A Mobile App Serious Game to Increase Awareness of Antibiotic Use in the Community

NCT05445414 | Completed

• 1 other identifier: FY2022HZ
• Study Type: interventional
• Target: 480
• Locations: 1 country
• Sites: 1

Brief Summary

The widespread and unnecessary use of antibiotics has encouraged the growth of antibiotic-resistant bacteria which can cause hard-to-treat and deadly infections. These infections are due to antimicrobial resistance (AMR). The public's lack of knowledge on the indication for and proper use of antibiotics often leads to unnecessary patient demands and subsequent misuse of antibiotics. Traditional mass public educational efforts through the use of brochures, posters and advertisements are extensive in outreach but questionable in effectiveness in improving the general public's knowledge on appropriate antibiotics use and AMR. Serious games app provides an additional venue for public education outreach to the population since a substantial amount of time is spent using smartphones. The use of serious games is expected to increase user engagement in learning, which will lead to short- and long-term improvements in knowledge, attitudes and perceptions on the appropriate use of antibiotics. The study team has co-developed an evidence-based serious game app- "SteWARdS Antibiotic Defense" -with Temasek Polytechnic. Users will be brought on a quest to learn about antibiotic use and AMR through mini-games and the bite-sized information released throughout the game quest. We intend to clinically validate our evidence-based app and improve its application with actual participants' feedback on its usage. Hence, this study aims to evaluate the effectiveness of an evidence-based serious game mobile application (SteWARdS Antibiotic Defense) in improving the knowledge on, attitude towards, and perception (KAP) of appropriate antibiotic use and AMR among Singaporeans. The primary objective is to assess the change in knowledge on antibiotic use and AMR among the app users compared with the control group. The secondary objectives are to:1) Assess the extent of user engagement of the app by evaluating the users' average screen time per day; and 2) Assess the level of user satisfaction in using the app for learning through a user satisfaction survey.

Conditions

Antimicrobial Resistance

Outcome Measures

Primary Outcomes (1)

• Change in the knowledge, attitudes, and perception of participants towards antibiotics use.

  Change in the knowledge, attitudes, and perception of participants towards antibiotics use and AMR at 6-10-weeks post-intervention from the baseline, measured by the survey. The immediate knowledge change will be measured by the in-app questionnaire knowledge questions, post-completion of the game quest.

  Baseline, immediate completion of intervention, 6-10 weeks post intervention

Secondary Outcomes (2)

• User engagement level

  Five days - 2 weeks

• Satisfaction level of playing the games in the app

  Immediately completing the game quest in the app

Study Arms (2)

Intervention group

EXPERIMENTAL

Participants randomized to the intervention group will be asked to use the "SteWARdS Antibiotic Defense" app-an evidence-based serious game app developed by the study team-for a minimum of five days. They will also need to complete three sets of questionnaires - one set at baseline, one set after completing the quest in the app, and another set 6-10 weeks after they complete the quest in the app.

Device: "SteWARdS Antibiotic Defense" app

Control group

NO INTERVENTION

Participants randomized to the intervention group would be asked to complete two sets of questionnaires - one set at baseline and another set 6-10 weeks later.

Interventions

"SteWARdS Antibiotic Defense" app DEVICE

The "SteWARdS Antibiotic Defense" app is an evidence-based serious game app developed by the study team. The app uses gamification theories to increase user engagement and to deliver bite-sized information to participants. For example, players will learn about the uses of antibiotics through the messages delivered through the game and the cost of tackling antibiotic-resistant infections through purchasing an expensive antibiotic with the virtual currency earned from the games.

Intervention group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Aged 18 - 65 years
• Have access to an Android smartphone
• Able to comprehend the English language

You may not qualify if:

• Unable to install Android mobile applications
• Not proficient with using smartphone applications
• Cognitive or visual impairment

Sponsors & Collaborators

• Tan Tock Seng Hospital: lead
• National Healthcare Group Polyclinics: collaborator
• Temasek Polytechnic: collaborator

Study Sites (1)

Ang Mo Kio Polyclinic

Singapore, Singapore

Location

Related Publications (2)

• Huang Z, Ow JT, Tang WE, Chow A. An Evidence-Based Serious Game App for Public Education on Antibiotic Use and Resistance: Randomized Controlled Trial. JMIR Serious Games. 2024 Sep 5;12:e59848. doi: 10.2196/59848.

  PMID: 39235853 DERIVED

• Huang Z, Tang WE, Guo H, Natarajan K, Lee TH, Yeo TW, Chow A. An Evidence-Based Serious Game App for Public Education on Antibiotic Use and Antimicrobial Resistance: Protocol of a Randomized Controlled Trial. JMIR Res Protoc. 2023 Mar 28;12:e45833. doi: 10.2196/45833.

  PMID: 36976619 DERIVED

Study Officials

• Zhilian Huang, Ph.D

  Tan Tock Seng Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: A two-arm randomised controlled trial with the intervention group receiving an educational app and the control group not receiving any app intervention

Study Record Dates

• First Submitted: June 27, 2022
• First Posted: July 6, 2022
• Study Start: January 4, 2022
• Primary Completion: May 29, 2023
• Study Completion: August 31, 2023
• Last Updated: October 18, 2023

Record last verified: 2023-10

Data Sharing

• IPD Sharing: Will not share

Locations

SG (1)