Pendergrass Tyra, Hieftje Kimberly, Duncan Lindsay, Fiellin Lynn
Yale Center for Health and Learning Games, Yale School of Medicine, New Haven, CT, USA.
Department of Kinesiology and Physical Education, McGill University, Montreal, Canada.
Mhealth. 2020 Jul 5;6:26. doi: 10.21037/mhealth.2020.01.05. eCollection 2020.
Adolescents in the United States account for one-fifth of new HIV cases, and have the highest rate of undiagnosed HIV, with more than half (51%) not knowing their status. It is a crucial public health concern to help equip youth with the information and autonomy to minimize their risk and know their status. Serious videogames are emerging as valuable tools for health and behavior change in adolescents, and have potential to engage this population and increase their use of HIV testing and counseling (HTC). The purpose of this study was to: (I) modify an original serious game targeting risk reduction and HIV prevention developed by the play2PREVENT Lab and create a new serious game that focuses on HTC; (II) evaluate its feasibility and acceptability; (III) pilot-test the assessment measures that are subsequently being used in a large randomized controlled trial.
Three focus groups with adolescents, aged 14-17 (n=13, mean age =15), informed artwork and storylines for After the game was completed, a pilot test was conducted using a one-group pretest-posttest design to collect data on: (I) participants' gameplay satisfaction and experience; (II) the validity of the project's assessments. Twenty-six participants, aged 15-16 were enrolled from a local after-school program. Participants played twice weekly for three weeks. Data were collected on behavior, intentions, knowledge, perceived susceptibility, and attitudes related to HTC at baseline, post-gameplay (three weeks), and follow-up (six weeks).
For the focus groups used in the game development, four major themes emerged: (I) adolescents have strong misperceptions about HTC, including who should get tested and what the test entails; (II) adolescents have incorrect knowledge about how HIV is contracted, spread, and treated; (III) adolescents are supportive of their peers getting tested for HIV, but are not likely to get tested themselves; (IV) while the majority of adolescents know where to get tested for HIV, social stigma, misperceptions around HTC, and fear of having a positive diagnosis keep them from seeking it. For the pilot study, overall, participant experience with the game was highly favorable. The assessments were sensitive enough to capture changes in our target variables: intentions (P=0.037) and knowledge (P=0.025) related to HTC at follow-up.
The game provides promising results regarding using an engaging and evidence-informed videogame intervention to promote HTC in adolescents.
美国青少年占新增艾滋病病毒（HIV）病例的五分之一，且未被诊断出感染HIV的比例最高，超过半数（51%）的青少年不知道自己的感染状况。帮助青少年掌握信息并获得自主权以降低风险并了解自身状况是一项至关重要的公共卫生问题。严肃游戏正成为促进青少年健康和行为改变的宝贵工具，有潜力吸引这一人群并增加他们对HIV检测与咨询（HTC）的利用。本研究的目的是：（I）修改由play2PREVENT实验室开发的一款旨在降低风险和预防HIV的原创严肃游戏，并创建一款专注于HTC的新严肃游戏；（II）评估其可行性和可接受性；（III）对随后将用于一项大型随机对照试验的评估措施进行预试验。
与14至17岁的青少年（n = 13，平均年龄 = 15岁）进行了三个焦点小组讨论，为……提供了艺术作品和故事情节。游戏完成后，采用单组前测-后测设计进行了预试验，以收集以下方面的数据：（I）参与者的游戏满意度和体验；（II）项目评估的有效性。从当地一个课后项目中招募了26名15至16岁的参与者。参与者每周玩两次，共玩三周。在基线、游戏后（三周）和随访（六周）时收集与HTC相关的行为、意图、知识、感知易感性和态度方面的数据。
对于游戏开发中使用的焦点小组，出现了四个主要主题：（I）青少年对HTC存在严重误解，包括谁应该接受检测以及检测涉及哪些内容；（II）青少年对HIV的感染、传播和治疗方式存在错误认识；（III）青少年支持同龄人进行HIV检测，但自己不太可能去检测；（IV）虽然大多数青少年知道在哪里进行HIV检测，但社会耻辱感、对HTC的误解以及对检测结果呈阳性的恐惧使他们不愿去检测。对于预试验，总体而言，参与者对游戏的体验非常满意。评估足够敏感，能够捕捉到我们目标变量的变化：随访时与HTC相关的意图（P = 0.037）和知识（P = 0.025）。
该游戏在使用引人入胜且基于证据的视频游戏干预措施来促进青少年HTC方面取得了有希望的结果。
