Sexual health discussions between parents and their preadolescent youth can delay sexual debut and increase condom and contraceptive use. However, parents frequently report being uncomfortable talking with their youth about sex, often reporting a lack of self-efficacy and skills to inform and motivate responsible decision making by youth.
Intergenerational games may support parent—youth sexual health communication. The purpose of this study was to explore parent and youth perspectives on a proposed intergenerational game designed to increase parent—youth sexual health communication and Sexual health education video games training.
Eight focus groups were conducted: Participants concurred that a sex education game could improve communication while being responsive to family time constraints. They affirmed the demand for an immersive story-based educational adventure game using mobile platforms and flexible communication modalities. Emergent themes informed the development of a features inventory including educational and gaming strategies, communication components, channel, and setting and upper-level program flow to guide future game development.
This study supports the potential of a game to be a viable medium to bring a shared dyadic sexual health educational experience to parents and youth that could engage them in a motivationally appealing way to meaningfully impact their sexual health communication and youth sexual risk behaviors.
A dolescents continue to shoulder the burden of sexually transmitted infections STIsincluding human immunodeficiency virus infection, and teen pregnancy.
Providing sexual health education in home settings and increasing parental involvement in adolescent sexual health interventions may increase reach, provide more timely sexual health education and skills-based learning, and improve parent and youth communication around sexual health.
Videogames can facilitate parent—child interaction and promote positive communication. In the health field, and particularly in the realm of sexual health education, IGG-based interventions are rare. Examination of the IGG practices has demonstrated intergenerational interaction, 3940 greater flexibility of player roles where youth adopt leadership roles mentored by older players, 3540 and collaborative engagement where intergenerational player dyads act more cooperatively than same-aged dyads.
The purpose of this study was to explore parent and youth perspectives to inform the development of an IGG for youth 11—14 years old and their parents to increase effective parent—child sexual health communication and to delay sexual debut in youth who are not sexually active or to increase condom and contraceptive use in sexually active youth. Specifications on game context, channel, content, design, components, features, and function may inform the design and development of a sexual health educational experience that can reach parents and youth, engage them in a motivationally appealing way, and meaningfully impact their sexual health communication and youth sexual risk behaviors.
Parent and youth groups were conducted separately, averaged five participants Sexual health education video games session range, 2—13were 2 hours in duration range, 1.
Parents and youth dyads were recruited through flyers and targeted Facebook advertisements. Eligibility criteria included age youth 11—14 years oldhome Internet access, and English proficiency. Written parental consent and youth assent were obtained prior to the study, which was approved by The University of Texas Health Science Center at Houston's Center for the Protection of Human Subjects, and gift cards were provided subsequent to the sessions.
Doctoral and Master's level researchers, trained in qualitative methods, facilitated the sessions using group moderating techniques to encourage all participants to provide input.
An adaptive structured interview guide was used to focus on how parents and youth engage in gaming and sexual health communication and to gain their perspectives on desired components and functions of an IGG for sexual health Table 1. Mock-ups of game graphics, storylines, and illustrated storyboards were developed as exemplars to evoke reactions to treatment elements through iterative group discussion.
Participants were shown several storyboards and provided reactions to Sexual health education video games. Audio files were transcribed by a transcription company specializing in medical research. The authors used thematic content analysis to code and analyze transcript data and assess content meaning. First-round coding was conducted using two transcripts to generate a codebook. Authors then separately coded remaining transcripts and used group consensus to facilitate agreement between coders when discrepancies occurred.
Adult participants were mothers 85 percent and fathers 15 percent of African American 40 percentwhite 45 percentSexual health education video games Hispanic 15 percent ethnicity, between 31 and 51 years of age, married 55 percentand college graduates 65 percent.
When asked about their perspectives on an intergenerational sex education game, six Sexual health education video games emerged described below. Parent—child communication was regarded as a central component for a sexual health game: Parents and youth reacted Sexual health education video games to the idea of a sexual health education game as a mediator of communication.
Thoughts on gameplay included inputting the parent as a game partner, as well as the dynamic of shared communication and discovery including a parental gate-keeping role to the youth's game progress Table 2perspectives A and B. Parents and youth recommended that sexual health skill-building topics be embedded in gameplay, including parent—child communication, negotiation and decision making, puberty, sexual behavior, and STIs.
However, parents recommended providing parent controls over the sexual health content so they could have discretion over the delivery of more mature content e. Youth echoed their parent's perceptions of discomfort: Many parents lacked role models for parent—youth communication about sex when they were young, increasing their Sexual health education video games about how to have the conversation: Parents and youth reported the connection experienced when playing games together, motivated by bonding around the shared gaming experience: This dynamic Sexual health education video games to more meaningful conversations: It also offers common ground: Mommy knows you're talking to her.
And try to make him feel comfortable, but he still won't act like he's interested. Parents and youth saw a game as a means of empowering youth to engage parents: Youth described how communication could transition from text to face-to-face: Parents and youth endorsed texting features to increase their comfort and as a way to start conversations: Parents and youth described how a game could cue this process Table 2perspective E.
Parents described the value of game-initiated conversation starters and guides: Parents expressed concerns about being a credible resource and their need for support: Parents described game scaffolding including prompts, updates, guidance through communication activities, and action cues to maintain the conversation dynamic and bonding Table 2perspective H. Youth described progressing gradually in their discussions from less to more mature content to allow for increased familiarity and comfort with the content, enabling future conversations following game completion Table 2perspective I.
You're working that full-time job. You don't have time.
Recommendations to accommodate busy lifestyles included dyadic play at distance Table 2perspective Kthe ability to pause gameplay Table 2perspective Land the use of smartphones as a preferred platform: Gaming frequently occurred in the car: "Sexual health education video games" and youth described learning about sexual health in terms of life choices and consequences, suggesting the importance of taking control of one's life and making smart decisions Table 2perspective M with embedded learning assessments that linked to game achievement Table 2perspective N.
Youth recommended these assessments be engaging e. Recommended game features included distinct competitive gaming levels that are brief under 45 minutes with learning opportunities that are nondidactic and a natural component of gaming fun Table 2perspective O.
The data were synthesized into a features inventory and conceptual framework to inform developers and researchers with a high-level summary of parent and youth perspectives on desired game specifications. The Game Features Inventory Table 3 is a synthesis of perspectives on IGG educational content, learning strategies, and gaming strategies. Game preferences supported the use of an immersive approach with engaging story narratives, fantasy elements, and interactive features that offer meaningful feedback and rewards that are also associated with positive outcomes.
Recommendations included explicit goals, scoring, audiovisual effects, customizable avatar characters, speaking characters, attention to gender relevance, realistic sound, graphics, and setting, and the beliefs, norms, needs, and behaviors of the target audience. Other recommendations were more specific to the intricacies of the sexual health domain and the accompanying communication and cultural challenges. These included defined sexual health content, progressive delivery and discussion of topics from less to more mature content over the course of gameplay, communication guidance and resources, and reflection of family values.
Although the results presented are cross-group and include the reports of both male and Sexual health education video games parents and youth, we found no substantial gender-based differences in themes. Here, updates, parallel learning opportunities, and gatekeeper communication and support enable a parent to play and learn in the dyad without demanding complete gameplay.
The association between the game components and targeted parent and youth mediators knowledge, beliefs, skills, and intentions of parent—youth communication and sexual behavior informed by previous models is also exemplified. Conceptual framework for a sexual health intergenerational game.
This study provides insight into parent and youth perspectives on the use of intergenerational gaming to mediate parent—youth communication for sexual health. Parents and youth affirmed that a game could offer a neutral point of shared inquiry that can be appealing to youth and supportive of parents without necessarily being burdensome.
These findings support many features that have become normative in gaming and provide a reminder of the Sexual health education video games of involving end-users in game design as well as formative evaluation. An apparent paradox is how to accommodate mobile platforms and flexible communication modalities text and face-to-face while aiming to strengthen the parent—youth bonding experience using a shared educational gaming journey.
The conceptual framework and inventory of game design preferences provide developers and researchers with a distillation of high-level parent and youth perspectives on desired game specifications. Results are consistent with previously reported youth preferences regarding goals, scoring, audiovisual effects, user-developed avatars, 44 attention to gender relevance, 264546 realism, 47 and salience to the attitudes and behaviors of players.
Several limitations should be noted, including the collaboration of a small, self-selected sample of parents and youth who were likely more disposed to discussing gaming and sexual health topics than the general population, and the limitations of the prompts and exemplars used to gather information.
Despite the small sample size, no new themes emerged after several focus groups and final groups confirmed those themes. In alignment with other parent-involved studies, there was low participation of fathers.