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Epic Allies: Development of a Gaming App to Improve Antiretroviral Therapy Adherence Among Young HIV-Positive Men Who Have Sex With Men.
JMIR Serious Games. 2016 May 13; 4(1):e6.JS

Abstract

BACKGROUND

In the United States, the human immunodeficiency virus (HIV) disproportionately affects young men who have sex with men (YMSM). For HIV-positive individuals, adherence to antiretroviral therapy (ART) is critical for achieving optimal health outcomes and reducing secondary transmission of HIV. However, YMSM often struggle with ART adherence. Novel mobile phone apps that incorporate game-based mechanics and social networking elements represent a promising intervention approach for improving ART adherence among YMSM.

OBJECTIVE

This study used a multiphase, iterative development process to create an ART adherence app for YMSM.

METHODS

The three-phase development process included: (1) theory-based concept development jointly by public health researchers and the technology team, (2) assessment of the target population's ART adherence needs and app preferences and development and testing of a clickable app prototype, and (3) development and usability testing of the final app prototype.

RESULTS

The initial theory-based app concept developed in Phase One included medication reminders, daily ART adherence tracking and visualization, ART educational modules, limited virtual interactions with other app users, and gamification elements. In Phase Two, adherence needs, including those related to information, motivation, and behavioral skills, were identified. Participants expressed preferences for an ART adherence app that was informational, interactive, social, and customizable. Based on the findings from Phase Two, additional gaming features were added in Phase Three, including an interactive battle, superhero app theme, and app storyline. Other features were modified to increase interactivity and customization options and integrate the game theme. During usability testing of the final prototype, participants were able to understand and navigate the app successfully and rated the app favorably.

CONCLUSIONS

An iterative development process was critical for the development of an ART adherence game app that was viewed as highly acceptable, relevant, and useful by YMSM.

Authors+Show Affiliations

Center for Health Policy and Inequalities Research, Duke Global Health Institute, Duke University, Durham, NC, United States. sara.legrand@duke.edu.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27178752

Citation

LeGrand, Sara, et al. "Epic Allies: Development of a Gaming App to Improve Antiretroviral Therapy Adherence Among Young HIV-Positive Men Who Have Sex With Men." JMIR Serious Games, vol. 4, no. 1, 2016, pp. e6.
LeGrand S, Muessig KE, McNulty T, et al. Epic Allies: Development of a Gaming App to Improve Antiretroviral Therapy Adherence Among Young HIV-Positive Men Who Have Sex With Men. JMIR Serious Games. 2016;4(1):e6.
LeGrand, S., Muessig, K. E., McNulty, T., Soni, K., Knudtson, K., Lemann, A., Nwoko, N., & Hightow-Weidman, L. B. (2016). Epic Allies: Development of a Gaming App to Improve Antiretroviral Therapy Adherence Among Young HIV-Positive Men Who Have Sex With Men. JMIR Serious Games, 4(1), e6. https://doi.org/10.2196/games.5687
LeGrand S, et al. Epic Allies: Development of a Gaming App to Improve Antiretroviral Therapy Adherence Among Young HIV-Positive Men Who Have Sex With Men. JMIR Serious Games. 2016 May 13;4(1):e6. PubMed PMID: 27178752.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epic Allies: Development of a Gaming App to Improve Antiretroviral Therapy Adherence Among Young HIV-Positive Men Who Have Sex With Men. AU - LeGrand,Sara, AU - Muessig,Kathryn Elizabeth, AU - McNulty,Tobias, AU - Soni,Karina, AU - Knudtson,Kelly, AU - Lemann,Alex, AU - Nwoko,Nkechinyere, AU - Hightow-Weidman,Lisa B, Y1 - 2016/05/13/ PY - 2016/02/23/received PY - 2016/03/21/accepted PY - 2016/03/20/revised PY - 2016/5/15/entrez PY - 2016/5/15/pubmed PY - 2016/5/15/medline KW - HIV KW - health knowledge, attitudes, practice KW - medication adherence KW - men who have sex with men KW - mobile applications KW - serious games KW - video games KW - youth SP - e6 EP - e6 JF - JMIR serious games JO - JMIR Serious Games VL - 4 IS - 1 N2 - BACKGROUND: In the United States, the human immunodeficiency virus (HIV) disproportionately affects young men who have sex with men (YMSM). For HIV-positive individuals, adherence to antiretroviral therapy (ART) is critical for achieving optimal health outcomes and reducing secondary transmission of HIV. However, YMSM often struggle with ART adherence. Novel mobile phone apps that incorporate game-based mechanics and social networking elements represent a promising intervention approach for improving ART adherence among YMSM. OBJECTIVE: This study used a multiphase, iterative development process to create an ART adherence app for YMSM. METHODS: The three-phase development process included: (1) theory-based concept development jointly by public health researchers and the technology team, (2) assessment of the target population's ART adherence needs and app preferences and development and testing of a clickable app prototype, and (3) development and usability testing of the final app prototype. RESULTS: The initial theory-based app concept developed in Phase One included medication reminders, daily ART adherence tracking and visualization, ART educational modules, limited virtual interactions with other app users, and gamification elements. In Phase Two, adherence needs, including those related to information, motivation, and behavioral skills, were identified. Participants expressed preferences for an ART adherence app that was informational, interactive, social, and customizable. Based on the findings from Phase Two, additional gaming features were added in Phase Three, including an interactive battle, superhero app theme, and app storyline. Other features were modified to increase interactivity and customization options and integrate the game theme. During usability testing of the final prototype, participants were able to understand and navigate the app successfully and rated the app favorably. CONCLUSIONS: An iterative development process was critical for the development of an ART adherence game app that was viewed as highly acceptable, relevant, and useful by YMSM. SN - 2291-9279 UR - https://www.unboundmedicine.com/medline/citation/27178752/Epic_Allies:_Development_of_a_Gaming_App_to_Improve_Antiretroviral_Therapy_Adherence_Among_Young_HIV_Positive_Men_Who_Have_Sex_With_Men_ L2 - https://games.jmir.org/2016/1/e6/ DB - PRIME DP - Unbound Medicine ER -
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