An Interactive Video Game for HIV Prevention in At-Risk Adolescents

用于预防高危青少年艾滋病毒的互动视频游戏

• 批准号: 8510694
• 负责人: Lynn Elizabeth Fiellin
• 金额: $ 69.89万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-10 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8510694
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adolescent; Affect; Age; Alcohol consumption; Alcohols; Anus; Artificial Intelligence; Attitude; Behavior; Behavioral; Cellular Phone; Characteristics; Choice Behavior; Cognitive; Computer software; Control Groups; Country; Coupled; Developing Countries; Development; Disease; Education; Educational Intervention; Educational process of instructing; Electronics; Elements; Enrollment; Environment; Epidemic; Ethnic Origin; Experimental Games; Foundations; Gender; Goals; HIV; HIV Infections; HIV risk; Health Promotion; Health behavior; Health behavior change; Hispanics; Home environment; Housing; Individual; Infection; International; Internet; Intervention; Knowledge; Lead; Learning; Life; Measures; Mediation; Minority; Minority Groups; Modeling; Not Hispanic or Latino; Outcome; Personal Digital Assistant; Pharmaceutical Preparations; Play; Populations at Risk; Prevalence; Prevention; Prevention strategy; Preventive Intervention; Primary Prevention; Psychology; Public Health; Race; Randomized; Randomized Clinical Trials; Research; Risk; Risk Behaviors; Risk Reduction; Risk Reduction Behavior; Risk-Taking; Role; Schools; Secondary Prevention; Self Efficacy; Series; Sex Behavior; Social Interaction; Software Tools; Technology; Testing; Time; Travel; Vagina; Video Games; Youth; after-school program; age group; alcohol risk; avoid sex; behavior change; behavior influence; cohort; design; experience; externalizing behavior; high risk; improved; meetings; member; neurobehavioral; positive youth development; prevent; primary outcome; programs; public health relevance; response; secondary outcome; sex; skills; skills training; social; social cognitive theory; social skills; theories; tool; transmission process; virtual

DESCRIPTION (provided by applicant): Video games are ubiquitous, can improve health behavior, but have not been evaluated as a tool to promote protection from HIV transmission in minority early adolescents. A major challenge in HIV prevention for minority adolescents is capturing individuals in their environment - meeting individuals "where they live". The current application combines proven HIV prevention strategies and an interactive video game platform that incorporates virtual environments and intelligent conversant virtual characters to address this challenge. Research demonstrates that adolescents who acquire new knowledge, skills and attitudes in a video game, and practice these skills in the game, are more likely to behave similarly in real life. Therefore, the goal of this application is to adapt existing software to develop and refine an interactive video game designed to decrease HIV risk by teaching minority adolescents sex, drug and alcohol negotiation and refusal skills. The game will be adapted with input from minority adolescents, and collaborators with expertise in positive youth development, social cognitive theory and self-efficacy, prospect theory and message framing, software and artificial intelligence development, and commercial game design. We will evaluate the efficacy of the game by conducting a randomized clinical trial in 330 minority youths, ages 9-14 years, attending an after-school and/or weekend youth program, who will be randomly assigned to play the interactive HIV prevention video game, "Retro-Warriors", or to play a commercial "off-the-shelf" video game. Subjects will play two sessions/week of their assigned game for four weeks. The primary outcome will be initiation of sexual activity, defined as the initiation of either vaginal or anal intercourse. Secondary outcomes include HIV risk behavior knowledge, social competency, self-efficacy, drug/alcohol use behaviors and overall risk-taking behaviors. We hypothesize that the experimental group will have lower rates of initiation of sexual activity and have higher knowledge scores at 1, 6, 12, and 24 months compared with the control group. We will also explore if selected baseline characteristics are associated with an improved response to the negotiation skills training intervention embedded in the interactive video game. Unique features of this intervention will include the use of virtual characters or avatars who can verbally respond to and interact with the player, a realistic virtual urban setting, the use of sex, drug/alcohol "risk challenges" that the subjects can practice repeatedly, the use of message framing according to prospect theory, a fun and engaging intervention that encourages repeated involvement, and the ability to track the players' choices and behaviors in the game. The successful implementation of this application will represent a paradigm shift, providing evidence for the role of interactive games as HIV/AIDS prevention in minority adolescents. Video game technology has the potential to expand the available vehicles for HIV prevention to the increasing number of electronic gaming platforms including the internet, personal digital assistants, and cell phones, thereby creating a new avenue for public health interventions. PUBLIC HEALTH RELEVANCE: This research is designed to develop and test a video game that will teach minority adolescents how to avoid sex, drug and alcohol risk behaviors that can lead to HIV infection. The research goes beyond the use of a game for education and proposes to create an interactive world in which the game players can engage in "role-playing" to learn to avoid risky behaviors. This application has far-reaching implications including the potential for this technology to "travel" with the player, i.e., the player ultimately can do sessions from home, on a console, a cell phone, or a personal digital assistant. There are international implications given that access to the internet is growing in developing countries and these technologies could be transferred to adolescents in countries experiencing a growing HIV epidemic but who have limited access to targeted risk reduction strategies. If successful, the results of this research will be video game technology that can improve individual and public health and decrease HIV transmission.

描述（由申请人提供）：视频游戏无处不在，可以改善健康行为，但尚未被评估为促进保护少数早期青少年免受艾滋病毒传播的工具。少数群体青少年艾滋病毒预防工作的一个主要挑战是， 他们的环境-满足个人“他们住的地方”。目前的应用程序结合了成熟的艾滋病毒预防策略和互动视频游戏平台，该平台包含虚拟环境和智能熟悉的虚拟角色，以应对这一挑战。研究表明，在电子游戏中获得新知识、技能和态度，并在游戏中练习这些技能的青少年，在真实的生活中更有可能表现出类似的行为。因此，这一应用的目标是调整现有软件，开发和完善互动视频游戏，通过教授少数民族青少年性、毒品和酒精谈判和拒绝技能，降低艾滋病毒风险。该游戏将根据少数民族青少年的意见进行改编，并与具有积极青年发展，社会认知理论和自我效能，前景理论和信息框架，软件和人工智能开发以及商业游戏设计专业知识的合作者进行合作。我们将通过对330名9-14岁的少数民族青少年进行随机临床试验来评估游戏的有效性，这些青少年参加课后和/或周末青少年计划，他们将被随机分配玩交互式艾滋病毒预防视频游戏“Retro-Warriors”或玩商业“现成”视频游戏。受试者将在四周内每周玩两次指定游戏。主要结局将是性活动的开始，定义为阴道或肛门性交的开始。次要结果包括HIV危险行为知识、社会能力、自我效能、药物/酒精使用行为和总体冒险行为。我们假设实验组与对照组相比，在1个月、6个月、12个月和24个月时的性活动开始率较低，知识得分较高。我们还将探讨选定的基线特征是否与对嵌入在交互式视频游戏中的谈判技能培训干预的改善反应相关。这种干预的独特功能将包括使用可以口头回应并与玩家互动的虚拟角色或化身，逼真的虚拟城市设置，使用受试者可以反复练习的性，毒品/酒精“风险挑战”，根据前景理论使用消息框架，鼓励重复参与的有趣和引人入胜的干预，以及追踪玩家在游戏中的选择和行为的能力。这一应用程序的成功实施将代表一种范式转变，为互动游戏在少数民族青少年中预防艾滋病毒/艾滋病的作用提供证据。视频游戏技术有可能将艾滋病毒预防的可用工具扩展到越来越多的电子游戏平台，包括互联网，个人数字助理和手机，从而为公共卫生干预创造新的途径。 公共卫生相关性：这项研究旨在开发和测试一种视频游戏，该游戏将教导少数民族青少年如何避免可能导致艾滋病毒感染的性、毒品和酒精风险行为。这项研究超越了使用游戏进行教育，并建议创造一个互动的世界，游戏玩家可以从事“角色扮演”，以学习避免危险行为。该应用具有深远的影响，包括该技术与玩家一起“旅行”的潜力，即，玩家最终可以在家、在控制台、蜂窝电话或个人数字助理上进行会话。鉴于互联网在发展中国家的普及率越来越高，这些技术可以转让给艾滋病毒流行日益严重但获得有针对性的减少风险战略的机会有限的国家的青少年，因此具有国际影响。如果成功，这项研究的成果将是视频游戏技术，可以改善个人和公共健康，减少艾滋病毒的传播。