Engaging African American Youth in the Development of a Serious Mobile Game for Sexual Health Education: Mixed Methods Study

Abstract

Background Although teen pregnancy rates decreased dramatically in the United States over the past decade, the rates of sexually transmitted infections (STIs) among adolescents and young adults increased. STI rates disproportionately affect African American youth and young adults. Innovative, accessible, and culturally relevant sexual health interventions are urgently needed. Objective This study aimed to identify the optimal modality for a game-based sexual health intervention; develop the educational, entertainment, and technological aspects of the serious game; and demonstrate its usability and acceptance by the target population. Methods This project was grounded in formative data collection with community-based participatory research principles and practices combined with a user-centered design and development approach. Sexually Active Adolescent–Focused Education (SAAFE) was developed using input and feedback from African American youths aged 15 to 21 years who participated in a youth advisory board and focus group discussions to inform the co-design and cocreation of the serious game. The process was highly iterative with multiple sessions for user input following design changes. It proceeded in 3 stages. Social cognitive theory and problem-solving theory were leveraged to provide evidence-based, trauma-informed education through a serious game. Usability testing assessed the quality of user experience with the prototype. Results Across all 3 stages, a total of 86 self-identified African American males and females aged 15 to 21 years from the District of Columbia and Birmingham, Alabama, participated. Participants requested a dating simulation game. They wanted SAAFE to be customizable, realistic, entertaining, educational, modern, and experiential, linking consequences to their gameplay decisions. Usability testing resulted in an initial System Usability Survey score of 77.7, placing the game in the 82nd percentile and above average for usability. Conclusions Initial results suggest that the SAAFE prototype is a promising intervention to engage African American youth in sexual health education using a role-playing game. If proven efficacious, the game has the potential to meet the need for sex education, counterbalance unhealthy portrayals of sex in popular media, and respond to the disparities in the STI epidemic.

Gamifying Sexual Education for Adolescents in a Low-Tech Setting: Quasi-Experimental Design Study

“…This study found that gamified learning contents were experienced as “relevant.” For instance, the students realized that there was a common connection between what they were learning and real life. These results were consistent with an earlier study [ 19 ], which had indicated that gamifying sexual health learning approaches was promising for adolescents because the role plays and scenarios reflect the actual lifestyle of the current generation. The students felt confident while going through the self-regulated learning material provided through the gamified learning (which stimulated and sustained their learning).…”

“…SG and GM methods were found to be effective and efficient in increasing motivation, improving attitudes, increasing knowledge acquisition, and encouraging engagement in the learning process. Future empirical studies may verify the efficacy of the My Future Begins Today learning platforms in improving sexual health literacy acquisition in other countries, especially in SSA, where the TT method is widely practiced and tends to limit the learning with gamified digital technologies and process [ 19 , 25 ]. This paper also addresses more than ever the call from a previous study [ 25 ] to evaluate the effect of gamifying sexual health education when different key stakeholders are involved in the design process in low-tech settings.…”

Enhancing instructional outcomes with a serious gamified system: a qualitative investigation of student perceptions

“…In fact, there is an interplay between serious gamified elements, on the one hand and motivation and engagement, on the other hand, to make gamified learning effective (Buckley et al, 2018). According to Patchen et al (2020), if all aspects of serious gamified elements were embedded in the gamified system to enhance motivation and engagement, learning could then be improved and sync with 21st-century skills, such as collaboration, communication, problem-solving and critical and the ability for thinking strategically.…”

Developing Graphic Messages for Vaping Prevention Among Black and Latino Adolescents: Participatory Research Approach

“…Engaging youths through PR can be successful for developing, implementing, and interpreting the results of research and can offer the potential to overcome the challenges of developing culturally and linguistically appropriate, community responsive interventions for underserved populations [ 41 ]. Moreover, as elucidated by Patchen et al [ 42 ], PR integrated with user-centered design methods offers practical, culturally relevant, and systematic guidance to develop appropriate interventions for underserved groups. Lastly, the use of abductive analysis provided a comprehensive method for developing graphic messages that were both empirically and theoretically grounded.…”