title: Randomized trial of a peer resistance skill-building game for Hispanic early adolescent girls.
abstract: BACKGROUND
  Adolescents can use peer resistance skills to avoid being pressured into risky behavior, such as early sexual behavior. Avatar-based virtual reality technology offers a novel way to help build these skills.
  
  
  OBJECTIVE
  The aims of this study were to evaluate the feasibility of an avatar-based virtual reality peer resistance skill building game (DRAMA-RAMA), to explore the impact of game play on peer resistance self-efficacy, and to assess how positively the game was perceived.
  
  
  METHODS
  Forty-four low-income early adolescent Hispanic girls were assigned randomly to either the intervention (DRAMA-RAMA) or attention control game (Wii Dancing With the Stars) condition. All participants were offered a five-session curriculum that included peer resistance skill content before playing their respective game for 15 minutes, once a week, for 2 weeks. Participants completed electronic surveys at baseline, after game play, and at 2 months to assess demographics, peer resistance self-efficacy, and sexual behavior. They also completed a paper-pencil game experience questionnaire immediately after game play. Data were analyzed using descriptive statistics, t test, chi-square, and analyses of covariance.
  
  
  RESULTS
  Separate analyses of covariance showed a significant game effect at posttest for the peer resistance self-efficacy measure (F = 4.21, p < .05), but not at follow-up (F = 0.01, p = .92). DRAMA-RAMA was rated as positively as the Wii Dancing With the Stars (p > .26).
  
  
  CONCLUSIONS
  This randomized control trial provides preliminary support for the hypothesis that playing an avatar-based virtual reality technology game can strengthen peer resistance skills, and early adolescent Hispanic girls will have a positive response to this game.
authors.affiliation: College of Nursing, University of Central Florida, Orlando, FL 32826, USA. Anne.Norris@ucf.edu
authors.forename: Anne E
authors.initials: AE
authors.lastname: Norris
authors.forename: Charles
authors.initials: C
authors.lastname: Hughes
authors.forename: Michael
authors.initials: M
authors.lastname: Hecht
authors.forename: Nilda
authors.initials: N
authors.lastname: Peragallo
authors.forename: David
authors.initials: D
authors.lastname: Nickerson
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002648:Child; D005240:Feasibility Studies; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D010379:Peer Group; D012309:Risk-Taking; D012381:Role Playing; D020377:Self Efficacy; D012737:Sex Factors; D018910:Video Games / Q000523:psychology*