We propose to rigorously test the effectiveness of No Baby No (No Bebé No) a bilingual videogame intervention to decrease contraception non-use (i.e., increase any contraception use) in a trial of 650 randomized English or Spanish-speaking, sexually active, 16-19-year-old Black and Hispanic adolescents in New York City.
Since 2015, we have partnered with English and Spanish-speaking Black and Hispanic adolescents and performed formative research utilizing human-centered design to iteratively develop and test the sex positive, interactive, No Baby No videogame to deliver a multi-component intervention with education, skill building, contraception promotion, and simulation training.
During pilot testing of the No Baby No videogame intervention, we demonstrated improvements in intentions to use more effective contraception, contraception self-efficacy, risk assessment, and sexual knowledge. However, sample sizes were small, no control group was included, and participants had low rates of sexual activity, limiting our ability to assess behavior effects. Earlier work also identified the need to expand game content to further engagement; target an older, sexually active group to maximize possible behavioral impact; and focus on contraception non-use as the primary outcome.
The updated No Baby No videogame intervention is now poised for rigorous effectiveness testing in a randomized trial. The scientific premise supporting the study is strong given the application of a theory-based digital health intervention, developed in conjunction with adolescents, adapted to their feedback, and tested using rigorous scientific methodology. This proposal holds promise for impacting a difficult problem in an overburdened population - unintended pregnancy in Black and Hispanic adolescents.
