title: Promoting Sex Education Among Teenagers Through an Interactive Game: Reasons for Success and Implications.
abstract: OBJECTIVE
  A game application, "Making Smart Choices", was developed to fill the gap of limited easy-to-access resources available on sex education in Hong Kong and to disseminate correct knowledge and positive attitudes toward sex to teenagers using popular platforms such as tablets, Facebook, and the Web.
  
  
  METHODS
  Three versions of the game (iPAD, Facebook, and Web-based) were developed using HTML5. A theoretical framework that involved game-based learning and participatory design approach was used to design, develop, modify, and optimize the game for use with secondary school students (n=1176) 12-16 years of age. Pre- and post-test scores of students' safer sex knowledge were compared to test the effectiveness of the game. Students' survey and interviews were analyzed to assess participant feelings and attitudes toward the game.
  
  
  RESULTS
  The Wilcoxon Signed-Rank test indicated that students' sex knowledge (n=788) improved with a medium effect size (0.477) after playing the game. Increases in positive attitudes toward sex and relationship and in awareness of making smart sexual choices were reported from student surveys and interviews. Students described the game as "interesting," "interactive," "informative," and "real-to-life."
  
  
  CONCLUSIONS
  We advocate that the participatory design approach, which supports collaborative efforts of different stakeholders, is an effective framework for developing game-based learning tools for sex education. Our work provides preliminary findings that suggest game-based learning, preferably delivered through popular interactive platforms, can be effective in promoting sex education to teenagers.
authors.affiliation: 1 Faculty of Education, The University of Hong Kong , Hong Kong SAR, China .
authors.forename: Samuel Kai Wah
authors.initials: SK
authors.lastname: Chu
authors.affiliation: 1 Faculty of Education, The University of Hong Kong , Hong Kong SAR, China .
authors.forename: Alvin C M
authors.initials: AC
authors.lastname: Kwan
authors.affiliation: 2 School of Communication and Information, Rutgers, The State University of New Jersey , New Brunswick, New Jersey.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Reynolds
authors.affiliation: 3 Institute of Human Performance, The University of Hong Kong , Hong Kong SAR, China .
authors.forename: Robin R
authors.initials: RR
authors.lastname: Mellecker
authors.affiliation: 4 FifthWisdom Technology Ltd. , Hong Kong SAR, China .
authors.forename: Frankie
authors.initials: F
authors.lastname: Tam
authors.affiliation: 5 The Family Planning Association of Hong Kong , Hong Kong SAR, China .
authors.forename: Grace
authors.initials: G
authors.lastname: Lee
authors.affiliation: 6 School of Nursing, The University of Hong Kong , Hong Kong SAR, China .
authors.forename: Athena
authors.initials: A
authors.lastname: Hong
authors.affiliation: 1 Faculty of Education, The University of Hong Kong , Hong Kong SAR, China .
authors.forename: Ching Yin
authors.initials: CY
authors.lastname: Leung
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D002648:Child; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006723:Hong Kong; D006801:Humans; D020407:Internet; D007398:Interpersonal Relations; D007858:Learning; D008297:Male; D015397:Program Evaluation; D021841:Safe Sex; D012736:Sex Education / Q000379:methods*; D012725:Sexual Behavior / Q000523:psychology; D012985:Software Design; D013334:Students / Q000523:psychology; D011795:Surveys and Questionnaires; D018910:Video Games