An Evidence Map on Serious Games in Preventing Sexually Transmitted Infections Among Adolescents: Systematic Review About Outcome Categories Investigated in Primary Studies

Background: Sexually transmitted infections (STIs) represent a global health risk. Adolescents are at increased risk of infection for several reasons such as lack of knowledge, risky sexual behaviors, and lack of behavioral sills (e.g. to negotiate safer sex). Given the fact that adolescents often use digital media and that serious games are considered to have the potential to change knowledge, attitudes and behavior, serious games represent an opportunity for the prevention of (STIs). Objective: The aim of this systematic review was to identify and systematically summarize the dimensions which have been investigated in primary studies on serious games targeting STI prevention among adolescents. Methods: A systematic review was conducted in PubMed and Web of Science. Studies published from 2009 to 2021 have been included that assessed the effectiveness of serious games on adolescent sexual health. A total of 18 studies met the inclusion criteria and where categorized according to dimensions of effectiveness and user experience. Results: Various dimensions of effectiveness and aspects of user experience were investigated within the primary studies. In total, nine dimensions of effectiveness have been observed: Sexual behavior, behavioral intentions, knowledge, attitudes and beliefs, self-efficacy and personal limitations, character traits and future orientation, environmental and individual risk factors, risk perception and risk assessment, as well as normative beliefs and (social) norms. Furthermore, several dimensions related to user experience have been investigated in the primary studies, which are motivation, acceptability, trustworthiness, comprehensibility, handling and control, perceived effectiveness, as well as satisfaction. Conclusions: The review provided an overview of serious games interventions that are vastly different in approach, content, and even platform. Within previous studies, knowledge has already been comprehensively assessed and a positive influence of serious games on knowledge about sexual topics is evident. The results clearly show that adolescents’ sexual knowledge was increased by the serious games interventions. However, methodological and content differences in the surveys make it difficult to draw conclusions about effectiveness related to changes in attitudes and behavior.