The Effect of Gamification on Breastfeeding Self-Efficacy and Infant Nutrition Attitudes of Pregnant Women (gamification)

January 26, 2026 updated by: Özlem Ülkü BULUT, Lokman Hekim University

The Effect of Breastfeeding Education Through Gamification on Breastfeeding Self-Efficacy and Infant Nutrition Attitudes of Pregnant Women: A Randomized Controlled Study

This study aimed to evaluate the effect of a gamification-based breastfeeding education program on breastfeeding self-efficacy and infant feeding attitudes among pregnant women. The study was designed as a randomized controlled, pretest-posttest, parallel-group trial and was conducted in the antenatal outpatient clinics of Lokman Hekim Etlik Hospital.

Eligible pregnant women were randomly assigned to either an intervention group or a control group. The intervention group received breastfeeding education delivered through a digital gamification-based program during the last trimester of pregnancy, while the control group received routine breastfeeding education as part of standard antenatal care. Data were collected before and after the educational intervention.

The primary focus of the study was to compare changes in breastfeeding self-efficacy and infant feeding attitudes between the two groups following the intervention. The findings of this study are expected to contribute to the growing evidence on the use of innovative digital and gamification-based educational approaches in antenatal breastfeeding education.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This randomized controlled study was designed to evaluate the effectiveness of a gamification-based digital breastfeeding education program on breastfeeding self-efficacy and infant feeding attitudes among pregnant women. The study was conducted at the Obstetrics and Gynecology outpatient clinics of Lokman Hekim Etlik Hospital, where pregnant women are routinely followed during the antenatal period.

After being informed about the purpose and procedures of the study, pregnant women who agreed to participate provided written and verbal informed consent. Participants were allocated to the intervention or control group using a block randomization method to ensure balanced group sizes. The randomization sequence was generated by an independent statistician, and group assignments were concealed using sequentially numbered, opaque sealed envelopes. This process was implemented to reduce selection bias and strengthen the internal validity of the study.

The intervention consisted of a structured breastfeeding education program delivered through a digital platform incorporating gamification elements. The educational content was designed to increase participant engagement and motivation by integrating interactive and game-based components into standard breastfeeding education. The program was administered during the last trimester of pregnancy and focused on enhancing confidence in breastfeeding and fostering positive infant feeding attitudes.

Participants in the control group received routine breastfeeding education provided as part of standard antenatal care services at the hospital. This education reflected usual clinical practice and did not include digital or gamification-based components.

Data collection was conducted at baseline and following completion of the educational intervention. The study evaluated changes in breastfeeding-related psychosocial outcomes by comparing pre- and post-intervention assessments between the intervention and control groups.

This study aims to contribute to the evidence base on innovative digital education strategies in maternal health by examining the potential benefits of gamification-enhanced breastfeeding education during pregnancy. The findings are expected to support the development of engaging, technology-supported antenatal education programs to improve breastfeeding preparedness.

Study Type

Interventional

Enrollment (Actual)

60

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 Locations

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

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Primipara,
  • Between 27-40 weeks of gestation,
  • Those who have not received breastfeeding training before,
  • Able to speak and understand Turkish,
  • Women with a smart phone/tablet/computer with internet connection will be included in the study.

Exclusion Criteria:

  • Having a high risk pregnancy
  • with a condition that prevents breastfeeding
  • fetus with abnormality

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: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Gamified Breastfeeding Education
Participants in this arm receive a structured breastfeeding education program delivered through a digital platform incorporating gamification elements during the last trimester of pregnancy.
Behavioral: Gamified Breastfeeding Education
Breastfeeding education content will be integrated into the game program designed with the gamification technique. A training program will be applied to the women in the experimental group in the last trimester. Women in the control group will receive the standard breastfeeding training in the hospital. Measurement tools will be applied to all participants before and after the training.
Active Comparator: Standard Antenatal Breastfeeding Education
Participants in this arm receive routine breastfeeding education provided as part of standard antenatal care services at the hospital.
Behavioral: Gamified Breastfeeding Education
Breastfeeding education content will be integrated into the game program designed with the gamification technique. A training program will be applied to the women in the experimental group in the last trimester. Women in the control group will receive the standard breastfeeding training in the hospital. Measurement tools will be applied to all participants before and after the training.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
breastfeeding self-efficacy
Time Frame: One week before the intervention and two weeks after completion of the intervention.
Breastfeeding self-efficacy was measured using the Breastfeeding Self-Efficacy Scale-Short Form, Antenatal Version (BSES-SF). The scale consists of 14 items with total scores ranging from 14 to 70. Higher scores indicate greater breastfeeding self-efficacy.
One week before the intervention and two weeks after completion of the intervention.
infant feeding attitudes
Time Frame: One week before the intervention and two weeks after completion of the intervention.
Infant feeding attitudes were assessed using the Iowa Infant Feeding Attitude Scale (IIFAS). The scale includes 17 items with total scores ranging from 17 to 85. Higher scores reflect more positive attitudes toward breastfeeding.
One week before the intervention and two weeks after completion of the intervention.

Collaborators and Investigators

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

Sponsor

Lokman Hekim 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)

February 1, 2023

Primary Completion (Actual)

March 30, 2023

Study Completion (Actual)

May 30, 2023

Study Registration Dates

First Submitted

March 22, 2024

First Submitted That Met QC Criteria

March 27, 2024

First Posted (Actual)

April 3, 2024

Study Record Updates

Last Update Posted (Actual)

January 28, 2026

Last Update Submitted That Met QC Criteria

January 26, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • oyunlastirmabeslenme

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

This study will be conducted to determine the effect of breastfeeding education given through gamification on breastfeeding self-efficacy and infant feeding attitudes of pregnant women.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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