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

NCT ID: NCT05445414

Last Updated: 2023-10-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

480 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-01-04

Study Completion Date

2023-08-31

Brief Summary

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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.

Detailed Description

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The widespread and unnecessary use of antibiotics has accelerated the development of antimicrobial resistance (AMR) which can cause infections that are fatal and resistant to treatment. One pertinent factor contributing to the misuse of antibiotics is the public's knowledge deficit of the indication for and proper use of antibiotics. This knowledge deficit often leads to unnecessary patient demand for antibiotics and subsequent misuse of them. The public has low awareness of the gravity of AMR as it appears to be a non-imminent life-threatening problem. 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. Leveraging digital technology to increase the awareness of antimicrobial resistance and the knowledge of appropriate antibiotic use is timely as Singapore develops into a smart nation. The use of serious games is postulated 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

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Antimicrobial Resistance

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A two-arm randomised controlled trial with the intervention group receiving an educational app and the control group not receiving any app intervention
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Intervention group

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.

Group Type EXPERIMENTAL

"SteWARdS Antibiotic Defense" app

Intervention Type 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.

Control group

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.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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"SteWARdS Antibiotic Defense" app

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 Type DEVICE

Eligibility Criteria

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Inclusion Criteria

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

Exclusion Criteria

* Unable to install Android mobile applications
* Not proficient with using smartphone applications
* Cognitive or visual impairment
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Healthcare Group Polyclinics

OTHER_GOV

Sponsor Role collaborator

Temasek Polytechnic

UNKNOWN

Sponsor Role collaborator

Tan Tock Seng Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Zhilian Huang, Ph.D

Role: PRINCIPAL_INVESTIGATOR

Tan Tock Seng Hospital

Locations

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Ang Mo Kio Polyclinic

Singapore, , Singapore

Site Status

Countries

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Singapore

References

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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.

Reference Type DERIVED
PMID: 39235853 (View on PubMed)

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.

Reference Type DERIVED
PMID: 36976619 (View on PubMed)

Other Identifiers

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FY2022HZ

Identifier Type: -

Identifier Source: org_study_id

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