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Evaluating a Behavioural Theory-Based Board Game (S-S-LIBOG) Against Traditional Health Talk (HT) in Prostate Cancer Education: Findings from a Quasi-Experimental Study, Plus Introducing 17 Other S-S-LIBOGs

Year: 2025

Type: article

Abstract: Background: Prostate cancer is a global health concern, with varying epidemiological, disease severity, and treatment outcome patterns across populations. Studies on disparities suggest that up to 80% of prostate cancer in Ghana are reported late, translating into a case-fatality rate of 55.2%. Prostate cancer awareness is vital for early detection and management. Traditional methods like health talks and recorded educational audios are common, but their effectiveness compared to interactive approaches like board games remains underexplored. Objective: To evaluate the effectiveness of a social cognitive theory/socio-ecological model-based Snakes, Ladders, and Arrows board game (the S-S-LIBOG) versus traditional educational methods in enhancing prostate cancer knowledge, attitudes, and behavioral intentions. Methods: Using a single-camp pretest-post-test interventional approach, a quasi-experimental study with randomized assignment of interventions was done. A multi-stage sampling method (stage 1, purposive, and stage 2, systematic random sampling) was used. The study involved 197 participants, divided into two groups of (80 for game arm, 61 for talk arm after correction for attrition). The study group received an educational game (the LIBOG), while the control group attended a didactic prostate cancer talk. The Knowledge, Attitudes, and Perception (KAP) questionnaire, based on a 5-point Likert scale, was administered before and after the intervention. A Two-Proportion Z-test assessed statistical significance between the pre-and post-intervention results within each group, while the Wilcoxon Signed-Rank Test was used to compare KAP changes in the two groups, all at an alpha level of 0.05% (95% CI). Results: Among participants, 29.4% were female, 64.5% male, and 6.1% other. Tertiary education was reported by 81.7%, secondary 9.6%, postgraduate 5.6%, and primary 3.0%. Ethnicities: Ewe 41.6%, Akan 26.9%, Northern 13.7%, Ga 6.6%, Guan 1.5%, others 9.6%. Rural dwellers: 29.9%. LIBOG improved ‘good knowledge level’ from 35.0% at baseline to 60.0% post-intervention; compared to 35.0% to 62.3% by the Health Talk (HT). LIBOG also narrowed gender, education, and lifestyle disparities in KAP, with males showing higher odds of positive attitude (OR = 4.16, p = 0.004) and perception (OR = 2.79, p = 0.047), and rural residents having increased odds of good knowledge (OR = 4.39, p = 0.041) post - its intervention. HT similarly equalized disparities, except for perception, which remained linked to education. HT showed higher overall percentage gains in knowledge (35.48% vs. 23.47%), but the difference was not statistically significant (Z = 1.11, p = 0.267). Wilcoxon Signed-Rank Test confirmed no statistically significant difference in median (W = 102.0, p = 0.107), indicating comparable effectiveness. Both interventions significantly improved knowledge (LIBOG: z = 2.85, p = 0.004; HT: z = 3.10, p = 0.002). LIBOG had a notable advantage in attitude enhancement (z = -2.07, z = 3.85) and was highly accepted, with over 80% of users reporting satisfaction. Conclusion: This study does not denigrate health talks (HT), which, overall, outperformed LIBOG (but with no statistically significant difference). The LIBOG produced 71% of the overall impact of HT, trailing in Knowledge impact, but leading marginally in impacting positive attitudes and perceptions. It is not inferior, has high acceptability, and is potentially a good adjunct to existing methods. Further research should explore LIBOG’s long-term impacts and applicability in broader populations.

Source: Healthcare

DOI: 10.3390/healthcare13233135