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Nishikawa M, Yamanaka M, Shibanuma A, Kiriya J, Jimba M. Japanese health and safety information for overseas visitors: a randomized controlled trial. BMC Public Health 2023; 23:1194. [PMID: 37340334 DOI: 10.1186/s12889-023-16117-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 06/13/2023] [Indexed: 06/22/2023] Open
Abstract
INTRODUCTION International travel to Japan increased steadily until the coronavirus disease 2019 (COVID-19) outbreak. Although international travel was curtailed worldwide due to the pandemic, the number of overseas visitors to Japan should increase again after the restrictions are lifted. We assessed the effect of a five-minute digital game on the knowledge of health information and the level of satisfaction with educational health resources of overseas visitors to Japan. METHODS We conducted a randomized controlled trial among 1062 previous and potential visitors to Japan utilizing an internet portal. We recruited previous and potential visitors to Japan from the internet portal sites of the UK, the US and Australia. We randomly allocated participants to two groups: an intervention group that played an animated game and a control group that viewed an online animation. All participants answered a self-administered questionnaire online from March 16 to 19, 2021. We assessed visitors' levels of health knowledge and satisfaction using the CSQ-8. We analyzed the data with a t test and the difference in differences test. Our RCT followed the SPIRIT guidelines. RESULTS Of the 1062 previous and potential visitors recruited via the three countries' internet portals (354 from each country), some had visited Japan previously (174 in the intervention group, 220 in the control group), while some were potential visitors to Japan (357 in the intervention group, 311 in the control group). Some had gathered health and safety information about Japan prior to this study (180 in the intervention group, 211 in the control group). Both groups improved their health information levels after the intervention. The level of satisfaction with health information in Japan was significantly increased in the intervention group (average difference of 4.5 points) compared to that in the control group (average difference of 3.9 points) (p < 0.05). Both groups' mean CSQ-8 scores increased significantly after the intervention (p < 0.001): from 23 to 28 in the intervention group and from 23 to 24 in the control group. CONCLUSIONS Our study introduced unique educational strategies using an online game to provide health and safety information to previous and potential visitors to Japan. The online game was a more effective way to increase satisfaction than the online animation about health information. This study was registered in the UMIN-CTR (University Hospital Medical Information Network Center Clinical Trials Registry) as Version 1, and the trial registration data are available as UMIN000042483, 17/11/2020. TRIAL REGISTRATION Trials UMIN-CTR (University Hospital Medical Information Network Center Clinical Trials Registry), UMIN000042483 (Japanese health and safety information for overseas visitors: A randomized controlled trial), 17/11/2020.
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Affiliation(s)
- Mariko Nishikawa
- Department of Global Health and Nursing, Graduate School of Nursing, The University of Human Environments, Nagoya, Japan.
- , 3-220, Ebata Cho, Obu City, 474-0035, Aichi, Japan.
| | - Masaaki Yamanaka
- Department of Maritime Science and Technology, Japan Coast Guard Academy, Kure, Japan
| | - Akira Shibanuma
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junko Kiriya
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Mitchell JT, Burns CM, Atkinson B, Cottrell M, Frye JK, McKellar MS, Kashuba ADM, McClernon FJ, Okeke NL. Feasibility, Acceptability, and Preliminary Efficacy of a Gamified Mobile Health Contingency Management Intervention for PrEP Adherence Among Black MSM. AIDS Behav 2022; 26:3311-3324. [PMID: 35416595 PMCID: PMC9474612 DOI: 10.1007/s10461-022-03675-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2022] [Indexed: 11/01/2022]
Abstract
Oral HIV pre-exposure prophylaxis (PrEP) is effective at preventing HIV. However, low adherence is common and undermines these protective effects. This is particularly relevant for groups with disproportionately higher rates of HIV, including Black men who have sex with men (MSM). The current study tested the feasibility, acceptability, and preliminary efficacy of a gamified mobile health contingency management intervention for PrEP adherence-called mSMART (Mobile App-Based Personalized Solutions for Medication Adherence of Rx Pill Tool). Fifteen Black MSM already prescribed PrEP in the community completed baseline and follow-up assessments separated by 8 weeks of using mSMART. Regarding feasibility, there was no study attrition, no mSMART functional difficulties that significantly interfered with use, and a mean rate of 82% daily mSMART use. Acceptability ratings were in the moderately to extremely satisfied range for factors such as willingness to recommend mSMART to others and user-friendliness, and in the low range for ratings on difficulty learning how to use mSMART. Scores on a system usability measure were in the acceptable range for 73% of the sample. Qualitative analysis of follow-up interviews identified individual components of mSMART that could be modified in future iterations to make it more engaging. PrEP composite adherence scores from biomarkers indicated an improvement from baseline to follow-up with a medium effect size, as well as a decrease in the number of perceived barriers to medication adherence. Findings indicate a future efficacy trial is needed to examine the effects of this gamified mobile health contingency management intervention on PrEP adherence.
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Affiliation(s)
- John T Mitchell
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, 2608 Erwin Road, Pavilion East, Suite 300, Durham, NC, 27705, USA.
- Duke Center for Addiction Science and Technology, Durham, NC, USA.
| | - Charles M Burns
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - Breyah Atkinson
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - Mackenzie Cottrell
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Justin K Frye
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - Mehri S McKellar
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
| | - Angela D M Kashuba
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - F Joseph McClernon
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, 2608 Erwin Road, Pavilion East, Suite 300, Durham, NC, 27705, USA
- Duke Center for Addiction Science and Technology, Durham, NC, USA
| | - Nwora Lance Okeke
- Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA
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Darville-Sanders G, Burns J, Chavanduka T, Anderson-Lewis C. The Male Domain-Digital Game-Based Learning for Human Papillomavirus Vaccination Among Young Males. Games Health J 2022; 11:312-320. [PMID: 35856843 DOI: 10.1089/g4h.2021.0141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Human papillomavirus (HPV) is the most common sexually transmitted disease, with the highest infection rates among those sexually active under 25. Although vaccination can reduce HPV cancers among men, public health interventions have primarily targeted females. Increased gaming rates among men provide innovative opportunities to motivate behavior change. This study sought to explore which game development and design strategies are most effective in a game for sexual health, specifically focused on HPV. We also sought to capture information relevant to preferred gaming platforms and game mechanics (health messages, avatars, and visual imagery). Materials and Methods: Twenty-two (n = 22) qualitative interviews were conducted with experts. Using grounded theory, interview data was coded, and emergent themes were identified. Results: Game mechanics most mentioned included simulation/role-playing, social interaction, narrative, and rewards. Experts felt it was important to keep the game in the context of the target audience and integrate the game into an existing game/game scenario or application. Experts also felt the game should link to external resources and enlist partnerships or collaborations with external health agencies. Moreover, while there are benefits to each gaming platform, games on mobile phones and tablets are most appropriate. Conclusion: Digital games are a nonconfrontational approach to discussing HPV and can increase knowledge/awareness and positively influence behavior change toward vaccine uptake. Digital games present a safe environment for role-playing through simulated activities without real-world consequences.
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Affiliation(s)
| | - Jade Burns
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Tanaka Chavanduka
- Department of Health Psychology and Clinical Science, The City University of New York, New York, New York, USA
| | - Charkarra Anderson-Lewis
- College of Nursing and Health Professions, The University of Southern Mississippi, Hattiesburg, Mississippi, USA
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Wilbourn B, Howard-Howell T, Castel A, D'Angelo L, Trexler C, Carr R, Greenberg D. Barriers and Facilitators to HIV Testing Among Adolescents and Young Adults in Washington, District of Columbia: Formative Research to Inform the Development of an mHealth Intervention. JMIR Form Res 2022; 6:e29196. [PMID: 35275083 PMCID: PMC8956991 DOI: 10.2196/29196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 10/20/2021] [Accepted: 01/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adolescents and young adults (AYA) in the United States, and in Washington, District of Columbia (DC), specifically, are disproportionately affected by HIV. Both the national Ending the HIV Epidemic initiative and DC-specific plans emphasize HIV testing, and innovative strategies to encourage testing among AYA are needed. OBJECTIVE The purpose of this study is to identify sexual behaviors, HIV knowledge, HIV perceptions (eg, susceptibility and severity), and perceived barriers and facilitators to HIV testing among AYA at risk for HIV in DC. METHODS This study was part of a larger study to determine the acceptability of using a life-and-dating simulation game to increase HIV testing among AYA. Focus groups and surveys stratified by self-reported sexual orientation were conducted among, and administered to, AYA aged 13-24 years in DC. HIV knowledge was explored during focus groups and measured using an adapted version of the Brief HIV Knowledge Questionnaire. Survey data were summarized using descriptive statistics and compared by self-reported sexual orientation. Transcripts were thematically analyzed. RESULTS Of the 46 AYA who participated in the focus groups, 30 (65%) identified as heterosexual and 16 (35%) as lesbian, gay, bisexual, transgender, or queer. A higher proportion of lesbian, gay, bisexual, transgender, or queer AYA reported sexual activity (12/16, 75%, vs 18/30, 60%), condomless sex (11/12, 92%, vs 15/18, 83%), and HIV testing (13/16, 81%, vs 17/29, 58%) than heterosexual AYA. HIV prevention ("condoms" and "...PrEP") and transmission ("exchange of fluids") knowledge was high, and most (34/44, 77%) of the AYA perceived HIV testing as beneficial. However, the AYA also demonstrated some misinformation concerning HIV: an average of 67% (31/46; SD 0.474) of the participants believed that an HIV test could deliver accurate results 1 week after a potential exposure and an average of 72% (33/46; SD 0.455) believed that an HIV vaccine exists. The AYA also identified individual ("...people...are scared"), interpersonal ("it's an awkward conversation"), and structural ("...people don't...know where they can go") barriers to testing. Most of the AYA indicated that they were very likely to use the demonstrated game prototype to help with getting tested for HIV (median 3.0, IQR 2.0-3.0, using a scale ranging from 0 to 3, with 3 indicating high likelihood) and strongly agreed that the game was interesting (median 5.0, IQR 5.0-5.0), fun (median 5.0, IQR 4.0-5.0), and easy to learn (median 5.0, IQR 5.0-5.0, using a scale ranging from 1 to 5, with 5 indicating strong agreement). CONCLUSIONS These results suggest a need for multilevel HIV testing interventions and informed the development of a mobile health intervention aiming to increase HIV knowledge and risk perception among AYA, while reducing barriers to testing at the individual and structural levels, supporting efforts to end the domestic HIV epidemic.
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Affiliation(s)
- Brittany Wilbourn
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | | | - Amanda Castel
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | | | | | - Rashida Carr
- Children's National Hospital, Washington, DC, United States
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van Steen T, Deeleman JRA. Successful Gamification of Cybersecurity Training. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2021; 24:593-598. [PMID: 34491845 DOI: 10.1089/cyber.2020.0526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The behavioral aspect of cybersecurity has gained more attention in recent years. By their actions, people can improve the security of their devices and organizations, but also hinder the successful implementation of security in these areas. As awareness campaigns where information is merely distributed are not effective, we designed a cybersecurity serious game applicable for cybersecurity training. The effectiveness of this game was experimentally tested against a noncybersecurity game that did or did not contain cybersecurity information, through measures of the theory of planned behavior. Results showed that the cybersecurity game resulted in higher self-reported scores on attitudes, perceived behavioral control, intentions, and behavior compared with both noncybersecurity games. For subjective norms, we only found an effect in the comparison between the cybersecurity game and the noncybersecurity game without additional information.
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Affiliation(s)
- Tommy van Steen
- Institute of Security and Global Affairs, Leiden University, The Hague, The Netherlands
| | - Julia R A Deeleman
- Institute of Security and Global Affairs, Leiden University, The Hague, The Netherlands.,L.I.B. Businessgames, Breda, The Netherlands
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Castel AD, Wilbourn B, Trexler C, D'Angelo LD, Greenberg D. A Digital Gaming Intervention to Improve HIV Testing for Adolescents and Young Adults: Protocol for Development and a Pilot Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e29792. [PMID: 34185022 PMCID: PMC8277397 DOI: 10.2196/29792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 04/23/2021] [Indexed: 11/13/2022] Open
Abstract
Background Two strategies of the US Ending the HIV Epidemic initiative are early diagnosis of infections via widespread testing and prevention of new infections using pre-exposure prophylaxis (PrEP). These strategies are particularly important for adolescents and young adults (AYAs) who are disproportionately affected by HIV, particularly if they identify as Black and/or lesbian, gay, bisexual, transgender, queer or questioning, and others (LGBTQ+). This study will develop and test an interactive life-simulation game in which players can enact real-life behaviors and receive their HIV risk profile to improve HIV testing and PrEP access among AYAs aged 13-24 years in Washington, DC. Objective This mixed methods study aims to determine the acceptability of an interactive, enhanced life-simulation game prototype among AYAs, conduct a pilot test of the gaming intervention among a small cohort of AYAs to ensure game usability and acceptability, and evaluate the efficacy of the game in a randomized controlled study with AYAs at risk for HIV in Washington, DC. Methods This research protocol will be conducted in 3 phases. A formative phase will involve surveys and focus groups (n=64) with AYAs living in the DC area. These focus groups will allow researchers to understand youth preferences for game enhancement. The second phase will consist of a pilot test (n=10) of the gaming intervention. This pilot test will allow researchers to modify the game based on formative results and test the planned recruitment and data collection strategy with intended end users. The third phase will consist of a randomized controlled study among 300 AYAs to examine the efficacy of the life-simulation game compared with app-based HIV educational materials on HIV and PrEP in changing HIV testing, knowledge, risk behaviors, and PrEP access. Participants will have unlimited access to either the life-simulation game or the educational app for 3 months from the time of enrollment. Study assessments will occur at enrollment and at 1, 3, and 6 months post enrollment via e-surveys. At 6 months, a subset of intervention participants (n=25) will participate in in-depth exit interviews regarding their experience being in the study. Results Institutional review board approval was received on February 5, 2020. This project is currently recruiting participants for the formative phase. Conclusions This interactive life-simulation intervention aims to increase HIV testing and PrEP access among AYAs in the DC area. In this intervention, players can enact real-life behaviors and receive their HIV risk profile to promote HIV testing and PrEP seeking. Such an intervention has great potential to improve knowledge of HIV and PrEP among AYAs, increase motivation and self-efficacy related to HIV testing and PrEP use, and decrease individual and structural barriers that often preclude engagement in HIV prevention services. Trial Registration ClinicalTrials.gov NCT04917575; https://clinicaltrials.gov/ct2/show/NCT04917575 International Registered Report Identifier (IRRID) PRR1-10.2196/29792
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Affiliation(s)
- Amanda D Castel
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Brittany Wilbourn
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
| | - Connie Trexler
- Adolescent Clinical Research, Children's National Hospital, Washington, DC, United States
| | - Lawrence D D'Angelo
- Division of Adolescent and Young Adult Medicine, Children's National Hospital, Washington, DC, United States
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Whiteley L, Olsen E, Mena L, Haubrick K, Craker L, Hershkowitz D, Brown LK. A Mobile Gaming Intervention for Persons on Pre-Exposure Prophylaxis: Protocol for Intervention Development and Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e18640. [PMID: 32924954 PMCID: PMC7522735 DOI: 10.2196/18640] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/08/2020] [Accepted: 07/14/2020] [Indexed: 01/17/2023] Open
Abstract
Background In the United States, young minority men who have sex with men (MSM) are the most likely to become infected with HIV. Pre-exposure prophylaxis (PrEP) is an efficacious and promising prevention strategy. However, PrEP’s safety and effectiveness can be greatly compromised by suboptimal adherence to treatment. To maximize the positive impact of PrEP, it is necessary to combine its prescription with cost-effective behavioral interventions that promote adherence and decrease HIV risk behaviors. In this project, we developed a theoretically informed app/gaming intervention to engage young MSM in learning information, practicing behaviors, and improving motivation for HIV preventative behaviors and PrEP adherence. Objective The goal of this project was to develop and test a cutting-edge, engaging, and entertaining app/gaming intervention for improving adherence to PrEP and building HIV prevention knowledge, skills, and behavior. Methods This study was conducted in two phases. In the developmental phase, we conducted qualitative interviews with young MSM (n=20) to guide the development of the gaming intervention. In the randomized controlled trial, we tested the preliminary efficacy of the gaming intervention compared to a comparison condition among young MSM. Subjects were recruited from the University of Mississippi Medical Center HIV/STI testing clinics (n=60). Results Institutional review board approval was received in February 2015. Research activities began in June 2015 and are still ongoing. Conclusions This app/gaming intervention aimed to improve PrEP adherence and HIV preventative behaviors in young MSM. Engaging young MSM in learning information, practicing behaviors, and improving motivation for increased adherence to PrEP has the potential to decrease HIV seroconversion. It is important to develop interventions that are enjoyable, engaging, and easily incorporated into clinical settings. Trial Registration ClinicalTrials.gov RCT02611362; https://tinyurl.com/y65gkuwr International Registered Report Identifier (IRRID) DERR1-10.2196/18640
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Affiliation(s)
- Laura Whiteley
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Elizabeth Olsen
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Leandro Mena
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, MS, United States
| | - Kayla Haubrick
- Department of Psychiatry, Rhode Island Hospital, Providence, RI, United States
| | - Lacey Craker
- Department of Psychiatry, Rhode Island Hospital, Providence, RI, United States
| | - Dylan Hershkowitz
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Larry K Brown
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, United States.,Department of Psychiatry, Rhode Island Hospital, Providence, RI, United States
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Whiteley L, Mena L, Craker LK, Healy MG, Brown LK. Creating a Theoretically Grounded Gaming App to Increase Adherence to Pre-Exposure Prophylaxis: Lessons From the Development of the Viral Combat Mobile Phone Game. JMIR Serious Games 2019; 7:e11861. [PMID: 30916652 PMCID: PMC6456850 DOI: 10.2196/11861] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/05/2018] [Accepted: 12/09/2018] [Indexed: 12/20/2022] Open
Abstract
Background In the United States, young minority men who have sex with men (MSM) are most likely to become infected with HIV. The use of antiretroviral medications to reduce the risk of acquiring HIV infection (pre-exposure prophylaxis, PrEP) is an efficacious and promising prevention strategy. There have been significant advances regarding PrEP, including the definitive demonstration that PrEP reduces HIV acquisition and the development of clinical prescribing guidelines. Despite these promising events, the practical implementation of PrEP can be challenging. Data show that PrEP’s safety and effectiveness could be greatly compromised by suboptimal adherence to treatment, and there is concern about the potential for an increase in HIV risk behavior among PrEP users. Due to these challenges, the prescribing of PrEP should be accompanied by behavioral interventions to promote adherence. Objective This study aimed to develop an immersive, action-oriented iPhone gaming intervention to improve motivation for adherence to PrEP. Methods Game development was guided by social learning theory, taking into consideration the perspectives of young adult MSM who are taking PrEP. A total of 20 young men who have sex with men (YMSM; aged 18-35 years) were recruited from a sexually transmitted infection (STI), HIV testing, and PrEP care clinic in Jackson, Mississippi, between October 2016 and June 2017. They participated in qualitative interviews guided by the information-motivation-behavioral skills (IMB) model of behavior change. The mean age of participants was 26 years, and all the participants identified as male. Acceptability of the game was assessed with the Client Service Questionnaire and session evaluation form. Results A number of themes emerged that informed game development. YMSM taking PrEP desired informational game content that included new and comprehensive details about the effectiveness of PrEP, details about PrEP as it relates to doctors’ visits, and general information about STIs other than HIV. Motivational themes that emerged were the desire for enhancement of future orientation; reinforcement of positive influences from partners, parents, and friends; collaboration with health care providers; decreasing stigma; and a focus on personal relevance of PrEP-related medical care. Behavioral skills themes centered around self-efficacy and strategies for adherence to PrEP and self-care. Conclusions We utilized youth feedback, IMB, and agile software development to create a multilevel, immersive, action-oriented iPhone gaming intervention to improve motivation for adherence to PrEP. There is a dearth of gaming interventions for persons on PrEP. This study is a significant step in working toward the development and testing of an iPhone gaming intervention to decrease HIV risk and promote adherence to PrEP for YMSM.
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Affiliation(s)
- Laura Whiteley
- Department of Psychiatry, Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Leandro Mena
- University of Mississippi Medical Center, University of Mississippi, Jackson, MS, United States
| | - Lacey K Craker
- Young Adult Behavioral Health, Department of Psychiatry and Human Behavior, Rhode Island Hospital, Providence, RI, United States
| | - Meredith Garver Healy
- Young Adult Behavioral Health, Department of Psychiatry and Human Behavior, Rhode Island Hospital, Providence, RI, United States
| | - Larry K Brown
- Department of Psychiatry, Warren Alpert Medical School, Brown University, Providence, RI, United States.,Young Adult Behavioral Health, Department of Psychiatry and Human Behavior, Rhode Island Hospital, Providence, RI, United States
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Potter SJ, Flanagan M, Seidman M, Hodges H, Stapleton JG. Developing and Piloting Videogames to Increase College and University Students' Awareness and Efficacy of the Bystander Role in Incidents of Sexual Violence. Games Health J 2019; 8:24-34. [DOI: 10.1089/g4h.2017.0172] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sharyn J. Potter
- Department of Sociology, Prevention Innovations Research Center, University of New Hampshire, Durham, New Hampshire
| | - Mary Flanagan
- Department of Film and Media Studies, Tiltfactor Lab, Dartmouth College, Hanover, New Hampshire
| | - Max Seidman
- Tiltfactor Lab, Dartmouth College, Hanover, New Hampshire
| | - Hannah Hodges
- Prevention Innovations Research Center, University of New Hampshire, Durham, New Hampshire
| | - Jane G. Stapleton
- Prevention Innovations Research Center, University of New Hampshire, Durham, New Hampshire
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Orji R, Oyibo K, Lomotey RK, Orji FA. Socially-driven persuasive health intervention design: Competition, social comparison, and cooperation. Health Informatics J 2018; 25:1451-1484. [PMID: 29801426 DOI: 10.1177/1460458218766570] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Persuasive technologies are tools for motivating behaviour change using persuasive strategies. socially-driven persuasive technologies employ three common socially-oriented persuasive strategies in many health domains: competition, social comparison, and cooperation. Research has shown the possibilities for socially-driven persuasive interventions to backfire by demotivating behaviour, but we lack knowledge about how the interventions could motivate or demotivate behaviours. To close this gap, we studied 1898 participants, specifically Socially-oriented strategies and their comparative effectiveness in socially-driven persuasive health interventions that motivate healthy behaviour change. The results of a thematic analysis of 278 pages of qualitative data reveal important strengths and weaknesses of the individual socially-oriented strategies that could facilitate or hinder their effectiveness at motivating behaviour change. These include their tendency to simplify behaviours and make them fun, challenge people and make them accountable, give a sense of accomplishment and their tendency to jeopardize user's privacy and relationships, creates unnecessary tension, and reduce self-confidence and self-esteem, and provoke a health disorder and body shaming, respectively. We contribute to the health informatics community by developing 15 design guidelines for operationalizing the strategies in persuasive health intervention to amplify their strengths and overcome their weaknesses.
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Abstract
There is a long history of using videogames in a therapeutic capacity including rehabilitation for stroke patients, people with traumatic brain injuries, burns victims, wheelchair users, Erb's palsy sufferers, children undergoing chemotherapy, children with muscular dystrophy, autistic children and individuals looking to overcome real-life challenges (including symptoms of depression) and boost their wellbeing (including boosting life satisfaction, self-efficacy and social support). This paper briefly and selectively examines a number of areas including: (1) videogames as physiotherapy and occupational therapy, (2) videogames as distractors in the role of pain management, (3) videogames and cognitive rehabilitation, (4) videogames and the development of social and communication skills among the learning disabled, (5) videogames and impulsivity/attention deficit disorders, (6) videogames and therapeutic benefits in the elderly, (7) videogames in psychotherapeutic settings, (8) videogames and health care, (9) videogames and anxiety disorders, and (10) videogames and psychological wellbeing. It is concluded that there has been considerable success when games are specifically designed to address a specific problem or to teach a certain skill. However, generalizability outside the game-playing situation remains an important consideration.
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Affiliation(s)
- Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Daria J. Kuss
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Angelica B. Ortiz de Gortari
- International Gaming Research Unit, Psychology Division, Nottingham Trent University, Nottingham, UK & Psychology and Neuroscience of Cognition Research Unit, University of Liège, Belgium
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Chen E, Mangone ER. A Systematic Review of Apps using Mobile Criteria for Adolescent Pregnancy Prevention (mCAPP). JMIR Mhealth Uhealth 2016; 4:e122. [PMID: 27833070 PMCID: PMC5122721 DOI: 10.2196/mhealth.6611] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 10/15/2016] [Accepted: 10/18/2016] [Indexed: 11/13/2022] Open
Abstract
Background Adolescents in the United States and globally represent a high-risk population for unintended pregnancy, which leads to high social, economic, and health costs. Access to smartphone apps is rapidly increasing among youth, but little is known about the strategies that apps employ to prevent pregnancy among adolescents and young adults. Further, there are no guidelines on best practices for adolescent and young adult pregnancy prevention through mobile apps. Objective This review developed a preliminary evaluation framework for the assessment of mobile apps for adolescent and young adult pregnancy prevention and used this framework to assess available apps in the Apple App Store and Google Play that targeted adolescents and young adults with family planning and pregnancy prevention support. Methods We developed an assessment rubric called Mobile Criteria for Adolescent Pregnancy Prevention (mCAPP) for data extraction using evidence-based and promising best practices from the literature. mCAPP comprises 4 domains: (1) app characteristics, (2) user interface features, (3) adolescent pregnancy prevention best practices, and (4) general sexual and reproductive health (SRH) features. For inclusion in the review, apps that advertised pregnancy prevention services and explicitly mentioned youth, were in English, and were free were systematically identified in the Apple App Store and Google Play in 2015. Screening, data extraction, and 4 interrater reliability checks were conducted by 2 reviewers. Each app was assessed for 92 facets of the mCAPP checklist. Results Our search returned 4043 app descriptions in the Apple App Store (462) and Google Play (3581). After screening for inclusion criteria, 22 unique apps were included in our analysis. Included apps targeted teens in primarily developed countries, and the most common user interface features were clinic and health service locators. While app strengths included provision of SRH education, description of modern contraceptives, and some use of evidence-based adolescent best practices, gaps remain in the implementation of the majority of adolescent best practices and user interface features. Of the 8 best practices for teen pregnancy prevention operationalized through mCAPP, the most commonly implemented best practice was the provision of information on how to use contraceptives to prevent pregnancy (15/22), followed by provision of accurate information on pregnancy risk of sexual behaviors (13/22); information on SRH communication, negotiation, or refusal skills (10/22); and the use of persuasive language around contraceptive use (9/22). Conclusions The quality and scope of apps for adolescent pregnancy prevention varies, indicating that developers and researchers may need a supportive framework. mCAPP can help researchers and developers consider mobile-relevant evidence-based best practices for adolescent SRH as they develop teen pregnancy prevention apps. Given the novelty of the mobile approach, further research is needed on the impact of mCAPP criteria via mobile channels on adolescent health knowledge, behaviors, and outcomes.
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Affiliation(s)
- Elizabeth Chen
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Emily Rose Mangone
- International Health Division, Abt Associates, Bethesda, MD, United States.,Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Evans AE, Edmundson-Drane E, Harris KK, Campbell-Ray T. A Cervical Cancer CD-ROM Intervention for College-Age Women: Lessons Learned from Development and Formative Evaluation. Health Promot Pract 2016. [DOI: 10.1177/152483902236714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite the decline of incidence rates of cervical cancer over the past 50 years, data suggest an increase of precervical cancer among college women. This increase may be the result of the high prevalence of the Human Papillomavirus (HPV) among this population. To increase cervical cancer prevention behaviors, we developed a computer-based intervention targeting women ages 18 to 24. Through the use of story scripts, role models, and demonstrations (both animated and videotaped procedures), women learn the importance of regular Pap smear screenings, personal risks for developing cervical cancer, the meaning of and dealing with abnormal Pap smears, communication with health care providers, and sexual practices that impact the transmission of HPV. Results from the formative evaluation support the viability of CD-ROM interventions in health education and emphasize the importance of addressing women’s cognitive and affective perceptions surrounding cancer, sexual health, and gynecological exams. Lessons learned from the development process are presented.
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Affiliation(s)
- Alexandra E. Evans
- Department of Health Promotion, Education, and Behavior at the Norma J. Arnold School of Public Health, University of South Carolina in Columbia
| | | | - Karol Kaye Harris
- Department of Kinesiology and Health Education at the University of Texas at Austin
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Bailey J, Mann S, Wayal S, Hunter R, Free C, Abraham C, Murray E. Sexual health promotion for young people delivered via digital media: a scoping review. PUBLIC HEALTH RESEARCH 2015. [DOI: 10.3310/phr03130] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundYoung people are at risk of poor sexual health and are, therefore, in need of comprehensive, effective sexual health education. Young people are confident and constant users of digital technology, such as the internet and mobile phones, and there are many innovative possibilities for sexual health education involving these technologies.ObjectivesTo summarise evidence on effectiveness, cost-effectiveness and mechanism of action of interactive digital interventions (IDIs) for sexual health; optimal practice for intervention development; contexts for successful implementation; research methods for digital intervention evaluation; and the future potential of sexual health promotion via digital media.DesignLiterature review of evidence on digital interventions for sexual health for young people, integrating the findings with the views of young people, parents and experts in digital media/sexual health. IDIs are defined as digital media programmes that provide health information and tailored decision support, behaviour-change support and/or emotional support. We focus on sexual well-being for young people aged 13–24 years in the UK.ResultsThere are many imaginative IDIs for sexual health promotion, but few interventions address issues that are important to young people, such as sexual pleasure and relationships. It is vital to collaborate with young people and to use Behaviour-Change Theory in designing interventions. We located 19 randomised controlled trials of IDIs for sexual health promotion for young people, finding a moderate effect on sexual health knowledge [standardised mean difference (SMD) 0.54, 95% confidence interval (CI) 0.17 to 0.92], a small effect on confidence (self-efficacy) (SMD 0.11, 95% CI 0.02 to 0.20) and a positive effect on sexual behaviour (odds ratio 1.28, 95% CI 1.01 to 1.61), but no significant effects on safer sex intention or biological outcomes. One study suggests that IDIs may be as good as face-to-face interventions for sexual health knowledge and safer sex intention. There are no existing data on the cost-effectiveness of IDIs for sexual health promotion. The impact of an IDI will be determined by the proportion of the target population reached, intervention efficacy, adoption in a setting, how well it is delivered and maintenance/sustainability. All of these elements must be addressed for IDIs to be successful. More collaboration is needed to capitalise on the knowledge of users and stakeholders, the design and software skills of the commercial sector and the theoretical expertise and evaluation skills of academia.ConclusionsIDIs are effective for knowledge acquisition and sexual behaviour, and could usefully contribute to sexual health education in schools, in clinic settings and online; however, there are obstacles to overcome, such as access to information technology and ensuring the quality and safety of interventions.Future workMore evidence is needed on the best designs for interventions (e.g. choice of behaviour-change mechanisms and interactive features) and the best models of delivery (e.g. setting, modes of delivery, methods of facilitation and support for engagement) to improve sexual behaviour, biological outcomes and sexual well-being in a cost-effective way.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Julia Bailey
- e-Health unit, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Sue Mann
- Camberwell Sexual Health Centre, King’s College Hospital, London, UK
| | - Sonali Wayal
- e-Health unit, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Rachael Hunter
- PRIMENT Clinical Trials Unit, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Caroline Free
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Elizabeth Murray
- e-Health unit, Research Department of Primary Care and Population Health, University College London, London, UK
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Ruggiero D. The effect of a persuasive social impact game on affective learning and attitude. COMPUTERS IN HUMAN BEHAVIOR 2015. [DOI: 10.1016/j.chb.2014.11.062] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Use of digital media technology for primary prevention of STIs/HIV in youth. J Pediatr Adolesc Gynecol 2014; 27:244-57. [PMID: 24332613 DOI: 10.1016/j.jpag.2013.07.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 07/22/2013] [Accepted: 07/23/2013] [Indexed: 02/06/2023]
Abstract
STUDY OBJECTIVE The relevant literature was reviewed to identify issues in research evaluating digital media technology (DMT) interventions for the primary prevention of STIs/HIV in adolescents and young adults. METHOD A literature search with relevant key terms was conducted in PubMed, for articles with studies that included: (a) participants between 11-29 years; (b) use of one or more of the following forms of DMT: interactive digital video or CD-ROM, computer, text messaging, or Internet; (c) evaluation of an STI/HIV primary prevention intervention; and (d) use of a cognitive, psychosocial, behavioral, or biological outcome. RESULTS Twenty-nine studies were identified and included in the review. Based on the review of these studies, 7 main issues were discussed and recommendations for improving future research were offered. The 7 main issues were: (a) need for a balance between universal application and specific sub-group focus, (b) lack of a developmental framework, (c) challenge of applying DMT in resource limited contexts, (d) rapidly changing nature of DMT, (e) lack of biological outcomes, (f) lack of comparison/control groups to assess the impact of DMT, and (g) limited temporal follow-up. CONCLUSIONS There is increasing literature evaluating the effectiveness of DMT for preventing STIs/HIV among adolescents and young adults. A careful consideration of 7 main issues identified in the literature can improve the design and evaluation of these interventions and enhance our understanding of their effectiveness.
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Shegog R, Peskin MF, Markham C, Thiel M, Karny E, Addy RC, Johnson KA, Tortolero S. It's Your Game-Tech: Toward Sexual Health in the Digital Age. CREATIVE EDUCATION 2014; 5:1428-1447. [PMID: 25705561 PMCID: PMC4334143 DOI: 10.4236/ce.2014.515161] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Adolescent sexually transmitted infection (STI) and birth rates indicate a need for effective middle school HIV/STI, and pregnancy prevention curricula to delay, or mitigate consequences of, early sexual activity. Individual and organizational barriers to adoption, implementation, and maintenance, however, can hamper dissemination of evidence-based sexual health curricula, adversely impacting fidelity and reach. Internet-based approaches may help mitigate these barriers. This paper describes the development and feasibility testing of It's Your Game (IYG)-Tech, a stand-alone 13-lesson Internet-based sexual health life-skills curriculum adapted from an existing effective sexual health curriculum-It's Your Game… Keep it Real (IYG). IYG-Tech development adaptation steps were to: 1) Select a suitable effective program and gather the original program materials; 2) Develop "proof of concept" lessons and test usability and impact; 3) Develop the program design document describing the core content, scope, and methods and strategies; and 4) produce the new program. Lab- and school-based tests with middle school students demonstrated high ratings on usability parameters and immediate impact on selected psychosocial factors related to sexual behavior-perceptions of friends' beliefs, reasons for not having sex, condom use self-efficacy, abstinence intentions, negotiating with others to protect personal rules, and improved knowledge about what constitutes healthy relationships (all p < .05). Youth rated IYG-Tech is favorably compared to other learning channels (>76.2% agreement) and rated the lessons as helpful in making healthy choices, selecting personal rules, detecting challenges to those rules, and protecting personal rules through negotiation and refusal skills (89.5% - 100%). Further efficacy testing is indicated for IYG-Tech as a potential strategy to deliver effective HIV/STI, and pregnancy prevention to middle school youth.
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Affiliation(s)
- Ross Shegog
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
| | - Melissa F. Peskin
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
| | - Christine Markham
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
| | - Melanie Thiel
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
| | - Efrat Karny
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
| | - Robert C. Addy
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
| | - Kimberly A. Johnson
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
| | - Susan Tortolero
- Center for Health Promotion & Prevention Research, The University of Texas School of Public Health, Houston, TX, USA
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Goal setting outcomes: Examining the role of goal interaction in influencing the experience and learning outcomes of video game play for earthquake preparedness. COMPUTERS IN HUMAN BEHAVIOR 2013. [DOI: 10.1016/j.chb.2012.11.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Shegog R, Markham CM, Peskin MF, Johnson K, Cuccaro P, Tortolero SR. It's Your Game…Keep It Real: can innovative public health prevention research thrive within a comparative effectiveness research framework? J Prim Prev 2013; 34:89-108. [PMID: 23344633 PMCID: PMC3653998 DOI: 10.1007/s10935-013-0293-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The federal comparative effectiveness research (CER) initiative is designed to evaluate best practices in health care settings where they can be disseminated for immediate benefit to patients. The CER strategic framework comprises four categories (research, human and scientific capital, data infrastructure, and dissemination) with three crosscutting themes (conditions, patient populations, and types of intervention). The challenge for the field of public health has been accommodating the CER framework within prevention research. Applying a medicine-based, research-to-practice CER approach to public health prevention research has raised concerns regarding definitions of acceptable evidence (an evidence challenge), effective intervention dissemination within heterogeneous communities (a dissemination and implementation challenge), and rewards for best practice at the cost of other promising but high-risk approaches (an innovation challenge). Herein, a dynamic operationalization of the CER framework is described that is compatible with the development, evaluation, and dissemination of innovative public health prevention interventions. An effective HIV, STI, and pregnancy prevention program, It's Your Game…Keep It Real, provides a case study of this application, providing support that the CER framework can compatibly coexist with innovative, community-based public health prevention research.
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Affiliation(s)
- Ross Shegog
- The University of Texas Prevention Research Center, Houston School of Public Health, 7000 Fannin, Houston, TX 77030, USA.
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Acute alcohol consumption and motivation to reduce drinking among injured patients in a Swedish emergency department. J Addict Nurs 2012; 23:152-8. [PMID: 24335731 DOI: 10.1097/jan.0b013e31826f4bbd] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Injuries constitute a major public health problem. Millions of people are injured each year, and acute drinking is a well-known risk factor for injuries. Research suggests that acknowledgment of alcohol as a factor in an injury enhances willingness to change drinking behavior, possibly because the patient becomes aware of the negative consequences of their drinking. This study aims to investigate the prevalence of acute alcohol consumption (drinking before the event) among injury patients and to examine the importance of factors potentially associated with motivation to reduce alcohol consumption among these patients. All patients aged 18-69 years were requested to answer alcohol-related questions on a touchscreen computer. Fifteen percent of injured patients were categorized as acute drinkers, and of these, 64% reported that their injury was connected to alcohol. There were significant differences for all sociodemographic and drinking characteristics between acute drinkers and nonacute drinkers. Acute drinkers were categorized as risky drinkers to a much higher extent than nonacute drinkers. Acute drinkers had a considerably higher average weekly alcohol consumption and engaged far more frequently in heavy episodic drinking than nonacute drinkers. Acute drinkers were motivated to reduce their alcohol intake to a greater extent than nonacute drinkers; 51% were in the action, preparation, and contemplation stages, compared with 19% of the nonacute drinkers. Acute drinkers had considerably more detrimental alcohol consumption than nonacute drinkers, and the acute drinkers were more motivated to reduce their drinking than the nonacute drinkers.
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The influence of virtual presence: Effects on experienced cognitive load and learning outcomes in educational computer games. COMPUTERS IN HUMAN BEHAVIOR 2012. [DOI: 10.1016/j.chb.2011.11.011] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
BACKGROUND The popularity of the Internet for health information and the growing availability of online access make the Internet a compelling medium for health promotion and HIV/STI prevention efforts for adolescents. Many private and federally funded programs have incorporated Web-based approaches and online technologies into their sexual education and HIV/STI prevention efforts for adolescents. These efforts have resulted in numerous Web sites and varied online content. This content is currently understudied and underevaluated. In this study, current sexual health Web sites targeted at adolescents were catalogued and coded. METHODS Web sites targeted at adolescents were coded for educational content, credibility, usability, as well as interactivity. RESULTS A significant amount of sexual health information geared toward teens is available online. All the Web sites reviewed showed deficiencies in educational content, as well as deficiencies in usability, authority, and interactivity. Planned Parenthood's Web site was the most well rounded of the sites assessed.
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Affiliation(s)
- Laura B Whiteley
- Bradley Hasbro Research Center, Brown University, 1 Hoppin Street, Providence, RI 02860, USA.
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23
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Wingood GM, Card JJ, Er D, Solomon J, Braxton N, Lang D, Seth P, Cartreine J, Diclemente RJ. Preliminary efficacy of a computer-based HIV intervention for African-American women. Psychol Health 2011; 26:223-34. [PMID: 21318931 DOI: 10.1080/08870446.2011.531576] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study evaluated the preliminary efficacy of a computer-based HIV intervention to enhance HIV-protective sexual behaviours, based on a randomised controlled trial among 135 African-American women, 21-29 years of age, seeking services at Planned Parenthood in Atlanta, GA. Participants were randomised either to a control session two, 60-minute computer-based HIV intervention sessions administered on a laptop computer that each concluded with a 15-minute small group session or to a control session of general health information including discussion on HIV prevention. Relative to controls, participants in the computer-based HIV intervention were more knowledgeable about HIV/STD prevention and reported higher scores on the measure of condom use self-efficacy at 3 months post-intervention; they also reported a higher percentage of condom-protected sex and were more likely to use condoms consistently for vaginal sex (odds ratio, OR = 5.9; p < 0.039) and were more likely to use condoms consistently for oral sex (OR = 13.83; p < 0.037). This relatively brief intervention provides preliminary support that an evidence-based group-based HIV prevention intervention for young African-American women can be adapted to a computer-based HIV intervention.
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Affiliation(s)
- Gina M Wingood
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Card JJ, Kuhn T, Solomon J, Benner TA, Wingood GM, DiClemente RJ. Translating an effective group-based HIV prevention program to a program delivered primarily by a computer: methods and outcomes. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2011; 23:159-174. [PMID: 21517664 DOI: 10.1521/aeap.2011.23.2.159] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We describe development of SAHARA (SISTAS Accessing HIV/AIDS Resources At-a-click), an innovative HIV prevention program that uses a computer to deliver an updated version of SiSTA, a widely used, effective group-level HIV prevention intervention for African American women ages 18-29. Fidelity to SiSTA's core components was achieved using: (1) video clips featuring group discussions and modeling of appropriate sexual- and contraceptive-related behavior; and (2) interactive Flash modules facilitating cognitive rehearsal, providing learning experiences through games and quizzes, and providing opportunities for simulated role-play. A preliminary outcome study of SAHARA conducted at Planned Parenthood, Atlanta, found that SAHARA, when followed by a brief 20-minute wrap-up group session facilitated by a health educator, was effective in promoting consistent condom use for vaginal sex. We discuss the potential advantages and challenges of an intervention like SAHARA delivered by computer to an individual, versus one like SiSTA delivered by a health educator to a small group.
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Schinke SP, Fang L, Cole KC, Cohen-Cutler S. Preventing substance use among Black and Hispanic adolescent girls: results from a computer-delivered, mother-daughter intervention approach. Subst Use Misuse 2011; 46:35-45. [PMID: 21190404 PMCID: PMC3057911 DOI: 10.3109/10826084.2011.521074] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This 2008 study involved 546 Black and Hispanic American adolescent girls and their mothers from New York, New Jersey, and Connecticut. Participants provided self-report data. Analysis of covariance indicated that the experimental intervention reduced risk factors, improved protective factors, and lowered girls' alcohol use and their future intentions to use substances. The study supports the value of computer-based and gender-specific interventions that involve girls and their mothers. Future work needs to replicate and strengthen study results.
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Affiliation(s)
- Steven P Schinke
- School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, USA.
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Tanes Z, Cemalcilar Z. Learning from SimCity: An empirical study of Turkish adolescents. J Adolesc 2010; 33:731-9. [DOI: 10.1016/j.adolescence.2009.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Revised: 10/03/2009] [Accepted: 10/10/2009] [Indexed: 10/20/2022]
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Lee KM, Peng W, Klein J. Will the experience of playing a violent role in a video game influence people’s judgments of violent crimes? COMPUTERS IN HUMAN BEHAVIOR 2010. [DOI: 10.1016/j.chb.2010.03.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Trinks A, Festin K, Bendtsen P, Nilsen P. Reach and effectiveness of a computer-based alcohol intervention in a Swedish emergency room. Int Emerg Nurs 2010; 18:138-46. [DOI: 10.1016/j.ienj.2009.08.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Revised: 08/19/2009] [Accepted: 08/25/2009] [Indexed: 11/30/2022]
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The effects of incorporating a virtual agent in a computer-aided test designed for stress management education: The mediating role of enjoyment. COMPUTERS IN HUMAN BEHAVIOR 2010. [DOI: 10.1016/j.chb.2009.12.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Trinks A, Festin K, Bendtsen P, Nilsen P. Alcohol consumption and motivation to reduce drinking among emergency care patients in Sweden. Int J Inj Contr Saf Promot 2010; 16:133-41. [PMID: 19941211 DOI: 10.1080/17457300903024087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study compares the alcohol consumption and motivation to reduce drinking among injured and non injured patients in a Swedish emergency department (ED). Patients aged 18-69 registered at the ED triage room were requested to answer alcohol-related questions on a touch-screen computer. Injury patients drank alcohol significantly more often than patients without injuries and in a significantly higher typical quantity than non-injury patients, yielding a significantly larger average weekly consumption. However, there were no significant differences between injury and non-injury patients with regard to heavy episodic drinking. As a consequence of injury patients being younger and more often male in comparison with non-injury patients nearly all differences between the two patient groups disappeared when controlling for age and sex. There were no significant differences in motivation to reduce drinking between injury and non-injury patients. There were small differences in the drinking variables and motivation to reduce drinking between injury patients and non-injury patients.
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Affiliation(s)
- Anna Trinks
- Department of Medical and Health Science, Division of Community Medicine, Linkoping University, Linkoping, Sweden.
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Baldwin MW, Dandeneau SD. Putting Social Psychology into Serious Games. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2009. [DOI: 10.1111/j.1751-9004.2009.00185.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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The role of health kiosks in 2009: literature and informant review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2009; 6:1818-55. [PMID: 19578463 PMCID: PMC2705220 DOI: 10.3390/ijerph6061818] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Accepted: 06/08/2009] [Indexed: 11/20/2022]
Abstract
Kiosks can provide patients with access to health systems in public locations, but with increasing home Internet access their usefulness is questioned. A literature and informant review identified kiosks used for taking medical histories, health promotion, self assessment, consumer feedback, patient registration, patient access to records, and remote consultations. Sited correctly with good interfaces, kiosks can be used by all demographics but many ‘projects’ have failed to become routine practice. A role remains for: (a) integrated kiosks as part of patient ‘flow’, (b) opportunistic kiosks to catch people’s attention. Both require clear ‘ownership’ to succeed.
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Carlfjord S, Nilsen P, Leijon M, Andersson A, Johansson K, Bendtsen P. Computerized lifestyle intervention in routine primary health care: evaluation of usage on provider and responder levels. PATIENT EDUCATION AND COUNSELING 2009; 75:238-243. [PMID: 19046844 DOI: 10.1016/j.pec.2008.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2008] [Revised: 10/07/2008] [Accepted: 10/09/2008] [Indexed: 05/27/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the use of a computerized concept for lifestyle intervention in routine primary health care (PHC). METHODS Nine PHC units were equipped with computers providing a lifestyle test and tailored printed advice regarding alcohol consumption and physical activity. Patients were referred by staff, and performed the test anonymously. Data were collected over a period of 1 year. RESULTS During the study period 3,065 tests were completed, representing 5.7% of the individuals visiting the PHC units during the period. There were great differences between the units in the number of tests performed and in the proportion of patients referred. One-fifth of the respondents scored for hazardous alcohol consumption, and one-fourth reported low levels of physical activity. The majority of respondents found the test easy to perform, and a majority of those referred to the test found referral positive. CONCLUSION The computerized test can be used for screening and intervention regarding lifestyle behaviours in PHC. Responders are positive to the test and to referral. PRACTICE IMPLICATIONS A more widespread implementation of computerized lifestyle tests could be a beneficial complement to face-to-face interventions in PHC.
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Affiliation(s)
- S Carlfjord
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
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Peng W. The mediational role of identification in the relationship between experience mode and self-efficacy: Enactive role-playing versus passive observation. ACTA ACUST UNITED AC 2009; 11:649-52. [PMID: 18954275 DOI: 10.1089/cpb.2007.0229] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract Based on Social Cognitive Theory, this study proposes a new concept-mediated enactive experience to understand game playing effects on self-efficacy in the context of a health promotion role-playing game. An experiment demonstrated that a mediated enactive experience afforded by game playing was more effective than a mediated observational experience provided by game watching in influencing self-efficacy. It was found that identification with the game character partially mediated the relationship between experience mode and self-efficacy.
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Affiliation(s)
- Wei Peng
- Department of Telecommunication, Information Studies, and Media, Michigan State University, East Lansing, Michigan 48824, USA.
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Implementation of a computerized alcohol advice concept in routine emergency care. Int Emerg Nurs 2009; 17:113-21. [PMID: 19341997 DOI: 10.1016/j.ienj.2008.11.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Revised: 11/07/2008] [Accepted: 11/21/2008] [Indexed: 11/24/2022]
Abstract
BACKGROUND There is a growing body of evidence for computer-generated advice for many health behaviours. This study evaluated the implementation of a computerized concept to provide tailored advice on alcohol in a Swedish emergency department (ED). AIM The aim was to evaluate the usage of the concept over 12 months: participation rate among the ED population; representativeness of the participants; and participation development over time. METHODS The target population was defined as all patients aged 18-69 years given a card from ED triage staff with a request to conduct a computerized test about their alcohol use. After completing the 5-10-min programme, the patient received a printout, containing personalised alcohol habit feedback, as calculated by the computer from the patient's answers. Data for this study were primarily obtained from the computer programme and ED logs. RESULTS Forty-one percent of the target population completed the computerized test and received tailored alcohol advice. The number of patients who used the concept showed a slight decreasing trend during the first half of the year, leveling off for the second half of the year. CONCLUSION A computerized concept for provision of alcohol advice can be implemented in an ED without unrealistic demands on staff and with limited external support to attain sustainability.
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Kato PM, Cole SW, Bradlyn AS, Pollock BH. A video game improves behavioral outcomes in adolescents and young adults with cancer: a randomized trial. Pediatrics 2008; 122:e305-17. [PMID: 18676516 DOI: 10.1542/peds.2007-3134] [Citation(s) in RCA: 300] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Suboptimal adherence to self-administered medications is a common problem. The purpose of this study was to determine the effectiveness of a video-game intervention for improving adherence and other behavioral outcomes for adolescents and young adults with malignancies including acute leukemia, lymphoma, and soft-tissue sarcoma. METHODS A randomized trial with baseline and 1- and 3-month assessments was conducted from 2004 to 2005 at 34 medical centers in the United States, Canada, and Australia. A total of 375 male and female patients who were 13 to 29 years old, had an initial or relapse diagnosis of a malignancy, and currently undergoing treatment and expected to continue treatment for at least 4 months from baseline assessment were randomly assigned to the intervention or control group. The intervention was a video game that addressed issues of cancer treatment and care for teenagers and young adults. Outcome measures included adherence, self-efficacy, knowledge, control, stress, and quality of life. For patients who were prescribed prophylactic antibiotics, adherence to trimethoprim-sulfamethoxazole was tracked by electronic pill-monitoring devices (n = 200). Adherence to 6-mercaptopurine was assessed through serum metabolite assays (n = 54). RESULTS Adherence to trimethoprim-sulfamethoxazole and 6-mercaptopurine was greater in the intervention group. Self-efficacy and knowledge also increased in the intervention group compared with the control group. The intervention did not affect self-report measures of adherence, stress, control, or quality of life. CONCLUSIONS The video-game intervention significantly improved treatment adherence and indicators of cancer-related self-efficacy and knowledge in adolescents and young adults who were undergoing cancer therapy. The findings support current efforts to develop effective video-game interventions for education and training in health care.
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Affiliation(s)
- Pamela M Kato
- Department of Pediatrics, Stanford Hospital, Stanford, California, USA.
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Lennon JL, Coombs DW. The utility of a board game for dengue haemorrhagic fever health education. HEALTH EDUCATION 2007. [DOI: 10.1108/09654280710742582] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Roberto AJ, Zimmerman RS, Carlyle KE, Abner EL. A computer-based approach to preventing pregnancy, STD, and HIV in rural adolescents. JOURNAL OF HEALTH COMMUNICATION 2007; 12:53-76. [PMID: 17365349 DOI: 10.1080/10810730601096622] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
A computer- and Internet-based intervention was designed to influence several variables related to the prevention of pregnancy, sexually transmitted diseases (STDs), and human immunodeficiency virus (HIV) in rural adolescents. The intervention was guided by the extended parallel process model and was evaluated using a pretest-post-test control group design with random assignment at the school level. Three hundred and twenty-six tenth-grade males and females enrolled in two rural Appalachian public high schools completed the survey at both points in time. Results indicate the vast majority (88.5%) of students in the experimental school completed at least one activity (M = 3.46 for those doing at least one activity). Further, both the overall program and all but one of the activities were rated positively by participants. Regarding the effects of the intervention, results indicate that students in the experimental school were less likely to initiate sexual activity and had greater general knowledge, greater condom negotiation self-efficacy, more favorable attitudes toward waiting to have sex, and greater situational self-efficacy than in the control school. In tandem, the results suggest that the computer-based programs may be a cost-effective and easily replicable means of providing teens with basic information and skills necessary to prevent pregnancy, STDs, and HIV.
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Affiliation(s)
- Anthony J Roberto
- School of Communication, The Ohio State University, Columbus, Ohio 43210, USA.
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Kreuter MW, Black WJ, Friend L, Booker AC, Klump P, Bobra S, Holt CL. Use of Computer Kiosks for Breast Cancer Education in Five Community Settings. HEALTH EDUCATION & BEHAVIOR 2006; 33:625-42. [PMID: 16923835 DOI: 10.1177/1090198106290795] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Finding ways to bring effective computer-based behavioral interventions to those with limited access to technology is a continuing challenge for health educators. Computer kiosks placed in community settings may help reach such populations. The Reflections of You kiosk generates individually tailored magazines on breast cancer and mammography and was adapted from an evidence-based intervention that increased mammography use in African American women. This usage study tracked patterns of use and characteristics of kiosk users in beauty salons, churches, neighborhood health centers, Laundromats, and social service agencies in St. Louis. Kiosks were used 4,527 times in 470 kiosk days at 40 different host sites. Highly significant differences among community settings were found in rates and patterns of kiosk use as well as user characteristics, breast cancer knowledge, and use of mammography. Findings inform strategic decision making about technology dissemination and community outreach to women needing information about breast cancer and mammography.
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Affiliation(s)
- Matthew W Kreuter
- Health Communication Research Laboratory, Department of Community Health, School of Public Health, Saint Louis University, 3545 Lafayette Ave., St. Louis, MO 63104, USA.
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Noar SM, Clark A, Cole C, Lustria MLA. Review of interactive safer sex Web sites: practice and potential. HEALTH COMMUNICATION 2006; 20:233-41. [PMID: 17137415 DOI: 10.1207/s15327027hc2003_3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The Internet is increasingly being viewed as a health promotion tool with enormous potential. However, this potential cannot be realized if Web sites do not utilize the features that make the Internet a "hybrid" mass and interpersonal communication medium. The purpose of this study was to examine interactive safer sex Web sites on a number of dimensions. A comprehensive search that included Internet search engines, links from well-known sites, and previously published reviews yielded 21 Web sites that met criteria. Web sites were coded on dimensions including targeting of the Web sites, safer sex messages presented, theoretical strategies utilized, interactivity, and other characteristics. Results indicate that a moderate amount of targeting of Web sites exists, especially on age group (e.g., teenagers); the most prevalent safer sex messages were to "use condoms" and "be sexually abstinent"; raising the perceived threat of sexually transmitted diseases and HIV was the most prevalent theoretical strategy used to motivate safer sex; and finally, a moderate amount of interactivity was found on the Web sites, with most Web sites containing 4 or 5 features out of 15 features examined. Evidence that Web sites were tailoring information or messages to individuals was not found. Implications of these results for improving safer sex Web sites and developing interventions online are discussed.
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Affiliation(s)
- Seth M Noar
- Department of Communication, University of Kentucky, Lexington 40506, USA.
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Gregor MA, Shope JT, Blow FC, Maio RF, Weber JE, Nypaver MM. Feasibility of using an interactive laptop program in the emergency department to prevent alcohol misuse among adolescents. Ann Emerg Med 2003; 42:276-84. [PMID: 12883517 DOI: 10.1067/mem.2003.265] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
STUDY OBJECTIVE Alcohol, the most commonly used substance among adolescents, is frequently associated with injury. Effective interventions to prevent adolescent alcohol use and misuse in acute care settings are lacking. A laptop-based alcohol prevention program could reinforce other prevention efforts that adolescents may receive. We determined the feasibility of using an interactive laptop program with adolescent emergency department (ED) patients to prevent alcohol use and misuse. METHODS We used the recruitment phase of a randomized controlled trial at an academic medical center and an urban teaching hospital. Patients were aged 14 to 18 years and presented within 24 hours of an acute injury. Measures included patient recruitment, mechanism of injury, injury severity score, alcohol use characteristics, and patients' opinion of the computer program. RESULTS Of 843 eligible patients, 671 (79.6%) were enrolled and 655 (77.7%) completed the program. Parent or guardian reluctance was the most frequent reason for refusal. The participants averaged 16.0 years of age (range 14 to 18 years; SD 1.5 years), 66.9% were male, and 68.3% were white. Approximately 71% reported "ever" drinking. Recent alcohol use (past 3 months) by those "ever" drinking was as follows: 62.3% drank, 31.2% got drunk, and 37.4% binge drank. Seventy-four percent of recent drinkers reported that the program made them rethink their alcohol use. Ninety-four percent of participants liked the program. Only 5.3% required assistance with the program. CONCLUSION Use of an interactive computer program in the ED appears feasible. Further work is being done to evaluate the effectiveness of the program in reducing alcohol-related behaviors among adolescents.
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Affiliation(s)
- Mary Ann Gregor
- Injury Research Center, the Department of Emergency Medicine, University of Michigan, Ann Arbor, MI 48109-0437, USA.
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Redsell SA, Collier J, Garrud P, Evans JHC, Cawood C. Multimedia versus written information for nocturnal enuresis education: a cluster randomized controlled trial. Child Care Health Dev 2003; 29:121-9. [PMID: 12603357 DOI: 10.1046/j.1365-2214.2003.00321.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE This study evaluated the impact of child-focused information provision using a multimedia software package 'All About Nocturnal Enuresis' and written leaflets containing the same information for bedwetting children. DESIGN A stratified cluster randomized controlled trial with data on 270 children collected longitudinally. SETTING Fifteen school nurse-led community enuresis clinics in Leicestershire, UK. MAIN OUTCOME MEASURES The outcome measures were becoming and remaining dry and time to dry, non-attendance and dropout rates. The psychological measures completed by children were the impact of bedwetting and Coopersmith self-esteem scales. Parents completed the maternal tolerance scale. RESULTS No significant intervention effect was found for any of the outcome measures recorded during treatment, at discharge or six-months post discharge. CONCLUSIONS Multimedia educational programs and written leaflets are widely used to enable children to learn more about their health-related conditions. However, our result suggests that multimedia is no more effective than traditional materials at effecting health-related behavioural change.
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Affiliation(s)
- S A Redsell
- Section of Behavioural Sciences, Division of Psychiatry, University of Nottingham, Queen's Medical Centre, Nottingham NG9 1EU, UK.
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Anderson ES, Winett RA, Wojcik JR, Winett SG, Bowden T. A computerized social cognitive intervention for nutrition behavior: direct and mediated effects on fat, fiber, fruits, and vegetables, self-efficacy, and outcome expectations among food shoppers. Ann Behav Med 2001; 23:88-100. [PMID: 11394559 DOI: 10.1207/s15324796abm2302_3] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
This study examined the direct and mediated impact of a self-administered, computer-based intervention on nutrition behavior self-efficacy, and outcome expectations among supermarket food shoppers. The intervention, housed in kiosks in supermarkets and based on social cognitive theory, used tailored information and self-regulation strategies delivered in 15 brief weekly segments. The study sample (N = 277), stratified and randomly assigned to treatment or control, was 96% female, was 92% White, had a median annual income of about $35,000, and had a mean education of 14. 78 +/- 2.11 years. About 12% of the sample reported incomes of $20,000 or less, and about 20% reported 12 years or fewer of education. Analysis of covariance immediately after intervention and at a 4- to 6-month follow-up found that treatment led to improved levels of fat, fiber, and fruits and vegetables. Treatment also led to higher levels of nutrition-related self-efficacy, physical outcome expectations, and social outcome expectations. Logistic regression analysis determined that the treatment group was more likely than the control group to attain goals for fat, fiber, and fruits and vegetables at posttest and to attain goals for fat at follow-up. Latent variable structural equation analysis revealed self-efficacy and physical outcome expectations mediated treatment effects on nutrition. In addition, physical outcome expectations mediated the effect of self-efficacy on nutrition outcomes. Implications for future computer-based health promotion interventions are discussed.
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Affiliation(s)
- E S Anderson
- Center for Research in Health Behavior, Virginia Tech, Blacksburg 24061, USA.
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Woodruff SI, Edwards CC, Conway TL, Elliott SP. Pilot test of an Internet virtual world chat room for rural teen smokers. J Adolesc Health 2001; 29:239-43. [PMID: 11587907 DOI: 10.1016/s1054-139x(01)00262-2] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This pilot study evaluated the acceptability and efficacy of an Internet-based virtual reality "world" for teen smoking cessation. Rural teens at six school sites interacted in real-time in the virtual world with a trained cessation counselor and other teen smokers over a 2-month period in seven 1-hour chat sessions. The cessation counselor used motivational interviewing, a "client-centered" nonconfrontational approach to behavior change that has shown promise with behaviors resistant to change. Smoking behavior and attitudes were assessed at baseline, after intervention, and at 1-month follow-up. Significant changes were found in quitting, amount smoked, and intentions to quit. Positive trends were seen in past-week abstinence rates, quit attempts, and attitudes toward quitting.
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Affiliation(s)
- S I Woodruff
- Graduate School of Public Health, San Diego State University, San Diego, California 92123, USA.
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Evans AE, Edmundson-Drane EW, Harris KK. Computer-assisted instruction: an effective instructional method for HIV prevention education? J Adolesc Health 2000; 26:244-51. [PMID: 10734271 DOI: 10.1016/s1054-139x(99)00093-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To compare the effectiveness of a computer-assisted instruction (CAI)-based intervention to a more traditional lecture-based intervention for influencing psychosocial correlates of human immunodeficiency virus (HIV) preventive behaviors. METHODS Students enrolled in a Human Sexuality course (N = 152) were randomly assigned to one of three groups: CAI, Lecture, or No Intervention group. Participants in the CAI group reviewed a 1-hour long CAI program, participants in the Lecture group were presented with a 1-hour long lecture, and participants in the No Intervention group received no intervention. After completing the respective interventions, all participants completed the HIV questionnaire, which measured selected Social Cognitive Theory constructs associated with HIV preventive behaviors. MANCOVA, ANCOVA and Post Hoc analyses were utilized to test for significant differences among the three groups. RESULTS The analyses disclosed that, compared to participants in the Lecture group, participants in the CAI group scored significantly higher on the scales measuring autoimmune deficiency syndrome (AIDS) knowledge, self-evaluative outcome motivation, and intention to practice HIV preventive behaviors with current partner. In addition, compared to the No Intervention group, the CAI group scored significantly higher on the scales measuring physical outcome motivation and social outcome motivation. CONCLUSIONS CAI-based programs can be effective for delivering instruction on HIV prevention. However, because of certain limitations, this type of program is best utilized as part of a more comprehensive intervention that uses several different delivery systems.
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Affiliation(s)
- A E Evans
- Department of Kinesiology and Health Promotion, University of Texas at Austin, Austin, Texas 78712, USA
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Hornung RL, Lennon PA, Garrett JM, DeVellis RF, Weinberg PD, Strecher VJ. Interactive computer technology for skin cancer prevention targeting children. Am J Prev Med 2000; 18:69-76. [PMID: 10808985 DOI: 10.1016/s0749-3797(99)00115-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Computer technology has become an integral part of health care, yet there have been few studies exploring the use of multimedia technology in the prevention of cancer, especially targeting children. OBJECTIVE The aims of this study were to develop and evaluate a new multimedia computer program for the primary prevention of skin cancer among a childhood population. DESIGN AND PARTICIPANTS An interactive CD-ROM program was developed, then pilot tested in a public elementary school in rural North Carolina. This intervention trial involved 8 third- and fourth-grade classes (N = 209 students), randomized into 3 groups: computer intervention, standard teacher-led intervention, and controls. MAIN OUTCOME MEASURES Students were tested using pre- and postintervention surveys that measured knowledge, attitudes, and self-reported behaviors. A 7-month follow-up survey was performed. RESULTS There was a significant increase in postintervention knowledge for the computer group when compared to either the teacher-led or control groups (mean scores out of 100: 75.2, 59.5, 55.0, respectively; p < 0.001). Attitudes about suntanning demonstrated a significant difference between the 3 groups (mean scores out of 100: 64.0, 53.0, 48.6, respectively; p = 0.002). There were slight improvements in the behavioral scores, especially among the computer group, but the overall differences were not significant. Similar overall results were found for the long-term follow-up survey, except that attitudes about suntanning no longer demonstrated a significant difference. CONCLUSION These results indicate that this new educational tool is an effective way to introduce health education programs for young children in typical classroom settings. This prototype may serve as a model for the development of future preventive school-based programs, including applications to other conditions associated with high-risk behaviors among children.
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Affiliation(s)
- R L Hornung
- Department of Pediatrics, University of Washington School of Medicine, Seattle, USA.
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Bensen C, Stern J, Skinner E, Beutner K, Conant M, Tyring S, Reitano M, Davis G, Wald A. An interactive, computer-based program to educate patients about genital herpes. Sex Transm Dis 1999; 26:364-8. [PMID: 10417026 DOI: 10.1097/00007435-199907000-00010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Education and counseling constitute a substantial portion of management of patients with genital herpes. Innovative methods for education about genital herpes are needed. GOAL To test the ability of an interactive, computer-based program to educate patients about genital herpes. STUDY DESIGN Persons seeking care at five urban offices were asked to participate. A knowledge test about genital herpes was administered before and after participation. Participants' satisfaction was assessed with a questionnaire. RESULTS Four hundred thirty-five participants enrolled, and 428 completed the herpes knowledge test. Of six questions evaluated, a statistically significant increase in the proportion of correct answers was noted on five of six questions. Fifty-one percent of participants answered all the questions correctly after the program, compared with 39% before the program. Satisfaction with the program was very high. CONCLUSIONS Innovative, computer-based programs can provide education and assist in the management of chronic sexually transmitted infections.
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Affiliation(s)
- C Bensen
- School of Nursing, University of Washington, Seattle, USA
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TOUCH-PAD TECHNOLOGY. Obstet Gynecol 1999. [DOI: 10.1097/00006250-199905000-00032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rhodes F, Fishbein M, Reis J. Using behavioral theory in computer-based health promotion and appraisal. HEALTH EDUCATION & BEHAVIOR 1997; 24:20-34. [PMID: 9112096 DOI: 10.1177/109019819702400105] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This article explores how behavioral theory can facilitate the development, implementation, and evaluation of health promotion software packages intended to influence personal health practices and/or assess health risks. Current behavioral theories and models are reviewed, and their relevance to developing health promotion software is discussed. A series of six steps is suggested for developing and evaluating health promotion and appraisal software within a behavioral theory framework. These steps should help to facilitate direct application of the theory-based process to health promotion software development.
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Affiliation(s)
- F Rhodes
- Center for Behavioral Research and Services, California State University, Long Beach 90803, USA.
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