Health literacy is primarily understood as an individual construct. People with intellectual disabilities still seem to be a “hidden” population in health literacy research. A target-orientated health literacy approach for this population is needed for developing precise and effective interventions that consider social context dimensions. Therefore, the following research question was answered: Which dimensions influence the health literacy of people with intellectual disabilities? A secondary data analysis containing 38 guided interviews with people with mild to moderate intellectual disabilities was conducted. The analysis followed the content analysis by Schreier (2012). Six main dimensions were inductively outlined, which are “interpersonal relationship”, “organizations and communities”, “healthcare system”, “education”, “digital interaction spaces”, “politics”, and “cultural contexts”. All these dimensions influence people with intellectual disabilities on an individual level regarding their level of health literacy. The importance of these single dimensions becomes clear, although for now, the link between all these dimensions is not yet considered. In future research, the focus should be on how to develop interventions considering social context dimensions. Furthermore, analyzing the connection between those dimensions seems promising.

Background Sexually transmitted infections (STIs) represent a global health risk. Adolescents are at increased risk of infection for several reasons such as lack of knowledge, risky sexual behaviors, and lack of behavioral sills (eg, to negotiate safer sex). Given the fact that adolescents often use digital media and that serious games are considered to have the potential to change knowledge, attitudes and behavior, serious games represent an opportunity for the prevention of STIs. Objective The aim of this systematic review was to identify and systematically summarize the dimensions that have been investigated in primary studies on serious games targeting STI prevention among adolescents. Methods A systematic review was conducted in PubMed and Web of Science. Studies published from 2009 to 2021 were included that assessed the effectiveness of serious games on adolescent sexual health. A total of 18 studies met the inclusion criteria and were categorized according to dimensions of effectiveness and user experience. Results Various dimensions of effectiveness and aspects of user experience were investigated in the primary studies. In total, 9 dimensions of effectiveness were observed: sexual behavior, behavioral intentions, knowledge, attitudes and beliefs, self-efficacy and personal limitations, character traits and future orientation, environmental and individual risk factors, risk perception and risk assessment, as well as normative beliefs and (social) norms. Furthermore, several dimensions related to user experience were investigated in primary studies, that is, motivation, acceptability, trustworthiness, comprehensibility, handling and control, perceived effectiveness, as well as satisfaction. Conclusions This review provides an overview of serious games interventions that are vastly different in approach, content, and even platform. In previous studies, knowledge has already been comprehensively assessed, and a positive influence of serious games on knowledge about sexual topics is evident. The results clearly show that adolescents’ sexual knowledge has been increased by the serious games interventions. However, methodological and content differences in the surveys make it difficult to draw conclusions about the effectiveness related to changes in attitudes and behavior.

Der Beitrag widmet sich den Erfahrungen von Spieler:innen mit sexueller Belästigung in Online-Spielen und entsprechenden Hilfesystemen. Dazu wird der Forschungsfrage nachgegangen, wie verfügbare Angebote und Massnahmen der Spielhersteller:innen sowie externe Beratungs- und Hilfesysteme von betroffenen Spielenden wahrgenommen werden. Gleichzeitig wird beleuchtet, welche Rolle das soziale Umfeld im Zuge einer eventuellen Inanspruchnahme spielt. Darüber hinaus wird elaboriert, welche Anforderungen sich auf Grundlage dieser Erfahrungen in Bezug auf die (Weiter-)Entwicklung von Hilfsangeboten ergeben. Zur Beantwortung des Forschungsanliegens wurden sieben Spielerinnen, die bereits Erfahrungen mit sexueller Belästigung in Online-Multiplayer-Spielen gemacht haben, in semistrukturierten Interviews befragt. Die Interviews wurden mittels qualitativer Inhaltsanalyse nach Mayring ausgewertet. Die Studienergebnisse liefern Erkenntnisse zur Wahrnehmung respektive Aufnahme und Verarbeitung von Informationen durch Spieler:innen zu bestehenden Hilfesystemen in Multiplayer-Online-Spielen. Es wird ein Beitrag zur Weiterentwicklung bestehender Hilfesysteme in Onlinewelten sowie zum Ausbau zusätzlicher Präventions-, Unterstützungs- und Beratungsmöglichkeiten geleistet. Die Untersuchung zeigt vor allem, dass weiterhin grosser Handlungsbedarf hinsichtlich präventiver Massnahmen sowie seitens der Akteure wie Spielhersteller:innen und Politik bestehen. Zu dessen Klärung wird auch die Durchführung weiterer Studien notwendig sein.

BACKGROUND Sexually transmitted infections (STIs) represent a global health risk. Adolescents, among other vulnerable groups, are at increased risk of infection due to an identified lack of knowledge and risky sexual behavior. Given the fact that adolescents often use digital media and that serious games are considered to have the potential to change knowledge, attitudes and behavior, serious games represent an opportunity for the prevention of (STIs). OBJECTIVE The aim of this systematic review was to describe the current state of evidence related to 1) the effectiveness/impact of serious games and 2) perceptions/game experiences of serious games users targeting sexual health and STI prevention. METHODS A systematic review has been conducted in PubMed and Web of Science. Studies published from 2009 to 2021 have been included that surveyed the effectiveness of serious games on adolescent sexual health. A total of 18 studies met the inclusion criteria and where categorized according to dimensions of effectiveness and gaming experience. RESULTS Various dimensions of effectiveness and aspects of gaming experience were investigated within the primary studies. In total, nine dimensions of effectiveness have been observed: Sexual behavior, behavioral intentions, knowledge, attitudes and beliefs, self-efficacy and personal limitations, personality traits and future orientation, environmental and individual risk factors, risk perception and risk assessment, as well as normative beliefs and (social) norms. Furthermore, several dimensions related to gaming experience have been investigated in previous studies, which are motivation, acceptance, trustworthiness, comprehensibility, handling and control, perceived effectiveness, as well as satisfaction. CONCLUSIONS Knowledge has already been comprehensively surveyed and a positive influence of serious games on knowledge about sexual topics is evident. The results clearly show that adolescents’ sexual knowledge was increased by the serious games interventions. However, methodological and content differences in the surveys as well as external conditions make it difficult to draw conclusions about effectiveness related to changes in attitudes and behavior.