Clinical trial NCT05445414: A Mobile App Serious Game to Increase Awareness of Antibiotic Use in the Community
Official title: A Mobile App Serious Game to Increase Public Awareness of Appropriate Antibiotic Use in the Community
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Antimicrobial Resistance
Lead sponsor: Tan Tock Seng Hospital
Sponsor class: OTHER
Collaborators: name: National Healthcare Group Polyclinics
name: Temasek Polytechnic
First posted: 2022-07-06
Enrollment: 480
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: A two-arm randomised controlled trial with the intervention group receiving an educational app and the control group not receiving any app intervention
Primary purpose: PREVENTION

Brief 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.

Detailed 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.

Eligibility criteria: 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

Primary outcomes:
measure: Change in the knowledge, attitudes, and perception of participants towards antibiotics use.
timeFrame: Baseline, immediate completion of intervention, 6-10 weeks post intervention
Secondary outcomes:
measure: User engagement level
timeFrame: Five days - 2 weeks
measure: Satisfaction level of playing the games in the app
timeFrame: Immediately completing the game quest in the app
Other outcomes:
Locations:
city: Singapore
country: Singapore
facility: Ang Mo Kio Polyclinic
Study officials:
affiliation: Tan Tock Seng Hospital
name: Zhilian Huang, Ph.D
role: PRINCIPAL_INVESTIGATOR
References: