Abstract
Background Escape rooms are timed, immersive group activities in which participants solve a series of puzzles and challenges, often organised around a narrative theme, in order to “escape” a physical or simulated space. They are increasingly used as innovative tools for public engagement in STEM, providing an immersive format that blends entertainment with education. Interactive, narrative-driven formats such as escape rooms may offer a novel route to convey health messages that are otherwise poorly retained through traditional, didactic communication. Improving public understanding of bone biology and osteoporosis prevention remains an important health literacy objective. Methods We developed “Science Pirates: The Bone Health Edition,” a bilingual (English and Welsh) pirate-themed pop-up escape room designed to promote skeletal awareness through interactive learning. More than 200 participants aged 2 to 82 engaged with the activity across multiple South Wales venues. The experience incorporated puzzle-solving, QR code–enabled digital content, and a “build-your-own-bone” model. Results Post-activity surveys (n = 202) indicated improved perceived knowledge of bone biology. Participants showed a shift from lower baseline self-ratings to higher post-activity ratings, with 95.2% selecting 4 or 5 stars after completion; as this was a single-arm evaluation using self-report data, this finding indicates association rather than a confirmed causal effect. Conclusions Pop-up escape rooms represent a promising approach for communicating complex scientific concepts to diverse audiences. The adaptability and inclusive design of the Science Pirates experience highlight the potential for escape room–based engagement to enhance health literacy across age groups.