# Exploring Gender-Sensitive Serious Games for Nutrition Communication: A Formative Qualitative Study in Rural Indonesia

## TL;DR

This study explores how gender-sensitive serious games can improve nutrition communication and reduce childhood stunting in rural Indonesia by aligning with local culture and family dynamics.

## Contribution

The paper introduces a conceptual design framework for gender-sensitive serious games tailored to rural Indonesian contexts, integrating feminist communication and technology acceptance theories.

## Key findings

- Acceptance of serious games depends on cultural alignment, institutional endorsement, and usability in low-resource settings.
- Games are seen as complementary to health workers, especially when integrating local narratives and religious values.
- Intergenerational co-play and low-connectivity functionality are key for engagement in rural areas.

## Abstract

Public health relevance—How does this work relate to a public health issue?
This study examines the ongoing issue of childhood stunting in rural Indonesia, where gender norms and inadequate nutritional knowledge impede effective solutions.It investigates culturally rooted communication tactics via serious games for moms, young women, and families residing in high-stunting areas.

This study examines the ongoing issue of childhood stunting in rural Indonesia, where gender norms and inadequate nutritional knowledge impede effective solutions.

It investigates culturally rooted communication tactics via serious games for moms, young women, and families residing in high-stunting areas.

Public health significance—Why is this work of significance to public health?
The research illustrates that gender-sensitive, game-based interventions might enhance nutritional knowledge and decision-making in high-risk populations, such as moms and brides-to-be.Findings emphasise the necessity of incorporating local culture, religion, and family dynamics to improve the acceptance of digital nutrition teaching tools.

The research illustrates that gender-sensitive, game-based interventions might enhance nutritional knowledge and decision-making in high-risk populations, such as moms and brides-to-be.

Findings emphasise the necessity of incorporating local culture, religion, and family dynamics to improve the acceptance of digital nutrition teaching tools.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Gender-sensitive serious games can enhance national stunting-reduction initiatives by providing interactive, accessible, and engaging educational experiences.The findings offer practical insights for public health professionals, politicians, and Puskesmas.

Gender-sensitive serious games can enhance national stunting-reduction initiatives by providing interactive, accessible, and engaging educational experiences.

The findings offer practical insights for public health professionals, politicians, and Puskesmas.

Stunting remains a major public health challenge in Indonesia, with a national prevalence of 21.6% in 2022. Rural regions such as Madura face heightened vulnerability due to cultural dietary taboos, gendered caregiving structures, intergenerational authority, and digital disparities that shape household nutrition decision-making. This formative qualitative study explores stakeholders’ perceptions to inform the conceptual development of gender-sensitive serious games for nutrition communication in rural Indonesia. Using an exploratory design, 42 informants, including mothers of children under five, brides-to-be, health cadres, midwives, religious and community leaders, and local digital actors, were recruited across rural Madura. Thematic analysis examined trust-based communication patterns, gender dynamics, perceptions of artificial intelligence (AI), and contextual conditions influencing digital health acceptance. Findings indicate that acceptance of gender-sensitive serious games depends on cultural alignment, institutional endorsement, perceived credibility, and usability in low-resource settings. Participants consistently positioned serious games and AI-supported features as complementary communication layers rather than replacements for health workers. Game-based tools were considered potentially relevant when designed to support intergenerational co-play, integrate local narratives and religious values, and function in low-connectivity environments. Rather than evaluating an implemented intervention, this study proposes a conceptual design framework grounded in feminist communication perspectives, serious games scholarship, and technology acceptance theory. The findings provide context-sensitive insights to guide future prototype development and pilot testing within hybrid, community-based nutrition communication systems.