PlayForward is a serious role-playing video game that engages youth with a variety of challenges and choices in fictional yet realistic life situations. Credit: Lynn Fiellin, M.D., Yale School of Medicine

A videogame designed by Yale researchers to promote health and reduce risky behavior in teens improves sexual health knowledge and attitudes among minority youth, according to a new study. The findings validate the value of the videogame as a tool to engage and educate teens at risk for HIV and other sexually transmitted infections (STIs), said the researchers.

"We saw significant and sustained positive changes in terms of attitudes about sexual health and sexual health knowledge," said Lynn Fiellin, M.D., associate professor of medicine at Yale School of Medicine and in the Child Study Center.

Adolescents are significantly affected by HIV and other STIs, yet many lack access to sexual health education that could minimize their risks, said the researchers, who note that videogames offer an accessible, portable tool for promoting health and reducing risky behavior among teenagers, particularly minority youth who are disproportionately impacted.

Led by Fiellin, the research team recruited more than 300 students, ages 11 to 14, from afterschool and summer programs in the New Haven area for the study. For six weeks, the youth either played the intervention game PlayForward: Elm City Stories, or one of several unrelated videogames on iPad tablets for up to 75 minutes twice per week. Designed with teen and expert input, PlayForward is a serious role-playing videogame that engages youth with a variety of challenges and choices in fictional yet realistic life situations.

During the one-year study period, the students were assessed for a range of outcomes, including sexual health attitudes, knowledge, intention to initiate sex, and sexual activity. Compared to youth who played the non-intervention games, the PlayForward teens demonstrated improvements in both sexual health attitudes and knowledge at the end of 12 months. For example, the PlayForward group was more likely to accurately respond that it was true that a girl can get pregnant the first time she has sex.

While the groups of teens did not differ in their intention to initiate sex or be sexually active, the findings are significant and important, said Fiellin: "It was proof of concept. To our knowledge, never before has a videogame intervention been developed with such extensive input from its target audience, and tested through rigorous scientific methods over a long stretch of time, demonstrating that kids will engage in a game with serious content and learn things that impact the way they think and potentially what they do."

Fiellin and her colleagues plan to refine and further disseminate the game content with the goal of influencing youth behavior. They have received additional funding to modify the PlayForward game to focus on other health outcomes in adolescents, including smoking and electronic cigarette use prevention and the promotion of HIV/STI testing.

The findings are published in the Journal of Medical Internet Research.

Explore further Age of first sexual intercourse may impact teens' risk of acquiring sexually transmitted infections