The game improved considerably from its initial conception through three stages of iterative design and feedback. Our assessment methods for each stage targeted and integrated learning, health, and engagement outcomes. Lessons learned through this iterative design process are a great contribution to the games for health community, especially in targeting the development of health and learning goals through game design.

Background Concentrations of antiretrovirals (ARVs) in the genital tract play a key role in pre-exposure prophylaxis. This study aims to describe rilpivirine (Edurant®) concentrations in the genital tract in pregnant and postpartum women. Methods International Maternal Pediatric Adolescent AIDS Clinical Trials Protocol P1026s is an ongoing, prospective study of antiretroviral pharmacokinetics (PK) in HIV infected pregnant women that include a cohort receiving rilpivirine combination regimen. Intensive PK evaluations were performed at steady state during the second and third trimester, and postpartum. Plasma and directly-aspirated cervicovaginal fluid (CVF) samples were collected at 4 timepoints around an observed dose, and measured using high-performance liquid chromatography with ultraviolet detection, (plasma; lower limit of quantification (LLQ) = 10ng/mL) or liquid chromatography-tandem mass spectrometry (CVF; LLQ = 1ng/mL). Results A total of 24 women were included in the analysis. For all time points combined, median (Interquartile range, IQR) rilpivirine concentrations were 70ng/ml (23–121) in CVF and 92 ng/ml (49–147) in plasma. The CVF to plasma AUC (0-4) ratios were significantly higher in the 2nd (0.90, 90% CI 0.61–1.46) and 3rd trimesters of pregnancy compared to postpartum (0.40, 90% CI 0.19–0.87). Three of 189 (1.6%) plasma samples in two women were below the LLQ as well as the corresponding CVF concentrations. Seventeen additional CVF concentrations (10.6%) were below LLQ in 13 participants. No major safety concerns were noted. Conclusions Rilpivirine concentrations were higher in the CVF during pregnancy compared to postpartum. CVF Rilpivirine is likely to achieve inhibitory concentrations effective for preventing peripartum HIV transmission.

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Introduction: Improving diet is a prime target for the prevention and management of chronic disease. The communal coping model suggests that families can mitigate shared risk of chronic disease through encouragement of healthful eating, eliciting preventive behaviors.Method: Using network data from 69 Australian families across three ancestry groups (Anglo, Italian, and Asian) with varied family health histories, the present study applied social network analysis to identify patterns of intergenerational encouragement of healthful eating behavior within families, and assess whether patterns varied by family ancestry or disease density. Results: Findings indicated variation in patterns of health encouragement by ancestry such thatAsian-Australian families were most distinct from the other ancestry groups. While there was no main effect of familial disease history, it moderated the effect of Italian ancestry on intergenerational encouragement patterns.Discussion: These results provide important context for future family-based interventions that leverage normative patterns of intergenerational exchange of encouragement or aim to modify such patterns in an effort to improve family health.