Introduction : Considering the lack of participatory awareness interventions to enhance TB literacy, we co-created and implemented a TB puzzle game for adolescents and assessed its impact on TB knowledge. We aimed to co-create and implement a TB puzzle game-based intervention study in the private schools of Chennai, an Indian megacity, to impart TB literacy to adolescents and evaluate its outcomes in terms of TB literacy.
Methods : We utilized the PRODCUES framework to co-create a crossword puzzle game to impart TB literacy. We used a quasi-experimental design to evaluate its usefulness in improving TB literacy among high school students in a metropolitan city. The study involved 11th and 12th-grade school students from Chennai who were divided into intervention and control arm. A TB crossword puzzle was used to impart TB literacy in intervention arm A and TB awareness pamphlets were used for the same in control arm B. A total of twenty engaging puzzles were developed which were related to 1) Interesting facts about TB (fig. 1.1), 2) Symptoms of TB (fig. 1.2), 3) Dos and Don’ts for TB (fig. 1.3), and 4) Treatment of TB (fig. 1.4). Puzzles were developed with an engaging and easy-to-follow language style. Puzzles were interlaced with hints to intrigue the participants to solve them using relatable concepts and facts. TB literacy levels were measured using a standardised scale before and after the intervention in both arms.
RESULTS : The baseline TB literacy scores in intervention arm A and control arm B were 15 (IQR 14, 18) and 6 (IQR 4, 7) respectively. The average score of completion of TB crossword puzzles out of 20 was 17 (max 20 and min 4) and was completed in 20 minutes on average.
CONCLUSION : The improvement in TB literacy achieved through game-based puzzles was found to be much higher among students as compared to routine IEC intervention.