Game on: Athletes, researchers reach youth with active education
Kids retain knowledge after games like 'HIV Attack'
Thirty years into the HIV/AIDS epidemic the grandchildren of the first generation impacted by AIDS have little interest in the disease. They increasingly need inventive and compelling HIV prevention strategies and messages. AIDS education has to compete with video games, texting, and social websites. So how do you get their attention?
A dynamic group of volunteers, investigators, and educators in the nation's capital might have found an ideal solution.
A model based on programs that have worked well in sub-Saharan Africa and Latin America has moved to Washington, DC, and is successfully pairing children with top college athletes who serve as role models, educators, and coaches. Athletes visit public middle schools, sometimes as part of physical education classes and sometimes as after-school programs. They teach children, ages 10 to 15, how HIV transmission and infection works.
They combine each education session with a physical game and activity, including HIV Attack, which demonstrates how the virus attacks the immune system. They also facilitate emotional discussions about the epidemic and how it might be impacting children in the groups.
Based on an analysis of the pilot year of the project, investigators found that children who participated in the intervention had significant increases in knowledge about HIV and AIDS, and they had improved behavioral intent to reduce HIV risk, as well as increased self-efficacy, says Karen A. McDonnell, PhD, an associate professor and director of the doctoral program in health behavior in the department of prevention and community health at George Washington School of Public Health in Washington, DC.
"So the students were saying they had an intention to engage in healthier behavior and HIV risk reduction," McDonnell says.
McDonnell and co-investigators have plans to study the students' risk behaviors to see if they actually have changed risk behaviors or continued with risk-reduction strategies as a result of the intervention.
The collaboration between Division 1 university athletes, a community-based organization, and George Washington University researchers has resulted in a program that so far has involved about 200 volunteer athletes, 500 youths, and 1,000 people in community outreach.
The grassroot project is based on the grassroot soccer's HIV education model that was piloted in Zambia and South Africa and also proved successful in Zimbabwe.1,2
Tyler Spencer, founder of the grassroot project and a former rower at Georgetown University, spent two summers in South Africa, volunteering in HIV prevention work in the DeBeers/Grassroot Soccer diamond mining communities. Spencer was struck when he returned to DC by how the epidemic is nearly as bad here as what he saw in some South African communities.
"I was shocked when I read the HIV statistics for DC because I'd been living there and I didn't realize the disease was as big a problem as it is," Spencer says. "In schools in DC, the fear and stigma of HIV was even greater than it is in South Africa."
Athletes as educators
The Washington, DC, area needed leaders to discuss the disease and educate youth about how HIV impacts people in the community, and Spencer thought athletes were the ideal educators for this message.
Division 1 college athletes are the nation's best college competitors. One athlete who now is an advisory board member, Somdev Devvarman, twice won the NCAA national singles championship in tennis and now is number 150 in the world ranking in tennis.
The project recently received a Division 1 NCAA Student-Athlete Advisory Committee award of excellence
College athletes are goal-driven and disciplined, and they like extra challenges, Spencer says.
But they're also very busy, and when the program began in 2009, Spencer aimed to recruit maybe a dozen athletes to give up two weekends per semester and three hours per week for visiting schools. Instead he had 40 athletes sign up for the original group, and now there are nearly 200 athletes involved in the project.
One impact Spencer and researchers have observed is similar to what was noted in earlier studies in sub-Saharan Africa with the grassroot soccer project, and that is the spreading of HIV-prevention information beyond the children enrolled in the project.
For one thing, parents became very enthusiastic supporters of the program.
"Some parents would show up to pick up their kids from the after-school program, and then the next time they would show up 30 minutes early and participate in the game," Spencer says. "Our whole goal was not just to give kids information; the focus was on giving them information and empowering them to share the information throughout the community."
For example, at the end of each eight- to 10-week program, the children would have a graduation program witnessed by friends and relatives. They'd be offered an opportunity to provide HIV education at the graduation program, and they'd sometimes volunteer to talk about family members who had AIDS and how that impacted them. Or they might play a game of HIV Attack in front of an audience, he says.
"They'd get up and have their parents play the part of germs and diseases while they led the game and showed them what they learned," Spencer says.
The games facilitate learning and make the subject matter interesting and dynamic to the youths.
"We think it's more effective to make learning participatory," Spencer says. "The curriculum overall is a series of games that builds on each other."
The reason athletes are involved as coaches/mentors/educators is because the pre-teens and teens are more likely to listen to role models who are seen as successful and who are closer to their age, he notes.
"Sometimes kids aren't always comfortable talking about these issues with someone who is a generation older," Spencer says.
What's intriguing about the grassroot project model is the way it engages youth in behavior change, McDonnell notes.
"Whenever you do behavior change work and have curriculum based on health, students don't tend to be as engaged, she says. "But this program is amazing."
McDonnell visited one of the graduation ceremonies and watched the children have fun playing AIDS Attack.
"This is how you reach kids," she says. "You let them have fun, and then they integrate the message into their own thinking."
Also, the children communicated their experiences and messages with the adults in their lives, and they could show their friends in their own words how the virus and immune system work.
"They get it you can see it in their eyes," McDonnell says. "They feel like they're mastering this material."
So far, the program has met several goals, including training youths to be social entrepreneurs of change in their own communities, she says.
"We found with this program that it really increased their knowledge, and we don't know yet about their behavior, but we know it's going in the right direction," McDonnell says.
References
- Clark TS, Friedrich GK, Ndlovu M, et al. An adolescent-targeted HIV prevention project using African professional soccer players as role models and educators in Bulawayo, Zimbabwe. AIDS Behav. 2006;10(4 Suppl):S77-S83.
- Peacock-Villada P, DeCelles J, Banda PS. Grassroot soccer resiliency pilot program: building resiliency through sport-based education in Zambia and South Africa. New Dir Youth Dev. 2007;116:141-154.
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