Accepted for/Published in: JMIR Serious Games
Date Submitted: Nov 2, 2019
Date Accepted: Jul 24, 2020
Engaging preteens ages 11-12 in decision making about HPV vaccination: A serious video game to facilitate conversations with parents and providers and promote uptake
ABSTRACT
Background:
The most common sexually transmitted infection (STI) in the US, human papillomavirus (HPV) causes genital warts and is associated with an estimated 33,700 newly diagnosed cancers annually in the US. HPV vaccination, especially at the preteen ages 11-12 is effective in preventing acquisition of HPV and HPV-associated cancers. Yet as of 2018, completion of the 2 or 3 dose HPV vaccination series increased only from 48.6% to 51.1% in teens 13 to 17, and this rise was observed just in boys. By comparison, 88.7% of teens had more than one dose of the recommended vaccine against tetanus, diphtheria and acellular pertussis and 85.1% had more than one dose of meningococcal vaccine. Immunizations for Tdap, Meningococcal and HPV can occur at the same clinical visit but often do not.
Objective:
Vaccination against human papillomavirus (HPV) is recommended for routine use in 11 and 12 year olds in the United States yet is underutilized. We developed an educational video game to engage preteens in the decision to vaccinate.
Methods:
Land of Secret Gardens is a metaphor for protecting seedlings (body) with a potion (vaccine). We screened 131 dyads of parents and preteens from 18 primary practices in North Carolina and who had not initiated HPV vaccination. We measured knowledge and vaccination intentions, story immersion and game play. We documented HPV vaccination rates.
Results:
We enrolled 55 dyads, randomly assigned 28 (21 completed) to play the game and 27 to the comparison group. Eighteen preteens reported playing the game. Post intervention, the mean knowledge score was higher in intervention than in comparison (2.56 vs. 2.28, P=0.03). The vaccination self-efficacy score was higher in comparison than intervention (1.65 vs. 1.45, P=0.052.) Although not significant, importance scores trended toward greater vaccination support. Vaccine initiation and completion rates were higher in intervention group than comparison (22% vs. 15%, P=0.31) and (9% vs 2%, P=0.10), although not significant.
Conclusions:
Video games help preteens in the decision to pursue HPV vaccination. A serious video game on HPV vaccination is acceptable to parents and preteens. A serious video game on HPV vaccination can be played as intended. Gamification is effective in increasing preteen knowledge about HPV vaccination as game features support HPV vaccine decision making. Clinical Trial: N/A
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