Abstract

This study looks at the limits and possibilities of an online game designed to build knowledge and awareness in adolescents in the field of affections, sexuality and reproduction. It evaluates the experience of a group of teenagers with a game called Papo Reto (‘Straight Talk’), over a period of three months. A total of 23 teenagers aged 15 to 18 took part in the study. The data were collected in two workshops held at a secondary school in the city of São Paulo (São Paulo State), Brazil. The dialogs were recorded and transcribed, and their content analyzed. The results showed a variety of possibilities of the Straight Talk online game for reconstruction of knowledge in the field of sexuality, and for helping the subject perceive and analyze the complexity of reality from a gender point of view. The subjects covered in the game were assessed, as motivating factors for the game and for the interaction. Adjustments were suggested for inclusion of elements to create a more ludic quality, more interaction, in the game.

Adolescent; Sexuality; Gender; Games and toys; Health education

Introduction

In Brazil, the subject of sexuality has been gaining increased space in schools, with the principal aim of preventing sexually transmitted diseases (STDs) and teenage pregnancy¹1. Brasil. Ministério da Educação (MEC). Secretaria de Educação Fundamental. Orientação Sexual. Brasília: Ministério da Educação; 2005..

More concern has recently been shown in various sectors, especially those of health and education, to seek strategies for facing adolescents’ problems that will translate into results that are more consistent, and harmonized with the specificities and singularities of this group in relation to sexuality. This field has received attention in terms of policies and practices in the various social spaces that involve young people¹1. Brasil. Ministério da Educação (MEC). Secretaria de Educação Fundamental. Orientação Sexual. Brasília: Ministério da Educação; 2005.^,22. Russo K, Arreguy ME. Projeto “Saúde e Prevenção nas Escolas”: percepções de professores e alunos sobre a distribuição de preservativos masculinos no ambiente escolar. Physis 2015; 25(2):501-523..

However, proposed educational practices have tended to emphasize actions formulated under the ‘biologicist’, verticalized, conception of health – distant from the context of adolescents’ real lives³3. Souza V. Adolescentes em cena: uma proposta educativa no campo da saúde sexual e reprodutiva. Rev Esc Enferm USP 2011; 45(n.esp2):1716-1721..

This creates a need for practices based on proximity to the real life experiences of adolescents, able to stimulate an exchange of experiences, critical-reflexive reasoning and their own protagonism in the field of affection, sex and reproduction. As a result, new approaches have been proposed to adolescents’ sexuality through active technologies that favor interaction and the production of new ways of involving the subjective.

Among these, this study highlights the use of games to create an approach to sexuality for adolescents that is ludic, and interactive. In health, there are innumerable educational practices that use games to facilitate a simulation of content. One observes, however, that they have very often been referred to as a resource that is complementary to the practice of education. In these games, the paths taken are usually previously established, including right-and-wrong situations – this runs the risk of undermining the players’ opportunity to build their own path, and limits any opening to invention and the creative process. Other experiments, on the other hand, show game formats with paths that are freer, in which a more privileged position is given to the player’s production of meanings, and subjectivity⁴4. Toscani NV, Santos AJDS, Silva LLM, Tonial CT, Chazan M, Wlebbelling AMP, Mezzari A. Desenvolvimento e análise de jogo educativo para crianças visando à prevenção de doençasparasitológicas. Interface (Botucatu). 2007; 11(22):281-294.

5. Barbosa SM, Dias FLA, Pinheiro AKB, Pinheiro, PNC, Vieira NFC. Jogo educativo como estratégia de educação em saúde para adolescentes na prevenção às DST/AIDS. Rev. Eletrônica Enferm 2010; 12(2):337-341.^-66. Araújo RB, Oliveira MMA, Cemi J. Desenvolvimento de role-playing game paraprevenção e tratamento da dependência de drogas na adolescência. Psic. Teor. e Pesq 2011; 27(3):347-355..

Those who study games in the educational process for training of health professionals⁷7. Pires MRG, Guilhem D, Göttems LBD. Jogo (IN)dica-SUS: estratégia lúdica na aprendizagem sobre o sistema único de saúde. Texto Contexto Enferm 2013; 22 (2):379-388. point to reflections that question whether it is possible for the normative environment of education not to restrain the spontaneous, free, disinterested and liberation character of games. This consideration aims for an effective relationship between liberation and critical pedagogies, and the emancipatory attributes of the ludic – seeking an interface between concepts that guide the ludic dynamic and the educational activity which, without necessarily subordinating one to the other, could potentialize the subjects’ creation by the exercise of liberty. Thus, the quest for a path for education that makes maximum use of the emancipatory characteristics of the ludic “needs to cultivate, up to the limit of the possible, a disinterested linking between the game and education”⁷7. Pires MRG, Guilhem D, Göttems LBD. Jogo (IN)dica-SUS: estratégia lúdica na aprendizagem sobre o sistema único de saúde. Texto Contexto Enferm 2013; 22 (2):379-388..

The game Papo Reto was conceived as a pedagogic device for approaching the subject of sexuality in adolescents. It aims to make the adolescent a protagonist, promote critical-reflexive thought, and build knowledge/awareness, using its ludic quality, and interaction. Its construction was thus based on contents relating to game theory⁸8. Huzinga J. Homo Ludens: o jogo como elemento da cultura. 5a ed. São Paulo: Perspectiva; 2010.^,99. Caillois R. Os Jogos e os Homens: a máscara e a vertigem. Lisboa: Editora Cotovia; 1990.. This conceptual field, articulated with the category gender, was the basis of the theoretical conception of this present study.

In the point of view on which this study is based, a game can be defined as “a free action, not motivated by interest, conscious, frivolous, lived in a fictitious realm, and situated beyond the bounds of current daily life”⁸8. Huzinga J. Homo Ludens: o jogo como elemento da cultura. 5a ed. São Paulo: Perspectiva; 2010.. This being a voluntary and pleasurable activity, the ludic nature of games favors dialog, group creation of knowledge, and development of autonomy in challenging and reflexive contexts⁷7. Pires MRG, Guilhem D, Göttems LBD. Jogo (IN)dica-SUS: estratégia lúdica na aprendizagem sobre o sistema único de saúde. Texto Contexto Enferm 2013; 22 (2):379-388.. The game proposed here is in the category of Mimicry⁹9. Caillois R. Os Jogos e os Homens: a máscara e a vertigem. Lisboa: Editora Cotovia; 1990., which consists of mimic and disguise, in such a way that the player escapes from his/her social role and assumes the role of the chosen character. Through mimicry, materialized in the figure of the avatar that is chosen, the adolescent has greater liberty to express what s/he really thinks. From a point of view of gender and emancipation, the game takes into account the social construction of sexuality, and the articulation with other social constructs that make possible the different life experiences of masculinity and femininity.

This is an online game aimed at teenagers aged 15 to 18, in which the scenario is a city in which various spaces can be progressively accessed – Home, School, Internet, Clubs and Street, as the player responds to the problem situations and interacts with his/her peers. The situations simulate realities experienced by the adolescents, presenting growing levels of complexity and depth.

There are set subjects related to each space, except for the Street, where the content is freely chosen. Examples of subjects dealt with in the Home space are: discovery of the body, and dialog with parents; in the school – love relationships, jealousy or trust; in Clubs – Drugs, attraction, seduction; on the Internet – pedophilia, and online sex. At the same time as players take positions in relation to the situations they face, they can also Like, Dislike or Comment on other players’ answers. They can also become Contributors, posting their own situations or questions.

The Papo Reto game aims to provide achievement through a ludic and free environment of pre-conceived responses, in which the interaction becomes the central element for reconstruction of knowledge and for a critical-reflexive positioning in relation to the reality presented and shared. The exercise of presenting reality for analysis in its complexity is found to be essential to the process of learning – in this case making it possible to come and go, create and reinvent the virtual reality, without the hard and heavy consequences of daily life.

Thus, this study aims to analyze the limits and the potentialities of the Papo Reto game, for construction of knowledge in the field of sexuality with adolescents.

Method

The Papo Reto game is accessible by invitation, which offers a username and password to previously registered users. It is the product of a research project by a partnership between the Nursing School of São Paulo University (EEUSP) and the Nursing School of the Federal University of Minas Gerais (UFMG). It is hosted in the IT environment of the Collective Health Nursing Department of EEUSP, and managed by the research team. It has been and is being used by adolescents from secondary schools of São Paulo and Belo Horizonte, undergraduate and postgraduate students in nursing, health teachers and professionals, on an experimental basis, with approximately 200 users registered.

This is a descriptive and exploratory study in which the context is a municipal secondary school in the city of São Paulo, Brazil. Until December 2014 the school had 320 registered pupils, of which 308 were invited to play and take part in the survey. Pupils who could not be contacted on any occasions of delivery of the invitations and presentation of the project were not invited.

Students from age 15 to 18, interested in taking part in the game and the investigative process, with authorization from father, mother, or legal guardian for children under 18, took part. The population comprised 62 teenagers. The others did not state any interest, or did not obtain the consent of their legal guardians. The access information and passwords were sent by email to the participants in August 2014. By the end of October of that year, 27 teenagers had accessed the game. Three months after sending of the registry details, those that accessed the game received a personally-delivered invitation to take part in the workshop.

For collection of data, the modality of Critical-Emancipatory Workshop (Oficina de Trabalho Crítico-emancipatória – or OTC)¹⁰10. Fonseca RMGS, Amaral MA. Reinterpretação da potencialidade das Oficinas de Trabalho Crítico-Emancipatórias. Rev Bras Enferm 2012; 65(5):780-787. was used. The OTC was held in November 2014, with 23 adolescents participating, divided into two groups, one comprising first-year pupils, and the other second- and third-year pupils.

The Critical-Emancipatory Workshop involves a process of collective construction of knowledge/awareness, based on the methodology of statement of problems, emancipatory education, and emotions as builders of knowledge. It is considered to be a powerful teaching tool for bringing together research and intervention. A characteristic of the strategy is the relaxed environment, facilitated by the use of teaching practices that incentivize integration and an equitable power relationship between participants and researchers¹⁰10. Fonseca RMGS, Amaral MA. Reinterpretação da potencialidade das Oficinas de Trabalho Crítico-Emancipatórias. Rev Bras Enferm 2012; 65(5):780-787..

The workshop comprises a systematized sequence of stages¹⁰10. Fonseca RMGS, Amaral MA. Reinterpretação da potencialidade das Oficinas de Trabalho Crítico-Emancipatórias. Rev Bras Enferm 2012; 65(5):780-787.: Warming up, Development (individual and group reflection), Synthesis and Assessment. As a support to facilitate reflection and interaction, dynamics such as games, dramatizations and other structures are used.

In the specific case of this study, an initial warmup was employed in which the individuals presented themselves and spoke freely about the Papo Reto game. This provided a moment of relaxation and the initial interaction between the group, and with the researchers. In the next stage, the map of the game was drawn on the floor of the room, and the participants took up positions in the various spaces, in accordance with their preference. Reflecting and discussing the experience that they had as players, they evaluated the design and the dynamic of the game, relating its spaces to the social spaces that they occupy.

The subjects for discussion were brought up on the basis of the problem-situations of the game, presented through dramatization, reading and video projection. The contents gave rise to discussions/arguments, debates and various reactions such as laughter, shouts and silence, in a relaxed and entertaining environment. Then, set out in a circle, the teenagers freely discussed their experience with the game. At the end, the coordinator put forward a summary, stating the central contents constructed by the group, and adding new contents in relation to sexuality, from the point of view of gender equality.

The last stage was the assessment of the workshop. Various objects were made available and it was proposed that each participant should choose one that represented the experience they had had. While speaking about their choice, they evaluated the workshop and also the experience with the game, in a fertile linking of their experiences with the process of construction of the knowledge.

The entire workshop was filmed, and the speeches recorded and transcribed in their entirety. The resulting empirical material was submitted to decodification by content analysis¹¹11. Minayo MCS. O desafio do conhecimento. Pesquisa qualitativa em saúde. São Paulo: Hucitec; 2006.. The study was carried out in accordance with the requirements of Health Ministry Resolution 466/12. The project was approved by the Ethics Committee on Research on Human Beings of the Federal University of Minas Gerais and of the School of Nursing of São Paulo University.

All the participants signed the Consent Form to take part in the study and those under the age of 18 delivered the Informed Consent Form signed by their legal guardians.

To ensure anonymity of the participants, and facilitate understanding on the context of the speeches, the interviewees were identified by nicknames that they themselves chose at the beginning of the workshop.

Results

From the content analysis of the discourses, subjects were extracted that constituted empirical categories that made it possible to assess the game, its limits and potentialities in the educational context for construction of knowledge in the field of the adolescents’ affective-sexual relationships.

Category 1 – the game articulated with the adolescents’ lives

The school was emphasized as a privileged space, both in the game, due to the subjects dealt with, and also in life, because it is the space of significant experiences for discovery of sexuality and possibilities of dialog with peers, of the same generation. These aspects can be seen in the following excerpt:

The school is the place where we talk the most about everything. We all have the same age, the same doubts and the dialog is easier. With my colleagues I don’t have any difficulty in talking about anything, but with my parents I have difficulty in talking about sexuality. (Kath)

In the statements, sex and sexuality were evidenced as subjects historically veiled in the spaces of dialog that are created in the institutions, such as family, health and school. Thus, the game appeared as a motivator of interaction and dialog, including with family members:

I started to play, and I saw that there were some slightly embarrassing questions in the House phase. My mother came past, saw it and said: Answer that one! And I thought: Hey, that’s really good, this Papo Reto has brought me together with my mother to talk about sex. What a strange thing. Something I really didn’t expect! She hardly talks to me about anything, and here she was talking about sex. (Negro)

As well as the spaces represented in the game, the teenagers also considered the subjects and the problem-situations to be stimulating, and convergent with their experiences in daily life.

I think it’s really cool that the game deals with [sexual] diversity, since it’s something that’s very real, present in people’s lives. (Ramona)

Another aspect that participants considered to be attractive, in favor of the Game, was highlighted the choice of subjects.

I thought it was really good, because of the subjects. There were things there that I didn’t know, in reality I hadn’t the slightest idea. And I liked the game a lot. (Vera)

Also, the players appreciated the anonymity, which ensured that the player had freedom of expression and could take a critical positioning without risk of being identified.

This thing of you not needing to put your name is good – in that you don’t expose yourself much: it makes us feel less shy, more at ease to, kind of, put your opinion out there. (Prima)

The progressive levels of complexity and depth of the subjects dealt with in the problem-situations of each space of the game – Home, School, Street, Clubs and Internet – were also indicated by the teenagers as a source or greater or lesser interest depending on the level of distance or proximity in relation to their own living experiences in the various social spaces. In the next excerpt the player makes clear his preference for the spaces that he considers to be closest to his real experience:

In the game I did get as far as the internet, but I identified more with the situations of home and school, because in the internet there were some things that I had not been in contact with yet. (Alma)

As an example of the opening-up that the game makes possible, here is one situation: In an activity for assessment of the workshop, in which the teenagers had to choose an object that remitted to the Papo Reto game, one participant mentioned the padlock, symbolizing the possibility of interaction and transformation:

I chose the padlock, because before playing the game, you are kind of closed-up, without knowing what’s going to happen. Then you open up, and afterward you feel like an unlocked padlock, open to anything, to discuss with people, to exchange ideas. This padlock is a symbol of the game because: At the beginning it’s closed, and when it leaves, it’s open. I come out like this: [opens the padlock]. (Mar)

Category 2 – The interaction as possibility

Another fundamental characteristic of Papo Reto is the priority that it gives to interaction between peers. In the comments, interaction was pointed to as a way of getting the player’s attention while waiting for the comment of the other participants on the answer the player had posted in the game. It was revealed as one of the most attractive elements of the game, because it made it possible not only to rethink one’s own positions, but also to state opposition or embarrassment in relation to the positioning of the other players.

In moments like that I was very attached to the game, because I was waiting for the opinion and comment of the person on what I had said. (Jacke)

Everything in the game are things that shake you up and make you think. (Magabis)

For some of the participants this interaction could be even more powerful, if the game were to enable the player to give responses and counter-responses, through creation of a chat:

To see the answers from other people helps you to form another opinion – as indeed commenting, seeing the comments, all of this, does. I agree with them that there should be a chat, to permit a greater interaction between people. (Prima)

The subject of protagonism emerged from the discourse of one teenager, and was confirmed by the group with affirmative gestures, when he revealed the similarity of the game with the discourse recommended by the school:

Here in the school they talk about protagonism the whole time, and in the game we actually have protagonism: we put forward our opinion, say what we want, and like or dislike what we wish to, without anyone prohibiting us. (Negro)

Category 3 – Reconstruction of knowledge: Limits and potentialities of the Papo Reto game

Based on the assessment of the experience of use of the first version of the game, the teenagers confirmed the potential of Papo Reto for construction of knowledge about sexuality. What the teenagers said also affirmed the game as a pedagogical device capable of transforming and reinventing reality, without being obligatorily linked to the traditional educator-pupil relationship. The next testimony shows the reconstruction of knowledge based on the reflection caused by the interaction of the game.

After we replied, and saw the others’ replies right there, we thought: Hey! Is what I wrote really right? So then you evaluate – that on some points you are right, and on others, you need to look again. When we see what the other people reply, in one way or another our opinion will change. I reflected on what I had written after I saw other people’s responses. (Negro)

The results also confirmed the potential power of the contents to present the complexity of reality from the point of view of gender.

These questions of differences between men and women, in the game, we often stop to think about [...]. For example, some people say they think women have totally the right to express their opinion, others say this is ugly, looks vulgar. The game brings out many of these opinions and it depends on how you are going to interpret that. (Magabis)

Violence in intimate relations also emerged in the discourses; they referred to certain situations of the game, and also, in the workshop, when they were invited to play out some of the situations contained in Papo Reto. These experiences generated a rich discussion between the group, involving different reactions of the participants, sometimes reaffirming and accepting situations of aggressiveness as part of the relationship of intimacy of a couple, and sometimes taking a definitive position against such types of reaction:

There was a question there, in which the boy hit his girlfriend and it asked what the girl should do. Then one person replied that the guy was right to do this, that he should even hit her more, for the woman to respect the man, so I got in there and commented, I wrote a whole lot of stuff. I didn’t like it. (Batatinha)

At the end of the OTC the participants suggested holding similar meetings for discussion of sexuality, also, raising the possibility of playing again to expand their perceptions on the subject.

I think we should have one more, one more chance to play after this conversation [the workshop] and have another meeting, because I think that we’ll look at the game differently, after this discussion. (Piper)

They also considered the OTC as an opportunity for opening of dialog between girls and boys, especially because they felt more free to express themselves on a subject that is still marked by embarrassment:

I’m leaving here now less embarrassed to talk about this, especially with girls, because previously I used to deal with these subjects more kind of talking like a kid, but with girls I couldn’t really exchange this type of idea. But at least as from today I have more freedom to talk. [The group applauds] I think this meeting has been really good. (Dani)

Discussion

The results confirm the metaphorized spaces of Papo Reto as being in line with the users’ experiences in the field of sexuality, and the game, as a provider of interaction and dialog. The school and the family did not emerge as especially successful scenarios for dealing with these subjects, since it is in the joint experience of life with their peers that teenagers share knowledge and experiences that involve sexuality.

The limits of the approach to sexuality in the school and in the family have been emphasized in other studies, which point to these social spaces as institutions with discourses that are more centered on traditional preventive methods, often curtailing influences, with a focus still limited to the aspects related to promotion of health and citizenship³3. Souza V. Adolescentes em cena: uma proposta educativa no campo da saúde sexual e reprodutiva. Rev Esc Enferm USP 2011; 45(n.esp2):1716-1721.^,1212. Pirotta KCM, Barboza R, Pupo LR, Unbehaum S, Cavasin S. Programas de orientação sexual nas escolas: uma análise das lacunas na implementação de políticas públicas a partir da percepção dos alunos da rede municipal de ensino de São Paulo. RG&PP 2013; 3(1):190-210..

International studies emphasize the growth of the use of “serious games” (games formulated for specific purposes), also in the field of health. The purpose of these games is training of health professionals, and also transformation of their practices in relation to specific problems such as abuse of alcohol, sexual abuse, prevention of HIV, sexual education of children and adolescents, and other subjects¹³13. Goldberg A, Katz D, Wang R, DeMaria S Jr. A Systematic Review of SeriousGames in Training Health Care Professionals. Simul Healthc 2016; 11(1):41-51.^,1414. Jander A, Crutzen R, Mercken L, Candel M, de Vries HJ.Effects of a Web-Based Computer-Tailored Game to Reduce Binge Drinking Among Dutch Adolescents: A Cluster Randomized Controlled Trial. Med Internet Res 2016;18(2):e29.. Based on the games it is possible to create active spaces of learning for immersion of the players in a world that removes them from the facts, but which has a profound relationship with the contents to be dealt with. From this point of view, the player is an active and autonomous subject¹⁵15. Day-Black C, Merrill EB, Konzelman L, Williams TT, Hart N. Gamification: An Innovative Teaching-Learning Strategy for the Digital Nursing Students in a Community Health Nursing Course. ABNF J 2015; 26(4):90-94..

The teenagers’ preference for the spaces Home and School, due to their being closer to their experiences, also pointed to the potential of the game to simulate situations that represent the reality of this social group. In this aspect, the School space of the game – school being the first institution of socialization between peers – has rich possibilities for use of the interactions, and of an informal education which also takes place outside its region of dominance.

Research studies point to the school as the highlight social space in relation to the process of promotion of adolescents’ sexual orientation. However, in general, this area of issues is expressively dealt with through technical contents and with verticalized methodologies for transmission of contents, without investment in the qualification of teachers and professionals involved. This verticalization of educational approach is also seen in the practice that brings together health professionals and the school for the promotion of sexual orientation, centered on the prevention of STDs and AIDS and prevention of teenage pregnancy¹⁶16. Borges JPA, Moura-Ferreira MC. Orientação sexual para adolescentes: conhecimento e prática de docentes das escolas públicas/Orientación sexual para adolescentes: conocimiento y práctica de profesores de escuelas públicas/Sexual orientation for teens: knowledge and practice of teachers at publics chools. Rev. enferm. atenção saúde 2015; 4(1):89-96.^,1717. Notahft SCS, Zanatta EA, Brumm MLB, Galli KSB, Erdtmann BK, Buss E, Silvan PRR. Sexualidade do adolescente no discurso de educadores: possibilidades para práticas educativas. Rev Min Enferm 2014; 18(2):284-289..

In relation to the experience with the Papo Reto game, the results confirm that the dialog, and the sharing of experiences, ideas and opinions between the parties, are elements that are capable, on their own, of generating emotions and reflections through a shared tension that has repercussions on the construction of knowledge caused by the game. This process takes place in a way that is freer than the approaches based on pre-established conceptions. The motivation toward dialog, for reflection about their reality based on interaction with other players, and the answering of doubts, was apparent ‘between the lines’ of the reports.

The player’s immersion, interaction, challenge, entertainment, control and skills are the primary components of the experience with the game. Papo Reto was revealed as a game whose rules were easy to understand and which involved the players due to its proximity to reality – an aspect that is in line with the recommendation that a game should not require the participant to have special skills, but sufficient information enabling it to be played without an excessive requirement for information that might discourage the player⁷7. Pires MRG, Guilhem D, Göttems LBD. Jogo (IN)dica-SUS: estratégia lúdica na aprendizagem sobre o sistema único de saúde. Texto Contexto Enferm 2013; 22 (2):379-388..

Negative emotions such as fear, anxiety and embarrassment can interfere with the motivation of a young person to access a game about sexuality. The development of games for sexual orientation of young people involves the challenge of making the game attractive, since in principle, the role of a game is a ludic one. It’s necessary for there to be a reason for people to seek the game and play it for long enough to cause the transformation that its use is intended to achieve. It’s necessary to be aware that not all adolescents are players, and an attractive game needs to contain characteristics that are accessible for those who do not usually play¹⁸18. Shegog R, Brown K, Bull S, Christensen JL, Hieftje K, Jozkowski KN, Ybarra ML Serious Games for Sexual Health. Games Health J 2015; 4(2):69-77..

The participants’ testimonies also confirm that the game is pertinent to the representation of the real on the level of the symbolic. In this category, adolescents can test choices, simulate realities and dissimulate their personalities in favor of their authentic construction⁵5. Barbosa SM, Dias FLA, Pinheiro AKB, Pinheiro, PNC, Vieira NFC. Jogo educativo como estratégia de educação em saúde para adolescentes na prevenção às DST/AIDS. Rev. Eletrônica Enferm 2010; 12(2):337-341.. This causes the interactions to occur in a manner that is more free, without the censures and constraints of the instituted discourse, providing openings for invention¹⁹19. Oliveira TRM. Encontros possíveis: experiências com jogos teatrais no ensino de ciências. Ciên. Educ 2012; 18(3):559-73., the unexpected and provocation, causing the player to see him/herself as incited to take a position, and change position.

In these cases, education is credited to a process of reconstruction of experiences, which is ratified in the speech of the adolescents when they emphasize the proximity of the situations in the game to their own realities, the amplification of experiences, the critical reflection and, as a result, personal and autonomous growth. This was confirmed by the group when they spontaneously brought the subject of protagonism into the discussion.

In Brazil, the last decade has been rich in legal guarantees for adolescents’ status as protagonists. The ‘National Guidelines for Integral Healthcare of Adolescents and Young People’ (Diretrizes Nacionais para a Atenção Integral à Saúde de Adolescentes e Jovens na Promoção, Proteção e Recuperação da Saúde)”²⁰20. Moraes SP, Vitalle MSS. Direitos sexuais e reprodutivos na adolescência: interações ONU-Brasil. Cien Saude Colet 2015; 20(8):2523-2531., which focus on work with adolescents and young people, centers on young people’s and adolescents’ capacity to take positions in relation to their life and their health. Thus, in legal terms, a line of activity with adolescents has been set down in which full development is centered on development of the skills necessary to achieve autonomy and guarantee rights.

In this study, the expressed desire of the adolescents in relation to development of their autonomy can be seen from the discourses. The protagonism relates to attitude and action in the direction of responsible acquisition of knowledge, which is necessary to their formation as citizens. Thus, the adolescent becomes capable of proposing initiatives and assuming positions of leadership, discovering and developing responsibilities²¹21. Silva MCAL, Cruz VMAC, Silva FF. A aprendizagem significativa: uma interface com protagonismo juvenil numa perspectiva socioafetiva. Rev Psicopedagogia 2013; 30(91):12-20..

Recognizing the format of the Papo Reto game as a generator of tensions, the adolescents report the uncomfortable moments arising from the interaction, due to disagreeing with the positioning of a colleague, or being surprised by an unexpected or unusual answer or problem-situation. With this reaction they portray fundamental principles of the game such as uneasiness, imagination, creation of alternative identities, freedom of access, and the courage to solve problems⁸8. Huzinga J. Homo Ludens: o jogo como elemento da cultura. 5a ed. São Paulo: Perspectiva; 2010.^,99. Caillois R. Os Jogos e os Homens: a máscara e a vertigem. Lisboa: Editora Cotovia; 1990.. This takes place, also, even though learning is not a fundamental principle of a game – “game” being defined as an action that has no material or utility interest⁹9. Caillois R. Os Jogos e os Homens: a máscara e a vertigem. Lisboa: Editora Cotovia; 1990.^,2222. Fantini MC, ES. Videogames: processos de aprendizagem cognitiva, social e cultural em jogo. In: Grupo de Trabalho 16 (Educação e Comunicação) da 34ª Reunião Anual da Associação Nacional de Pós-Graduação e Pesquisa em Educação, 2011. Natal: Associação Nacional de Pós-Graduação e Pesquisa em Educação. [acessado 2012 jan 20]. Disponível em: http://34reuniao.anped.org.br/images/trabalhos/GT16/GT16-356%20int.pdf
http://34reuniao.anped.org.br/images/tra... . In its materiality, the game can favor projection of the player in his/her own history, enabling the player to mobilize the knowledge acquired for other instances of his/her life, who knows, even for reconstruction of new ways of being and living in the field of sexuality.

A study in 2010 on the use of games as a health education strategy for prevention of STDs, corroborates the positive aspects of the interaction as promoting shared construction of elements of knowledge³3. Souza V. Adolescentes em cena: uma proposta educativa no campo da saúde sexual e reprodutiva. Rev Esc Enferm USP 2011; 45(n.esp2):1716-1721.. In this study, the testimonies of the adolescents confirm the potential of the game as a promoter of interaction and of playfulness for learning.

Researchers in the area of games point to the advantages and disadvantages of the use of games for sexual health education. Games are an intuitive medium for young people, and when made available on popular sites can promote an increase of exposure to content, and through practice enable skills to be acquired and sustained. The disadvantages include the high cost, and the limitations on assessment of the results, which can usually be evaluated only over the long term¹⁸18. Shegog R, Brown K, Bull S, Christensen JL, Hieftje K, Jozkowski KN, Ybarra ML Serious Games for Sexual Health. Games Health J 2015; 4(2):69-77..

A systematic review study with meta-analysis investigated the efficacy of interventions promoting sexual health based on the use of games. The confidential nature of the games can encourage the users to discuss the subject of sexuality, since this still involves taboos, it being possible to adapt the messages to the needs of the individual, making the games intrinsically motivating. The study reveals that assessment of the results of application of these games showed a small change in certain behaviors of young people; but there is still a need for studies of efficacy with rigorous evaluations, over the long term, and using measures of behavior instead of only their determining factors: only two studies have evaluated changes in behavior, which were not significant²³23. DeSmet A, Shegog R, Van Ryckeghem D, Crombez G, Bourdeaudhuij I. A Systematic Review and Meta-analysis of Interventions for Sexual Health Promotion Involving Serious Digital Games. Games for Health Journal 2015; 4(2):78-90..

Some theories suggest that change of behavior depends on change in the factors in an individual that determine behavior. Thus, based on this focus, it is believed that increasing someone’s knowledge, or consciousness that the behavior in question can make the person vulnerable to more damage to health, could influence the person’s will to become involved with the behavior¹⁸18. Shegog R, Brown K, Bull S, Christensen JL, Hieftje K, Jozkowski KN, Ybarra ML Serious Games for Sexual Health. Games Health J 2015; 4(2):69-77.. However, the knowledge and the becoming aware are not the only aspects involved in transformations for change of behavior, since behavior is deeply interwoven with strict and dialectic relationships with cultural, social and subjective characteristics of each individual and of the social group to which the individual belongs, and evaluation of results based on the models predominantly used by the studies is still a challenge.

The fact that, in the Papo Reto game, teenagers come face to face with the questions dealt with in a progressive manner, with a degree of difficulty and depth in each space, was revealed between the lines of what they said, making it possible for subjects that are avoided and repressed in dialog in society to be treated in a ludic fashion, with an agenda of joy, sharing, celebration and involvement⁷7. Pires MRG, Guilhem D, Göttems LBD. Jogo (IN)dica-SUS: estratégia lúdica na aprendizagem sobre o sistema único de saúde. Texto Contexto Enferm 2013; 22 (2):379-388.. The non-confirmation of variables very close to formal education, such as theoretical-practical association, and previous contents worked on in the school, are examples of the irreverence of the game on the question of the constraints of teaching⁷7. Pires MRG, Guilhem D, Göttems LBD. Jogo (IN)dica-SUS: estratégia lúdica na aprendizagem sobre o sistema único de saúde. Texto Contexto Enferm 2013; 22 (2):379-388.. This study revealed possibilities of the Papo Reto game for construction of knowledge based on protagonism, irreverence and freedom, in a logic which, totally without educational interests, educates while transforming through experience.

The comments by the participants also dealt with violence in love relationships, a phenomenon that is present in the reality of adolescents and which has an influence in the construction of sexuality and the way of experiencing relationships in the sexual and reproductive area. We highlight that violence expressed in intimate relations between adolescents and young people is a precursor of intimate-partner gender violence – which curtails autonomous, conscious and secure exercise of sexuality²⁴24. Organização Mundial da Saúde (OMS). Prevenção da violência sexual e da violência pelo parceiro íntimo contra a mulher: ação e produção de evidência. Geneva: OMS; 2012..

At the same time as Papo Reto revealed potentialities for motivating critical reflection on questions of gender in the field of sexuality, it showed itself to be potent for the recognition of which questions are also part of adolescents’ lives. The discourses remit to gender as intrinsic to understanding of phenomena relating to sexuality, confirming the assumptions set in the conceptual stage of the study, which remit to construction of sexuality. This construction takes place within a wide, historically and socially determined, system of inequalities of gender, generation, ethnicity and social class. Dealing with sexuality jointly with gender issues is thus essential for conception of strategies that propose dealing with sexuality²⁵25. Melo VP, Gandra LRL, Amaral MA, Fonseca RMGS. Adolescência, sexualidade e gênero: possibilidades das oficinas de trabalho crítico-emancipatórias. Rev Min Enferm 2008; 12(3):390-395..

The results of this study confirm the challenge put forward, of construction of knowledge about sexuality in a manner that is free, ludic and has dialog. This process necessarily involves approximation to adolescents’ reality, rebuilding the way of producing the paths of learning, in a democratic exercise¹⁰10. Fonseca RMGS, Amaral MA. Reinterpretação da potencialidade das Oficinas de Trabalho Crítico-Emancipatórias. Rev Bras Enferm 2012; 65(5):780-787. of respect for diversity and for citizenship.

Given that, at various moments of the game, there was mobilization for reflection on the existence of inequalities in the relationships between men and women, we may conclude that the results found indicate possibilities of the game for dealing with sexuality from a point of view of promotion of gender equality. This was also indicated in the testimonials of the participants when they took positions in relation to the problem-situations proposed, and in their reactions to colleagues’ responses.

It also needs to be pointed out that there are limits to this type of approach, in view of its involvement with questions that go outside the game and which involve differences of social classes, ethnicities and age ranges. The adolescents also highlighted the holding of the OTC, after the experience of the game, as a strategy that potentializes critical reflection, and expansion of their point of view on the questions contained in the game. Thus, this study reveals significant possibilities for the interface between games and transformative education, recognizing that, as well as collective spaces of construction of knowledge, new potentialities can also be seen ahead.

Final considerations

Based on this application of the first version of the Papo Reto game, the participants of the study confirmed the possibilities of the game to be used as a pedagogic device for dealing with the subject of sexuality in adolescents. Both the motivation for dialog and the reflection on the reality were evidenced, based on the interaction with the other players, and also provision of answers to their own questions on the subject.

The results confirm the potentiality of the contents raised, for dealing with the complexity of reality from the point of view of gender; and the subjects and problem-situations are indicated as mobilizing factors for participation in the game. Another highlighted factor is their convergence with the day-to-day experience of the participants in the field of sexuality.

The testimonials confirm the relevance of the game for representation of the real at the level of the symbolic, of metaphors and characters – aspects which the adolescents also consider as favoring free expression, autonomy and protagonism. The limits pointed out by the adolescents were more related to the lack of dynamism, not being identified as remitting to inconsistency or lack of relevance in relation to the contents and form of approach of the game.

The limitations of this study mainly relate to the restricted number of adolescents who took part, making the interaction less powerful and, as a result, to a certain extent obstructing compliance with the mission of the game, which was grounded on interactions and ensuring progression of the players in the game until the space called Street is finally opened. This also meant a barrier to achieving the status of Contributor: few players achieved this condition in the game – which would have enabled them to contribute by posting new situations.

There are also limitations relating to the experimental character of this present study: the small number of players, and the short space of time in which the game was made available, meant that the game was inserted into the subjects’ school life unrelated to the contents, projects and approaches developed in the school. Although the school has been involved in the process, there is still a great gap in relation to the continuity of the project and the model of dealing with the subject matter. Many adolescents did not obtain the consent of their parents or guardians to participate in the game because it involves sexuality.

The school as a scenario of the study resulted in pupils also sharing experiences about the game in the classroom, leading other adolescents to access the device. Because this was a study in which adolescents, in the school environment, were invited and stimulated to take part in a game, to which access is restricted and takes place by invitation – which is not the case with most of the games they use – the results have limitations, because it is not yet known how the experience would be if based on spontaneous access, in non-controlled environments not linked to educational institutions. As an outcome of this first phase of application of Papo Reto, it is expected that its use with a larger number of adolescents may be able to generate new results that would contribute other processes of investigation and intervention in relation to the approach to sexuality in adolescents.

Based on the proposal constructed, it is also expected that through the interaction and communication of the meanings that circulate in the adolescents’ life environments, possibilities may be seen of reconstruction of the reality for which the discourses will be able to be re-signified and appropriated for an activity of thinking, feeling and acting in relation to the subject of gender and sexuality. It is also hoped that this study will make possible further advances in professional research, training and qualification in health.

To transfer health practices qualitatively, in education and in public policies for adolescents, priority needs to be given to the various means of facilitating processes of learning, making them more free and democratic, with the aim of educating thinking, feeling and active people for the exercise of sexuality and for the construction of a society with more gender equality for boys and girls.

Acknowledgments

We thank Fapesp, the São Paulo State Foundation to Support Research (Fundação de Apoio à Pesquisa do Estado de São Paulo) for the financial help for planning the study, which was fundamental for the development of the game; and for giving the post-doctoral internship grant from which this study resulted. Thanks also to the CNPq, for granting of the Research Productivity Scholarship to the coordinator of the plan of the study and for the post-doctoral grant that gave rise to the plan for creation of the Papo Reto game. Thanks also to Fapemig, the Minas Gerais State Foundation to Support Research (Fundação de Amparo à Pesquisa de Minas Gerais) for the financial support for the project for creation of the Papo Reto game.

References

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