Intervention to encourage HIV Testing and Counseling among Adolescents

鼓励青少年进行艾滋病毒检测和咨询的干预措施

• 批准号: 9146463
• 负责人: Lynn Elizabeth Fiellin
• 金额: $ 22.46万
• 依托单位: SCHELL GAMES, LLC
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-05-01 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9146463
• 关键词: 14 year old; 16 year old; AIDS prevention; AIDS/HIV problem; Address; Adolescence; Adolescent; Affect; Age; Back; Behavior; Benefits and Risks; Centers for Disease Control and Prevention (U.S.); Cities; Clinic; Counseling; Data; Decision Making; Development; Ensure; Female Adolescents; Focus Groups; Foundations; Future; Goals; HIV; HIV Infections; Health; Health Promotion; Health behavior; High School Student; Hour; Human immunodeficiency virus test; Incentives; Incidence; Individual; Intention; Intervention; Knowledge; Life; Link; Literature; Male Adolescents; Manuals; Mediator of activation protein; Methods; Minority; Modeling; Motivation; Nature; Older Population; Outcome; Participant; Patient Self-Report; Phase; Pilot Projects; Planning Theory; Play; Population; Prevention; Prevention program; Preventive Intervention; Randomized Controlled Trials; Reporting; Research Personnel; Rewards; Risk; Risk Reduction; Role; Self Efficacy; Series; Technology; Teenagers; Testing; Theoretical model; Translating; Travel; Treatment Efficacy; Vulnerable Populations; Work; Youth; age group; aged; base; behavior change; boys; cost; cost effectiveness; design; disorder prevention; evidence base; experience; girls; high risk; high school; improved; junior high school; meetings; parent grant; phase 1 study; phase 2 study; primary outcome; programs; public health relevance; sex; sexual initiation delay; skills; social cognitive theory; social learning; uptake; videogame intervention; virtual; young adult

 DESCRIPTION (provided by applicant): HIV disproportionately impacts minority adolescents, and most of them have neither undergone HIV testing and counseling (HTC) nor know their status. Adolescence is a "window of opportunity" to intervene with HIV behavior change interventions. Challenges to implementing and disseminating some effective HIV prevention programs in adolescents may limit their impact. To address these challenges, videogames can be used as interventions to improve health-related behaviors. They meet adolescents "where they are at," are engaging, provide more consistent fidelity to the intervention, and are easier to disseminate, leading to potentially greater reach at a lower cost. Therefore, the goal of this proposal is to adapt an existing iPad-based HIV prevention videogame with demonstrated efficacy, Play Forward: Elm City Stories (developed for teens aged 11-14 and focused on sexual risk reduction) to create a new videogame intervention focused on promoting access to and uptake of HTC in adolescents, aged 15-16. In the original Play Forward, players create a virtual character they use to travel through life, facing challenges and making decisions that bring different risks, benefits, and consequences. The players can see how their actions in the game influence their future. The game involves a series of realistic stories representing risky situatios faced by teens in middle or high school, and players successfully resolve each story by playing skill-based mini-games to acquire "senses" and "powers." For the proposed Phase 1 study, we will conduct formative work with focus groups, and our team of game developers and researchers will adapt the game for a focus on HTC in an older adolescent age group. We will evaluate the game in a subsequent pilot study with 30 adolescents, examining its feasibility and acceptability, as well as determining its preliminary efficacy for impacting adolescents' intention to seek HTC, actual obtaining of HTC, and knowledge about HIV/AIDS. They will play the game for 2 hours per week for 3 weeks, and standardized assessment data will be collected at baseline, 3, and 6 weeks. In a subsequent Phase 2 study, we will plan to integrate into the game opportunities and incentives that promote the adolescent connecting with a health clinic program that will help to directly link the participant with one of the clinics for HTC. After successful testing, the participant can enter key data back into the game and be rewarded additional game incentives for completing testing. Given the compelling evidence supporting the efficacy of videogames in health promotion and disease prevention, and their increased access, fidelity, and potential cost-effectiveness, this proposal holds the promise of an effective, engaging, and tailored prevention intervention with the potential for greater sustainable dissemination and considerable impact on this vulnerable population of adolescents.

 描述（由申请人提供）：艾滋病毒对少数族裔青少年的影响尤为严重，他们中的大多数人既没有接受过艾滋病毒检测和咨询（HTC），也不知道自己的状况。青春期是进行艾滋病毒行为改变干预措施的“机会之窗”。在青少年中实施和传播一些有效的艾滋病毒预防计划所面临的挑战可能会限制其影响。为了应对这些挑战，视频游戏可以用作改善健康相关行为的干预措施。他们会见青少年“在他们所处的位置”，具有参与性，对干预提供更一致的忠诚度，并且更容易 传播，从而以更低的成本实现更大的覆盖范围。因此，本提案的目标是改编现有的基于 iPad 的 HIV 预防视频游戏（已证明有效），即 Play Forward：Elm City Stories（专为 11-14 岁青少年开发，重点关注降低性风险），创建一种新的视频游戏干预措施，重点促进 15-16 岁青少年接触和吸收 HTC。在原版《Play Forward》中，玩家创建一个虚拟角色，用它来度过人生，面对挑战并做出会带来不同风险、收益和后果的决定。玩家可以看到他们在游戏中的行为如何影响他们的未来。游戏涉及一系列现实故事，代表初高中青少年面临的危险情境，玩家通过玩基于技能的小游戏来成功解决每个故事，以获得“感觉”和“力量”。对于拟议的第一阶段研究，我们将与焦点小组一起开展形成性工作，我们的游戏开发者和研究人员团队将调整游戏，以重点关注年龄较大的青少年年龄段的 HTC。我们将在后续对 30 名青少年进行的试点研究中评估该游戏，考察其可行性和可接受性，并确定其对青少年寻求 HTC 的意愿、实际获得 HTC 以及艾滋病知识的影响的初步效果。他们将每周玩游戏 2 小时，持续 3 周，并在基线、第 3 周和第 6 周收集标准化评估数据。在随后的第 2 阶段研究中，我们将计划将促进青少年与健康诊所计划建立联系的机会和激励措施融入到游戏中，这将有助于将参与者与 HTC 的诊所之一直接联系起来。测试成功后，参与者可以将关键数据重新输入游戏，并因完成测试而获得额外的游戏奖励。鉴于支持电子游戏在健康促进和疾病预防方面的功效的令人信服的证据，以及电子游戏增加的可及性、保真度和潜在的成本效益，该提案有望提供有效、有吸引力和量身定制的预防干预措施，并有可能实现更大程度的可持续传播，并对这一弱势青少年群体产生重大影响。