评估一款针对中国青年学生的艾滋病教育手机游戏（《艾滋战士·健康防御》），以提高与高风险行为相关的艾滋病知识、消除耻辱感及改善态度：随机对照试验。
Evaluation of an AIDS Educational Mobile Game (AIDS Fighter · Health Defense) for Young Students to Improve AIDS-Related Knowledge, Stigma, and Attitude Linked to High-Risk Behaviors in China: Randomized Controlled Trial.
作者信息
Tang Jian, Zheng Yu, Zhang Daiying, Yu Xingli, Ren Jianlan, Li Mei, Luo Yue, Tian Min, Chen Yanhua
机构信息
Department of Operating Room, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Department of Rheumatology and Immunology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
出版信息
JMIR Serious Games. 2022 Jan 24;10(1):e32400. doi: 10.2196/32400.
BACKGROUND
The AIDS epidemic among young students is serious, and effective preventive interventions are urgently needed. Game-based intervention has become an innovative way to change healthy behaviors, and we have developed an AIDS educational game called AIDS Fighter · Health Defense.
OBJECTIVE
In this study, we tested the effect of AIDS Fighter · Health Defense on young students in improving AIDS-related knowledge, stigma, and attitude related to high-risk behaviors in Southwest China.
METHODS
A randomized controlled trial was conducted from September 14 to 27, 2020. In total, 96 students from 2 classes in a middle school were selected by stratified cluster sampling in Luzhou City, Southwest China. The students were randomly divided into the intervention group (n=50, 52%) and the control group (n=46, 48%). The intervention group played the AIDS educational game AIDS Fighter · Health Defense; the control group learned AIDS-related knowledge through independent learning on the QQ chat group. An AIDS-related knowledge questionnaire, a stigma scale, and an attitude questionnaire on AIDS-related high-risk behaviors were used to measure the effect of the AIDS educational game via face-to-face interviews. The user experience of the game was assessed using the Educational Game User Experience Evaluation Scale. The difference was statistically significant at P≤.05.
RESULTS
After the intervention, the AIDS knowledge awareness rate (X̅ [SD], %) of the intervention and control groups were 70.09 (SD 11.58) and 57.49 (SD 16.58), with t=4.282 and P<.001. The stigma scores of the 2 groups were 2.44 (SD 0.57) and 2.48 (SD 0.47), with t=0.373 and P=0.71. The positive rate (X̅ [SD], %) of attitudes of high-risk AIDS behaviors of the 2 groups were 82.00 (SD 23.44) and 79.62 (SD 17.94), with t=0.555 and P=0.58. The mean percentage of the game evaluation was 54.73% as excellent, 31.45% as good, 13.09% as medium, and 0.73% as poor.
CONCLUSIONS
AIDS Fighter · Health Defense could increase AIDS-related knowledge among young students, but the effect of the game in reducing AIDS-related stigma and improving the attitudes of high-risk AIDS behaviors was not seen. Long-term effects and large-scale studies are needed to assess the efficacy of game-based intervention.
TRIAL REGISTRATION
Chinese Clinical Trial Registry ChiCTR2000038230; https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR2000038230.
背景
青年学生中的艾滋病疫情严峻，迫切需要有效的预防干预措施。基于游戏的干预已成为改变健康行为的一种创新方式，我们开发了一款名为《防艾战士·健康保卫战》的艾滋病教育游戏。
目的
在本研究中，我们测试了《防艾战士·健康保卫战》对中国西南部青年学生在提高艾滋病相关知识、消除耻辱感以及改变与高危行为相关态度方面的效果。
方法
于2020年9月14日至27日进行了一项随机对照试验。在中国西南部泸州市，通过分层整群抽样从一所中学的2个班级中选取了96名学生。这些学生被随机分为干预组（n = 50，52%）和对照组（n = 46，48%）。干预组玩艾滋病教育游戏《防艾战士·健康保卫战》；对照组通过在QQ聊天群上自主学习艾滋病相关知识。通过面对面访谈，使用一份艾滋病相关知识问卷、一份耻辱感量表以及一份关于艾滋病相关高危行为的态度问卷来衡量艾滋病教育游戏的效果。使用教育游戏用户体验评价量表评估游戏的用户体验。差异在P≤0.05时具有统计学意义。
结果
干预后，干预组和对照组的艾滋病知识知晓率（X̅ [标准差]，%）分别为70.09（标准差11.58）和57.49（标准差16.58），t = 4.282，P < 0.001。两组的耻辱感得分分别为2.44（标准差0.57）和2.48（标准差0.47），t = 0.373，P = 0.71。两组对艾滋病高危行为态度的积极率（X̅ [标准差]，%）分别为82.00（标准差23.44）和79.62（标准差17.94），t = 0.555，P = 0.58。游戏评价中，平均百分比为优秀占54.73%，良好占31.45%，中等占13.09%，差占0.73%。
结论
《防艾战士·健康保卫战》可以增加青年学生的艾滋病相关知识，但未观察到该游戏在减少艾滋病相关耻辱感以及改善对艾滋病高危行为态度方面的效果。需要进行长期效果和大规模研究来评估基于游戏的干预措施的疗效。
试验注册
中国临床试验注册中心ChiCTR2000038230；https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR2000038230 。
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