Improving Breast Health Knowledge Among Women Using a Gamified Metaverse-Based Platform

This randomized controlled trial aimed to evaluate the effectiveness of Mammoverse, a gamified metaverse-based educational platform, in improving breast health knowledge among women in China. Participants were randomly assigned to either a gamified or non-gamified version of the platform. Both groups received identical educational content, but only the gamified group experienced interactive game elements such as avatars, progress feedback, and rewards. Knowledge was assessed at baseline, immediately post-intervention, and at 4-week follow-up. The study found that the gamified platform significantly improved knowledge retention and participant engagement compared to the non-gamified version. This ClinicalTrials.gov registration reflects only the randomized controlled trial (RCT) portion of a broader mixed-methods study that was approved by the University of Malaya Research Ethics Committee (Ref: UM.TNC2/UMREC\_3967). The full study protocol includes three methodological approaches, and this registration pertains specifically to the RCT component involving the Mammoverse platform. Other study components are not included in this registration.

Mammoverse is a 3D metaverse environment designed to promote breast health knowledge through immersive and interactive learning. The gamified version included user avatars, badges, tasks, and personalized feedback to increase motivation and engagement. The study recruited 72 women aged 18 and above, and used a pre-post-follow-up design. Outcome measures were based on an adapted 18-item Breast Health Literacy Questionnaire. The trial was conducted entirely online, with ethics approval from the University of Malaya Research Ethics Committee.