A qualitative analysis on parent-youth perspectives of The Secret of Seven Stones : An online, intergenerational HIV, STI, and pregnancy prevention computer game

Background: Adolescent sexual behavior remains a significant issue in the United States with high rates of unintended pregnancies and sexually transmitted infections (STIs). Parents are a strong influence in preventing negative health outcomes and delaying sexual initiation. The Secret of Seven Stones (SSS) is an Internet-based, intergenerational computer game designed to impact parent-youth communication on sexual health topics and provides life skills training to youth. Methods: SSS was tested in a randomized controlled trial in which 39 parent-youth (11–14 years) dyads were randomly assigned to play SSS over a three-month period. At 3-months, exit interviews were conducted separately with parents and youth to learn about their SSS experience. Thematic analysis axial coding using ATLAS.ti established thematic patterns regarding SSS acceptability and perceived impact. Seven interviews from dyads with youth diagnosed with neurodevelopmental disorders were omitted from analysis for separate analysis. Results: Dyads (n=33) comprised parents (43.6 ±6 years, 97% female), and youth (12.9 ±11.2 years, 53% female) who were mainly Caucasian (47%) and African-American (28%). Most dyads completed all (58%) or at least half of SSS (10%). Emergent themes informed on dyads’ experience with intervention outcomes, beneficial gaming strategies, and barriers to SSS use. SSS was a useful resource in improving parent-youth general and sexual health communication. Dyads affirmed that SSS features were too young while content presented was too mature. Conclusion: Qualitative inquiry provided understanding of how an intergenerational sexual health games can best facilitate parent-youth communication and provide sexual health skills training in youth, while also identifying critical barriers to future implementation and dissemination of this innovative strategy