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

Antimicrobial Resistance Clinical Trial

Official title:

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05445414
• Other study ID #: FY2022HZ
• Status: Completed
• Phase: N/A
• Start date: January 4, 2022
• Est. completion date: August 31, 2023

Study information

• Verified date: October 2023
• Source: Tan Tock Seng Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

Description:

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 480
• Est. completion date: August 31, 2023
• Est. primary completion date: May 29, 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 65 Years

Eligibility

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

Related Conditions & MeSH terms

• Antimicrobial Resistance

Intervention

Device:
• "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.

Locations

Country	Name	City	State
Singapore	Ang Mo Kio Polyclinic	Singapore

Sponsors (3)

Lead Sponsor	Collaborator
Tan Tock Seng Hospital	National Healthcare Group Polyclinics, Temasek Polytechnic

Country where clinical trial is conducted

Singapore, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	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	User engagement level	The time spent on the app each day, tracked by the study team backend	Five days - 2 weeks
Secondary	Satisfaction level of playing the games in the app	Satisfaction level of playing the games in the app after completing the game quest via a questionnaire	Immediately completing the game quest in the app