Empowering Unvaccinated Youth: Feasibility, Acceptability, and Efficacy of a COVID-19 Serious Game-Based Intervention

<b><i>Objective:</i></b> To evaluate a serious game-based intervention's feasibility, acceptability, and efficacy in encouraging coronavirus disease (COVID-19) vaccination among 11-14-year-olds in the United States and assess participant experiences. <b><i>Materials and Methods:</i></b> The study, grounded in social cognitive theory and health belief model, recruited and engaged 32 English-speaking parent-child dyads with unvaccinated youths via snowball sampling and social media outreach. These dyads were randomly assigned to either the COVID-19 serious game-based intervention group (<i>n</i> = 16) or a usual care group (<i>n</i> = 16). The study measured beliefs, self-efficacy, and intentions regarding vaccination using surveys before and after the intervention, with follow-up at 2 months to evaluate vaccine uptake. Semistructured interviews provided insights into the gaming experience and study process. <b><i>Results:</i></b> All 32 eligible parent-youth dyads (16 in each group) completed the study with full participation. Most participants were Black or African American fathers, making up 75% and 81.3% of the intervention and control groups, respectively. The intervention impacted vaccine uptake, with 75% of the intervention group vaccinating their children compared with 37.5% of the control group [χ²(1, <i>n</i> = 32) = 4.57, <i>P</i> = 0.033]. Key factors for vaccine uptake included parents' motivation and youths' perceived susceptibility, with correlations of <i>r</i>(30) = 0.66, <i>P</i> = 0.006, and <i>r</i>(30) = 0.55, <i>P</i> = 0.029, respectively. The intervention reshaped youth perceptions about self and community protection. Participants expressed overall satisfaction with both the intervention and the study process. <b><i>Conclusions:</i></b> The intervention was found to be feasible and acceptable, with potential for integration into youth vaccination strategies to support COVID-19 vaccine decision-making.