The Effectiveness of the Board Game on Primary Healthcare Nurses' Knowledge, Attitudes, and Confidence in Dengue-related Practice

January 11, 2026 updated by: Nuzul Sri Hertanti, Taipei Medical University

The Effectiveness of the Board Game on Primary Healthcare Nurses' Knowledge, Attitudes, and Confidence in Dengue-related Practice: a Cluster Randomized Controlled Trial

This cluster randomized controlled trial aims to evaluate the effectiveness of an educational board game compared to a lecture-based intervention on improving knowledge, attitudes, and confidence in dengue-related practice among nurses working in primary healthcare (PHC) units. Additionally, the study will assess PHC nurses' satisfaction with the learning experience. A total of 82 participants from 14 PHC unit clusters in Yogyakarta, Indonesia will be randomly assigned to either the intervention group (educational board game) or the control group (lecture-based intervention). Each group will receive a one-time 90-minute session of assigned intervention. Outcomes related to knowledge, attitudes, and confidence will be measured at multiple time points.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Considering the multiple roles of PHC nurses in dengue prevention and management, there is a need for training methods that are not only informative but also actively engaging and time-efficient. Educational board games offer a promising interactive learning strategy. However, their application among healthcare professionals, particularly nurses, remains underexplored.

The main purpose of this study is to examine whether an educational board game can improve PHC nurses' knowledge, attitudes, and confidence in dengue-related practice compared to a lecture-based intervention. In addition, the study will evaluate participants' satisfaction with the learning experience.

This two-arm parallel cluster randomized controlled trial will be conducted in Yogyakarta, Indonesia, involving 82 participants from 14 PHC unit clusters. These clusters will be randomly allocated into two groups: the intervention group (educational board game) and the control group (lecture-based intervention). Each group will receive a single 90-minute educational session.

Outcomes on knowledge, attitudes, and confidence will be assessed at multiple time points. Data will be analyzed using a linear mixed-effects model (LMM) to evaluate the interaction effects between group and time. Findings from this study may offer valuable insights for healthcare institutions and policymakers to consider integrating board games into professional training and continuing professional development (CPD) programs.

Study Type

Interventional

Enrollment (Actual)

106

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

    • Special Region of Yogyakarta
      • Yogyakarta, Special Region of Yogyakarta, Indonesia, 55111
        • Primary Healthcare

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Full-time employed nurses in the PHC unit
  • Nurses who have experience in assessing dengue-suspected patients
  • Nurses who have at least three months of work experience in the current PHC unit
  • Nurses who have a smartphone for online communication
  • Nurses who are familiar with WhatsApp applications

Exclusion Criteria:

  • Nurses on maternity or annual leave during the data collection period.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Educational board game
Participants will receive an educational board game one time for 90 minutes.
The educational board game will be administered once for a duration of 90 minutes, consisting of a gameplay session followed by a debriefing.
Active Comparator: Lecture group
Participants will receive a lecture-based intervention one time for 90 minutes.
The lecture will be administered once for a duration of 90 minutes, consisting of video lecture followed by question and answer (QnA) session.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Knowledge
Time Frame: Baseline, immediately after intervention, and follow up at one-month post intervention.
This study will use the Indonesian version of Dengue Knowledge Questionnaire to measure PHC nurses' knowledge of dengue. The questionnaire consists of seven items, with response options of "true," "false," or "unknown." Each correct answer will receive 1 point, while incorrect or unknown responses receive 0 points. Total scores range from 0 to 7, with higher scores reflecting a better knowledge of dengue.
Baseline, immediately after intervention, and follow up at one-month post intervention.
Attitude
Time Frame: Baseline, immediately after intervention, and follow up at one-month post intervention.
The study will use the Indonesian version of Dengue Preventive Attitudes Questionnaire to measure nurses' attitudes toward dengue prevention. It consists of seven items, each rated on a five-point Likert scale, with 1 indicating "strongly disagree" and 5 indicating "strongly agree." Total scores range from 7 to 35, with higher scores representing more favorable attitudes toward dengue prevention.
Baseline, immediately after intervention, and follow up at one-month post intervention.
Confidence
Time Frame: Baseline, immediately after intervention, and follow up at one-month post intervention.
The study will use the Indonesian version of the five-item Confidence-Scale (C-Scale) to measure nurses' confidence in their practice. Responses will be recorded on a five-point Likert scale, ranging from 1 to 5, with 5 indicating "higher confidence." Total scores ranged from 5 to 25, with higher scores indicating greater confidence.
Baseline, immediately after intervention, and follow up at one-month post intervention.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Learning satisfaction
Time Frame: Immediately after intervention.
This study will use the Indonesian version of the five-item Satisfaction in Learning questionnaire to assess nurses' satisfaction with the assigned learning methods. Responses will be recorded on a five-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Higher score indicated more satisfied with learning methods.
Immediately after intervention.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Nuzul S Hertanti, RN, MS, Taipei Medical University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 8, 2025

Primary Completion (Actual)

October 21, 2025

Study Completion (Actual)

October 21, 2025

Study Registration Dates

First Submitted

June 11, 2025

First Submitted That Met QC Criteria

June 11, 2025

First Posted (Actual)

June 19, 2025

Study Record Updates

Last Update Posted (Actual)

January 13, 2026

Last Update Submitted That Met QC Criteria

January 11, 2026

Last Verified

June 1, 2025

More Information

Terms related to this study

Other Study ID Numbers

  • KE/FK/0902/EC/2025

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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