Serious games for sex education of adolescents and youth: integrative literature review

Alencar, Nadyelle Elias Santos; Pinto, Maria Aparecida Oliveira; Leite, Nicácio Torres; Silva, Claudia Maria Vieira da

doi:10.1590/1413-81232022278.00632022EN

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REVIEW • Ciênc. saúde coletiva 27 (08) • Aug 2022 • https://doi.org/10.1590/1413-81232022278.00632022EN copy

Serious games for sex education of adolescents and youth: integrative literature review

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Abstract

This study aims to map educational games related to the sexuality of adolescents/young people, based on publications that occurred over the last decade (2011 to 2020). An integrative review was performed in the Web of Science, SCOPUS, MEDLINE/PubMed, and LILACS databases in September 2020, with the final inclusion of 16 studies. Games developed on four continents were identified, predominantly in high-income countries, with the United States of America and Brazil being those that published the most. The tools consisted mostly of videogames and digital games, with the adoption of simulated scenarios and plots. Regarding development, there was a preference for the participatory construction mode, while some also underwent a validation process. The tools addressed several areas of human sexuality and demonstrated a positive potential for use, with educational gains and changes in habits, but their results need to be carefully considered. Only the effects of three games were evaluated by randomized controlled trials.

Key words:
Sexuality; Adolescent; Health education; Play and playthings

Authors, year	Name of game	Target-public (age)	Type of game	Focus of game
Patchen et al., 2020	SAAFE	African-American youth (15 to 21)	Videogame	Sexuality
Pensak et al., 2020	Sexpert High School	Hispanic teens	Videogame	Sexuality
Haruna et al., 2019	My Future Begins Today	Students (11 to 15) from Sub-Saharan Africa	Gamified learning platform	Sexual health
Winskell; Sabben; Obong’o, 2019	Tumaini	African preteens (11 a 14)	Smartphone game	HIV prevention
Conceição et al., 2019	A aventura do adolescente com TEA: descobrindo a sexualidade	Teens with mild ASD (12 to 18)	Board game	Sex education
Monteiro et al., 2018	DECIDIX	Teenagers (11 to 19)	Digital game	Sexual and affectional relationships
Sousa et al., 2018	Contando bem que mal tem?	Teenagers	Card game	Corporeality, relationships, STD, and contraceptive methods
Bertozzi et al., 2018	My Future Family	Teenagers (14 to 19)	Digital game	Puberty, sexual and reproductive health, and contraception
Gariepy et al.,2018	-	Black and Hispanic teens (15 to 17)	Digital game	Risky sexual behaviors
Souza et al., 2017	Papo Reto	Teenagers (15 to 18)	N-line game	Sexuality and gender relations
Fiellin et al., 2016	PlayForward: Elm City Stories	Teenage minorities	iPad video game	Risky behaviors, including those associated with HIV
Gilliam et al., 2015	Lucidity	Teenage high school students	Videogame	Sexual violence
Norris et al., 2015	DRAMA-RAMA™	Hispanic female preteens	Virtual reality game	Peer pressure and risky sexual behavior
Chu et al., 2015	Making SmartChoices	Teenagers (12 to 16)	Online game	Knowledge and attitudes towards sex
Gilliam et al., 2014	InFection Four	Teenagers	Card game	STD
Arnab et al., 2013	PREPARE	Teenagers (13 to 14)	“Game show” videogame	Sexual coercion in relationships

Authors, year	Methodology	Results
Patchen et al., 2020	Methodological study in three stages (advisory board for the development of the game prototype, usability testing, and focus groups).	Preference for simulation games that are customizable, modern, competitive, fun, and educational. The SAAFE game was developed and presented satisfactory usability.
Pensak et al., 2020	Methodological study (participatory construction) and intervention, time series type, with a group.	The Sexpert High School game was designed, demonstrated high feasibility and acceptability. Increased knowledge about condoms.
Haruna et al., 2019	Methodological study (participatory construction) and intervention study (semi-experimental, pre- and post-test).	My Future Begins Today was designed, generated knowledge about sexual health, and spurred a change in attitude.
Winskell, Sabben, Obong’o, 2019	Methodological study (participatory construction).	Development of the Tumaini game, which allows interactive construction of narratives, offers mini games with themed challenges, and a connection between the game and the player's personal life.
Conceição et al., 2019	Methodological study - previous integrative review.	The review showed a scarcity of materials on the subject. The "A aventura do adolescente com TEA: descobrindo a sexualidade" game was then developed.
Monteiro et al., 2018	Methodological validation study by experts and target audience	The DECIDIX game allowed debate, stimulated autonomy, knowledge sharing, and promoted important experiences.
Sousa et al., 2018	Methodological validation study by experts.	“Contando bem que mal tem?” was validated in terms of appearance and content and proved to be useful for educational practices.
Bertozzi et al., 2018	Methodological study (participatory construction) and intervention study (semi-experimental, pre- and post-test).	My Future Family featured high gameplay and educational benefits.
Gariepy et al.,2018	Methodological and intervention study (quasi-experimental, time series, with one group).	The game increased knowledge, self-efficacy, and risk perception but had no effect on adolescents’ intentions.
Souza et al., 2017	Methodological study (validation by experts and qualitative assessment of the game).	Papo Reto was constructed, validated, and demonstrated better knowledge about sexuality by sharing experiences and reflections.
Fiellin et al., 2016	Methodological study (participatory construction) and intervention (randomized controlled trial with two groups, time series type).	PlayForward was built, and the results of the intervention study are still under construction.
Gilliam et al., 2015	Methodological study (participatory construction) and intervention (qualitative evaluation of the game).	Lucidity was designed and perceived as an attractive, interactive game, but hard to understand. It has helped to acquire knowledge and promote awareness of sexual health and violence.
Norris et al., 2015	Intervention study (controlled and randomized trial) with two groups, time series type.	DRAMA-RAMA™ proved capable of increasing self-efficacy to resist peer pressure.
Chu et al., 2015	Methodological study (participatory construction) and intervention, with a group, pre- and post- test.	Making Smart Choices was classified as fun/interesting, and increased participants’ knowledge, influencing their attitudes/decisions.
Gilliam et al., 2014	Methodological study (participatory construction) and intervention (game incorporated into the sex education curriculum), with a group, post-test.	Only 27% of teenagers said they learned with the game InFection Four, with symptoms, treatment, and prevention being the topics with the greatest impact.
Arnab et al., 2013	Methodological study (participatory construction) and intervention (controlled and randomized trial, with two groups, pre- and post-test).	PREPARE facilitated the recognition of coercive situations, risk factors and behaviors, in addition to helping in decision-making.

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[1] Collaborations

NES Alencar worked on the conception, design, data collection, analysis and interpretation. MAO Pinto e NT Leite worked on the data collection, analysis and interpretation. CMV Silva worked on the data analysis and interpretation. All authors contributed and approved the final version.