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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

Overview
Publisher JMIR Publications
Date 2016 May 15
PMID 27178752
Citations 47
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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.

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References
1.
Stokes J, Peterson J . Homophobia, self-esteem, and risk for HIV among African American men who have sex with men. AIDS Educ Prev. 1998; 10(3):278-92. View

2.
Levy M, Watson C, Wilton L, Criss V, Kuo I, Glick S . Acceptability of a Mobile Smartphone Application Intervention to Improve Access to HIV Prevention and Care Services for Black Men Who Have Sex with Men in the District of Columbia. Digit Cult Educ. 2015; 7(2):169-191. PMC: 4652936. View

3.
Brown S, Lieberman D, Germeny B, Fan Y, Wilson D, Pasta D . Educational video game for juvenile diabetes: results of a controlled trial. Med Inform (Lond). 1997; 22(1):77-89. DOI: 10.3109/14639239709089835. View

4.
Muessig K, Nekkanti M, Bauermeister J, Bull S, Hightow-Weidman L . A systematic review of recent smartphone, Internet and Web 2.0 interventions to address the HIV continuum of care. Curr HIV/AIDS Rep. 2015; 12(1):173-90. PMC: 4370788. DOI: 10.1007/s11904-014-0239-3. View

5.
Aliabadi N, Carballo-Dieguez A, Bakken S, Rojas M, Brown 3rd W, Carry M . Using the Information-Motivation-Behavioral Skills Model to Guide the Development of an HIV Prevention Smartphone Application for High-Risk MSM. AIDS Educ Prev. 2015; 27(6):522-37. PMC: 4868035. DOI: 10.1521/aeap.2015.27.6.522. View