Using Videogame Apps to Assess Gains in Adolescents' Substance Use Knowledge: New Opportunities for Evaluating Intervention Exposure and Content Mastery.
BACKGROUND
Videogame interventions are becoming increasingly popular as a means to engage people in behavioral interventions; however, strategies for examining data from such interventions have not been developed.


OBJECTIVE
The objective of this study was to describe how a technology-based intervention can yield meaningful, objective evidence of intervention exposure within a behavioral intervention. This study demonstrates the analysis of automatic log files, created by software from a videogame intervention, that catalog game play and, as proof of concept, the association of these data with changes in substance use knowledge as documented with standardized assessments.


METHODS
We analyzed 3- and 6-month follow-up data from 166 participants enrolled in a randomized controlled trial evaluating a videogame intervention, PlayForward: Elm City Stories (PlayForward). PlayForward is a videogame developed as a risk reduction and prevention program targeting HIV risk behaviors (substance use and sex) in young minority adolescents. Log files were analyzed to extract the total amount of time spent playing the videogame intervention and the total number of game levels completed and beaten by each player.


RESULTS
Completing and beating more of the game levels, and not total game play time, was related to higher substance use knowledge scores at the 3- (P=.001) and 6-month (P=.001) follow-ups.


CONCLUSIONS
Our findings highlight the potential contributions a videogame intervention can make to the study of health behavior change. Specifically, the use of objective data collected during game play can address challenges in traditional human-delivered behavioral interventions.


BACKGROUND
Clinicaltrials.gov NCT01666496; https://clinicaltrials.gov/ct2/show/NCT01666496 (Archived by WebCite at http://www.webcitation.org/6cV9fxsOg).
Yale University, New Haven, CT, United States. erika.montanaro@yale.edu.
Erika
http://orcid.org/0000-0001-8936-6372
E
Montanaro
Lynn E
http://orcid.org/0000-0003-0160-6613
LE
Fiellin
Tamer
http://orcid.org/0000-0001-9053-9605
T
Fakhouri
Tassos C
http://orcid.org/0000-0001-8913-108X
TC
Kyriakides
Lindsay R
http://orcid.org/0000-0002-2861-3349
LR
Duncan
D000293:Adolescent; D018479:Early Intervention, Educational / Q000379:methods*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D040242:Risk Reduction Behavior; D019966:Substance-Related Disorders; D017216:Telemedicine / Q000379:methods*; D018910:Video Games / Q000941:ethics*
HIV; eHealth; evaluation; intervention studies; substance use; video games