Intervention to encourage HIV Testing and Counseling among Adolescents

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

PUBLIC HEALTH RELEVANCE This project will adapt an evidence based HIV prevention videogame for a population of older minority adolescents and evaluate its efficacy at promoting HIV testing and counseling in this population This Phase study serves as a foundation and has far reaching implications as it builds on the engaging and compelling nature of videogames for behavior change as well as the advantages of technology based interventions for increasing access to and optimizing intervention implementation dissemination and sustainability