Study on STDs prevention
We present the results from a randomized controlled trial including the visitors of the "sjekkdeg.no" website. Sjekkdeg.no is a gamified educational web app on sexual health targeting Norwegian youth, aiming at facilitating their access to sexual health services. The website visitors were randomized into two different versions of the app, one version contains only with educational purposes, and the other version includes a gamified appointment system. The randomized controlled trial allocating website visitors from the city of Tromsø or surroundings to two different versions of a gamified web app on sexual health was carried out from 1st January to 31st December 2015. Version A of the web app provides access to educational content on sexual health. Version B has exactly the same educational contents, and includes also an appointment system allowing users to get an appointment at the local venereology unit. The web app visitors that said they were not living in Tromsø area were given access to the Version A. The educational web app was promoted among Norwegian youth through Facebook advertisements. The Facebook advertisement was displayed 11671 times among youth living in Tromsø and surroundings, reaching a total of 7275 individuals. Among these 7275 Facebook users, 393 clicked the link to the educational web app (5,4%). The total amount spent on the Facebook advertisement campaign was 797 NOK. Along the year, the gamified website on sexual health had 4535 visitors. We expected to randomize 1000 website visitors from Tromsø to any of the two versions of the website. Among the 4535 website visitors, 996 of them identified themselves as "living in Tromsø". These 996 website visitors were included in the RCT (501 were randomly allocated in Group A, and 495 to the Group B). Unexpectedly, none of the visitors allocated to Version B fully completed the requirements to get an appointment at the venereology unit. Along the study, one web app visitor showed up at the venereology unit without being completed the web requirements; and another visitor completed all the site requirements, but failed in the last step, confirming by SMS his/her intentions of showing up at the venereology unit. Although website users did not use the appointment system, we could observe that randomized site visitors spent about 3 times more on the educational web app than the rest of the website visitors (10:00 and 9:46 minutes for the visitors allocated in Version A or Version B; versus 3:17 minutes for the users not included in the randomization procedure). Randomized users also visited more pages per visit, visited the site more times, and had a lower bounce rate. Therefore, sjekkdeg.no visitors from Tromsø were exposed to sexual health educational contents for more time, and hence, more likely to change their sexual health behavior. Despite the great potential with this new appointment system integrated in the gamified web app, it did not facilitate the access the sexual health services in this study. However, it is interesting to observe that the site visitors from the selected area and agreeing participating in the study spent more time on the educational site, checked more content, and potentially increased their sexual health literacy. Future research could explore factors that can facilitate the access to sexual health services for youth.
We expected that the gamified appointment system integrated in the website "sjekkdeg.no" would have increased the number of visits at the venereology unit at UNN. However the use of the appointment system included in the gamified web app did not facilitate the access the sexual health services in this study. Nevertheless, the website visitors from Tromsø and agreeing participating in the study spent more time on the educational site, and checked more content. These website visitors potentially increased their sexual health literacy, and were more likely to change their sexual health behavior. Future research could explore factors that facilitate the access to sexual health services for youth.
"Sjekkdeg.no" web promotion through Social Media, and Randomized Controlled Trial recruitment
From the 1st January, and until the 31st of December 2015, the "sjekkdeg.no" web app users were randomized to two different versions of the site (Control Group, or Appointment System Group), as stated in the study protocol. In order to recruit more web app visitors, "sjekkdeg.no" was promoted through Facebook advertisements to youths from Tromsø.
Background and objectives: The objective of this research project is to test if a Game-Based Appointment System integrated in the web app on sexual health "sjekkdeg.no" can facilitate access to health services for youth, and if the new functionality can increase the number of visits to the educative components of the web app. Methodology: In order to analyze its impact, we tested the new Game-Based Appointment System that was created from scratch, and it was built on the successful internet health intervention (sjekkdeg.no). An A/B testing methodology was used. This methodology consist on the redirection of the users to two different versions of the website, and therefore allows to assess the interactivity of the users according to the design of the webpage and determine which one has a higher impact on the clinical settings, and consequently on prevention of sexually transmitted infections. The site use is being tracked with Google Analytics. For the A/B test we tested the interactivity of two versions of a web app "sjekkdeg.no": the A version (Control Group), consisting on the educative web app; and the B version, including additionally the Game-Based Appointment System. Users directed to the Appointment System Group have the option to book an appointment with the venereology unit at the University Hospital of North Norway, after reporting their symptoms in the Symptom Checker of the sjekkdeg.no web app. The appointment system was planned so that users do not need to write their name or any other personal data. Based on the data provided in the Symptom Checker, the program offers the users a choice of available appointments, according to the severity of symptoms, within a period ranging from a few days, until some weeks. After the users select their preferred day in the system, they are asked to send an SMS to the Venereology unit at UNN to confirm their intention to show up. The venereology unit at UNN offered 4 hours per week, for potential visits from the study. Once the users reach the "sjekkdeg.no", they are informed about the nature of the study, and asked if they are from Tromsø. Users answering “Yes, I am from Tromsø” were randomized either to the Group A or the Group B. All the remaining web app visitors were not included in this study. The web app randomization started on the 1st January 2015, and it lasted until the 31st of December 2015, as stated in the study protocol. In order to recruit more web app visitors, "sjekkdeg.no" was promoted through Facebook advertisements along the year. These Facebook advertisements were targeting all the youths living in Tromsø and surroundings. The study was registered in Clinicaltrials.org, with the identifier NCT02128620 https://clinicaltrials.gov/ct2/show/NCT02128620 Results: During this 1 year randomized controlled trial, the educational site on sexual health "sjekkeg.no" received a total of 4.535 visits. Among these visitors, 996 selected the option “Yes, I am from Tromsø”, and therefore they were randomized: 501 were allocated in the Control Group, and 495 were allocated in the Appointment System Group. During the study period, a total of 6 appointments were asked through "sjekkdeg.no", but none of them sent an SMS to the Venereology unit to confirm their intention to show up. One more web app user showed up at the Venereology unit spontaneously without asking an appointment through the site, and he/she mentioned the"sjekkdeg.no".
Study on STDs prevention
Chlamydia is the most common reportable sexually transmitted disease (STD) in Norway. To assess the impact of the game-based appointment system on both, clinical settings and use of the educational web app, an A/B testing methodology is used. Users from Tromsø will be randomized to one of the two versions web app www.sjekkdeg.no.
Background: Chlamydia is the most common reportable sexually transmitted disease (STD) in Norway, and its incidence in the two northernmost counties has been nearly twice the Norwegian average. Last publically available rates showed that 85,6% of new diagnosed cases are on people under 29 years old. The information and communication technologies are among the most powerful influences in the lives of young people and, can potentially represent a way to educate on sexual health, and encourage them to be tested for STDs if those websites include an easy and anonymous system for obtaining appointments with the clinic. Methods: To assess the impact of the game-based appointment system on both, clinical settings and use of the educational web app, an A/B testing methodology is used. Users from the city of Tromsø will be randomized to one of the two versions of the gamified web app on sexual health www.sjekkdeg.no. Group A consisting on educative content; and Group B consist on the same educative content, and a game-based appointment functionality with an automatic prioritization system. After one year of the trial, we will analyze if the game-based appointment system can increase the number of consultancies at the venereology unit; and if the health professionals can get a benefit from it. Discussion: This study will examine if to facilitatefacilitating the access to health services for youth through the use of a game-based appointment system integrated in a gamified web app on sexual health education including social media, can have an impact on clinical setting services. Trial registration: The trial is registered at clinicaltrials.org, under the identifier NCT:02128620
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