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个游戏模拟，旨在增加疟疾知识，并为实践提供风险评估和预防决策。疟疾是减少风险干预的一个极好范例，因为范围不断扩大；危及生命的后果，以及坚持个人预防措施的迫切需要[1-6]。疟疾正在全球范围内死灰复燃并重新分布，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]。气候和土地利用变化正在放大传播，而疫苗的缺乏以及对抗疟疾药物和杀虫剂的耐药性的发展增加了风险[12-28]。尽管风险因素存在这种趋同，但研究表明旅行者低估了疟疾风险，并没有遵守建议[29-44]。由于项目在疟疾风险地区的迅速扩张，美国公民普遍缺乏获得性免疫和疟疾知识，以及年轻成年人群的发展不可战胜感，出国留学的学生处于危险之中[45-52]。初步工作提供了关于疟疾和其他旅行健康风险的风险陈述和个人保护措施的海外研究人口数据，以及进行在线调查的可行性测试。这些发现和自我调节模型（SRM）的规则以及多媒体学习的认知理论为设计定制的基于网络的模拟提供了依据[53-55]。评估将使用三组随机试验和前后评估来比较游戏过程中做出决策的不同反馈策略。结果度量是知识、游戏分数和玩家满意度。综合评估将使用ANCOVA来调整干预前知识得分。方差分析将用于游戏分数和玩家满意度评估。Tukey-Kramer将用于检查治疗组的所有配对方法。第二层次的分析将采用结构方程模型来检验SRM认知表征维度和情绪表征维度以及预防自我效能对游戏得分和玩家满意度的直接和中介作用。该研究项目通过设计/测试一个交互式的基于网络的工具来改善自我管理，以及使用不断发展的在线数据收集和模拟软件[56]来实现NINR的目标。

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].