Gamification Method on the Menstruation and Genital Hygiene Behaviors of Female Students

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

The Effect of Training Provided Through Gamification Method on the Menstruation and Genital Hygiene Behaviors of Female Students

This quasi-experimental study aimed to evaluate the effect of a gamification-based educational intervention on menstruation and genital hygiene behaviors among female students. The study was conducted with 77 female students aged 10-15 years who were attending a public secondary school in Ankara, Türkiye, during the 2023-2024 academic year. The intervention consisted of a web-based gamified education program developed by the researchers using Web 2.0 tools and implemented through an interactive online platform in four sessions. Data were collected before and one month after the intervention using the Menstrual Hygiene Behaviors Form and the Genital Hygiene Behaviors Scale (GHBS). Findings indicated a significant improvement in general hygiene, menstrual hygiene, and awareness of abnormal findings after the intervention (p < 0.05). The study suggests that gamified online education can be an effective and engaging approach to improving menstrual and genital hygiene behaviors among adolescent girls.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study was designed as a one-group pretest-posttest quasi-experimental research to evaluate the effect of a gamification-based educational intervention on menstruation and genital hygiene behaviors among female students. The research was carried out with 77 female students aged 10-15 years who were attending a public secondary school in Ankara, Türkiye, during the 2023-2024 academic year. Participants were recruited on a voluntary basis, and written informed consent was obtained from their parents prior to participation.

The intervention consisted of a web-based gamified educational program developed by the researchers using Web 2.0 tools. The content was structured based on the D6 gamification design model (Discover, Define, Design, Develop, Deploy, Determine). The educational material was delivered in four interactive online sessions, each lasting approximately 20 minutes. The sessions included visual materials, short videos, quizzes, badges, levels, and virtual rewards to increase motivation and engagement. The educational modules covered reproductive anatomy, the importance of hand and personal hygiene, perineal hygiene, the use of menstrual hygiene products, and waste management.

Data were collected using the Menstrual Hygiene Behaviors Form and the Genital Hygiene Behaviors Scale (GHBS), which evaluates three dimensions: general hygiene, menstrual hygiene, and awareness of abnormal findings. Measurements were obtained before and one month after the intervention.

Statistical analyses were performed using SPSS version 27. Paired-sample t-tests and Wilcoxon tests were used to compare pretest and posttest results. A statistically significant improvement was observed in students' general hygiene, menstrual hygiene, and awareness of abnormal findings scores after the gamified education program (p < 0.05).

The study received ethical approval from the Lokman Hekim University Non-Interventional Research Ethics Committee (Protocol No: 2023/01-45; Date: February 28, 2023). Institutional permission was also obtained from the Ankara Provincial Directorate of the Ministry of National Education.

Overall, the findings suggest that gamified online education can effectively improve menstrual and genital hygiene behaviors among adolescent girls. Integrating gamification-based approaches into school health education programs may contribute to sustainable hygiene behaviors and promote adolescent health.

Study Type

Interventional

Enrollment (Actual)

77

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

  • Child

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Female students enrolled in a public secondary school in Ankara
  • Aged between 10 and 15 years
  • Having experienced menarche (menstruating)
  • Able to read and understand Turkish
  • Having internet access to complete online training
  • Willing to participate voluntarily in the study
  • Parental written consent provided

Exclusion Criteria:

  • Students who have not yet experienced menarche
  • Incomplete questionnaire or missing data
  • Lack of parental consent
  • Students who did not complete all four gamified education sessions
  • Students with any condition limiting participation in online learning activities

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: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Gamified Training Group
All participants received the web-based gamified educational program designed to improve menstruation and genital hygiene behaviors. The program included four interactive online sessions of approximately 20 minutes each, incorporating gamification elements such as avatars, badges, levels, and virtual rewards to enhance engagement. Pre- and post-test assessments were administered to evaluate changes in hygiene behaviors.
Behavioral: Gamified Training Program
The intervention consisted of a web-based gamified educational program developed using Web 2.0 tools. The program included four interactive online sessions, each lasting approximately 20 minutes, and aimed to improve menstruation and genital hygiene behaviors among female students. Gamification elements such as avatars, badges, levels, and virtual rewards were integrated following the D6 design model (Discover, Define, Design, Develop, Deploy, Determine). The training combined visuals, videos, and quizzes to enhance engagement and motivation. Post-intervention assessments were conducted one month after the completion of all sessions to evaluate behavioral outcomes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Genital Hygiene Behaviors Scale (GHBS) Total Score
Time Frame: From baseline (pre-test) to 1 month after completion of the gamified educational program
The Genital Hygiene Behavior Scale (GHBS) is a 23-item Likert-type instrument designed to assess genital hygiene behaviors across three subdomains: general hygiene, menstrual hygiene, and awareness of abnormal genital findings. Each item is scored on a 5-point Likert scale, yielding a total score ranging from 23 to 115, with higher scores indicating better genital hygiene behaviors.
From baseline (pre-test) to 1 month after completion of the gamified educational program

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in General Hygiene Subscale Score (GHBS)
Time Frame: Baseline to 1 month post-intervention
Evaluates basic hygiene practices such as handwashing, perineal cleaning, and drying habits. The General Hygiene subscale consists of 12 items scored on a 5-point Likert scale. Subscale scores range from 12 to 60, with higher scores indicating better general genital hygiene behaviors.
Baseline to 1 month post-intervention
Change in Menstrual Hygiene Subscale Score (GHBS)
Time Frame: Baseline to 1 month post-intervention
Assesses menstrual hygiene management practices such as product use, cleaning, and waste disposal. The Menstrual Hygiene subscale consists of 8 items scored on a 5-point Likert scale. Subscale scores range from 8 to 40, with higher scores indicating better menstrual hygiene behaviors.
Baseline to 1 month post-intervention
Change in Awareness of Abnormal Findings Subscale Score (GHBS)
Time Frame: Baseline to 1 month post-intervention
Measures students' awareness of symptoms indicating possible infection or abnormal genital conditions. The Awareness of Abnormal Findings subscale consists of 3 items scored on a 5-point Likert scale. Subscale scores range from 3 to 15, with higher scores indicating greater awareness of abnormal genital findings.
Baseline to 1 month post-intervention
Change in Menstrual Hygiene Behaviors Form Score
Time Frame: Baseline to 1 month post-intervention
Menstrual Hygiene Behaviors Form: It was developed by the researchers based on the literature and consists of 4 categorical items assessing bathing style, cleaning method, genital cleansing direction, and drying practices during menstruation. The items are evaluated individually, and no total score is calculated
Baseline to 1 month post-intervention

Collaborators and Investigators

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

Sponsor

Lokman Hekim University

Investigators

  • Study Chair: Ozlem Ulku Bulut, Assistant Professor, Lokman Hekim University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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)

September 1, 2023

Primary Completion (Actual)

January 15, 2024

Study Completion (Actual)

June 1, 2024

Study Registration Dates

First Submitted

January 18, 2026

First Submitted That Met QC Criteria

January 18, 2026

First Posted (Actual)

January 27, 2026

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

  • genital hijyen

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared because the study involved minors and was conducted under strict ethical confidentiality agreements. Only aggregate (summary) data will be reported in publications.

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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