Project 1: HIV/STI Prevention for Out-of-School Emerging Adults Using A Video Game

The PROBLEM

Emerging adults (age 18-25) have the highest incidence of unprotected sex and very high infection rates
for HIV and other STIs.

• Although exposed to prevention messages since youth, emerging adults still engage in risky behavior.
  
  
• Men and young adults who are not in school are a tough audience:
       - Out of school emerging adults are understudied compared to college students (Collins, et al., 2005) and are
         harder to reach with traditional interventions.
  
       - Tests of popular television programming delivering persuasive safer sex messages found effects on women's        attitudes and behaviors, but not men's (Farrar, 2006; Huston, et al., 1998; Ward & Rivadeneyra, 1999).
  
  
• Men are less likely to use the media to learn about interpersonal relationships (Huston, et al., 1998).
  

The INTERVENTION

The intervention is a fun, interactive video game about safer sex and abstinence designed for use by urban, ethnically diverse, emerging adults.

• Youth play video games so it is a good medium with which to reach them:
  
        - About 75% of 15-18 year old African-American and Hispanic males play video games daily.
  
        - About 50% of white males, African-American females, and white females play daily (Kaiser data).
  
        - One third of Hispanic females play video games daily.

• Our formative research with the target group strongly suggests they want to learn more about sex, and they like the concept of a safer sex video game.

ADVANTAGES of Video Games

• Learning by discovery.
• Potential for long exposure times.
• Opportunity to model positive behaviors and show consequences of both positive and negative behaviors.
• Content can be tailored based on in-game assessment.
• Learning through role-plays and identification with game characters.

EMPIRICAL EVIDENCE for the EFFECTIVENESS of Video Games

• Adventure style video games with colorful graphics and engaging storylines are very effective in teaching young children to manage chronic health conditions (Lieberman, 1998, 2001).
  
  
• Computer based role-playing can effectively teach interpersonal skills (Holsbrink-Engels, 1997) and
  improve decision making skills (taylor et al., 1997).
  
  
• School based electronic (Lightfoot & LaCour, 2006), and traditional non-electronic games (Fisher et al., 1999, 2002; Jemmott et al., 1992) have been used effectively for HIV prevention for teens.

GAME CONCEPT

• The game will feature 3-D characters and visuals.
  
  
• Players will do "missions," playing self and different characters in romantic or sexual interpersonal encounters, including wihtin established relationships (e.g. "baby daddy", "wifey"), transactional (for goods or services, e.g. "sugar daddy"), familiar infrequent (e.g. known personally, friend of a friend), and strangers (e.g. "jump off").
  
  
• Game will be tailored by sexual experience, gender, and cultural factors.
  
  
• Safe behavior will be rewarded; risky behavior will have negative consequences.
  
  
• There will be in-game rewards, meters, and built-in advice givers.
  
  
• The game will ultimately be distributed via the web and/or through community organizations.

KEY MESSAGE POINTS and BEHAVIOR CHANGE MODEL

Print the Video Game project brochure (pdf)

                  "Xperience" Collaborating with Young Urban Artists: A Multilevel Drug Prevention Intervention Pilot                           
Dr. Jean Schensul, Project Director, Institute for Community Research (ICR), Hartford, CT

• Create drug-free safe spaces for youth.
  
  
• Involve young artists in creating performances with drug prevention messages.
  
  
• Disseminate drug prevention messages through live shows and on branded items
  (i.e. T shirts, key chains, posters, CDs and DVDs).
  
  
• Evaluate intervention efficacy in sustaining non-use of drugs among youth.
  
  
• Expand organizations and youth groups who support drug-free lifestyles.
  
  
• Disseminate Xperience locally and nationally.

• Developed 7 messages reinforcing resistance to marijuana, alcohol and MDMA, based on core values, party drug expectancies and social influence.
  
  
• Held 4 "Xperience Hartford" drug free shows using the tag line "for those who choose not to use."
  
  
• 17 local performing artists created new, original works of art containing drug prevention messages.
  
  
• Received IRB approval to waive parental consent.

• N = 145 youth aged 15-20 (mean 16.37).
  51% African-American, 43% Latino, and 5% White.
  
  
• Survey Pilot: N = 88 for pre-test; N = 2 for pre and post- test.
  53% had never used alcohol; and 75% had never used marijuana.
  
  
• Less than 10% reported marijuana or alcohol use one or more times in past 30 days; 5% had used MDMA at leats once.

• Total audience reached = approximately 115 youth across shows. There is feasibility and acceptability of drug-free entertainment and persuasive drug resistance messaging with urban youth ages 14-20.
  
  
• Post-test survey responses showed high levels of trust and belief in messages and mode of delivery.
  
  
• A quai-experimental design in 2007-2008 will evaluate short term efficacy.
  

This project is a collaboration between the ICR, CHCM and the Hartford Animation Institute.

Dr. Jean Schensul, Founding Director
Institute for Community Research
Two Hartford Square West, Suite 100
146 Wyllys Street
Hartford, CT 06106-5128
860.278.2044 fax 860.278.2141
email info@icrweb.org
http://www.incommunityresearch.org/index.htm

We conduct research related to health communication, health marketing, and health interventions across a range of disciplines. Our aim is to study the dynamics of health-risk behavior within at-risk populations and to develop health interventions and marketing strategies that reduce risky behaviors.

CHCM welcomes opportunities to collaborate on new research. Please feel free to contact us to discuss potential projects.

MAJOR ONGOING PROJECTS

We are designing and testing the efficacy of two innovative entertainment-education approaches for promoting healthy behaviors among urban adolescents and young adults:

• Project 1 tests the efficacy of video game format to influence abstinence and safer sex behaviors:
  HIV/STI Prevention for Out-of-School Emerging Adults Using A Video Game
  
  
• Project 2 uses a community participatory approach involving local musicians to promote substance-free social norms and behaviors:
  Place-Based Social Marketing to Prevent Urban Youth Party Drug Use