Mirrored selves: The influence of self-presence in a virtual world on health, appearance, and well-being

Exploring the Relationship Between Avatar Ego Types and Communication: A Comparative Study of South Korea and the United States Based on the Expectation Confirmation Model

This research explores the significance of avatar communication in the virtual world, where individuals can create new identities and establish relationships beyond real-world limitations. Avatar users engage in virtual interactions to fulfill their desires, enjoy entertainment, and experience surrogate satisfaction. This study integrates the Expectation Confirmation Model (ECM) and Impression Management Theory (IMT) to investigate the impact of various avatar ego types on communication satisfaction and continued intention to use. Two surveys (n = 600) were administered using South Korean and American samples. The results suggest a significant relationship between expectancy confirmation and perceived usefulness. Specifically, high perceived usefulness leads to increased communication satisfaction. Also, when pre-experience expectancy confirmation is low, it positively affects communication satisfaction. In addition, the study highlights differences between Western and Eastern cultural contexts in avatar ego type's expression. This study contributes to the understanding of virtual interactions, offering theoretical insights through the integration of ECM and IMT. Theoretical and practical implications are discussed.

Virtually simulated interpersonal touch negatively affects perceived closeness and social affiliation to an avatar partner

Interpersonal touch is an essential component of human non-verbal communication, facilitating social affiliation and bonding. With the widespread use of digital interfaces and online platforms in all realms of human interactions, there are fewer opportunities for communicating through touch. Popular online platforms that virtually simulate human interactions rely primarily on visual and auditory modalities, providing limited or no capacity for the exchange of tactile cues. Previous studies of virtual interactions have explored the simulation of social touch using haptic devices, but little is known about how the visual representation of interpersonal touch is perceived and integrated into a virtual social experience. In two studies we examined how the exchange of virtual touch mediated by simulated 3-dimensional human characters, or avatars, within an online virtual environment influenced affiliation towards an unfamiliar interaction partner. Surprisingly, the exchange of virtual touch negatively affected the perceived closeness and affiliation to the partner and the social evaluation of the interaction but did not affect the level of physiological arousal during the interaction. These results indicate that the visual representation of social touch is sufficient to virtually communicate touch-related cues that impact social affiliation, but the influence of touch may be dependent on the interaction context.

The Effects of Patient Health Information Seeking in Online Health Communities on Patient Compliance in China: Social Perspective

BACKGROUND

Online health communities (OHCs) can alleviate the uneven distribution and use of medical resources and severe hospital congestion. Patients may seek health information through OHCs before or after visiting physicians, which may affect their cognition, health literacy, decision-making preferences, and health-related behaviors such as compliance. Social factors (social support, social presence, and responsiveness) are closely related to patients' health information-seeking behavior and are significantly considered in OHCs.

OBJECTIVE

This study aimed to explore the effects of patients' health information-seeking behavior (way and effectiveness) on compliance with physicians from the perspectives of patients' perceived social support, social presence, and responsiveness.

METHODS

This study established a research model from the perspective of social information processing by using the social exchange theory. An anonymous questionnaire survey was conducted with several Chinese OHCs to collect data. Partial least squares and structural equation modeling were adopted to test the hypotheses and develop the model.

RESULTS

This study received 403 responses, of which 332 were valid, giving a validity rate of 82.4% (332/403). Among the sample, 78.6% (261/332) of the individuals were aged between 20 and 40 years, 59.3% (197/332) were woman, 69.9% (232/332) lived in urban areas, and 50% (166/332) had at least a bachelor's degree. The reliability, convergent validity, and discriminant validity were acceptable. Both the way and effectiveness of patients seeking health information through OHCs have a positive impact on their compliance through the mediation of their perceived social support, social presence, and responsiveness from OHCs and other users, and patient compliance can be improved by guiding patient health information-seeking behavior in OHCs from a social perspective.

CONCLUSIONS

This study proposes a research model to corroborate that patient health information-seeking behavior (way and effectiveness) in OHCs exerts positive effects on patient compliance with the treatment and physician's advice and provides suggestions for patients, physicians, and OHC service providers in China to help guide patients' health-related behaviors through OHCs to improve patient compliance, patient satisfaction, treatment efficiency, and health outcomes.

Virtual Reality in Health Science Education: Professors’ Perceptions

Virtual reality (VR) is a simulated experience in a three-dimensional (3D) computer-simulated world. Recent advances in technology position VR as a multipurpose technology in the healthcare sector and as a critical component in achieving Health 4.0. In this article, descriptive and correlationally quantitative research is carried out on the assessments made by Latin American health sciences university professors on the didactic use of virtual reality technologies. The main objective was to analyze the differences in the perceptions expressed by the public or private tenure of the universities where the professors teach. In addition, gender and age gaps were identified in the assessments obtained from each of the types of universities. The results reveal that Latin American health science professors at private universities have a higher selfconcept of their digital skills for the use of virtual reality in the lectures. This greater selfconcept also leads to a reduction in the gender and age gaps in the participating private universities with respect to the public counterparts. It is advisable to increase both faculty training in the didactic use of virtual reality and funding for its use, mainly in public universities.

Licensing Effect of Pro-Environmental Behavior in Metaverse

The Metaverse is an important virtual venue in people's daily lives. This study examined whether pro-environmental behaviors in the Metaverse with a self-customized avatar lead to licensing effects, thereby reducing pro-environmental intention in reality. In addition, the study examined the mediating effect of self-presence on the relationship between avatar customization and pro-environmental behavior. A laboratory experiment was conducted using ZEPETO, a Metaverse platform. A total of 60 participants were randomly assigned to the self-customized avatar condition or the assigned avatar condition, and they engaged in pro-environmental behaviors on the Metaverse platform. Participants with self-customized avatars had less intention to engage in pro-environmental behavior in reality after engaging in pro-environmental behavior in the Metaverse than those with assigned avatars. Furthermore, self-presence partially mediated the relationship between avatar customization and pro-environmental intention.

Perspective-Taking in Virtual Reality and Reduction of Biases against Minorities

This study examines the effect of perspective-taking via embodiment in virtual reality (VR) in improving biases against minorities. It tests theoretical arguments about the affective and cognitive routes underlying perspective-taking and examines the moderating role of self-presence in VR through experiments. In Study 1, participants embodied an ethnic minority avatar and experienced workplace microaggression from a first-person perspective in VR. They were randomly assigned to affective (focus on emotions) vs. cognitive (focus on thoughts) perspective-taking conditions. Results showed that ingroup bias improved comparably across both conditions and that this effect was driven by more negative perceptions of the majority instead of more positive perceptions of minorities. In Study 2, participants experienced the same VR scenario from the third-person perspective. Results replicated those from Study 1 and extended them by showing that the effect of condition on ingroup bias was moderated by self-presence. At high self-presence, participants in the affective condition reported higher ingroup bias than those in the cognitive condition. The study showed that in VR, the embodiment of an ethnic minority is somewhat effective in improving perceptions towards minority groups. It is difficult to clearly distinguish between the effect of affective and cognitive routes underlying the process of perspective-taking.

Me, Myself, and Not-I: Self-Discrepancy Type Predicts Avatar Creation Style

In video games, identification with avatars—virtual entities or characters driven by human behavior—has been shown to serve many interpersonal and intraindividual functions (like social connection, self-expression, or identity exploration) but our understanding of the psychological variables that influence players' avatar choices remains incomplete. The study presented in this paper tested whether players' preferred style of avatar creation is linked to the magnitude of self-perceived discrepancies between who they are, who they aspire to be, and who they think they should be. One-hundred-and-twenty-five undergraduate gamers indicated their preferred avatar creation style and completed a values measure from three different perspectives: their actual, ideal, and ought selves. The average actual/ideal values discrepancy was greater among those who preferred idealized avatars vs. those who preferred realistic avatars. The average actual/ought values discrepancy was greater among those who preferred completely different avatars (i.e., fantasy/role-players) vs. those who preferred realistic avatars. These results, therefore, offer additional evidence that self-discrepancy theory is a useful framework for understanding avatar preferences.

Using avatars in weight management settings: A systematic review

BACKGROUND

Obesity interventions rely predominantly on managing dietary intake and/or increasing physical activity but sustained adherence to behavioural regimens is often poor. Avatar technology is well established within the computer gaming industry and evidence suggests that virtual representations of self may impact real-world behaviour, acting as a catalyst for sustained weight loss behaviour modification. However, the effectiveness of avatar technology in promoting weight loss is unclear.

AIMS

We aimed to assess the quantity and quality of empirical support for the use of avatar technologies in adult weight loss interventions.

METHOD

A systematic review of empirical studies was undertaken. The key objectives were to determine if: (i) the inclusion of avatar technology leads to greater weight loss achievement compared to routine intervention; and (ii) whether weight loss achievement is improved by avatar personalisation (avatar visually reflects self).

RESULTS

We identified 6 papers that reported weight loss data. Avatar-based interventions for weight loss management were found to be effective in the short (4-6 weeks) and medium (3-6 months) term and improved weight loss maintenance in the long term (12 months). Only 2 papers included avatar personalisation, but results suggested there may be some added motivational benefit.

CONCLUSIONS

The current evidence supports that avatars may positively impact weight loss achievement and improve motivation. However, with only 6 papers identified the evidence base is limited and therefore findings need to be interpreted with caution.

Cues for Increasing Social Presence for Mobile Health App Adoption

As mobile health apps become increasingly influential in daily life, they present an important opportunity for health communication for disease prevention. User impressions of app designs are influential for adoption. Using cues to increase feelings of being with others (social presence) is one way to encourage favorable impressions and health app adoption. To examine the impact of social context cues (conversation cues vs. community cues vs. no cue control) on two forms of social presence (emergent and transcendent social presence), we conducted an online experiment (n = 587) with US adults. We also examined the indirect effects of conversation and community cues through social presence on app trust, perceived ease of use, perceived usefulness, and intentions to use the app. We found that conversational cues elicited intended feelings for new, emergent interactions and that community cues increased perceptions of ongoing or established social formations for transcendent interactions. These cues also had positive indirect effects for increased trust, perceived usefulness, and intentions to use the health apps and should be considered when developing mHealth to improve uptake and delivery of health promotion online.

Health literacy practices in social virtual worlds and the influence on health behaviour

This study explored how health information accessed via a 3D social virtual world and the representation of ‘self’ through the use of an avatar impact physical world health behaviour.

In-depth interviews were conducted in a sample of 25 people, across 10 countries, who accessed health information in a virtual world (VW): 12 females and 13 males. Interviews were audio-recorded via private in-world voice chat or via private instant message. Thematic analysis was used to analyse the data.

The social skills and practices evidenced demonstrate how the collective knowledge and skills of communities in VWs can influence improvements in individual and community health literacy through a distributed model. The findings offer support for moving away from the idea of health literacy as a set of skills which reside within an individual to a sociocultural model of health literacy. Social VWs can offer a place where people can access health information in multiple formats through the use of an avatar, which can influence changes in behaviour in the physical world and the VW. This can lead to an improvement in social skills and health literacy practices and represents a social model of health literacy.

Analyzing Unstructured Communication in a Computer-Mediated Environment for Adults With Type 2 Diabetes: A Research Protocol

Background

Individuals with type 2 diabetes have an increased risk for comorbidities such as heart disease, lower limb amputations, stroke, and renal failure. Multiple factors influence development of complications in a person living with type 2 diabetes; however, an individual’s self-management behaviors may delay the onset of, or lessen the severity of, these complications. Social support provides personal, informal advice and knowledge that helps individuals initiate and sustain self-management and adherence.

Objective

Our aim was to gain an understanding of type 2 diabetes social interaction in a virtual environment, one type of computer-mediated environment (CME), and the social support characteristics that increase and sustain self-management in adults living with chronic illness.

Methods

This study is a secondary analysis of longitudinal data collected in a CME study, Second Life Impacts Diabetes Education & Self-Management (1R21-LM010727-01). This virtual environment replicated a real-life community where 6 months of naturalistic synchronous voice conversations, emails, and text chats were recorded among participants and providers. This analysis uses a mixed-methods approach to explore and compare qualitative and quantitative findings. This analysis is guided by two theories: Strong/Weak Ties Theory and Social Penetration Theory. Qualitative data will be analyzed using content analysis, and we will complete descriptive statistics on the quantified variables (eg, average number of ties). Institutional review board approval was obtained in June 2016.

Results

This study is in progress.

Conclusions

Interventions provided through virtual environments are a promising solution to increasing self-management practices. However, little is known of the depth, breadth, and quality of social support that is exchanged and how interaction supports self-management and relates to health outcomes. This study will provide knowledge that will help guide clinical practice and policy to enhance social support for chronic illness via the Internet.

An internet forum analysis of stigma power perceptions among women seeking fertility treatment in the United States

Infertility is a condition that affects nearly 30 percent of women aged 25-44 in the United States. Though past research has addressed the stigmatization of infertility, few have done so in the context of stigma management between fertile and infertile women. In order to assess evidence of felt and enacted stigma, we employed a thematic content analysis of felt and enacted stigma in an online infertility forum, Fertile Thoughts, to analyze 432 initial threads by women in various stages of the treatment-seeking process. We showed that infertile women are frequently stigmatized for their infertility or childlessness and coped through a variety of mechanisms including backstage joshing and social withdrawal. We also found that infertile women appeared to challenge and stigmatize pregnant women for perceived immoral behaviors or lower social status. We argue that while the effects of stigma power are frequently perceived and felt in relationships between infertile women and their fertile peers, the direction of the enacted stigma is related to social standing and feelings of fairness and reinforces perceived expressions of deserved motherhood in the United States.

Self-Presence and the Effects of the Avatar on Health and Appearance

Self-presence, defined as the degree of connectedness with one's avatar as well as the effects of the avatar on perceptions of oneself, suggests that interactions with an avatar may have real implications for how one perceives and treats the body offline. A study examining the influence of the "Second Life" avatar on "Second Life" users' offline appearance, health, and well-being is discussed, along with the importance of examining self-presence as a theoretical mechanism. This research engages with the idea that immersion with an avatar via social virtual play has an influence on our health offline.