The "Secret of Seven Stones": Short-Term Efficacy of an Online Intergenerational Sexual Health Education Game for Early Adolescents and Their Parents.

Objectives: Intergenerational games offer a potential channel to impact parent-youth sexual health communication. The "Secret of Seven Stones" (SSS) is an 18-level online adventure game and parent website designed to engage parents and youth (11-14 years) in conversations about healthy dating relationships and sexual behavior and to provide sexual health skills training to youth. Study hypotheses were that SSS exposure would increase sexual health parent-child communication, increase youth intentions to delay sexual debut, and reduce youth exposure to situations that promote sexual activity. Materials and Methods: SSS was evaluated in the homes of parent-youth dyads randomly assigned to intervention (n = 40) and comparison (n = 45) conditions. Online surveys were used to collect baseline and three-month follow-up data on dyadic sexual health communication, determinants for communication and youth sexual behavior, and game usability ratings. Results: Dyads comprised parents (n = 83, 47% white, 93% female, 44.4 ± 5.8 years) and youth (n = 83, 42% white, 54% male, 12.9 ± 1.1 years, and 96% sexually inexperienced). Frequency of parent-youth sexual health communication and youth communication self-efficacy increased in those playing SSS compared with those in the comparison group (P < 0.01). Youth perceived parent-youth communication as more open and demonstrated significant improvement in condom and human immunodeficiency virus/sexually transmitted infection knowledge and perceptions of parents' beliefs about sex (<0.001). Usability ratings were higher on ease, credibility, and helpfulness (all >78%) but lower on duration and appeal (<56%). Conclusion: This study demonstrated the utility of an in-home intergenerational sexual health education game to impact parent-youth communication by short-term follow-up. Further investigation of longer-term behavioral impact is indicated.