Gamification-Based Peer Education in Nursing Students: Effects on Sexual Health Literacy and Attitudes

The Effect of Gamification-Based Peer Education on Sexual Health Literacy and Sexual Health Attitudes in Nursing Students: A Randomized Controlled Trial

This randomized controlled trial aimed to examine the effect of gamification-based peer education on sexual health literacy and sexual health attitudes among nursing students. Sexual health is a fundamental component of overall well-being, and knowledge and attitudes developed during young adulthood influence lifelong health behaviors. However, university students often have limited sexual health knowledge and are influenced by misconceptions and sexual myths, increasing the risk of unsafe sexual practices, sexually transmitted infections, and unintended pregnancies.

Improving sexual health literacy and promoting positive attitudes are essential for preventive healthcare. Although educational interventions are effective, traditional approaches may not sufficiently engage students. Gamification, which incorporates elements such as points, tasks, and feedback into learning environments, has been shown to enhance motivation, participation, and knowledge retention. Peer education further supports learning by facilitating communication and behavioral change among individuals of similar age groups.

The study was conducted with third-year nursing students during the 2025-2026 academic year. Participants were randomly assigned to intervention and control groups. The intervention group received a gamification-based peer education program covering sexual health, contraception, sexually transmitted infections, safe sexual practices, consent, and communication skills, delivered through interactive activities. The control group received no intervention.

Data were collected at baseline and one month after the intervention using validated scales. The findings are expected to contribute to the development of innovative and student-centered educational strategies in nursing education.

Study Overview

• Status: Not yet recruiting
• Conditions: Sexual Health
• Intervention / Treatment: Behavioral: Gamification-Based Peer Education

Detailed Description

This study is designed as a randomized controlled trial to evaluate the effectiveness of a gamification-based peer education program on sexual health literacy and sexual health attitudes among nursing students. Sexual health is a key component of overall well-being, encompassing physical, psychological, and social dimensions. During young adulthood, individuals develop knowledge, attitudes, and behaviors that significantly influence their future sexual health outcomes. However, previous research indicates that university students often have insufficient knowledge about sexual health and are influenced by misconceptions and sexual myths, which may lead to risky sexual behaviors, sexually transmitted infections, and unintended pregnancies.

Improving sexual health literacy is essential for enabling individuals to access, understand, evaluate, and use reliable health information. In addition, fostering positive sexual health attitudes contributes to safer behaviors and increased utilization of healthcare services. Although educational interventions have demonstrated effectiveness, traditional didactic methods may not fully engage learners or support active participation. Therefore, innovative and interactive approaches are needed.

Gamification is an emerging educational strategy that integrates game design elements such as points, badges, levels, tasks, and feedback into non-game contexts to enhance motivation, engagement, and learning outcomes. Peer education is another effective approach that facilitates communication and learning among individuals of similar age and social backgrounds. Combining gamification with peer education offers a comprehensive and interactive model that supports both cognitive and behavioral learning processes.

The study will be conducted during the 2025-2026 academic year with third-year nursing students enrolled in the Faculty of Health Sciences. Participants will be randomly assigned to intervention and control groups using a computer-based randomization method. The intervention group will receive a gamification-based peer education program delivered by trained peer educators. The training will include topics such as basic sexual health concepts, sexual health literacy, contraceptive methods, sexually transmitted infections, safe sexual practices, consent, and communication skills. The program will be delivered through interactive and gamified activities, including scenario-based case exercises, group competitions, task completion activities, and question-answer sessions.

The intervention will consist of two sessions, each lasting approximately 60 minutes. The control group will not receive any educational intervention during the study period.

Data will be collected at baseline and one month after the intervention using validated instruments, including a Sociodemographic Characteristics Form, the Sexual Health Literacy Scale, and the Sexual Health Attitudes Scale. Statistical analyses will be conducted to assess within-group and between-group differences.

The findings of this study are expected to provide evidence on the effectiveness of gamification-based peer education and contribute to the development of innovative, student-centered educational strategies in nursing education, particularly in the field of sexual health.

• Study Type: Interventional
• Enrollment (Estimated): 94
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Beyzanur İşbay Aydemir, Msc; Phone Number: +905456078994; Email: bisbay94@hotmail.com

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Being a third-year nursing student Enrollment in the Faculty of Health Sciences during the 2025-2026 academic year Having completed the Women's Health and Diseases Nursing course Willingness to participate in the study Providing written informed consent

Exclusion Criteria:

• Refusal to participate in the study Incomplete data or failure to complete study forms

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 - Gamification-Based Peer Education; The education to be applied to the intervention group will be conducted using a gamification-based peer education model. The training sessions will be delivered by 14 peer educators selected from the senior internship group of the Department of Nursing (Gynecology Nursing), who will be trained in advance by the researchers. Prior to the study, peer educators will receive standardized training on the content, educational methods, and gamification applications. The training module will be structured using gamification components, including: The training module will be structured using gamification components, including: Scenario-based case games Task completion activities Group competitions Point and level systems Badges/achievement cards Question-answer tournaments Participants will be divided into small groups and actively engaged in the process through interactive methods. Each training session will be planned and conducted by peer educators.	Behavioral: Gamification-Based Peer Education; The intervention consists of a gamification-based peer education program designed to improve sexual health literacy and attitudes among nursing students. The training is delivered by 14 trained peer educators selected from senior nursing students, who receive standardized preparation on educational content, teaching methods, and gamification techniques prior to the study. The educational module includes topics such as basic sexual health concepts, sexual health literacy, access to reliable information, contraceptive methods, sexually transmitted infections, safe sexual practices, consent, and communication skills. The program is structured using gamification elements, including scenario-based case activities, task completion exercises, group competitions, point and level systems, badges/achievement cards, and interactive question-answer sessions. Participants are divided into small groups and actively engaged through interactive learning methods.
No Intervention: Control group; No educational intervention will be applied to the students in the control group during the study period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sexual Health Literacy	Measured using the Sexual Health Literacy Scale at baseline (pre-test) and 1 month after the intervention (post-test).	1 month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sexual Health Attitudes	Measured using the Sexual Health Attitudes Scale at baseline and 1 month after the intervention.	1 month

Collaborators and Investigators

• Sponsor: Saglik Bilimleri Universitesi
• Investigators: Principal Investigator: Beyzanur İşbay Aydemir, Msc, Istanbul Aydın University

Publications and helpful links

Helpful Links

• PubMed article related to sexual health education and literacy

Study record dates

Study Major Dates

• Study Start (Estimated): May 1, 2026
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): July 1, 2026

Study Registration Dates

• First Submitted: April 1, 2026
• First Submitted That Met QC Criteria: April 1, 2026
• First Posted (Actual): April 8, 2026

Study Record Updates

• Last Update Posted (Actual): April 8, 2026
• Last Update Submitted That Met QC Criteria: April 1, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Health Literacy; Sexual Health; Gamification; Peer Group
• Other Study ID Numbers: Gamification

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