NATIVE-It's Your Game: Adapting a Technology-Based Sexual Health Curriculum for American Indian and Alaska Native youth.

Sexually transmitted infection (STI) and birth rates among American Indian/Alaska Native (AI/AN) youth indicate a need for effective middle school HIV/STI and pregnancy prevention curricula to delay, or mitigate, the consequences of early sexual activity. While effective curricula exist, there is a dearth of curricula with content salient to AI/AN youth. Further, there is a lack of sexual health curricula that take advantage of the motivational appeal, reach, and fidelity of communication technology for this population, who are sophisticated technology users. We describe the adaptation process used to develop Native It's Your Game, a stand-alone 13-lesson Internet-based sexual health life-skills curriculum adapted from an existing promising sexual health curriculum, It's Your Game-Tech (IYG-Tech). The adaptation included three phases: (1) pre-adaptation needs assessment and IYG-Tech usability testing; (2) adaptation, including design document development, prototype programming, and alpha testing; and (3) post-adaption usability testing. Laboratory- and school-based tests with AI/AN middle school youth demonstrated high ratings on usability parameters. Youth rated the Native IYG lessons favorably in meeting the needs of AI/AN youth (54-86 % agreement across lessons) and in comparison to other learning channels (57-100 %) and rated the lessons as helpful in making better health choices (73-100 %). Tribal stakeholders rated Native IYG favorably, and suggested it was culturally appropriate for AI/AN youth and suitable for implementation in tribal settings. Further efficacy testing is indicated for Native IYG, as a potential strategy to deliver HIV/STI and pregnancy prevention to traditionally underserved AI/AN middle school youth.

Promoting Parent-Child Sexual Health Dialogue with an Intergenerational Game: Parent and Youth Perspectives.

OBJECTIVES: 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 effective parent-youth sexual health communication and skills training. MATERIALS AND METHODS: Eight focus groups were conducted: four with parents (n=20) and four with their 11-14-year-old youth (n=19), to identify similarities and differences in perspectives on gaming context, delivery channel, content, and design (components, features, and function) that might facilitate dyadic sexual health communication. RESULTS: 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. CONCLUSIONS: 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.