Electronic games delivered via smartphones have the potential to become valuable tools in HIV prevention in high-prevalence and low-resource international settings. To ground theoretical elaboration around novel mHealth interventions in contextual realities, it is important to understand the mechanisms of their effects as perceived by local populations. Such perspectives are particularly important when working cross-culturally. 'Tumaini' is an interactive narrative-based smartphone game that uses a 'choose-your-own-adventure' format. It is designed to prevent HIV among young African adolescents (aged 11-14) by increasing age and condom use at first sex. It was developed with a US-based commercial game developer and is grounded in social behavioral theory, evidence-based practice and contextually relevant scenarios. In a 2017 randomized pilot study (n = 60) in Western Kenya, 'Tumaini' showed promising effects on behavioral mediators of sexual debut. In subsequent focus group discussions, adolescent participants and their parents shared their perceptions of the game's mechanisms of effect, which included motivation to play, future orientation, decision-making, relationship to a diverse range of characters and a bridging of the virtual and real worlds. These findings align with our theoretical framework, confirm its successful translation into the intervention and will inform mediation analyses in an upcoming efficacy trial.

中文翻译：

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一款预防肯尼亚年轻人中艾滋病毒的智能手机游戏：当地人对作用机制的看法。

通过智能手机提供的电子游戏有可能成为在艾滋病流行和资源匮乏的国际环境中预防艾滋病毒的宝贵工具。为了在现实情况下围绕新颖的mHealth干预进行理论阐述，重要的是要了解当地居民感知到的影响机制。当跨文化工作时，这种观点尤其重要。“ Tumaini”是一款基于交互式叙事的智能手机游戏，使用“选择自己的冒险”格式。它旨在通过增加年龄和首次使用安全套来预防非洲青少年（11至14岁）中的HIV。它是由一家美国的商业游戏开发商开发的，其基础是社会行为理论，循证实践以及与情境相关的场景。在2017年在肯尼亚西部进行的一项随机试验研究（n = 60）中，“ Tumaini”显示出对性首次亮相的行为调解者有希望的影响。在随后的焦点小组讨论中，青少年参与者及其父母分享了他们对游戏效果机制的看法，包括游戏动机，未来取向，决策，与各种角色的关系以及虚拟世界与现实世界的桥梁。这些发现符合我们的理论框架，确认了其成功转化为干预措施，并将在即将进行的疗效试验中为调解分析提供信息。青少年参与者及其父母分享了他们对游戏效果机制的看法，其中包括游戏动机，未来取向，决策，与各种角色的关系以及虚拟世界与现实世界的桥梁。这些发现符合我们的理论框架，确认了其成功转化为干预措施，并将在即将进行的疗效试验中为调解分析提供信息。青少年参与者及其父母分享了他们对游戏效果机制的看法，其中包括游戏动机，未来取向，决策，与各种角色的关系以及虚拟世界与现实世界的桥梁。这些发现符合我们的理论框架，确认了其成功转化为干预措施，并将在即将进行的疗效试验中为调解分析提供信息。