, girl, 10 years old and EAN, girl, 11 years old). // They portray some people who live in the community, for example, there are many people who drink and do not think about the family (LTS, girl, 16 years old). // The story shows the reality of the community, because it really happens (CTS, girl, 17 years old, LTS, girl, 16 years old, and SNS, girl, 14 years old).

The validation of the info-geography of the community scenery, the info-biography of the characters, and the social and cultural information presented in the narratives promoted the reflection of the adolescents who understood the meaning of the comic book "A possible story." The story of the gameleira tree was a cultural instrument of mediation of information regarding the effects of alcohol on the behavior of the human being, in a playful and artistically represented manner. No changes were requested by the group, and the comic book was qualitatively validated.

DISCUSSION

The participatory diagnosis was the first step in the production-validation methodology of the comic book, since it provided the info-geography of the Quilombola community and the sociocultural information, which created the scenery and the caricatures of the comic book characters. The narratives of the adolescents showed the social place of alcohol in the community and its effects on human behavior systematized to constitute the storyboard that originated the comic book.

A comic book, in addition to being a didactic technology, entertains and can mediate health education. In its construction, texts and images preserve bordering characteristics between the forms of scientific systematization, considered by the popular conception of "useful information."¹⁶ At the same time, they act as an environment for the expression of popular culture, maintaining, creating, and recreating the universe of life and science.¹⁷ The adolescents were challenged to understand the meaning of their experiences by reflecting on their social practice in their meeting with their family members and community members in relation to alcohol. Thus, the naive curiosity about alcohol, perceived as such, became critical, evidenced by the demand for scientific content: namely the effects of alcohol on behavior, which was represented in the comic book as a curious fact.

Brazilian adolescents, either boys or girls, whether living in urban or rural communities, are immersed in a sociocultural context of daily experience with alcohol as a means to gather people, and whose consumption is understood as "legal" by adults, and with small restriction regarding the target audience of adolescents.^18-19 However, their experimentation reflects the reality as part of their rites of passage.⁸ From this perspective, this stage of life is highlighted as a period of intense experience and experimentation. In this transition phase, new personal relationships are created through interaction with peers, generating mediated interpersonal learning.

The knowledge acquired by adolescents is socially constructed in their community practice; it is constituted in and of mediated cultural and social relations. For such knowledge to emerge, conditions should exist for its production and construction through criticism and reflection. According to Freire,⁶ reflections promote human being's awareness and learning. The ability to learn drives reality transformation, leading to interference and re-creation of the reality. The material, economic, and sociocultural conditions of people almost always involve obstacles to be overcome to accomplish the historical task of changing the world. But, critically thinking, today's or yesterday's practice can improve the next practice, because the more an adolescent reflects, the more he or she will be able to change his/her story.

Regarding the production of educational technologies presented in the scientific literature with the aim of improving the cognitive process in learning, sometimes readers and students find specific content about health and illness processes abstract. It often contains previously structured knowledge that does not involve the experiences of students.^20-21 Contrary to the linearity of this way of producing educational materials, the circularity of knowledge was a characteristic of this methodology for comic book construction. The knowledge of the researcher in participatory research, and of the adolescent, was also respected; the process ensured autonomy to include and exclude what did not constitute cultural identity. In addition, they valued knowledge built by them during the process, with ethical and negotiating dialogue during the production of educational material as a comic book. With dialogue, democracy, and the plurality of voices of adolescents and the researcher,⁶ the product of this technology materialized for use in health education environments.

The educational actions were recognized by the users of the Unified Health System (SUS) as a place for listening and dialogue. However, they emphasized that educational actions are centered on the hegemonic medical model, with specific themes for certain population groups, emphasizing knowledge transfer, not valuing the social and historical context where the user is inserted and the impact on his/her health.²²

Nurses involved in educational activities are constantly challenged to seek optional materials to support them in health education with individuals, groups, and communities, with those more dialogic materials as strong allies in this process.^23-25 However, for professionals to effectively use this educational tools, they have to be developed and then validated by representatives of the target audience to increase the credibility and acceptance of scientific knowledge mediated by educational technology. In Brazil, a large country of different cultures, considering the diversity of the contexts where the adolescents live (rural and urban areas), taking into account the different ethnic groups, will imply different experiences and specific meanings,²⁶ which is a condition to understand Brazilian adolescents and develop health policies and strategies.

This study had limitations regarding the fact that it was based on only one of the 18 Quilombola communities in the north region of the state of Espírito Santo, which makes it difficult to generalize the findings and extend them to other similar ethnic communities. Thus, further studies should be conducted to explore the theme, addressing other aspects not covered by this study. Another study limitation referred to the high cost of color production for the final version of the comic book.

CONCLUSION

The participatory research methodology for the shared production of a comic book combined the popular knowledge of adolescents living in a Quilombola community with scientific knowledge of alcohol drinking. One differentiation of this technology applied to health is the participation of potential readers in the construction of the story content as a comic book, from the diagnostic stage to the validation of the final product. Boys and girls constructed the comic book based on a sociocultural and sociogeographic identity, having reflected in each story their personal experiences and experiences in the family and community with occasional experimentation or continued alcohol consumption. The dialogical and participatory character of comic book creation-validation addressing alcohol experimentation for Quilombola adolescents allowed the narrative to present stories from this community in the rite of passage of adolescents living in rural areas close to urban centers.

The circularity of knowledge valued in the comic book took ethnicity into account, inserting the black people into public health discussions, in agreement with the National Policy of Integral Health of the Black Population. The approach to the theme of "alcohol with adolescents" required (re-)invention of a methodology for the creation of educational material that was dialogical, interactive, creative, sensitive and close to their reality, with the potential to promote the habit of reading and interest in health education when used by health and education professionals, particularly when it refers to materials for black adolescents living in rural Quilombola communities.

• 1
  Article extracted from the dissertation - Adolescents of Quilombola Community participation on constructing the educational material about alcohol, submitted to the Graduate Program in Nursing, Escola de Enfermagem Anna Nery (EEAN), Universidade Federal do Rio de Janeiro (UFRJ), in 2016.

Acknowledgments

The authors would like to thank the Coordination for the Improvement of Higher Education Personnel - CAPES (AUXPE 0266/2013) and the Espírito Santo Research and Innovation Foundation - FAPES (protocol 0494/2015) for the doctor's degree scholarship and research funding, respectively.

The authors also thank Mrs. Silvia Lucindo (community health agent), Maria Luísa Lucindo (professor), and Mr. Sebastião (community leader), for their support in the ethnographic immersion in the community.

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Publication Dates

• Publication in this collection
  2017

History

• Received
  31 Mar 2017
• Accepted
  22 Aug 2017