Evaluation of an AIDS Educational Mobile Game (AIDS Fighter · Health Defense) for Young Students to Improve AIDS-Related Knowledge, Stigma, and Attitude Linked to High-Risk Behaviors in China: Randomized Controlled Trial

Tang, Jian; Zheng, Yu; Yu, Zhaolan; daiying, Zhang; Yu, Xingli; Ren, Junfeng; Li, Mei; Luo, Yue; Tian, Min; Chen, Yanhua

doi:10.2196/32400

Cited by 13 publications

(8 citation statements)

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“…According to statistics found in this study, among newly infected HIV patients in Chongqing recorded every year, the proportion of MSM showed an increased trend. However, this proportion in Chongqing was higher than the national average [9,10]. Therefore, it is of great social and practical significance to prevent and treat diseases among MSM in Chongqing.…”

Section: Discussionmentioning

confidence: 96%

Influencing factors and knowledge related to AIDS among high-risk male population in Chongqing

2023

Journal of Men's Health

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This study aims to investigate the influencing factors and Acquired Immune Deficiency Syndrome (AIDS) related knowledge among high-risk male population in Chongqing. A total of 388 men who had sex with their fellow men (MSM) and volunteered for counseling or human immunodeficiency virus (HIV) testing in Chongqing were divided into two groups identified as: aware group (n = 299) and unaware group (n = 89). According to the study subjects, the MSM sentinel surveillance questionnaire of the Chinese Center for Disease Control and Prevention was utilized to investigate their AIDS awareness demographic and behavioral characteristics. Univariate analysis was also applied to analyze the influencing factors of their AIDS knowledge. Binary multivariate logistic analysis was further used to screen the independent risk factors of AIDS inadequate knowledge, leading to the use of regression analysis model. Furthermore, hosmer and lemeshow were employed to test the goodness and fitness of the regression analysis model. Finally, SPSS was used to draw receiver operating characteristic (ROC) curves to evaluate the predictive value of the regression analysis model. Among 388 respondents, 299 participants were aware while 89 participants were unaware of AIDS-related knowledge with an overall awareness rate of 77.06%; univariate and multivariate logistic regression analysis showed that education (high school and below) and household registration (other places) were risk factors for AIDS-related knowledge in high-risk male groups in Chongqing. In addition, a probability model predicted high incidence of AIDS in high-risk male groups in Chongqing because of inadequate AIDS knowledge: P = 1/[1 + exp (1.429 − 1.169X2 − 0.969X3)]. The overall level of awareness of AIDS-related knowledge among high-risk male groups in Chongqing was not high because of low education levels (high school or below) and foreign household registration.

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Section: Discussionmentioning

confidence: 96%

Influencing factors and knowledge related to AIDS among high-risk male population in Chongqing

2023

Journal of Men's Health

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“…In our previous studies, an AIDS educational game called AIDS Fighter· Health Defense was developed, and a randomized controlled trial was conducted and proved that this game has a good education effect on AIDS prevention for young students. Students have good comments on the game and believe it could help them learn more about AIDS [ 36 ]. In this study, we would like to evaluate the effect of this game to improve ART adherence of young people newly diagnosed with HIV.…”

Section: Discussionmentioning

confidence: 99%

“…Players are required to collect ART medicine and condoms, avoid HIV, alcohol and drug, take ART medicine regularly, and answer questions about ART. More information about the game can be found in our published studies [ 35 , 36 ]. It had been shown that the game can improve the AIDS-related knowledge and has the potential to improve AIDS prevention ability of young students.…”

Section: Introductionmentioning

confidence: 99%

Game-based health education to improve ART adherence of newly diagnosed young people with HIV: protocol for a stepped-wedge design randomized controlled trial

et al. 2022

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Background Antiretroviral therapy (ART) is one of the most effective ways for HIV-infected to treat AIDS. However, it is difficult to start ART among young people those newly diagnosed HIV-infection in China, and their adherence to ART is poor. We have designed an AIDS educational game called AIDS Fighter · Health Defense, which could improve the AIDS-related knowledge and has the potential to improve AIDS prevention ability of young students. In this study, AIDS Fighter · Health Defense will be used with newly diagnosed young people with HIV to evaluate the education effect of the game in improving ART adherence. Design A stepped-wedge design randomized controlled trial will be conducted to confirm the education effect of AIDS Fighter · Health Defense on improving ART adherence of newly diagnosed young people with HIV, and to verify when to start game-based health education could be more effective for newly diagnosed young people with HIV. Methods Participants will receive AIDS education from health workers and start ART when diagnosed with HIV and assigned into four groups randomly. The first step group to the fourth step group will receive AIDS Fighter · Health Defense in turn at the star of ART, one week, one month and three months after the start of ART. The primary outcomes are medication adherence, CD4( +) T cell count, and HIV viral load. The secondary outcomes are ART-related knowledge, ART-related skills, psychological resilience, and self-discrimination. Assessments will be completed before the intervention and one week, first month, and third month of the intervention, and then a one-year follow-up evaluation will be conducted after the intervention. Discussion AIDS Fighter · Health Defense may be an effective approach to help newly diagnosed young people with HIV to improve ART adherence. A stepped-wedge design randomized controlled trial of this study may find the optimal time of AIDS education to improve ART adherence of newly diagnosed young people with HIV. Registration number Chinese Clinical Trial Registry: ChiCTR2200059766, registered 11 May 2022. http://www.chictr.org.cn/showproj.aspx?proj=169420

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“…One of the few effect evaluations of HIV/AIDS educational games in China found that the hero combat game AIDS Fighter • Health Defense did not have a significant effect on decreasing HIV-related stigma [40]. The researchers suggested that the decrease in stigma may need time to take effect.…”

Section: Comparison With Prior Workmentioning

confidence: 99%

A Web-Based Gaming Approach to Decrease HIV-Related Stigma: Game Development and Mixed Methods Evaluation

Zhang¹,

Lai²

2022

JMIR Serious Games

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Background The stigma faced by people living with HIV causes difficulties in the treatment of HIV/AIDS. Decreasing this stigma is thus no less urgent than implementing behavioral interventions. Serious games are being increasingly adopted as an intervention mechanism to control HIV/AIDS around the world. However, the development and evaluation of these games in China are far from adequate. Objective This research aimed to help decrease HIV-related stigma in China via the development and evaluation of a serious game, as well as promote a participatory gamification culture for health interventions. Methods Initially, a serious game was developed using free resources from a user-generated content website. Then, quantitative and qualitative methods were employed for game evaluation. A randomized controlled trial was conducted to explore the game’s effect on HIV-related stigma. The trial included 167 university students, who were randomly allocated to game and control groups. After the experimental evaluation, focus group discussions were held with 64 participants, who were invited to form 16 groups. Results The game was called The Second Kind of Life with HIV (SKLWH), which is a free online game that can be played on computers and smartphones. This game hopes to publicize that people living with HIV can live a normal life, that is, a second life different from that imagined by the public. Based on the gamification practice of SKLWH, the participatory serious game development model (PSGDM) was proposed, which guided the development of 3 other HIV-themed games. The trial showed that intimacy stigma was much more severe than morality stigma and personal interaction stigma. Females were more tolerant of morality stigma than males (mean score: 1.29 vs 1.50; P=.01). The game intervention showed an advantage in decreasing intimacy stigma (mean score [game vs control]: 2.43 vs 2.73; P=.04). The group discussions validated the quantitative results and provided further in-depth information. The game intervention was largely preferred by participants, and the belief in intimacy impossibility was commonly expressed by participants when considering their relationship with people living with HIV. Conclusions HIV/AIDS education should adopt appropriate media interventions to mitigate different dimensions of HIV-related stigma. Serious games should be used to decrease intimacy stigma, which is the hardest form to diminish. It is expected that the PSGDM can promote the development of more health games. Furthermore, HIV/AIDS intervention requires interdisciplinary efforts and cooperation that will allow more people to participate and share the responsibility of promoting health.

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Evaluation of an AIDS Educational Mobile Game (AIDS Fighter · Health Defense) for Young Students to Improve AIDS-Related Knowledge, Stigma, and Attitude Linked to High-Risk Behaviors in China: Randomized Controlled Trial

Cited by 13 publications

References 34 publications

Influencing factors and knowledge related to AIDS among high-risk male population in Chongqing

Influencing factors and knowledge related to AIDS among high-risk male population in Chongqing

Game-based health education to improve ART adherence of newly diagnosed young people with HIV: protocol for a stepped-wedge design randomized controlled trial

A Web-Based Gaming Approach to Decrease HIV-Related Stigma: Game Development and Mixed Methods Evaluation

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