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Id 78
Author Fiellin, L., E.; Hieftje, K., D.; Pendergrass, T., M.; Kyriakides, T., C.; Duncan, L., R.; Dziura, J., D.; Sawyer, B., G.; Mayes, L.; Crusto, C., A.; Forsyth, B., WC.; Fiellin, D. A.
Title Video Game Intervention for Sexual Risk Reduction in Minority Adolescents: Randomized Controlled Trial.

Fiellin, L. E., Hieftje, K. D., Pendergrass, T. M., Kyriakides, T. C., Duncan, L. R., Dziura, J. D., ... & Fiellin, D. A. (2017). Video game intervention for sexual risk reduction in minority adolescents: Randomized controlled trial. Journal of medical Internet research, 19(9), e314.

Keywords games; gamification; serious games; health; medicine; prevention; care; sex education; sex behavior; adolescents
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Abstract Human immunodeficiency virus (HIV) disease and sexually transmitted infections (STIs) significantly impact young people, with racial/ethnic minority youth disproportionately affected. Nearly 10,000 youth were diagnosed with HIV in 2014 in the United States, accounting for 22% of new infections . There is a considerable range in both the quantity and quality of education around sexual health, HIV, and acquired immune deficiency syndrome (AIDS) adolescents receive. Only 22 states and the District of Columbia require that public schools teach sex education. Nineteen states require that if sex education is taught, it must be factually accurate. Another 12 states require HIV/AIDS education. Although there are effective HIV and STI prevention programs, challenges in their implementation and fidelity exist. Service providers may lack access to programs , selectively implement program components, or never implement programs at all. Barriers to implementation include access to adequately trained providers, resource constraints, fidelity, and challenges of adapting an intervention from one population to another. To address these issues, digital health interventions have demonstrated efficacy at influencing sexual health , featuring adaptable content for broader reach, with greater fidelity, at a potentially lower cost. Our objective was to test the efficacy of a digital health intervention in the form of a theory-driven interactive video game intervention compared to a set of control games on sexual risk behaviors, knowledge, attitudes, and intentions in a population of racial/ethnic minority adolescents. We hypothesized that a highly engaging theory-based video game intervention would have a greater impact on our outcomes of interest than a set of control games.

Metodology Participants aged 11 to 14 years from 12 community afterschool, school, and summer programs were randomized 1:1 to play up to 16 hours of an experimental video game or control video games over 6 weeks. Assessments were conducted at 6 weeks and at 3, 6, and 12 months. Primary outcome was delay of initiation of vaginal/anal intercourse. Secondary outcomes included sexual health attitudes, knowledge, and intentions. We examined outcomes by gender and age.

Findings Serious video games as digital health interventions offer the unique opportunity to increase the accessibility and reach of theory-driven and tested interventions. The PlayForward intervention demonstrated efficacy in improving sexual attitudes and knowledge in racial/ethnic minority adolescents that persisted up to 12 months. Future research should assess PlayForward’s efficacy in populations with higher rates of sexual initiation and its comparative efficacy, effectiveness, and implementation.
Open Access YES
DOI 10.2196/jmir.8148
Search Database Researcher knowledge
Technique Statistics; Randomized controlled trial
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