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

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.

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