Antimicrobial ResistanceNCT05445414
A Mobile App Serious Game to Increase Awareness of Antibiotic Use in the Community
A study testing "SteWARdS Antibiotic Defense" app in people with Antimicrobial Resistance, run by Tan Tock Seng Hospital at 1 site in Singapore.
Trial 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). Read more about this study
- Who is it for?
- Ages 18 to 65 yearsHealthy volunteers can take part
- Conditions the study is for
- Antimicrobial Resistance
- What is being tested?
- "SteWARdS Antibiotic Defense" app
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 480 participants
- Where
- 1 siteSingapore
- Study dates
- 4 Jan 2022to 31 Aug 2023
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Aged 18 - 65 years
- Have access to an Android smartphone
- Able to comprehend the English language
Who cannot join
- Unable to install Android mobile applications
- Not proficient with using smartphone applications
- Cognitive or visual impairment
Trial locations and contacts
1 site in 1 country.
About this study
Official title: A Mobile App Serious Game to Increase Public Awareness of Appropriate Antibiotic Use in the Community
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.
Read more
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.
Read the 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.
- Conditions
- Antimicrobial Resistance
- Being tested
- "SteWARdS Antibiotic Defense" app
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
"SteWARdS Antibiotic Defense" appDevice
The "SteWARdS Antibiotic Defense" app is an evidence-based serious game app developed by the study team. The app uses gamification theories to increase user engagement and to deliver bite-sized information to participants. For example, players will learn about the uses of antibiotics through the messages delivered through the game and the cost of tackling antibiotic-resistant infections through purchasing an expensive antibiotic with the virtual currency earned from the games.
| Study group | Role | What they receive |
|---|---|---|
| Intervention group | Experimental | Participants randomized to the intervention group will be asked to use the "SteWARdS Antibiotic Defense" app-an evidence-based serious game app developed by the study team-for a minimum of five days. They will also need to complete three sets of questionnaires - one set at baseline, one set after completing the quest in the app, and another set 6-10 weeks after they complete the quest in the app. Receives: Device: "SteWARdS Antibiotic Defense" app |
| Control group | No intervention | Participants randomized to the intervention group would be asked to complete two sets of questionnaires - one set at baseline and another set 6-10 weeks later. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in the knowledge, attitudes, and perception of participants towards antibiotics use.
Change in the knowledge, attitudes, and perception of participants towards antibiotics use and AMR at 6-10-weeks post-intervention from the baseline, measured by the survey. The immediate knowledge change will be measured by the in-app questionnaire knowledge questions, post-completion of the game quest.
Measured: Baseline, immediate completion of intervention, 6-10 weeks post intervention
Secondary outcomes (2)
User engagement level
The time spent on the app each day, tracked by the study team backend
Measured: Five days - 2 weeks
Satisfaction level of playing the games in the app
Satisfaction level of playing the games in the app after completing the game quest via a questionnaire
Measured: Immediately completing the game quest in the app
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Jul 2022
- Study start4 Jan 2022
- Primary completion29 May 2023
- Study completion31 Aug 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Antimicrobial ResistanceStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- 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
- Masking
- None (open label)
- Enrolment
- 480 participants (actual)
Sponsor and investigators
- Lead sponsor
- Tan Tock Seng Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- National Healthcare Group Polyclinics, Temasek Polytechnic
- Responsible party
- Sponsor
- Investigators
- Zhilian Huang, Ph.D, Principal investigator, Tan Tock Seng Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05445414
- Sponsor's protocol ID
- FY2022HZ
- Status last verified
- Oct 2023
- First submitted
- 27 Jun 2022
- Last updated
- 18 Oct 2023
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data will not be shared with other researchers to ensure participants' data confidentiality.
Publications
Huang Z, Ow JT, Tang WE, Chow A. An Evidence-Based Serious Game App for Public Education on Antibiotic Use and Resistance: Randomized Controlled Trial. JMIR Serious Games. 2024 Sep 5;12:e59848. doi: 10.2196/59848.
PubMed 39235853Huang Z, Tang WE, Guo H, Natarajan K, Lee TH, Yeo TW, Chow A. An Evidence-Based Serious Game App for Public Education on Antibiotic Use and Antimicrobial Resistance: Protocol of a Randomized Controlled Trial. JMIR Res Protoc. 2023 Mar 28;12:e45833. doi: 10.2196/45833.
PubMed 36976619
Study at a glance
From the registry record, last updated by the sponsor on 18 Oct 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Mobile App Serious Game to Increase Public Awareness of Appropriate Antibiotic Use in the Community
- ClinicalTrials.gov ID
- NCT05445414
- Acronym / sponsor ID
- FY2022HZ
- Conditions
- Antimicrobial Resistance
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 480 participants (actual)
- Lead sponsor
- Tan Tock Seng HospitalUniversity, hospital or other
- Collaborators
- National Healthcare Group Polyclinics, Temasek Polytechnic
- Study start
- 4 Jan 2022 (actual)
- Primary completion
- 29 May 2023 (actual)
- Study completion
- 31 Aug 2023 (actual)
- First posted
- 6 Jul 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- 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
| Arm | Type | Receives |
|---|---|---|
| Intervention group | Experimental | Device: "SteWARdS Antibiotic Defense" appParticipants randomized to the intervention group will be asked to use the "SteWARdS Antibiotic Defense" app-an evidence-based serious game app developed by the study team-for a minimum of five days. They will also need to complete three sets of questionnaires - one set at baseline, one set after completing the quest in the app, and another set 6-10 weeks after they complete the quest in the app. |
| Control group | No intervention | –Participants randomized to the intervention group would be asked to complete two sets of questionnaires - one set at baseline and another set 6-10 weeks later. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Aged 18 - 65 years
- Have access to an Android smartphone
- Able to comprehend the English language
Key exclusion criteria (3 listed)
- Unable to install Android mobile applications
- Not proficient with using smartphone applications
- Cognitive or visual impairment
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| "SteWARdS Antibiotic Defense" appThe "SteWARdS Antibiotic Defense" app is an evidence-based serious game app developed by the study team. The app uses gamification theories to increase user engagement and to deliver bite-sized information to participants. For example, players will learn about the uses of antibiotics through the messages delivered through the game and the cost of tackling antibiotic-resistant infections through purchasing an expensive antibiotic with the virtual currency earned from the games. | Device | Intervention group |
Primary outcome
Change in the knowledge, attitudes, and perception of participants towards antibiotics use.
Time frame: Baseline, immediate completion of intervention, 6-10 weeks post intervention
Change in the knowledge, attitudes, and perception of participants towards antibiotics use and AMR at 6-10-weeks post-intervention from the baseline, measured by the survey. The immediate knowledge change will be measured by the in-app questionnaire knowledge questions, post-completion of the game quest.
2 secondary outcomes
User engagement level
Time frame: Five days - 2 weeks
Satisfaction level of playing the games in the app
Time frame: Immediately completing the game quest in the app
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Oct 2023.
- Derived from this study: PubMed 39235853Huang Z, Ow JT, Tang WE, Chow A. An Evidence-Based Serious Game App for Public Education on Antibiotic Use and Resistance: Randomized Controlled Trial. JMIR Serious Games. 2024 Sep 5;12:e59848. doi: 10.2196/59848.
- Derived from this study: PubMed 36976619Huang Z, Tang WE, Guo H, Natarajan K, Lee TH, Yeo TW, Chow A. An Evidence-Based Serious Game App for Public Education on Antibiotic Use and Antimicrobial Resistance: Protocol of a Randomized Controlled Trial. JMIR Res Protoc. 2023 Mar 28;12:e45833. doi: 10.2196/45833.
- Individual participant dataSharing planned: No. Individual participant data will not be shared with other researchers to ensure participants' data confidentiality.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Zhilian Huang, Ph.D principal investigator
Tan Tock Seng Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing "SteWARdS Antibiotic Defense" app in people with Antimicrobial Resistance, run by Tan Tock Seng Hospital at 1 site in Singapore.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 18 Oct 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in the knowledge, attitudes, and perception of participants towards antibiotics use. (time frame: Baseline, immediate completion of intervention, 6-10 weeks post intervention). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05445414, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Oct 2023.