Intervention to encourage HIV Testing and Counseling among Adolescents

 描述(申请人提供)：艾滋病毒对少数族裔青少年的影响不成比例，他们中的大多数人既没有接受艾滋病毒检测和咨询(HTC)，也不知道他们的状况。青春期是干预艾滋病毒行为改变干预的“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方案面临的挑战可能会限制它们的影响。为了应对这些挑战，可以使用视频游戏作为干预措施，以改善与健康相关的行为。他们会在青少年所在的地方遇到他们，他们很有吸引力，为干预提供了更一致的忠诚度，并且更容易 传播，从而以较低的成本潜在地扩大覆盖范围。因此，这项提议的目标是改编一款现有的基于iPad的艾滋病预防视频游戏，并展示其有效性，Play Forward：Elm City Stories(为11-14岁的青少年开发，专注于减少性风险)，以创建一种新的视频游戏干预，重点是促进15-16岁的青少年接触和接受HTC。在最初的Play Forward中，玩家创建了一个虚拟角色，他们用来在生活中旅行，面对挑战，并做出带来不同风险、好处和后果的决定。玩家可以看到他们在比赛中的行为如何影响他们的未来。这款游戏包含了一系列现实故事，代表了初中或高中青少年面临的危险情况，玩家通过玩基于技能的小游戏成功地解决了每个故事，以获得“感官”和“能力”。在拟议的第一阶段研究中，我们将与焦点小组一起进行形成性工作，我们的游戏开发和研究团队将调整游戏，使其专注于年龄较大的青少年群体的HTC。我们将在随后对30名青少年进行的初步研究中对这款游戏进行评估，检查其可行性和可接受性，并确定其对影响青少年寻求HTC的意愿、HTC的实际获得和艾滋病毒/艾滋病知识的初步效果。他们将每周玩游戏2小时，持续3周，并在基线、3周和6周收集标准化评估数据。在随后的第二阶段研究中，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整合到游戏中，该计划将帮助参与者与HTC的其中一家诊所直接联系。测试成功后，参与者可以将关键数据输入到游戏中，并因完成测试而获得额外的游戏奖励。鉴于令人信服的证据支持视频游戏在促进健康和预防疾病方面的有效性，以及它们更多地获得机会、保真度和潜在的成本效益，这项提议有望实现有效、有吸引力和量身定做的预防干预措施，有可能对这一脆弱的青少年群体产生更大的可持续传播和相当大的影响。

 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.