"It's your game": an innovative multimedia virtual world to prevent HIV/STI and pregnancy in middle school youth.

Early sexual initiation is associated with increased risk of unintended pregnancy and sexually transmitted infection(STI). Effective HIV/STI/pregnancy prevention interventions for middle school youth are urgently needed. "It's Your Game, Keep It Real" (IYG) is a curriculum delivered in 7th and 8th grade that combines classroom activities with individualized, tailored computer-based activities embedded in a 'virtual world' environment. Interactive multimedia can offer a confidential, tailored, and motivational educational experience. Virtual world game interfaces offer further potential to immerse the learner. The purpose of this study was to evaluate the multimedia education program component of IYG on student attitudes of importance of the curriculum content, self-efficacy regarding refusal skills, and usability parameters of ease of use, credibility, understandability, acceptability, and motivation to determine that a broader efficacy field test would be indicated. Results of the study indicated acceptable usability criteria and impact on short-term psychosocial outcomes. IYG is currently being evaluated in a randomized controlled trial in ten Texas middle schools.