Digital Game Interventions to Improve Adolescent Reproductive Health Knowledge, Attitudes, and Self-Efficacy: A Systematic Review and Meta-Analysis

Abstract

Digital games are powerful for health education and can improve health determinants and behaviors, yet limited research focuses on their effectiveness in enhancing adolescent sexual and reproductive health. This review aimed to synthesize the current studies on the effectiveness of digital games for sexual and reproductive health among adolescents (10–19 years old). We followed PRISMA guidelines and searched eight electronic databases and gray literature that were published in English and Indonesian from January 2012 to December 2022, retrieving 1,762 articles, of which 14 studies met the inclusion criteria. All articles received high-quality ratings. Fourteen articles were systematically reviewed, and 10 were subgroup meta-analyzed based on the study type. Overall effect size using a random-effects model (Hedges’ g) for knowledge was moderate with the standardized mean difference (SMD = 0.74, 95% CI: 0.11–1.38), for attitude, large (SMD = 0.95, 95% CI: 0.03–1.88), and for self-efficacy, small and not significant (SMD = 0.17, 95% CI: −0.19–0.54) in favor of the intervention condition compared to the controls. The difference between the RCTs and quasi-experimental subgroups was non-significant. Digital games effectively enhance adolescents’ knowledge and attitudes toward sexual and reproductive health. Future studies should explore game elements, measurement consistency, and attainable goals to improve digital game effectiveness.