Improving sexual health education for adolescent students using game-based learning and gamification

Abstract

This study investigated the effectiveness of deploying innovative game-based pedagogies in promoting sexual health education among natives in Sub-Saharan Africa. In three iterations, a participatory research design involving active game users and other key stakeholders helped to develop and revise the digital games for sexual health education. A quasi-experimental research design was conducted using two experimental conditions—game-based learning and gamification—with an existing traditional teaching method serving as a control condition. In all, 348 students aged 11-15 were recruited from three secondary schools based in Dar es Salaam, Tanzania, to participate in a series of sexual health education. A masked fashion was used to eliminate the potential contamination of the conditions. Each school participated in one iteration, with students divided into three groups for each of the three teaching methods. The results from game-based learning and gamification experimental conditions were then compared with those obtained under traditional teaching to establish differences among the three teaching conditions. The sexual health education topics were delivered in 40-minute sessions per week for five weeks. A multi-iteration mixed method was then used to assess and analyse the results for the students. The Adolescent Sexual Health Literacy Test (ASHLT) was used before and after each iteration to evaluate sexual health information acquisition. Then the comprehensive Motivation, Attitude, Knowledge, and Engagement (MAKE) evaluation instrument developed was used to assess the efficacy innovative pedagogies in fostering sexual health education using self-rating surveys and interviews. Subsequently, statistical methods was used to analyse the quantitative data collected using ASHLT and the MAKE framework. Interview transcripts were analysed using the themes developed from the MAKE framework. The results supplemented and corroborated the quantitative results. In the three iterations of developing and revising, students under experimental conditions of gamified learning platforms achieved significantly more improvements in their sexual health information scores than those under the traditional conditions. Moreover, feedback from experimental conditions indicates that the two experimental conditions significantly improved the students’ motivation. The experimental conditions also boosted their attitude change, enhanced their knowledge acquisition, and fostered their engagement in active learning. In contrast, the traditional teaching method was shown to have largely failed to add value or generate students’ interest to engage in active learning. This could be the benefits of combining the constructs of motivation and engagement features in the digital gamified-learning-platforms resulted in improved knowledge gain and attitude change. These results suggest that digital game-based and gamification learning for sexual health education have a potential of fostering sexual and reproductive health education necessary for positive changes in healthy sexual behaviour, attitude, and practices among today’s digitally-savvy adolescents, particularly in urban Dar es Salaam. Overall, the study findings provide an evidence base, add to the developing areas, and provide suggestions to compliment and employ approaches for future development and investigation of sexual health education and promotion programmes particularly in low technology environments. Thus, this thesis could serve as a starting point and the potential guideline for the development and use of gamified learning platforms in the SSA context.