Background
Breast cancer is a major public health issue, with screening participation rates in France below European recommendations. Health literacy is a key determinant of screening uptake, surpassing sociodemographic factors, leading the World Health Organization to recommend community empowerment and health literacy enhancement to promote early diagnosis. The problem lies in the fact that traditional awareness-raising formats struggle to engage target audiences, who prefer fun educational activities. In this context, escape games appear to be a relevant, low-cost, and high-impact educational tool when based on evidence.
 
Objectives
The aim of this project was to design, implement, and evaluate an educational escape game as an innovative tool to raise awareness of breast cancer prevention and screening among diverse populations, beyond hospital settings.
 
Methods
An immersive escape game focusing on breast cancer risk factors, prevention, screening, and early detection was co-designed by healthcare professionals, patient partners, social sector stakeholders, and communication specialists. Based on the codes of recreational escape games, the intervention combined puzzles, sensory activities, and teamwork. It was followed by a debriefing session led by a healthcare professional–patient partner dyad, tailored to participants’ needs and values to support informed decision-making.
 
The intervention has been implemented since October 2023 across various community and healthcare settings, including community centres, public markets, a town hall, a private non-profit hospital, and a university hospital. Each session lasted 35 minutes, comprising 20 minutes of gameplay and 15 minutes of debriefing. A total of 300 participants from diverse age groups, educational backgrounds, and socioeconomic profiles took part. Evaluation was based on a satisfaction and perceived educational impact questionnaire using a five-point Likert scale.
 
Results
Overall satisfaction was high, with 91.4% of participants reporting being very satisfied. The escape game was perceived as effective in raising awareness of breast cancer prevention and screening (90.1%) and in delivering key messages clearly (90.8%). The playful, innovative, and engaging nature of the intervention was identified as a major contributor to learning. The debriefing session was considered essential for consolidating knowledge by 90.1% of participants. Nearly all participants (98.6%) stated that they would recommend the escape game to others as a breast cancer awareness tool.
 
 
Conclusions / Implications
This educational escape game represents a relevant, reproducible, and low-cost intervention to strengthen breast cancer prevention and health literacy. By combining evidence-based content, experiential learning, and patient partnership, it enhances engagement among diverse populations and facilitates the translation of knowledge into concrete public health actions. Further research is needed to assess its long-term impact on screening behaviours.