A Smartphone Game-Based Intervention (Tumaini) to Prevent HIV Among Young Africans: Pilot Randomized Controlled Trial

Winskell, Kate; Sabben, Gaëlle; Akelo, Victor; Ondenge, Ken; Obong’o, Christopher; Stephenson, Rob; Warhol, David; Mudhune, Victor

doi:10.2196/10482

Cited by 52 publications

(118 citation statements)

References 47 publications

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“…Additional results related to acceptability and to the study’s secondary (behavioral) outcomes were analyzed, and these are reported in separate [27] and forthcoming publications.…”

Section: Resultsmentioning

confidence: 99%

“…Primary outcomes for this study focused on the feasibility and safety of the study. Secondary outcomes included acceptability of the game and behavioral mediators of sexual initiation and condom use, reported elsewhere [27].…”

Section: Methodsmentioning

confidence: 99%

“…Both this and the game experience survey were implemented via Audio Computer-Assisted Self-Interview software (ACASI, Tufts University) using headphones to ensure participants’ privacy. Outcome data for behavioral mediators are reported elsewhere [27].…”

Section: Methodsmentioning

confidence: 99%

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A Smartphone Game to Prevent HIV Among Young Africans: Protocol for a Randomized Pilot Study of a Mobile Intervention

Sabben¹,

Akelo²,

Mudhune³

et al. 2019

JMIR Res Protoc

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Background Young people aged under 25 years make up an increasing proportion of the population in emerging economies such as Kenya, where half of new adult HIV infections are among 15- to 24-year olds. Interventions targeting this age group have the potential to avert HIV infections among an increasingly large at-risk population. Interactive communication technologies offer a promising platform for reaching young people in engaging ways. Objective Tumaini is a narrative-based smartphone game designed to help young Africans protect themselves from HIV. The objective of this study was to pilot test the game, focusing on the data needed to inform a future randomized controlled efficacy trial, including assessments of study feasibility and safety. Methods The study took place in Kisumu Town, western Kenya, in spring 2017. The game-based intervention was pilot tested for 16 days with a sample of 60 preadolescents aged 11 to 14 years. Participant recruitment was initiated through schools. Participants were randomly assigned to the control or intervention arms of the study. One parent for each of the intervention arm participants was also recruited (n=30). The intervention arm participants were provided with smartphones on which Tumaini was loaded so that they could play the game at home. Youth completed behavioral surveys at baseline, posttest, and 6-week follow-up. The intervention arm participants provided quantitative feedback on their experience of the game-based intervention at posttest. They and their parents further participated in postintervention focus group discussions. Feasibility-related study metrics were collected on recruitment, enrollment, attrition, safety of participants, and return of phones. Results Recruitment and enrollment of the 60 preadolescents and parents were successfully completed within 18 days. No participants were lost to follow-up: all youth completed all 3 waves of the survey and 27 intervention arm youth and 22 parents and caregivers participated in the focus groups. No safety concerns were reported. All phones were returned after the intervention period; none were damaged or lost. All intervention arm participants initiated gameplay, recording a mean exposure time just under 27 hours. Conclusions Findings indicate that it is feasible and safe to test a smartphone-based HIV prevention intervention for very young adolescents in urban and peri-urban sub-Saharan Africa by initiating recruitment in schools and temporarily providing youth participants with smartphones on which the game is loaded. A randomized controlled trial powered to assess the efficacy of the game-based intervention is being designed to be carried out in the same geographic area as the pilot, using similar methods. Trial Registration ClinicalTrials.gov NCT03054051; https://clinicaltrials.gov/ct2/show/NCT03054051 (Archiv...

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“…Additional results related to acceptability and to the study’s secondary (behavioral) outcomes were analyzed, and these are reported in separate [27] and forthcoming publications.…”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

A Smartphone Game to Prevent HIV Among Young Africans: Protocol for a Randomized Pilot Study of a Mobile Intervention

Sabben¹,

Akelo²,

Mudhune³

et al. 2019

JMIR Res Protoc

Self Cite

View full text Add to dashboard Cite

show abstract

“…(41) In HIV, telehealth studies have increased HIV risks awareness and retention into care. (42,43) Telehealth innovations targeting communicable diseases and maternal-child health have been found to be highly acceptable, feasible, and have significantly improved medication adherence, engagement in care, and use of health services. (40) Therefore, it is important to use the already established precedence in these disease areas to increase the use of telehealth along the HCC.…”

Section: Discussionmentioning

confidence: 99%

Opportunities to Leverage Telehealth Approaches Along the Hypertension Control Cascade in Sub-Saharan Africa

et al. 2019

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Purpose of Review: To review current literature on the use of telehealth at different stages of the hypertension control cascade in sub-Saharan Africa (SSA) and to discuss opportunities to harness information and communication technology infrastructure to improve population level hypertension control. Recent findings: There are a limited number of telehealth studies at the different stages of the hypertension control cascade. The small body of evidence suggests several promising innovations. These innovations include the use of interactive text messaging, smartphone applications, and telephone calls demonstrated significant reduction in mean systolic blood pressure and increase in the proportion of hypertensives with blood pressure control. Interventions that included text messaging with educational content had the potential to improve hypertension knowledge and also influence behavioral modification and health-seeking behavior. Summary: There is a need for studies on feasibility, acceptability, and scaling up of telehealth interventions with rigorous study designs.

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“…App entertainment and gamification have been found to improve user engagement and the reach of sexual health app interventions. 37,40 The PrEP-related apps did not score well in terms of engagement, thus apps for improving PrEP utilisation may benefit from incorporating additional gaming and entertainment features. PrEP-related apps could also benefit from including more features that allow for app user communication with healthcare providers or educators, 36,39 tracking of key personal sexual behaviours 37,41 and locating other types of sexual healthcare services, such as HIV testing.…”

Section: Key Findingsmentioning

confidence: 99%

A systematic evaluation of mobile apps to improve the uptake of and adherence to HIV pre-exposure prophylaxis

Sharpe

Kamara

2018

Sex. Health

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Background Pre-exposure prophylaxis, or PrEP, has been shown to be effective at reducing the risk of HIV infection, yet persons at-risk for acquiring HIV exhibit suboptimal uptake of and adherence to this prevention modality. Although PrEP use among all at-risk groups is low, mobile apps have been shown to increase the use of PrEP; however, it is unknown whether currently available apps have been designed with features to facilitate PrEP uptake and adherence. Methods: The Google Play store and Apple App store were systematically searched for currently available PrEP-related apps. A qualitative evaluation was conducted on apps that met the inclusion criteria for the presence of features that can contribute to PrEP uptake and adherence, and the quality of apps was assessed using the Mobile Apps Rating Scale (MARS) tool. Results: From the systematic search, less than 2% (11/621) of the identified apps were relevant to improving PrEP uptake and adherence. Demonstrating a moderate capacity for facilitating PrEP use, the 11 PrEP-related apps, on average, contained features that addressed two of four factors that can contribute to the uptake of PrEP, particularly features that provided comprehensive information on PrEP and resources to locate providers and clinics offering PrEP services. Findings from the app quality assessment suggested that existing PrEP-related apps are of acceptable quality (mean overall MARS score: 3.2 on a five-point scale). Conclusion: Overall, currently available mobile apps for PrEP demonstrate some promise as potential avenues for increasing PrEP uptake and adherence among persons at-risk for HIV infection.

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A Smartphone Game-Based Intervention (Tumaini) to Prevent HIV Among Young Africans: Pilot Randomized Controlled Trial

Cited by 52 publications

References 47 publications

A Smartphone Game to Prevent HIV Among Young Africans: Protocol for a Randomized Pilot Study of a Mobile Intervention

A Smartphone Game to Prevent HIV Among Young Africans: Protocol for a Randomized Pilot Study of a Mobile Intervention

Opportunities to Leverage Telehealth Approaches Along the Hypertension Control Cascade in Sub-Saharan Africa

A systematic evaluation of mobile apps to improve the uptake of and adherence to HIV pre-exposure prophylaxis

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