Malaria risk reduction among travelers using web-based simulation tool

描述(由申请人提供)：该项目的目的是评估一种旨在增加疟疾知识的游戏模拟，并为风险评估和预防决策提供实践。疟疾是一个极好的降低风险干预的范例，因为疟疾的范围扩大了，造成了危及生命的后果，而且非常需要坚持个人预防措施[1-6]。疟疾正在全球范围内死灰复燃和重新分布，有32亿人面临感染风险，每年有3.5亿至5亿次临床发作，每天有3000人死亡[7-11]。气候和土地利用的变化正在放大传播，而缺乏疫苗以及对抗疟疾药物和杀虫剂产生抗药性增加了风险[12-28]。尽管风险因素汇聚在一起，但研究表明，旅行者低估了疟疾风险，未能遵守建议[29-44]。由于疟疾高危地区项目的迅速扩大，美国公民普遍缺乏获得性免疫力和疟疾知识，以及年轻成年人口对不可战胜的发展感觉[45-52]，海外留学生处于危险之中。初步工作提供了国外人口研究中关于疟疾和其他旅行健康风险的风险表现和个人保护措施的数据，以及进行在线调查的可行性测试。自我调节模型(SRM)和多媒体学习的认知理论的这些发现和戒律启发了基于网络的定制模拟的设计[53-55]。评估将使用三臂随机试验和前后评估来比较不同的反馈策略在游戏过程中做出的决定。结果衡量标准是知识、游戏得分和玩家满意度。综合评估将使用ANCOVA对干预前的知识得分进行调整。ANOVA将被用于比赛得分和球员满意度评估。图基-克莱默将被用来检查治疗武器中的所有对手段。第二层分析将使用结构方程模型来检验SRM认知和情绪表征维度以及预防自我效能感对游戏得分和玩家满意度的直接和中介效应。这项研究计划通过1)设计/测试基于网络的交互式工具来改进自我管理，以及‘2)使用不断发展的在线数据收集和模拟软件技术来实现NINR目标[56]。

DESCRIPTION (provided by applicant): The aim of this project is to evaluate a gaming simulation designed to increase malaria knowledge and to provide practice with risk appraisal and prevention decision-making. Malaria is an excellent exemplar for a risk reduction intervention due to the expanding range; life-threatening consequences, and the vital need for adherence to personal prevention measures [1-6]. Malaria is resurging and redistributing on a global scale, with 3.2 billion individuals at risk for infection, 350-500 million clinical episodes per year, and 3000 deaths per day [7-11]. Climate and land use changes are amplifying transmission, while lack of a vaccine and development of resistance to anti-malaria drugs and pesticides heighten risk [12-28]. Despite this convergence of risk factors, studies have demonstrated that travelers underestimate malaria risk and fail to adhere to recommendations [29-44]. Study abroad students are in jeopardy due to the rapid expansion of programs in malaria risk regions, the general lack of acquired immunity and malaria knowledge among US citizens, and the developmental feelings of invincibility in a young adult population [45-52]. Preliminary work provided data from a study abroad population about risk representations and personal protection measures for malaria and other travel health risks, and feasibility testing for conducting on-line surveys. These findings and precepts of the self-regulation model (SRM) and the cognitive theory of multimedia learning informed the design of a tailored web-based simulation [53-55]. Evaluation will be conducted using a three arm randomized trial and pre/post assessments to compare different feedback strategies for decisions made during game play. Outcome measures are knowledge, game score, and player satisfaction. Omnibus assessment will use ANCOVA to adjust for pre-intervention knowledge score. ANOVA will be used for the game score and player satisfaction assessments. Tukey-Kramer will be used to examine all pairs of means in the treatment arms. A second tier of analysis will use structural equation modeling to test the direct and mediating effects of SRM cognitive and emotional representational dimensions and prevention self-efficacy on game score and player satisfaction. This program of research addresses NINR objectives by 1) designing/testing an interactive web-based tool to improve self-management, and '2) using evolving technology for on-line data collection and simulation software [56].