A gamified metaverse platform (Mammoverse) for breast health education: A mixed-methods study

Breast cancer is one of the most common cancers among women globally, but there is a lack of public knowledge about breast health, and traditional health education methods are insufficiently interactive and difficult to sustain motivation for learning. Metaverse is a 3D immersive environment that allows real-time interaction through digital bodies. Integration of metaverse and gamification technologies provides new solutions to enhance learning.

The objective of this study is to evaluate the immediate and short-term effects of a gamified metaverse platform (Mammoverse) on breast health knowledge, and to explore how key design elements influence users' learning motivation and behavioural intentions.

This explanatory sequential mixed-methods study was conducted between December 2024 and March 2025 with 36 women aged 20-30 years. Participants completed a single 20-minute experience with the Mammoverse platform and were assessed on breast health knowledge at baseline, immediately post-intervention, and 4 weeks later using Friedman and Wilcoxon signed-rank tests. Semi-structured interviews were conducted post-intervention and analysed thematically to explore user experience and motivation.

Knowledge scores improved significantly post-intervention and at 4-week follow-up compared to baseline (17.44 ± 0.97 and 15.72 ± 1.83 vs 8.97 ± 2.57, P < 0.001). Qualitative data confirmed that immersive and gamified features - such as points, challenges, and achievements - enhanced user motivation and knowledge acquisition.

The Mammoverse platform excelled in enhancing immediate and short-term retention of women's breast health knowledge, reflecting the advantages and potential of gamified metaverse technology in the field of breast health education, which is worthy of further dissemination and research.