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: 10017321
• 负责人: S KATE WINSKELL
• 金额: $ 64.49万
• 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/10017321
• 关键词: AIDS prevention; Address; Adolescence; Adolescent; Adult; Africa; Africa South of the Sahara; African; Age; Android; Attitude; Behavior assessment; Behavioral; Car Phone; Cellular Phone; Cognitive; Communication; Country; Data; Data Collection; Decision Making; 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 of activation protein; Mentors; Monitor; Motivation; National Institute of Child Health and Human Development; National Institute of Mental Health; Outcome; Parents; Participant; Pattern; Play; Positioning Attribute; Preventive Intervention; 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; Testing; Theory of Change; Unsafe Sex; Youth; aged; arm; base; behavior influence; boys; condoms; cost; delay sexual debut; design; efficacy trial; experience; follow-up; girls; high risk behavior; insight; mobile computing; pedagogy; post intervention; prevent; 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：该研究的目的是为减少子的艾滋病毒事件减少 撒哈拉非洲。我们的目标是通过评估交互式智能手机的效率来促进该目标 旨在通过延迟性行会并增加性行为来防止非洲青少年中的艾滋病毒的游戏 首先使用避孕套。基于游戏的干预措施已在NIMH资助的随机分组中显示出希望 肯尼亚的可行性研究。干预措施由社会行为和教学理论，证据 - 基于撒哈拉以南非洲青年性文化的独特实践研究。 tumaini（锡瓦希里（Kiswahili）中的“对未来的希望”）是一个选择自己的冒险游戏应用程序，适用于廉价 使用交互式叙述来促进观察性学习，认知和行为的Android智能手机 排练，解决问题和沉浸。 Tumatsuri旨在通过以下方式增加年龄和避孕套的使用： 对性健康和艾滋病毒的了解增加；建立避免风险和降低风险的技能以及相关 自我效能；挑战艾滋病毒的污名和有害性别规范和出席；促进未来的定位，目标 - 设置和计划；并促进与成人导师的对话。游戏跟随六个角色（3个女孩，3个 男孩）有不同的社会人口统计学和背景故事，他们在三场比赛中穿越青少年 水平。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。 该研究将遵循912名肯尼亚青少年的性别均衡样本，入学时13-14岁， 随机分配给干预措施或控制游戏45个月，行为45个月 评估。它将在基线和端线测试HIV和HSV-2 干预组参与者，并与参与者，他们的父母和其他 利益相关者。 拟议的项目具有以下目的：（1）确定基于理论的经验基础移动 基于电话游戏的干预延迟性行为，并在首次性交时增加了避孕套的使用； （2）确定 基于游戏的干预措施是否影响行为媒介（知识，吸引力，行为 早期和不受保护的性别的意图以及相关的自我效能感； （3）通过分析结果数据和 手机日志文件，确定哪些游戏组件和理论结构介导的效果。 此外，我们有以下次要目标：（SA1）确定游戏是否减少了HSV-2和HIV 感染; （SA2）进行定性研究以优化试验实施，监控内部或 外部有效性，加强干预的变化理论，并为潜在的传播提供信息。 如果证明有效，则提出的干预措施有可能高度扩展，低成本和文化 适用于撒哈拉以南国家的各个国家。