Interactive gamified health education to improve knowledge, attitudes, and practices on intestinal parasitic infections: A community pilot in Malaysia's urban public housing.

Intestinal parasitic infections (IPIs) remain a major yet under-recognised public health challenge in rapidly urbanising settings. In Malaysia, most IPIs research has focused on indigenous communities, leaving critical knowledge gaps among urban poor populations living in public housing programmes (PHPs), where inadequate sanitation and waste management can sustain disease transmission. We conducted a pre-post pilot at one PHP in the Klang Valley to evaluate a multi-component community-based health education intervention incorporating gamified participatory learning activities on IPI-related knowledge, attitudes, and practices (KAP). Ninety participants from three age groups: children (7-12 years), adolescents (13-17 years), and adults (>18 years), completed standardised KAP questionnaires immediately before and after the intervention. The programme combined educational briefings, illustrated materials, and age-tailored interactive activities (e.g., card games, charades, Pictionary, Bingo, and matching activities) to deliver key prevention and hygiene messages. At baseline, adolescents scored highest across KAP domains, followed by children and adults. Post-intervention, mean scores improved significantly in all domains: knowledge improved by 60.5 ± 24.7 points, attitudes by 26.9 ± 32.5 points, and practices by 29.3 ± 33.4 points (p < 0.001). Gains were observed across age groups, suggesting broad acceptability and learning effectiveness. This participatory and culturally attuned approach demonstrates potential as a low-cost, scalable strategy to strengthen health literacy in underserved urban communities. As the social and environmental drivers of IPIs are common in many rapidly growing cities, this approach is generalisable and aligns well with One Health efforts to address enteric infections at the human-animal-environment interface. This low-cost, scalable approach can complement deworming, sanitation, and surveillance programmes by translating prevention messages into actionable behaviours.