An Accessible Digital Intervention to Promote HIV Testing/Counseling and Prevention Among Adolescents

Sponsor
Yale University (Other)
Overall Status
Completed
CT.gov ID
NCT03713034
Collaborator
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) (NIH)
296
1
2
23
12.9

Study Details

Study Description

Brief Summary

This is Phase II of a study previously registered on ClinicalTrials.gov (NCT02812329). Phase II focuses on adapting and expanding the reach of a previously developed video game aimed at HIV prevention. The game will be adapted to include web access/distribution and be evaluated using a randomized controlled trial.

Condition or Disease Intervention/Treatment Phase
  • Other: PlayTest!
  • Other: Control games
N/A

Detailed Description

The specific aims for Phase II of this study are to:

Further adapt and expand our culturally and socially-tailored videogame to have a greater focus on HIV testing and counseling (HTC) in addition to HIV prevention in an older age group of 14-18 year old boys and girls.

This will be accomplished by refining the conceptual model of the theoretical mechanisms of behavior change to be applied specifically within the game. New content will be created with additional input from 4 focus groups of 5 adolescents each (n = 20, aged 14-18) and these participants will also play-test the game. In addition, this model will inform new intervention manuals ("Game Playbooks") targeting these new outcomes. Building the new content from focus groups into the game are intended to adapt and expand its scope.

A system will be established for the newly adapted game for web access/distribution and program integration. Work will continue with commercialization partners on widespread distribution of the adapted game.

The final piece of the study will be to conduct a randomized controlled trial in 296 adolescents (aged 14-18) to evaluate the acceptability and efficacy of the adapted game on its new web-based platform compared with a set of control games.

Study Design

Study Type:
Interventional
Actual Enrollment :
296 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Double (Investigator, Outcomes Assessor)
Primary Purpose:
Prevention
Official Title:
An Accessible Digital Intervention to Promote the Use of School-based Health Centers and to Empower Adolescents With Their Sexual Health
Actual Study Start Date :
Nov 1, 2018
Actual Primary Completion Date :
Oct 1, 2020
Actual Study Completion Date :
Oct 1, 2020

Arms and Interventions

Arm Intervention/Treatment
Experimental: Active Game

PlayTest! is an interactive world in which the player, using an avatar they have created, "travels" through life in high school. They face challenges that bring different risks and benefits, requiring them to practice decision-making skills. The player learns skills that aim to empower them to make safe choices in situations that may otherwise increase their risk for HIV/STI infection. The game also provides opportunities for the player to practice advocating for their health by modeling a conversation with a medical professional. PlayTest! incorporates evidence-based tools for behavior change including social learning theory and self-efficacy. message framing, motivational interviewing to identify the variables that must be targeted to increase HTC among adolescents.

Other: PlayTest!
Participants in the PlayTest! intervention arm played the game on their assigned iPads once per week for an hour over the course of 4-5 weeks.

Active Comparator: Control Game

Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. The control games contained not relevant content related to HIV Testing and Counseling.

Other: Control games
Participants in the control arm played the games on their assigned iPads once per week for an hour over the course of 4-5 weeks.

Outcome Measures

Primary Outcome Measures

  1. Attitudes Around HIV Testing and Counseling [Baseline, 4 weeks, 3 months and 6 months]

    HTC attitudes were assessed with 7 items (e.g., "I feel it is important for me to get tested for HIV"). The items were scored on a 5-point scale ranging from - 2 (strongly disagree) to +2 (strongly agree) with positive values indicating healthier attitudes towards HTC. Participants had the option to respond "not sure" which was given a neutral score of 0. A mean of the seven items was calculated for each participant. A few items were reverse coded, because the lower value was indicating healthier attitudes. Not sure was coded as a neutral option. Higher scores equal more positive attitudes toward HIV testing and counseling.

Secondary Outcome Measures

  1. Intentions to Get Tested for HIV [Baseline, 4 weeks, 3 months and 6 months]

    Intentions were assessed with 7 items (e.g., "I intend to get tested for HIV at some point in the next 3 months" and "I intend to use a school-based health center to get tested for HIV". The items were scored on a 5-point scale ranging from - 2 (strongly disagree) to +2 (strongly agree) with positive values indicating healthier intentions. Participants had the option to respond "not sure" which was given a neutral score of 0. Higher scores equal greater intentions to get tested for HIV. The total range for scores was -14 to 14.

  2. Number of Students Tested for HIV at Month 1 [Month 1]

    The number of participants tested for HIV was measured by tracking data reported by school-based health center staff. The school-based health center staff recorded (by study Id number) if participant came in for testing in the last month and the date of the test.

  3. Number of Students Tested for HIV at Month 2 [Month 2]

    The number of participants tested for HIV was measured by tracking data reported by school-based health center staff. The school-based health center staff recorded (by study Id number) if participant came in for testing in the last month and the date of the test.

  4. Number of Students Tested for HIV at Month 3 [Month 3]

    The number of participants tested for HIV was measured by tracking data reported by school-based health center staff. The school-based health center staff recorded (by study Id number) if participant came in for testing in the last month and the date of the test.

  5. Number of Students Tested for HIV at Month 4 [month 4]

    The number of participants tested for HIV was measured by tracking data reported by school-based health center staff. The school-based health center staff recorded (by study Id number) if participant came in for testing in the last month and the date of the test.

  6. Number of Students Tested for HIV at Month 5 [Month 5]

    The number of participants tested for HIV was measured by tracking data reported by school-based health center staff. The school-based health center staff recorded (by study Id number) if participant came in for testing in the last month and the date of the test.

  7. Number of Students Tested for HIV at Month 6 [Month 6]

    The number of participants tested for HIV was measured by tracking data reported by school-based health center staff. The school-based health center staff recorded (by study Id number) if participant came in for testing in the last month and the date of the test.

  8. Knowledge About HTC [Baseline, 4 weeks, 3 months, 6 months]

    Participants' knowledge about HTC was measured with 12 questions (e.g., "If you are tested for HIV, you have to wait a long time to find out the results" and "The earlier HIV is caught, the better chance a person has of effectively managing the virus"). Participants responded true, false, or not sure. Responses were recoded into 1 (correct) or 0 (incorrect; responses of "not sure" were coded as incorrect) and a sum of all 12 items was calculated to provide a HTC knowledge score for each participant (Total range was from 0 to 12.) Higher values represent higher knowledge around HTC.

  9. Self-efficacy Around HIV Testing and Counseling [Baseline, 4 weeks, 3 months, 6 months]

    Self-efficacy for HTC was assessed with 4 items, rated on a confidence scale (e.g., "How confident are you that you could find information about how and where you can get STI and/or HIV testing?"). The total range was from 0-100. A higher score indicates a higher level of self-efficacy around HTC. A mean of the 4 items was calculated for each participant with higher scores indicating higher self-efficacy for HTC.

  10. Self-efficacy Around Overall Health [Baseline, 4 weeks, 3 months, 6 months]

    Self-efficacy for managing overall health was assessed with 4 items, rated on a 100% confidence scale (e.g., "How confident are you that you could discuss your health concerns with a health provider?"). The total range was from 0-100%.A mean of the 4 items was calculated for each participant with higher scores indicating higher self-efficacy for managing overall health.

  11. HIV Testing and Counseling Behavior (Self-Report) [Baseline, 4 Weeks, 3 Months, 6 Months]

    At each time point the participants indicated whether they had ever been tested for HIV with the response options: yes, no, not sure, and decline to answer.

  12. Perceived Barriers to HIV Testing [Baseline]

    Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.

  13. Perceived Barriers to HIV Testing [4 weeks]

    Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.

  14. Perceived Barriers to HIV Testing [3 months]

    Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.

  15. Perceived Barriers to HIV Testing [6 months]

    Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.

  16. Perceived Barriers to STI Testing [Baseline]

    Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.

  17. Perceived Barriers to STI Testing [4 weeks]

    Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.

  18. Perceived Barriers to STI Testing [3 months]

    Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.

  19. Perceived Barriers to STI Testing [6 months]

    Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.

Eligibility Criteria

Criteria

Ages Eligible for Study:
14 Years to 18 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
Yes
Inclusion Criteria:
  • Ability to participate in a web-based videogame (willing to sit for 60 minutes/session to play the game)

  • Have not been tested for HIV in the past year

  • Ability to provide assent/parental/guardian consent+

  • Have a completed and signed enrollment form for their school's health clinic allowing them, if they choose, to access the clinic for testing and health care

  • Students can be older than 18 as long as they were 18 or younger at the time of signing consent

Exclusion Criteria:
  • Failure to meet any of the eligibility criteria

Contacts and Locations

Locations

Site City State Country Postal Code
1 Yale School of Medicine New Haven Connecticut United States 06510

Sponsors and Collaborators

  • Yale University
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Investigators

  • Principal Investigator: Lynn Fiellin, MD, Associate Professor of Medicine (General Medicine) and in the Child Study Center; Director, Yale Center for Health & Learning Games; Director, play2PREVENT Lab at Yale

Study Documents (Full-Text)

More Information

Publications

None provided.
Responsible Party:
Yale University
ClinicalTrials.gov Identifier:
NCT03713034
Other Study ID Numbers:
  • 1604017531_II
  • 5R42HD088317-03
First Posted:
Oct 19, 2018
Last Update Posted:
Jan 18, 2022
Last Verified:
Jan 1, 2022
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
No
Keywords provided by Yale University

Study Results

Participant Flow

Recruitment Details
Pre-assignment Detail
Arm/Group Title PlayTest! Game Control Games
Arm/Group Description Participants who were randomized to the intervention arm of the project, played the PlayTest! game on their assigned iPad, once per week for an hour, over the course of 4-5 weeks. Participants who were randomized to the control arm were provided a menu of attention control games to choose from on their iPads that had no content related to HTC or HIV. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. Participants played the choice of control games on their assigned iPad, once per week for and hour, over the course of 4-5 weeks.
Period Title: Overall Study
STARTED 150 146
COMPLETED 145 142
NOT COMPLETED 5 4

Baseline Characteristics

Arm/Group Title PlayTest! Game Control Games Total
Arm/Group Description PlayTest! is an interactive world in which the player, using an avatar they have created, "travels" through life in high school. They face challenges that bring different risks and benefits, requiring them to practice decision-making skills. The player learns skills that aim to empower them to make safe choices in situations that may otherwise increase their risk for HIV/STI infection. The game also provides opportunities for the player to practice advocating for their health by modeling a conversation with a medical professional. PlayTest! incorporates evidence-based tools for behavior change including social learning theory and self-efficacy. message framing, motivational interviewing to identify the variables that must be targeted to increase HTC among adolescents. Participants who were randomized to the intervention arm of the project, played the PlayTest! game on their assigned iPad, once per week for an hour, over the course of 4-5 weeks. Participants who were randomized to the control arm were provided a menu of attention control games to choose from on their iPads that had no content related to HTC or HIV. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. Participants played the choice of control games on their assigned iPad, once per week for and hour, over the course of 4-5 weeks. Total of all reporting groups
Overall Participants 145 142 287
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]
15.39
(1.24)
15.45
(1.25)
15.42
(1.24)
Sex/Gender, Customized (Count of Participants)
Male
73
50.3%
68
47.9%
141
49.1%
Female
68
46.9%
69
48.6%
137
47.7%
Self-Described
4
2.8%
5
3.5%
9
3.1%
Race/Ethnicity, Customized (Count of Participants)
American Indian or Native American
4
2.8%
4
2.8%
8
2.8%
Asian or Pacific Islander
8
5.5%
5
3.5%
13
4.5%
Black or African American
57
39.3%
58
40.8%
115
40.1%
Multi-racial
15
10.3%
17
12%
32
11.1%
Other
27
18.6%
23
16.2%
50
17.4%
White
34
23.4%
35
24.6%
69
24%
Region of Enrollment (participants) [Number]
United States
145
100%
142
100%
287
100%

Outcome Measures

1. Primary Outcome
Title Attitudes Around HIV Testing and Counseling
Description HTC attitudes were assessed with 7 items (e.g., "I feel it is important for me to get tested for HIV"). The items were scored on a 5-point scale ranging from - 2 (strongly disagree) to +2 (strongly agree) with positive values indicating healthier attitudes towards HTC. Participants had the option to respond "not sure" which was given a neutral score of 0. A mean of the seven items was calculated for each participant. A few items were reverse coded, because the lower value was indicating healthier attitudes. Not sure was coded as a neutral option. Higher scores equal more positive attitudes toward HIV testing and counseling.
Time Frame Baseline, 4 weeks, 3 months and 6 months

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title PlayTest! Game Control Games
Arm/Group Description Participants who were randomized to the intervention arm of the project, played the PlayTest! game on their assigned iPad, once per week for an hour, over the course of 4-5 weeks. Participants who were randomized to the control arm were provided a menu of attention control games to choose from on their iPads that had no content related to HTC or HIV. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. Participants played the choice of control games on their assigned iPad, once per week for and hour, over the course of 4-5 weeks.
Measure Participants 145 142
Baseline
0.33
(0.65)
0.33
(0.70)
4 Weeks
0.74
(0.66)
0.26
(0.59)
3 Months
0.67
(0.64)
0.24
(0.63)
6 Months
0.65
(0.66)
0.27
(0.62)
2. Secondary Outcome
Title Intentions to Get Tested for HIV
Description Intentions were assessed with 7 items (e.g., "I intend to get tested for HIV at some point in the next 3 months" and "I intend to use a school-based health center to get tested for HIV". The items were scored on a 5-point scale ranging from - 2 (strongly disagree) to +2 (strongly agree) with positive values indicating healthier intentions. Participants had the option to respond "not sure" which was given a neutral score of 0. Higher scores equal greater intentions to get tested for HIV. The total range for scores was -14 to 14.
Time Frame Baseline, 4 weeks, 3 months and 6 months

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title PlayTest! Game Control Games
Arm/Group Description Participants who were randomized to the intervention arm of the project, played the PlayTest! game on their assigned iPad, once per week for an hour, over the course of 4-5 weeks. Participants who were randomized to the control arm were provided a menu of attention control games to choose from on their iPads that had no content related to HTC or HIV. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. Participants played the choice of control games on their assigned iPad, once per week for and hour, over the course of 4-5 weeks.
Measure Participants 145 142
Baseline
0.14
(0.83)
0.06
(0.82)
4 Weeks
0.57
(0.87)
0.05
(0.85)
3 Months
0.55
(0.81)
0.07
(0.85)
6 Months
0.55
(0.93)
0.11
(0.88)
3. Secondary Outcome
Title Number of Students Tested for HIV at Month 1
Description The number of participants tested for HIV was measured by tracking data reported by school-based health center staff. The school-based health center staff recorded (by study Id number) if participant came in for testing in the last month and the date of the test.
Time Frame Month 1

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title PlayTest! Game Control Games
Arm/Group Description Participants who were randomized to the intervention arm of the project, played the PlayTest! game on their assigned iPad, once per week for an hour, over the course of 4-5 weeks. Participants who were randomized to the control arm were provided a menu of attention control games to choose from on their iPads that had no content related to HTC or HIV. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. Participants played the choice of control games on their assigned iPad, once per week for and hour, over the course of 4-5 weeks.
Measure Participants 145 142
Count of Participants [Participants]
1
0.7%
0
0%
4. Secondary Outcome
Title Number of Students Tested for HIV at Month 2
Description The number of participants tested for HIV was measured by tracking data reported by school-based health center staff. The school-based health center staff recorded (by study Id number) if participant came in for testing in the last month and the date of the test.
Time Frame Month 2

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title PlayTest! Game Control Games
Arm/Group Description Participants who were randomized to the intervention arm of the project, played the PlayTest! game on their assigned iPad, once per week for an hour, over the course of 4-5 weeks. Participants who were randomized to the control arm were provided a menu of attention control games to choose from on their iPads that had no content related to HTC or HIV. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. Participants played the choice of control games on their assigned iPad, once per week for and hour, over the course of 4-5 weeks.
Measure Participants 145 142
Count of Participants [Participants]
1
0.7%
0
0%
5. Secondary Outcome
Title Number of Students Tested for HIV at Month 3
Description The number of participants tested for HIV was measured by tracking data reported by school-based health center staff. The school-based health center staff recorded (by study Id number) if participant came in for testing in the last month and the date of the test.
Time Frame Month 3

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title PlayTest! Game Control Games
Arm/Group Description Participants who were randomized to the intervention arm of the project, played the PlayTest! game on their assigned iPad, once per week for an hour, over the course of 4-5 weeks. Participants who were randomized to the control arm were provided a menu of attention control games to choose from on their iPads that had no content related to HTC or HIV. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. Participants played the choice of control games on their assigned iPad, once per week for and hour, over the course of 4-5 weeks.
Measure Participants 145 142
Count of Participants [Participants]
0
0%
0
0%
6. Secondary Outcome
Title Number of Students Tested for HIV at Month 4
Description The number of participants tested for HIV was measured by tracking data reported by school-based health center staff. The school-based health center staff recorded (by study Id number) if participant came in for testing in the last month and the date of the test.
Time Frame month 4

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title PlayTest! Game Control Games
Arm/Group Description Participants who were randomized to the intervention arm of the project, played the PlayTest! game on their assigned iPad, once per week for an hour, over the course of 4-5 weeks. Participants who were randomized to the control arm were provided a menu of attention control games to choose from on their iPads that had no content related to HTC or HIV. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. Participants played the choice of control games on their assigned iPad, once per week for and hour, over the course of 4-5 weeks.
Measure Participants 145 142
Count of Participants [Participants]
0
0%
0
0%
7. Secondary Outcome
Title Number of Students Tested for HIV at Month 5
Description The number of participants tested for HIV was measured by tracking data reported by school-based health center staff. The school-based health center staff recorded (by study Id number) if participant came in for testing in the last month and the date of the test.
Time Frame Month 5

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title PlayTest! Game Control Games
Arm/Group Description Participants who were randomized to the intervention arm of the project, played the PlayTest! game on their assigned iPad, once per week for an hour, over the course of 4-5 weeks. Participants who were randomized to the control arm were provided a menu of attention control games to choose from on their iPads that had no content related to HTC or HIV. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. Participants played the choice of control games on their assigned iPad, once per week for and hour, over the course of 4-5 weeks.
Measure Participants 145 142
Count of Participants [Participants]
0
0%
0
0%
8. Secondary Outcome
Title Number of Students Tested for HIV at Month 6
Description The number of participants tested for HIV was measured by tracking data reported by school-based health center staff. The school-based health center staff recorded (by study Id number) if participant came in for testing in the last month and the date of the test.
Time Frame Month 6

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title PlayTest! Game Control Games
Arm/Group Description Participants who were randomized to the intervention arm of the project, played the PlayTest! game on their assigned iPad, once per week for an hour, over the course of 4-5 weeks. Participants who were randomized to the control arm were provided a menu of attention control games to choose from on their iPads that had no content related to HTC or HIV. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. Participants played the choice of control games on their assigned iPad, once per week for and hour, over the course of 4-5 weeks.
Measure Participants 145 142
Count of Participants [Participants]
1
0.7%
0
0%
9. Secondary Outcome
Title Knowledge About HTC
Description Participants' knowledge about HTC was measured with 12 questions (e.g., "If you are tested for HIV, you have to wait a long time to find out the results" and "The earlier HIV is caught, the better chance a person has of effectively managing the virus"). Participants responded true, false, or not sure. Responses were recoded into 1 (correct) or 0 (incorrect; responses of "not sure" were coded as incorrect) and a sum of all 12 items was calculated to provide a HTC knowledge score for each participant (Total range was from 0 to 12.) Higher values represent higher knowledge around HTC.
Time Frame Baseline, 4 weeks, 3 months, 6 months

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title PlayTest! Game Control Games
Arm/Group Description Participants who were randomized to the intervention arm of the project, played the PlayTest! game on their assigned iPad, once per week for an hour, over the course of 4-5 weeks. Participants who were randomized to the control arm were provided a menu of attention control games to choose from on their iPads that had no content related to HTC or HIV. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. Participants played the choice of control games on their assigned iPad, once per week for and hour, over the course of 4-5 weeks.
Measure Participants 145 142
Baseline
8.18
(2.68)
7.74
(3.11)
4 Weeks
10.01
(3.09)
8.15
(3.32)
3 Months
9.91
(3.06)
7.92
(3.61)
6 Months
9.93
(3.25)
8.26
(3.54)
10. Secondary Outcome
Title Self-efficacy Around HIV Testing and Counseling
Description Self-efficacy for HTC was assessed with 4 items, rated on a confidence scale (e.g., "How confident are you that you could find information about how and where you can get STI and/or HIV testing?"). The total range was from 0-100. A higher score indicates a higher level of self-efficacy around HTC. A mean of the 4 items was calculated for each participant with higher scores indicating higher self-efficacy for HTC.
Time Frame Baseline, 4 weeks, 3 months, 6 months

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title PlayTest! Game Control Games
Arm/Group Description Participants who were randomized to the intervention arm of the project, played the PlayTest! game on their assigned iPad, once per week for an hour, over the course of 4-5 weeks. Participants who were randomized to the control arm were provided a menu of attention control games to choose from on their iPads that had no content related to HTC or HIV. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. Participants played the choice of control games on their assigned iPad, once per week for and hour, over the course of 4-5 weeks.
Measure Participants 145 142
Baseline
60.49
(24.87)
57.80
(24.38)
4 Weeks
70.91
(24.80)
59.24
(25.87)
3 Months
69.84
(23.46)
58.11
(27.95)
6 Months
69.93
(26.54)
58.93
(29.34)
11. Secondary Outcome
Title Self-efficacy Around Overall Health
Description Self-efficacy for managing overall health was assessed with 4 items, rated on a 100% confidence scale (e.g., "How confident are you that you could discuss your health concerns with a health provider?"). The total range was from 0-100%.A mean of the 4 items was calculated for each participant with higher scores indicating higher self-efficacy for managing overall health.
Time Frame Baseline, 4 weeks, 3 months, 6 months

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title PlayTest! Game Control Games
Arm/Group Description Participants who were randomized to the intervention arm of the project, played the PlayTest! game on their assigned iPad, once per week for an hour, over the course of 4-5 weeks. Participants who were randomized to the control arm were provided a menu of attention control games to choose from on their iPads that had no content related to HTC or HIV. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. Participants played the choice of control games on their assigned iPad, once per week for and hour, over the course of 4-5 weeks.
Measure Participants 145 142
Baseline
76.84
(22.47)
73.33
(25.59)
4 Weeks
78.00
(24.12)
71.09
(26.45)
3 Months
75.53
(25.29)
68.31
(29.21)
6 Months
76.53
(24.45)
69.36
(29.77)
12. Secondary Outcome
Title HIV Testing and Counseling Behavior (Self-Report)
Description At each time point the participants indicated whether they had ever been tested for HIV with the response options: yes, no, not sure, and decline to answer.
Time Frame Baseline, 4 Weeks, 3 Months, 6 Months

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title
Arm/Group Description
13. Secondary Outcome
Title Perceived Barriers to HIV Testing
Description Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.
Time Frame Baseline

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title Active Game Control Game
Arm/Group Description PlayTest! is an interactive world in which the player, using an avatar they have created, "travels" through life in high school. They face challenges that bring different risks and benefits, requiring them to practice decision-making skills. The player learns skills that aim to empower them to make safe choices in situations that may otherwise increase their risk for HIV/STI infection. The game also provides opportunities for the player to practice advocating for their health by modeling a conversation with a medical professional. PlayTest! incorporates evidence-based tools for behavior change including social learning theory and self-efficacy. message framing, motivational interviewing to identify the variables that must be targeted to increase HTC among adolescents. PlayTest!: Participants in the PlayTest! intervention arm played the game on their assigned iPads once per week for an hour over the course of 4-5 weeks. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. The control games contained not relevant content related to HIV Testing and Counseling. Control games: Participants in the control arm played the games on their assigned iPads once per week for an hour over the course of 4-5 weeks.
Measure Participants 145 142
I don't know where to go
57
39.3%
67
47.2%
Outpatient clinic too far away
15
10.3%
13
9.2%
Costs too much
39
26.9%
39
27.5%
No time to get tested
15
10.3%
22
15.5%
Test pain/uncomfortable
57
39.3%
54
38%
Embarrasment
88
60.7%
82
57.7%
Someone might recognize me
60
41.4%
63
44.4%
Parents would find out
92
63.4%
89
62.7%
Boyfriend/girlfriend might find out
35
24.1%
39
27.5%
Parents' permission (afraid to ask)
52
35.9%
48
33.8%
Don't want to know if I have HIV
30
20.7%
26
18.3%
Friends might find out
30
20.7%
26
18.3%
Too much trouble
11
7.6%
16
11.3%
Little I can do if I have HIV
31
21.4%
29
20.4%
Other
10
6.9%
10
7%
14. Secondary Outcome
Title Perceived Barriers to HIV Testing
Description Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.
Time Frame 4 weeks

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title Active Game Control Game
Arm/Group Description PlayTest! is an interactive world in which the player, using an avatar they have created, "travels" through life in high school. They face challenges that bring different risks and benefits, requiring them to practice decision-making skills. The player learns skills that aim to empower them to make safe choices in situations that may otherwise increase their risk for HIV/STI infection. The game also provides opportunities for the player to practice advocating for their health by modeling a conversation with a medical professional. PlayTest! incorporates evidence-based tools for behavior change including social learning theory and self-efficacy. message framing, motivational interviewing to identify the variables that must be targeted to increase HTC among adolescents. PlayTest!: Participants in the PlayTest! intervention arm played the game on their assigned iPads once per week for an hour over the course of 4-5 weeks. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. The control games contained not relevant content related to HIV Testing and Counseling. Control games: Participants in the control arm played the games on their assigned iPads once per week for an hour over the course of 4-5 weeks.
Measure Participants 145 142
I don't know where to go
23
15.9%
53
37.3%
Outpatient clinic too far away
9
6.2%
16
11.3%
Costs too much
17
11.7%
41
28.9%
No time to get tested
21
14.5%
24
16.9%
Test pain/uncomfortable
16
11%
47
33.1%
Embarrasment
81
55.9%
82
57.7%
Someone might recognize me
52
35.9%
58
40.8%
Parents would find out
67
46.2%
79
55.6%
Boyfriend/girlfriend might find out
24
16.6%
29
20.4%
Parents' permission (afraid to ask)
35
24.1%
46
32.4%
Don't want to know if I have HIV
21
14.5%
20
14.1%
Friends might find out
21
14.5%
20
14.1%
Too much trouble
7
4.8%
13
9.2%
Little I can do if I have HIV
18
12.4%
21
14.8%
Other
7
4.8%
4
2.8%
15. Secondary Outcome
Title Perceived Barriers to HIV Testing
Description Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.
Time Frame 3 months

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title Active Game Control Game
Arm/Group Description PlayTest! is an interactive world in which the player, using an avatar they have created, "travels" through life in high school. They face challenges that bring different risks and benefits, requiring them to practice decision-making skills. The player learns skills that aim to empower them to make safe choices in situations that may otherwise increase their risk for HIV/STI infection. The game also provides opportunities for the player to practice advocating for their health by modeling a conversation with a medical professional. PlayTest! incorporates evidence-based tools for behavior change including social learning theory and self-efficacy. message framing, motivational interviewing to identify the variables that must be targeted to increase HTC among adolescents. PlayTest!: Participants in the PlayTest! intervention arm played the game on their assigned iPads once per week for an hour over the course of 4-5 weeks. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. The control games contained not relevant content related to HIV Testing and Counseling. Control games: Participants in the control arm played the games on their assigned iPads once per week for an hour over the course of 4-5 weeks.
Measure Participants 145 142
I don't know where to go
27
18.6%
50
35.2%
Outpatient clinic too far away
12
8.3%
14
9.9%
Costs too much
22
15.2%
43
30.3%
No time to get tested
18
12.4%
29
20.4%
Test pain/uncomfortable
13
9%
45
31.7%
Embarrasment
77
53.1%
74
52.1%
Someone might recognize me
51
35.2%
62
43.7%
Parents would find out
65
44.8%
71
50%
Boyfriend/girlfriend might find out
23
15.9%
29
20.4%
Parents' permission (afraid to ask)
31
21.4%
44
31%
Don't want to know if I have HIV
18
12.4%
20
14.1%
Friends might find out
18
12.4%
20
14.1%
Too much trouble
11
7.6%
14
9.9%
Little I can do if I have HIV
23
15.9%
15
10.6%
Other
6
4.1%
8
5.6%
16. Secondary Outcome
Title Perceived Barriers to HIV Testing
Description Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.
Time Frame 6 months

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title Active Game Control Game
Arm/Group Description PlayTest! is an interactive world in which the player, using an avatar they have created, "travels" through life in high school. They face challenges that bring different risks and benefits, requiring them to practice decision-making skills. The player learns skills that aim to empower them to make safe choices in situations that may otherwise increase their risk for HIV/STI infection. The game also provides opportunities for the player to practice advocating for their health by modeling a conversation with a medical professional. PlayTest! incorporates evidence-based tools for behavior change including social learning theory and self-efficacy. message framing, motivational interviewing to identify the variables that must be targeted to increase HTC among adolescents. PlayTest!: Participants in the PlayTest! intervention arm played the game on their assigned iPads once per week for an hour over the course of 4-5 weeks. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. The control games contained not relevant content related to HIV Testing and Counseling. Control games: Participants in the control arm played the games on their assigned iPads once per week for an hour over the course of 4-5 weeks.
Measure Participants 145 142
I don't know where to go
28
19.3%
47
33.1%
Outpatient clinic too far away
12
8.3%
20
14.1%
Costs too much
19
13.1%
42
29.6%
No time to get tested
31
21.4%
25
17.6%
Test pain/uncomfortable
22
15.2%
43
30.3%
Embarrasment
81
55.9%
69
48.6%
Someone might recognize me
55
37.9%
59
41.5%
Parents would find out
74
51%
69
48.6%
Boyfriend/girlfriend might find out
26
17.9%
33
23.2%
Parents' permission (afraid to ask)
40
27.6%
45
31.7%
Don't want to know if I have HIV
20
13.8%
19
13.4%
Friends might find out
20
13.8%
19
13.4%
Too much trouble
11
7.6%
11
7.7%
Little I can do if I have HIV
21
14.5%
25
17.6%
Other
5
3.4%
6
4.2%
17. Secondary Outcome
Title Perceived Barriers to STI Testing
Description Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.
Time Frame Baseline

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title Active Game Control Game
Arm/Group Description PlayTest! is an interactive world in which the player, using an avatar they have created, "travels" through life in high school. They face challenges that bring different risks and benefits, requiring them to practice decision-making skills. The player learns skills that aim to empower them to make safe choices in situations that may otherwise increase their risk for HIV/STI infection. The game also provides opportunities for the player to practice advocating for their health by modeling a conversation with a medical professional. PlayTest! incorporates evidence-based tools for behavior change including social learning theory and self-efficacy. message framing, motivational interviewing to identify the variables that must be targeted to increase HTC among adolescents. PlayTest!: Participants in the PlayTest! intervention arm played the game on their assigned iPads once per week for an hour over the course of 4-5 weeks. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. The control games contained not relevant content related to HIV Testing and Counseling. Control games: Participants in the control arm played the games on their assigned iPads once per week for an hour over the course of 4-5 weeks.
Measure Participants 145 142
I don't know where to go : Baseline
58
40%
62
43.7%
Outpatient clinic too far away
13
9%
17
12%
Costs too much
42
29%
46
32.4%
No time to get tested
12
8.3%
22
15.5%
Test pain/uncomfortable
50
34.5%
51
35.9%
Embarrasment
85
58.6%
90
63.4%
Someone might recognize me
56
38.6%
63
44.4%
Parents would find out
87
60%
92
64.8%
Boyfriend/girlfriend might find out
31
21.4%
34
23.9%
Parents' permission (afraid to ask)
65
44.8%
60
42.3%
Don't want to know if have STI
33
22.8%
26
18.3%
Friends might find out
58
40%
46
32.4%
Too much trouble
12
8.3%
18
12.7%
Little I can do if I have a STI
31
21.4%
26
18.3%
Other
11
7.6%
11
7.7%
18. Secondary Outcome
Title Perceived Barriers to STI Testing
Description Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.
Time Frame 4 weeks

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title Active Game Control Game
Arm/Group Description PlayTest! is an interactive world in which the player, using an avatar they have created, "travels" through life in high school. They face challenges that bring different risks and benefits, requiring them to practice decision-making skills. The player learns skills that aim to empower them to make safe choices in situations that may otherwise increase their risk for HIV/STI infection. The game also provides opportunities for the player to practice advocating for their health by modeling a conversation with a medical professional. PlayTest! incorporates evidence-based tools for behavior change including social learning theory and self-efficacy. message framing, motivational interviewing to identify the variables that must be targeted to increase HTC among adolescents. PlayTest!: Participants in the PlayTest! intervention arm played the game on their assigned iPads once per week for an hour over the course of 4-5 weeks. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. The control games contained not relevant content related to HIV Testing and Counseling. Control games: Participants in the control arm played the games on their assigned iPads once per week for an hour over the course of 4-5 weeks.
Measure Participants 145 142
I don't know where to go : Baseline
26
17.9%
53
37.3%
Outpatient clinic too far away
11
7.6%
13
9.2%
Costs too much
21
14.5%
42
29.6%
No time to get tested
25
17.2%
21
14.8%
Test pain/uncomfortable
18
12.4%
46
32.4%
Embarrasment
78
53.8%
81
57%
Someone might recognize me
52
35.9%
58
40.8%
Parents would find out
71
49%
75
52.8%
Boyfriend/girlfriend might find out
26
17.9%
32
22.5%
Parents' permission (afraid to ask)
41
28.3%
53
37.3%
Don't want to know if have STI
23
15.9%
20
14.1%
Friends might find out
38
26.2%
47
33.1%
Too much trouble
13
9%
12
8.5%
Little I can do if I have a STI
13
9%
22
15.5%
Other
8
5.5%
4
2.8%
19. Secondary Outcome
Title Perceived Barriers to STI Testing
Description Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.
Time Frame 3 months

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title Active Game Control Game
Arm/Group Description PlayTest! is an interactive world in which the player, using an avatar they have created, "travels" through life in high school. They face challenges that bring different risks and benefits, requiring them to practice decision-making skills. The player learns skills that aim to empower them to make safe choices in situations that may otherwise increase their risk for HIV/STI infection. The game also provides opportunities for the player to practice advocating for their health by modeling a conversation with a medical professional. PlayTest! incorporates evidence-based tools for behavior change including social learning theory and self-efficacy. message framing, motivational interviewing to identify the variables that must be targeted to increase HTC among adolescents. PlayTest!: Participants in the PlayTest! intervention arm played the game on their assigned iPads once per week for an hour over the course of 4-5 weeks. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. The control games contained not relevant content related to HIV Testing and Counseling. Control games: Participants in the control arm played the games on their assigned iPads once per week for an hour over the course of 4-5 weeks.
Measure Participants 145 142
I don't know where to go : Baseline
30
20.7%
40
28.2%
Outpatient clinic too far away
11
7.6%
14
9.9%
Costs too much
19
13.1%
42
29.6%
No time to get tested
28
19.3%
29
20.4%
Test pain/uncomfortable
13
9%
38
26.8%
Embarrasment
71
49%
74
52.1%
Someone might recognize me
50
34.5%
60
42.3%
Parents would find out
63
43.4%
72
50.7%
Boyfriend/girlfriend might find out
20
13.8%
26
18.3%
Parents' permission (afraid to ask)
33
22.8%
49
34.5%
Don't want to know if have STI
14
9.7%
23
16.2%
Friends might find out
35
24.1%
40
28.2%
Too much trouble
11
7.6%
15
10.6%
Little I can do if I have a STI
20
13.8%
17
12%
Other
4
2.8%
8
5.6%
20. Secondary Outcome
Title Perceived Barriers to STI Testing
Description Perceived Barriers was measured with a one question instrument that asks participants what reasons would most likely keep them from getting tested if they thought they had HIV (examples of options were "I don't know where to go", "It costs too much"). The instrument allowed participants to select all reasons that apply.
Time Frame 6 months

Outcome Measure Data

Analysis Population Description
Only participants that completed the study were analyzed in the study
Arm/Group Title Active Game Control Game
Arm/Group Description PlayTest! is an interactive world in which the player, using an avatar they have created, "travels" through life in high school. They face challenges that bring different risks and benefits, requiring them to practice decision-making skills. The player learns skills that aim to empower them to make safe choices in situations that may otherwise increase their risk for HIV/STI infection. The game also provides opportunities for the player to practice advocating for their health by modeling a conversation with a medical professional. PlayTest! incorporates evidence-based tools for behavior change including social learning theory and self-efficacy. message framing, motivational interviewing to identify the variables that must be targeted to increase HTC among adolescents. PlayTest!: Participants in the PlayTest! intervention arm played the game on their assigned iPads once per week for an hour over the course of 4-5 weeks. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. The control games contained not relevant content related to HIV Testing and Counseling. Control games: Participants in the control arm played the games on their assigned iPads once per week for an hour over the course of 4-5 weeks.
Measure Participants 145 142
I don't know where to go : Baseline
28
19.3%
48
33.8%
Outpatient clinic too far away
17
11.7%
20
14.1%
Costs too much
23
15.9%
46
32.4%
No time to get tested
36
24.8%
30
21.1%
Test pain/uncomfortable
19
13.1%
41
28.9%
Embarrasment
75
51.7%
72
50.7%
Someone might recognize me
58
40%
59
41.5%
Parents would find out
76
52.4%
72
50.7%
Boyfriend/girlfriend might find out
23
15.9%
31
21.8%
Parents' permission (afraid to ask)
46
31.7%
48
33.8%
Don't want to know if have STI
19
13.1%
17
12%
Friends might find out
36
24.8%
37
26.1%
Too much trouble
11
7.6%
16
11.3%
Little I can do if I have a STI
21
14.5%
19
13.4%
Other
5
3.4%
6
4.2%

Adverse Events

Time Frame Adverse event data were collected up to 6 months.
Adverse Event Reporting Description
Arm/Group Title PlayTest! Game Control Games
Arm/Group Description Participants who were randomized to the intervention arm of the project, played the PlayTest! game on their assigned iPad, once per week for an hour, over the course of 4-5 weeks. Participants who were randomized to the control arm were provided a menu of attention control games to choose from on their iPads that had no content related to HTC or HIV. Some examples of control games that participants could play are: The Sims, Harry Potter, Subway Surfer, Tetris. Participants played the choice of control games on their assigned iPad, once per week for and hour, over the course of 4-5 weeks.
All Cause Mortality
PlayTest! Game Control Games
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/145 (0%) 0/142 (0%)
Serious Adverse Events
PlayTest! Game Control Games
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/145 (0%) 0/142 (0%)
Other (Not Including Serious) Adverse Events
PlayTest! Game Control Games
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/145 (0%) 0/142 (0%)

Limitations/Caveats

This study was impacted by COVID. Please refer to attached data analysis document that highlights how COVID impacted the project and data collection.

More Information

Certain Agreements

All Principal Investigators ARE employed by the organization sponsoring the study.

There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

Results Point of Contact

Name/Title Tyra Pendergrass Boomer
Organization Yale University
Phone (203) 737-6101
Email tyra.pendergrass@yale.edu
Responsible Party:
Yale University
ClinicalTrials.gov Identifier:
NCT03713034
Other Study ID Numbers:
  • 1604017531_II
  • 5R42HD088317-03
First Posted:
Oct 19, 2018
Last Update Posted:
Jan 18, 2022
Last Verified:
Jan 1, 2022