An iterative process for developing digital gamified sexual health education for adolescent students in low-tech settings

Abstract

Purpose Digital technology has great potential for educating today’s digitally oriented adolescents on health. In particular, digital health gamified learning can make the promotion of the sexual well-being of adolescents more effective. Although venereal diseases such as HIV/AIDS have become a greater problem in Sub-Saharan African (SSA) countries than in any country outside of Africa, little is publicly known about the development of gamified learning for use in counter-measures. This paper aims to address that deficit by presenting the process of developing one such game. The paper highlights how the “My Future Begins Today” game for sexual health education was developed, evaluated and refined in the real-world of low-tech settings and made improvements based on the response of users. Design/methodology/approach Design-based research (DBR) was used to guide the design, develop, test and refine the digital game in iterative cycles. The evaluation of the effectiveness of iterations of the game was done using adolescent sexual health literacy tests and the validated Motivation, Attitude, Knowledge and Engagement framework, the authors developed based on existing approaches. That framework combines the elements of motivation, attitude, knowledge and engagement, effectiveness was evaluated based on the game’s ability to motivate students, improve their attitudes, increase their acquisition of knowledge and engage them in learning self-rating surveys and interviews. The whole process of game design, testing, evaluation and refinement were underpinned by the activity theory, DBR and participatory design (PD) research. Findings Participants in the gamified learning platforms demonstrated higher average scores on their post-tests than their counterparts subjected to the traditional teaching classroom. Also, gamified learning groups commented positively on the effectiveness of their instructional approach than their counterparts in the traditional learning group. The stakeholders’ involvement in developing gamified learning provided a good understanding of the importance of the game to the adolescent students and how it was going to be used to address the problem identified. The application of PD contributed to the effectiveness of the game. It involved various actors from various fields who were relevant to the game. Also, engaging targeted users from the beginning resulted in the creation of a better correspondence with the preferences of end-users. Practical implications This study has contributed to a better understanding of sex education and knowledge in the area of adolescent reproductive health issues, using developed innovative game mechanics features and its applicability in low-tech settings. Originality/value The study will be a recommendation for future researchers in applying this gamified learning concept and its suitability in their teaching practice, particularly regarding sexual health education and adolescent reproductive health issues in low-tech settings of SSA.

Enhancing instructional outcomes with a serious gamified system: a qualitative investigation of student perceptions

“…The interview guide was developed based on the MAKE evaluation criteria suggested in the prior study of Haruna et al (2019aHaruna et al ( , 2019b. This MAKE evaluation instrument has four key elements: motivation, attitude, knowledge and engagement (Figure 1).…”

“…Serious gamified instructions also received positive comments on motivation relative to teacher-centred learning. Previous studies indicated that creating a gamified learning system that promised to engage students' needs to consider factors of tracking points, scores, awards (badges) on the leaderboards (Haruna et al, 2019a(Haruna et al, , 2019b. This reinforced students to compete positively within a class to perform different difficult and demanding learning activities in a proactive manner, ultimately leading to contributing in their learning progress and achieving the highest level on the leaderboards, as student engagement is multidimensional aspects that involve three aspects (Fredricks et al, 2004).…”

Utilizing Theories and Evaluation in Digital Gaming Interventions to Increase Human Papillomavirus Vaccination Among Young Males: Qualitative Study

“…Previous research has shown that theoretical models such as the health belief model show promise as theoretical frameworks for understanding for vaccine uptake among young adult males living in urban settings [ 24 ]. Our study clarifies the broader relationships between multiple theories and constructs (including the health belief model) that can be used to measure the impact of gaming on individuals, particularly for educating this population on the importance of HPV [ 18 ].…”

“…However, this game was not theory-based and is only meant to increase awareness and knowledge of HPV. A game that is developed as a health intervention must have the ability to be appropriately evaluated and engaging [ 18 ]. In the absence of standardized evaluation methods for serious games, design principles (ie, usability, playability, and visualization) are incorporated into designing a gameplay experience that does not distract the user from the intended outcomes.…”

The Influence of MEDULA (Education Media for Snakes and Ladders) on Adolescent Knowledge Levels on Reproductive Health

“…Currently, several methods of health education regarding adolescent reproductive health have been developed, including lectures and discussions, focus group discussions, games and peer groups (Ambrose, 17 C.E. ; Haruna et al, 2018Haruna et al, , 2019Nyumba, 2018). Meanwhile, one of the health education methods that we would like to highlight here is a method that uses the snake and ladder playing technique.…”