Educational VR Game Intervention to Enhance Hygiene Practices in Primary School Children

An Educational Intervention Using a Virtual Reality Game to Improve Compliance With Coronavirus 2019 Disease-related Hygiene Practices and Participation in Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV-2) Screening, for the Prevention of SARS-CoV-2 Transmission Between Primary Schoolchildren in Communities: a Stratified Cluster-randomised Controlled Trial

The goal of this observational study is to investigate if VR game-based educational intervention can enhance primary schoolchildren's compliance with hygiene practices to prevent the transmission of SARS-CoV-2 and other upper respiratory pathogens in the community.

The main questions the study aims to answer are, after receiving the VR game-based education intervention:

• Does VR game-based educational intervention improve hygiene-practice compliance in primary schoolchildren?
• What are the bacterial loads on primary schoolchildren's hands?
• What are the rates of infections caused by SARS-CoV-2 and other respiratory viruses in primary schoolchildren?

Researchers will compare the interventional group to the control group to see if VR game-based educational intervention can enhance primary schoolchildren's hygiene practices.

Participants will

• Receive in a training programme on hygiene practices through playing VR games for two weeks, 1 hour per week.
• Do a questionnaire on hygiene knowledge before and after receiving the education programme
• Provide hand swabs and saliva samples before and after receiving the education programme

Study Overview

• Status: Enrolling by invitation
• Conditions: Healthy Participants
• Intervention / Treatment: Other: VR game -based education program

Detailed Description

This study aims to evaluate the effectiveness of a VR game (VRG)-based educational program on hygiene practices among primary schoolchildren in Hong Kong. The research design employs a randomized controlled trial with repeated measures.

Participants will be primary schoolchildren aged 6 to 12 who can communicate and read in Chinese. To minimize selection bias, children will remain unaware of their group assignments. The sample size calculation aims for a statistical power of at least 0.8, targeting 2160 participants across 18 school clusters. Thirty-six local primary schools will be randomly assign to the intervention group or the control group in a ratio of 1:1.

The pilot phase will refine the VRG educational program based on feedback from a previous intervention. Two schools will be selected for this pilot, where trained teachers will assist in student recruitment. The main intervention will involve an VRG-based educational program delivered over two to three weeks. Children in the intervention group will engage with VRGs that cover topics such as SARS-CoV-2 and influenza virus transmission, hygiene practices, importance of rapid testing and vaccination in the prevention of upper respiratory tract infections. The control group will receive standard community health education and will be invited to participate in the VRG program after the intervention period.

Each child's involvement will last six months, with assessments occurring at baseline (T1) and at two subsequent intervals: immediately-post (T2), 1-month post (T3). Data collection will include demographic data, questionnaire to assesses hygiene knowledge, videos to record handwashing practices, hand swabs to measures bacterial loads on hands and saliva samples to tests for respiratory viruses.

• Study Type: Interventional
• Enrollment (Estimated): 2160
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Hong Kong, China
    • The Hong Kong Polytechnic University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Primary schoolchildren aged 6-12 years.
• Able to communicate in Chinese and to read Chinese.

Exclusion Criteria:

• Reported mental or physical health disorders.
• Participated in other health educational programs related to hygiene practices 2 months or less before recruitment.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention group; School children will participate in a VR game-based education programme	Other: VR game -based education program; The schoolchildren in the intervention group participate in an innovative VR game-based educational programme featuring: (1) Web-based health education on (i) SARS-CoV-2 and Influenza virus transmission, (ii) proper hand and respiratory hygiene practices and (iii) the importance of rapid screening and vaccination in the prevention of upper respiratory tract infections.
No Intervention: Control group; Schoolchildren in this group will receive the usual health education

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in the compliance with hygiene practices immediately after intervention	Knowledge of hygiene practices assessed through a true/false questionnaire.	Day 0, Month 1, Month 2
Change from baseline in the number of participants who comply with hand washing procedures immediately after intervention	Hand washing procedure compliance measured using video recordings.	Day 0, Month 1, Month 2
Change from baseline in the number of bacteria on the hands of the participants immediately after intervention	Bacterial counts on the hands of participants will be assessed using hand swab sampling and quantitative microbiological analysis. Specifically, hand swabs will be collected from the participants before and after intervention. This will be followed by using plate count method to detect the number of bacterial cells present on the hand swabs collected from the participants.	Day 0, Month 1, Month 2
Change from baseline in the vaccination uptake rates by the participants immediately after intervention	Data on vaccination uptake rates will be collected from the participants using a standardized questionnaire before and after intervention. The data will be aggregated to calculate the percentage change in vaccination uptake rates from pre- to post-intervention.	Day 0, Month 1, Month 2

Collaborators and Investigators

• Sponsor: The Hong Kong Polytechnic University

Study record dates

Study Major Dates

• Study Start (Actual): May 2, 2023
• Primary Completion (Estimated): October 31, 2025
• Study Completion (Estimated): December 1, 2025

Study Registration Dates

• First Submitted: July 17, 2025
• First Submitted That Met QC Criteria: September 4, 2025
• First Posted (Estimated): September 11, 2025

Study Record Updates

• Last Update Posted (Estimated): September 11, 2025
• Last Update Submitted That Met QC Criteria: September 4, 2025
• Last Verified: June 1, 2025

More Information

Terms related to this study

• Keywords: Schoolchildren; Upper respiratory tract infections; Hand hygiene; VR games; Hygiene compliance
• Additional Relevant MeSH Terms: Infections; Respiratory Tract Diseases; Respiratory Tract Infections
• Other Study ID Numbers: HMRF2025

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