Gamifying sexual education for adolescents in a low-Tech setting: Quasi-experimental design study

Background: Sexual education has become increasingly important as unhealthy sexual practices and subsequent health risksbecome more prevalent during adolescence. Traditional sex education teaching methodologies are limiting for digital nativesexposed to various digital technologies. Harnessing the power of technology applications attractive to the younger generationmay be a useful approach for teaching sex education.Objective: The aim of this study was to improve sexual health knowledge and understanding of the problems associated withunhealthy sexual practices and address sexual and reproductive health challenges experienced in a low-Tech setting.Methods: A participatory design approach was used to develop the digital gamified methodology. A sample of 120 secondaryschool students aged 11-15 were randomly assigned to either experimental or control group for each of the 3 teaching approaches:(1) gamified instruction (actual serious games [SG] in teaching); (2) gamification (GM; making nongames, such as game-likelearning); and (3) traditional teaching (TT) methods.Results: The SG and GM approaches were more effective than TT methods in teaching sexual health education. Specifically,the average scores across groups demonstrated an increase of mean scores from the pre-to posttest (25.10 [SD 5.50] versus 75.86[SD 13.16]; t119=41.252; P<.001 [2 tailed]). Analysis of variance indicated no significant differences across groups for pretestscores (F2,117=1.048, P=.35). Significant differences across groups were evident in the posttest scores. Students in the SG andGM groups had higher average scores than the TT group (F2,117=83.98; P<.001). Students reported increased learning motivation,attitude, know-how, and participation in learning (P<.001) when using SG and GM approaches.Conclusions: Digital health technologies (particularly teaching and learning through gamified instruction and other novelapproaches) may improve sexual health education. These findings may also be applied by practitioners in health care settingsand by researchers wishing to further the development of sex education.