Efficacy trial for a smartphone game to prevent HIV among young Africans

智能手机游戏在非洲年轻人中预防艾滋病毒的功效试验

• 批准号: 10670357
• 负责人: S KATE WINSKELL
• 金额: $ 58万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-12 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10670357
• 关键词: AIDS prevention; Address; Adolescence; Adolescent; Adult; Africa; Africa South of the Sahara; African; Age; Android; Attitude; Behavior assessment; Behavioral; Cellular Phone; Cognitive; Communication; Country; Data; Data Collection; Decision Making; Electronics; Evidence based practice; Feasibility Studies; Fostering; Funding; Future; Gender; Goals; HIV; HIV Infections; Health; Human Herpesvirus 2; Human Resources; Human immunodeficiency virus test; Immersion; Incidence; Individual; Infection; Intention; Intervention; Kenya; Knowledge; Learning; Measures; Mediating; Mediator; Mentors; Monitor; Motivation; National Institute of Child Health and Human Development; National Institute of Mental Health; Outcome; Parents; Participant; Pattern; Persons; Play; Positioning Attribute; Problem Solving; Qualitative Research; Randomized; Randomized, Controlled Trials; Research; Risk; Risk Management; Risk Reduction; Risk Taking; Safe Sex; Safety; Sampling; Self Efficacy; Sexual Health; Social Behavior; Surveys; Technology; Theory of Change; Unsafe Sex; Writing; Youth; aged; arm; behavior influence; boys; condoms; cost; delay sexual debut; design; efficacy evaluation; efficacy trial; experience; feasibility testing; follow-up; girls; high risk behavior; insight; mobile computing; post intervention; prevent; preventive intervention; recruit; rehearsal; sex; sexual debut; skills; skills training; social culture; social stigma; sociodemographics; theories; tool; treatment arm; young woman

Project Summary: The goal of the study is to contribute to reductions in HIV incidence among youth in sub- Saharan Africa. Our objective is to advance that goal by evaluating the efficacy of an interactive smartphone game that is designed to prevent HIV among African adolescents by delaying sexual debut and increasing condom use at first sex. The game-based intervention has shown promise in an NIMH-funded randomized feasibility study in Kenya. The intervention is informed by socio-behavioral and pedagogical theories, evidence- based practice, and unique formative research on youth sexual culture in sub-Saharan Africa. Tumaini (meaning “hope for the future” in Kiswahili) is a choose-your-own-adventure game app for inexpensive Android smartphones that uses interactive narrative to promote observational learning, cognitive and behavioral rehearsal, problem-solving, and immersion. Tumaini is designed to increase age and condom use at first sex by: increasing knowledge about sexual health and HIV; building risk-avoidance and risk-reduction skills and related self-efficacy; challenging HIV stigma and harmful gender norms and attitudes; fostering future orientation, goal- setting, and planning; and promoting dialogue with adult mentors. The game follows six characters (3 girls, 3 boys) with diverse socio-demographics and backstories, as they proceed through adolescence over three game levels. Players make decisions for the characters and experience the consequences of those decisions on characters' lives, health, and future goals. The study will follow a gender-balanced sample of 912 Kenyan adolescents, aged 13-14 at enrolment, and randomly assigned to the intervention or to a control game for 45 months with 4-monthly behavioral assessments. It will test for HIV and HSV-2 at baseline and endline, analyze game log files from the phones of intervention arm participants, and conduct qualitative research with participants, their parents and other stakeholders. The proposed project has the following aims: (1) Determine if a theory-based, empirically grounded mobile phone game-based intervention delays sexual debut and increases condom use at first sex; (2) Determine whether the game-based intervention influences behavioral mediators (knowledge, attitudes, behavioral intentions, and related self-efficacy) of early and unprotected sex; (3) Through analysis of outcome data and the mobile phone log files, determine which game components and theoretical constructs mediated effects. In addition, we have the following secondary aims: (SA1) Determine whether the game reduces HSV-2 and HIV infection; (SA2) Conduct qualitative research to optimize trial implementation, monitor threats to internal or external validity, strengthen the intervention's theory of change, and inform potential dissemination. If proven efficacious, the proposed intervention has the potential to be highly scalable, low cost, and culturally adaptable to individual sub-Saharan countries.

项目摘要：该研究的目标是为降低亚健康地区青少年的艾滋病毒发病率做出贡献。 撒哈拉非洲。我们的目标是通过评估交互式智能手机的功效来推进这一目标。 旨在通过推迟首次性行为和增加性行为来预防非洲青少年感染艾滋病毒的游戏 在 NIMH 资助的一项随机研究中，基于游戏的干预措施显示出在第一次性行为时使用安全套的前景。 肯尼亚的可行性研究。干预措施以社会行为和教学理论、证据为基础。 基于实践和对撒哈拉以南非洲青年性文化的独特形成性研究。 Tumaini（斯瓦希里语的意思是“对未来的希望”）是一款价格低廉的选择你自己的冒险游戏应用程序 Android 智能手机使用交互式叙事来促进观察学习、认知和行为 Tumaini 旨在通过以下方式提高初次性行为时的年龄和安全套使用率。 增加有关性健康和艾滋病毒的知识；培养避免和减少风险的技能及相关知识； 自我效能感；挑战艾滋病毒耻辱和有害的性别规范和态度；培养未来的方向、目标； 设定和规划；以及促进与成人导师的对话。游戏有六个角色（3 个女孩，3 个）。 男孩）具有不同的社会人口特征和背景故事，随着他们在三场比赛中度过青春期 玩家为角色做出决定，并体验这些决定的后果。 角色的生活、健康和未来目标。 该研究将对 912 名入学时年龄为 13-14 岁的肯尼亚青少年进行性别平衡抽样调查， 随机分配到干预组或控制游戏组，为期 45 个月，并进行 4 个月的行为测试 它将在基线和终点测试 HIV 和 HSV-2，分析手机中的游戏日志文件。 干预措施对参与者进行干预，并与参与者、他们的父母和其他人进行定性研究 利益相关者。 拟议项目有以下目标：（1）确定是否有一个基于理论、基于经验的移动设备 (2) 确定基于手机游戏的干预会延迟首次性行为并增加首次性行为时安全套的使用； 基于游戏的干预是否影响行为中介（知识、态度、行为 (3)通过结果数据分析 手机日志文件，确定哪些游戏组件和理论结构介导了影响。 此外，我们还有以下次要目标：（SA1）确定游戏是否会减少 HSV-2 和 HIV (SA2) 进行定性研究以优化试验实施，监控对内部或外部的威胁 外部有效性，加强干预的变革理论，并为潜在的传播提供信息。 如果被证明有效，所提议的干预措施有可能具有高度可扩展性、低成本和文化性 适用于各个撒哈拉以南非洲国家。