An Intervention Using Gamification to Increase Human Immunodeficiency Virus and Sexually Transmitted Infection Screening Among Young Men Who Have Sex With Men in California: Rationale and Design of Stick To It

Abstract

BackgroundIn the United States, young men who have sex with men (YMSM) remain disproportionately affected by human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Although routine HIV/STI screening is pivotal to the timely diagnosis of HIV and STIs, initiation of appropriate treatment, and reduced onward disease transmission, repeat screening is underused. Novel interventions that incorporate elements of games, an approach known as gamification, have the potential to increase routinization of HIV/STI screening among YMSM.ObjectiveThe study aims to test the hypothesis that an incentive-based intervention that incorporates elements of gamification can increase routine HIV/STI screening among YMSM in California.MethodsThe study consists of a formative research phase to develop the intervention and an implementation phase where the intervention is piloted in a controlled research setting. In the formative research phase, we use an iterative development process to design the intervention, including gathering information about the feasibility, acceptability, and expected effectiveness of potential game elements (eg, points, leaderboards, rewards). These activities include staff interviews, focus group discussions with members of the target population, and team meetings to strategize and develop the intervention. The final intervention is called Stick To It and consists of 3 components: (1) online enrollment, (2) Web-based activities consisting primarily of quizzes and a countdown “timer” to facilitate screening reminders, and (3) in-person activities that occur at 2 sexual health clinics. Participants earn points through the Web-based activities that are then redeemed for chances to win various prizes during clinic visits. The pilot study is a quasi-experimental study with a minimum of 60 intervention group participants recruited at the clinics, at community-based events, and online. We will compare outcomes in the intervention group with a historical control group consisting of individuals meeting the inclusion criteria who attended study clinics in the 12 months prior to intervention implementation. Eligible participants in the pilot study (1) are 18 to 26 years old, (2) were born or identify as male, 3) report male sexual partners, and 4) have a zip code of residence within defined areas in the vicinity of 1 of the 2 implementation sites. The primary outcome is repeat HIV/STI screening within 6 months.ResultsThis is an ongoing research study with initial results expected in the fourth quarter of 2017.ConclusionsWe will develop and pilot test a gamification intervention to encourage YMSM to be regularly screened for HIV/STIs. The results from this research will provide preliminary evidence about the potential effectiveness of using gamification to amplify health-related behavioral change interventions. Further, the research aims to determine the processes that are essential to developing and implementing future health-related gamification interventions.Trial RegistrationClinicaltrials.g...

Evidence and implication of interventions across various socioecological levels to address HIV testing uptake among men who have sex with men in the United States: A systematic review

“… 26 , 43 , 51 , 52 , 57 , 58 , 64 , 71 , 76 , 78 , 79 Most studies were implemented after 2000. 20 – 26 , 34 – 37 , 39 – 79 , 81 …”

“… 43 , 53 , 54 , 65 , 71 , 74 , 78 , 79 , 81 Thirty-one interventions were evaluated by RCTs. 20 , 21 , 23 , 26 , 35 , 36 , 38 , 42 – 44 , 49 – 51 , 53 , 54 , 57 , 59 , 64 , 65 , 67 , 68 , 71 – 76 , 78 – 81 Eleven studies were evaluated by using a quasi-experimental design; 24 , 25 , 33 , 34 , 39 , 41 , 45 , 47 , 55 , 60 , 61 5 of the 11 used a pretest-posttest design. 24 , 25 ...…”

AIDS fighter health defense: protocol for a randomized controlled trial to test a game-based intervention to improve adolescents’ AIDS prevention ability

“…In developed countries, the focus of AIDS prevention education is on the sexual behavior of high-risk groups, but the focus of AIDS education in our study is on the AIDS-related knowledge of adolescents. The awareness rate of AIDS knowledge among the public in developed countries might be higher than China, and existing studies are mainly aimed at high-risk groups, such as men who have sex with men and adolescents who have sex without condoms [ 18 , 19 ]. But in China, the awareness rate of AIDS among the public is low [ 20 ], especially adolescents in poor areas and western China [ 21 , 22 ].…”

Stick To It: pilot study results of an intervention using gamification to increase HIV screening among young men who have sex with men in California

“…The intervention development process was influenced by game design and human-centered design and has been previously described in detail along with the proposed theory of change (39,44). In brief, a series of in-depth interviews with clinic staff and focus group discussions with YMSM solicited feedback about specific game elements followed by an iterative design process.…”