Evaluating a Transformational Health Game to Influence Perceptions of the Condoms-as-Evidence Policy.

Objective: Some countries treat carrying condoms as evidence of prostitution, commonly referred to as "condoms-as-evidence" policy/practice. This policy has deleterious outcomes on the health and safety of sex workers worldwide. This study evaluates the impact of a simulation game that advocates against the policy in an effort to increase advocacy attitudes and intentions against condoms-as-evidence policies and practices. Materials and Methods: A between-subjects randomized experiment (N = 70) was conducted to evaluate the effectiveness of the intervention game relative to a pamphlet. The game, Cops & Rubbers, is a simulation-based tabletop game situating participants in the role of a sex worker trying to balance competing financial, safety, and health-related goals. The research for and development of the pamphlet was funded by Open Society Foundations to highlight the impact of the condoms-as-evidence policy and elicit advocacy efforts. Results: Although the game elicited similar levels of advocacy attitudes toward the pamphlet, it elicited significantly higher advocacy intentions than the pamphlet. Conflicting results were witnessed in psychological reactance. Conclusion: The present results demonstrate the utility of games as an advocacy tool for health and human rights among a polarizing topic such as sex worker advocacy. These results have both practical utility and research implications. From a practical standpoint, we demonstrate that the game can increase advocacy intentions and tangibly contribute to human rights and health issues. Furthermore, these results have the potential to inform novel game design strategies to influence persuasive outcomes in transformational games.