Pilot Randomized Controlled Trial of Game Plan for PrEP: A Brief, Web and Text Message Intervention to Help Sexual Minority Men Adhere to PrEP and Reduce Their Alcohol Use

Wray, Tyler B.; Chan, Philip A.; Kahler, Christopher W.; Ocean, Erik M. S.; Nittas, Vasileios

doi:10.1007/s10461-023-04223-9

Cited by 1 publication

(9 citation statements)

References 43 publications

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“…In addition, a secondary reference search was performed, yielding 1 more relevant record. Consequently, a total of 26 articles were included in the qualitative analysis [ 13 24-48 undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined ]. Furthermore, of the 26 articles, 6 RCTs were chosen for the meta-analysis [ 24 29 30 32 33 39 ].…”

Section: Resultsmentioning

confidence: 99%

“…An overview of the different risks of bias in each study is presented in Tables S4-1 and S4-2 in Multimedia Appendix 3 [ 13 24 25 28-30 32-36 39 42 43 45 48 undefined undefined undefined undefined undefined undefined ]. The weighted Cohen κ coefficient was 0.88, suggesting good agreement between raters [ 53 ].…”

Section: Resultsmentioning

confidence: 99%

“…Overall, 10 RCTs were assessed using the RoB2, with 6 rated as having a high risk of bias. A high risk of bias occurred in the domains outcome measurement [ 24 28 30 42 ] and missing outcome data [ 29 43 ] (Figure S4-1 in Multimedia Appendix 3 ). Of the 6 nonrandomized studies assessed using the ROBINS-I tool, 2 presented a serious risk of bias [ 34 35 ] and 4 a critical risk of bias [ 25 36 45 48 ] (Figure S4-2 in Multimedia Appendix 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…The 10 RCTs under each outcome of interest in this review are listed in Table S5-1 in Multimedia Appendix 4 [ 13 24-39 41-48 undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined ]. The meta-analysis on the effect of gamification on CAS reduction contained 3 RCTs (total N=2138).…”

Section: Resultsmentioning

confidence: 99%

“…Authors of the initial publications were contacted when additional information was needed. Because of multiple classifications proposed for the term gamification, the components in each digital gamified intervention were analyzed through the lens of the Octalysis gamification framework [ 23 ], which comprises 8 core drives into which various gamification elements can be placed, namely, epic meaning and calling, development and accomplishment, empowerment creativity and feedback, ownership and possession, social influence and relatedness, scarcity and impatience, unpredictability and curiosity, and loss and avoidance (Table S3-2 in Multimedia Appendix 2 [ 13 24-48 undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined undefined ]). Laine et al [ 49 ] mapped their interview results from schoolchildren to the Octalysis framework to better establish a digital gamification-based intervention for promoting active school transport.…”

Section: Methodsmentioning

confidence: 99%

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mHealth-Based Gamification Interventions Among Men Who Have Sex With Men in the HIV Prevention and Care Continuum: Systematic Review and Meta-Analysis

Luo,

Zhang,

Wang

et al. 2024

JMIR Mhealth Uhealth

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Background In the past few years, a burgeoning interest has emerged in applying gamification to promote desired health behaviors. However, little is known about the effectiveness of such applications in the HIV prevention and care continuum among men who have sex with men (MSM). Objective This study aims to summarize and evaluate research on the effectiveness of gamification on the HIV prevention and care continuum, including HIV-testing promotion; condomless anal sex (CAS) reduction; and uptake of and adherence to pre-exposure prophylaxis (PrEP), postexposure prophylaxis (PEP), and antiretroviral therapy (ART). Methods We comprehensively searched PubMed, Embase, the Cochrane Library, Web of Science, Scopus, and the Journal of Medical Internet Research and its sister journals for studies published in English and Chinese from inception to January 2024. Eligible studies were included when they used gamified interventions with an active or inactive control group and assessed at least one of the following outcomes: HIV testing; CAS; and uptake of and adherence to PrEP, PEP, and ART. During the meta-analysis, a random-effects model was applied. Two reviewers independently assessed the quality and risk of bias of each included study. Results The systematic review identified 26 studies, including 10 randomized controlled trials (RCTs). The results indicated that gamified digital interventions had been applied to various HIV outcomes, such as HIV testing, CAS, PrEP uptake and adherence, PEP uptake, and ART adherence. Most of the studies were conducted in the United States (n=19, 73%). The most frequently used game component was gaining points, followed by challenges. The meta-analysis showed gamification interventions could reduce the number of CAS acts at the 3-month follow-up (n=2 RCTs; incidence rate ratio 0.62, 95% CI 0.44-0.88). The meta-analysis also suggested an effective but nonstatistically significant effect of PrEP adherence at the 3-month follow-up (n=3 RCTs; risk ratio 1.16, 95% CI 0.96-1.38) and 6-month follow-up (n=4 RCTs; risk ratio 1.28, 95% CI 0.89-1.84). Only 1 pilot RCT was designed to evaluate the effectiveness of a gamified app in promoting HIV testing and PrEP uptake. No RCT was conducted to evaluate the effect of the gamified digital intervention on PEP uptake and adherence, and ART initiation among MSM. Conclusions Our findings suggest the short-term effect of gamified digital interventions on lowering the number of CAS acts in MSM. Further well-powered studies are still needed to evaluate the effect of the gamified digital intervention on HIV testing, PrEP uptake, PEP initiation and adherence, and ART initiation in MSM.

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