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

Overview

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.

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.