Metaverse- and VR-Supported Education in a Digital Breastfeeding Museum: Long-Term Effects on Breastfeeding Process, Self-Efficacy, and Motivation

April 2, 2026 updated by: Aysenur Akkaya Gul, Uludag University

The Long-Term Effects of Metaverse- and Virtual Reality-Supported Education Delivered to Mothers in a Digital Breastfeeding Museum on the Breastfeeding Process, Self-Efficacy, and Motivation: A Prospective Randomized Controlled Study

This randomized controlled prospective study aimed to evaluate the long-term effects of Metaverse- and virtual reality (VR)-supported education provided in a digital breastfeeding museum on the breastfeeding process, breastfeeding self-efficacy, breastfeeding motivation, and breastfeeding-related problems in primiparous mothers. While the intervention group received Metaverse- and VR-supported breastfeeding education in the digital breastfeeding museum, the control group received standard education provided in routine antenatal classes. The study population consisted of primiparous mothers who had participated in the previous randomized controlled study and voluntarily agreed to take part in this new prospective study. Participants were followed at four postpartum periods: 0-6 months, 6-12 months, 12-18 months, and 18-24 months. Data were collected using the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), the Breastfeeding Motivation Scale, the Breastfeeding Problems Assessment Scale, and a questionnaire form (including breastfeeding duration and other parameters). Assessments were conducted at the planned follow-up intervals.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Breastfeeding is the most ideal method for ensuring infants' healthy growth and nutrition and is a public health priority due to its short- and long-term health benefits. Emerging technologies in the 21st century have added new dimensions to educational processes, and tools such as virtual reality (VR) and the Metaverse support traditional educational methods by offering multimodal learning opportunities. The literature indicates that the use of VR in breastfeeding education is limited, and no Metaverse-based studies have been reported.

This study represents a prospective follow-up of a randomized controlled trial conducted between July 2023 and April 2024 in three hospitals. In the previous study, 53 primiparous pregnant women-who were attending antenatal classes for the first time in their third trimester and had no prior breastfeeding experience-were randomly assigned to an intervention group (n=28) and a control group (n=25). In the new prospective study, 20 mothers from each group were reached, resulting in a total of 40 participants who continued to be followed in their originally assigned groups.

Participants in the intervention group received Metaverse- and VR-supported breastfeeding education in a digital breastfeeding museum consisting of multiple educational rooms. They explored the museum through personalized avatars using VR headsets, accessing educational content that included photo frames, written boards, and instructional videos. The control group continued to receive routine antenatal breastfeeding education at the participating hospitals. In the prospective follow-up, no additional postnatal interventions were applied; data were collected only on long-term outcomes at four postnatal periods: 0-6 months, 6-12 months, 12-18 months, and 18-24 months. Data collection tools included maternal and infant demographic forms, a breastfeeding knowledge questionnaire, the Breastfeeding Motivation Scale, the Breastfeeding Self-Efficacy Scale-Short Form, and the Breastfeeding Problems Assessment Scale. Participants were contacted by phone, and data were collected via online surveys.

This study is the first to prospectively evaluate the long-term effects of Metaverse- and VR-supported digital breastfeeding education on postnatal breastfeeding practices, self-efficacy, and motivation. It provides evidence on the sustained impact of technology-based educational models on breastfeeding behavior.

Study Type

Interventional

Enrollment (Actual)

40

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

  • Turkey (Türkiye)
    • Istanbul
      • Ataşehir, Istanbul, Turkey (Türkiye), 34758
        • Fenerbahçe Üniversitesi

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

Yes

Description

Inclusion Criteria:

  • Having previously participated in a randomized controlled trial by providing written informed consent,
  • Primiparous mothers who voluntarily agree to participate in the new study,
  • Being reachable by telephone and having digital access to complete an online questionnaire,
  • Being able to read and understand Turkish,
  • Having sufficient cognitive ability to recall the breastfeeding process,
  • The infant not having any health condition requiring prolonged hospitalization in a neonatal intensive care unit.

Exclusion Criteria:

  • The presence of a serious health condition in the mother or infant that may contraindicate breastfeeding,
  • Having experienced infant loss during the postpartum period,
  • A diagnosis of a severe psychiatric or physiological condition in the mother during the postpartum period that may interfere with breastfeeding.

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: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Routine Antenatal Class Education Program Group
In the previous randomized controlled study, no additional intervention was administered to the pregnant women in this group; they only received the routine breastfeeding education provided by the antenatal education program. In the prospective follow-up study, no additional postnatal education was provided; only long-term follow-up data were collected at four postpartum periods: 0-6 months, 6-12 months, 12-18 months, and 18-24 months.
Experimental: Training Supported by Metaverse and VR in the Digital Breastfeeding Museum Group

In the previous randomized controlled study, pregnant women in this group received Metaverse- and virtual reality (VR)-supported education in a digital breastfeeding museum. The sole intervention consisted of a digital breastfeeding education program delivered via virtual reality and Metaverse platforms. All content was provided exclusively through head-mounted VR devices, without the need for any pharmacological agents or invasive procedures. The environment was explored by participants using virtual reality (VR) headsets (Meta Quest 2).

In the prospective follow-up study, no additional postnatal education was provided; only long-term follow-up data were collected at four postpartum periods: 0-6 months, 6-12 months, 12-18 months, and 18-24 months.
Other: Training Supported by Metaverse and Virtual Reality (VR) in the Digital Breastfeeding Museum Group

In the previous randomized controlled study, pregnant women in this group received Metaverse- and virtual reality (VR)-supported education in a digital breastfeeding museum. The sole intervention consisted of a digital breastfeeding education program delivered via virtual reality and Metaverse platforms. All content was provided exclusively through head-mounted VR devices, without the need for any pharmacological agents or invasive procedures. The environment was explored by participants using virtual reality (VR) headsets (Meta Quest 2).

In the prospective follow-up study, no additional postnatal education was provided; only long-term follow-up data were collected at four postpartum periods: 0-6 months, 6-12 months, 12-18 months, and 18-24 months.

Device: Virtual Reality Headset (Meta Quest 2)
A head-mounted virtual reality (VR) device used to deliver immersive educational content in a digital breastfeeding museum. Participants interacted with the virtual environment using VR headsets.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Breastfeeding Motivation Scale
Time Frame: Assessed during ongoing breastfeeding up to 24 months postpartum.
The Breastfeeding Motivation Scale was developed by Kestler-Peleg and colleagues in 2015. It is a 24-item, five-point Likert-type scale with five subscales. Cronbach's alpha coefficients for the subscales range from 0.56 to 0.89. The validity and reliability of the scale for the Turkish population were tested by Mızrak in 2017 among primiparous and multiparous women.The Turkish version of the Breastfeeding Motivation Scale for primiparous women consists of 23 items, five subscales, and uses a four-point Likert format. The subscales are: (1) integrated regulation, (2) intrinsic motivation - identified regulation, (3) introjected regulation - social approval, (4) introjected regulation - social pressure, and (5) external regulation - instrumental needs. The scale does not have a total score; subscale scores are evaluated individually. A higher score on a subscale indicates greater motivation in the domain represented by that subscale.
Assessed during ongoing breastfeeding up to 24 months postpartum.
Breastfeeding Self-Efficacy Scale - Short Form (BSES-SF) Score
Time Frame: 0-6 months, 6-12 months, 12-18 months, and 18-24 months postpartum
The Breastfeeding Self-Efficacy Scale is used to assess how confident mothers feel about their ability to breastfeed. The original scale was developed in 1999. In 2003, the scale was shortened to a 14-item version known as the Breastfeeding Self-Efficacy Scale - Short Form (BSES-SF), which is recommended for use in research and practice. The BSES-SF is a 5-point Likert-type scale, with responses ranging from 1 ("Not at all confident") to 5 ("Always confident"). The minimum possible score is 14, and the maximum is 70. Higher scores indicate higher levels of breastfeeding self-efficacy. The Turkish validity and reliability study of the scale was conducted in 2010. In this study, the Cronbach's alpha coefficient was reported as 0.86.
0-6 months, 6-12 months, 12-18 months, and 18-24 months postpartum
Breastfeeding Problems Assessment Scale
Time Frame: 0-6 months, 6-12 months, 12-18 months, and 18-24 months postpartum
The Breastfeeding Problems Assessment Scale was developed by Karen Wambach in 1990. The validity and reliability of the Turkish version were established by Uyanık in 2019, with a Cronbach's alpha of 0.776. Turkish form consists only of the first section, containing 18 items across five subscales: mechanical concerns, process concerns, insufficient milk concerns, nipple concerns, and social concerns. Items are scored as follows: 1 = none, 2 = mild, 3 = moderate, 4 = severe, 5 = unbearable. Total scores range from 18 to 90, with higher scores indicating more severe breastfeeding problems. The scale has been reported as a valid tool for the Turkish population. In the present study, Cronbach's alpha was found to be 0.83.
0-6 months, 6-12 months, 12-18 months, and 18-24 months postpartum

Collaborators and Investigators

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

Sponsor

Uludag University

Investigators

  • Principal Investigator: Assistant Professor Ayşenur AKKAYA GÜL, PhD, Fenerbahçe 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)

March 15, 2024

Primary Completion (Actual)

March 27, 2026

Study Completion (Actual)

March 27, 2026

Study Registration Dates

First Submitted

March 27, 2026

First Submitted That Met QC Criteria

April 2, 2026

First Posted (Actual)

April 7, 2026

Study Record Updates

Last Update Posted (Actual)

April 7, 2026

Last Update Submitted That Met QC Criteria

April 2, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • UU-26-DIGI-BF-MUSE/AAKKAYAGUL

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

De-identified individual participant data (IPD) may be shared upon reasonable request.

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.

Clinical Trials on Virtual Reality

Clinical Trials on Training Supported by Metaverse and Virtual Reality (VR) in the Digital Breastfeeding Museum Group

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in New Zealand

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe