Can Customizing an Avatar Motivate Exercise Intentions and Health Behaviors Among Those with Low Health Ideals?

Are We More Reactive to Persuasive Health Messages When They Appear in Our Customized Interfaces? The Role of Sense of Identity and Sense of Control

Online users today are provided with a variety of customization tools to build their own information environment. A growing number of public health messages reach their target audiences via these digital venues. Given the deeply personal and individualized nature of customized environments, do online users show lesser reactance to persuasive health messages? Or, are they more likely to show reactance because they feel intruded upon? We conducted a 2 (Customization: present vs. absent) × 2 (Message threat: high vs. low) experiment (N = 145) to find out. Data showed that interface customization increases the sense of control and sense of identity among users. Sense of control is positively associated with threat to freedom of action, causing more affective reactance. In contrast, a sense of identity is negatively associated with anger toward the persuasive message. Theoretical and practical implications for online health campaigns are discussed.

Exercising With Embodied Young Avatars: How Young vs. Older Avatars in Virtual Reality Affect Perceived Exertion and Physical Activity Among Male and Female Elderly Individuals

This study demonstrated that implementation of the Proteus effect via manipulation of avatar age in VR is effective among elderly individuals in the context of exercise. One hundred and four elderly adults aged 60 years and older who did not engage in vigorous physical activities participated in this experiment with a 2 (avatar age: young vs. older) × 2 (sex: male vs. female) design. The results showed that the embodiment of younger avatars (age approximately 20 years) in VR leads to greater perceived exercise exertion regardless of sex after controlling for age and emotion. Older adults with young avatars perceived a greater contribution of efforts to exercise. This study also found that among those who did not engage in vigorous exercise, female older adults who embodied young avatars reported greater self-efficacy for future exercise and greater physical activity during the exercise phase than those who embodied older avatars. This study suggests that females are more likely to be motivated to continue exercising through young avatar embodiment. In contrast, female elderly who embodied old avatars reported significant fewer physical activity than male elderly who embodied old avatars. This indicated that the Proteus effect had stronger effects among females than among older males. Although we found the Proteus effect through VR avatar manipulation, the effect was temporary and limited to the experimental phase. This study is the first to examine the Proteus effect among elderly individuals in the context of exercise. It also contributes to the literature by indicating that avatar age manipulation is an effective means of promoting exercise among elderly individuals and helping them achieve exercise outcomes. This study further demonstrates that female elderly individuals respond to young avatars differently than male elderly individuals, with female elderly individuals showing more positive effects of young avatar embodiment than males. Implications and theoretical contributions are discussed.

The development of a Credible Virtual Clinician Promoting Colorectal Cancer Screening via Telehealth Applications for and by Black Men: A Qualitative Study

Background

Traditionally, promotion of colorectal cancer (CRC) screening among Black men was delivered by community health workers, patient navigators, and decision aids (printed text or video media) at clinics and in the community setting. A novel approach to increase CRC screening of Black men includes developing and utilizing a patient-centered, tailored message delivered via virtual human technology in the privacy of one’s home.

Objective

The objective of this study was to incorporate the perceptions of Black men in the development of a virtual clinician (VC) designed to deliver precision messages promoting the fecal immunochemical test (FIT) kit for CRC screening among Black men in a future clinical trial.

Methods

Focus groups of Black men were recruited to understand their perceptions of a Black male VC. Specifically, these men identified source characteristics that would enhance the credibility of the VC. The modality, agency, interactivity, and navigability (MAIN) model, which examines how interface features affect the user’s psychology through four affordances (modality, agency, interactivity, and navigability), was used to assess the presumed credibility of the VC and likability of the app from the focus group transcripts. Each affordance triggers heuristic cues that stimulate a positive or a negative perception of trustworthiness, believability, and understandability, thereby increasing source credibility.

Results

In total, 25 Black men were recruited from the community and contributed to the development of 3 iterations of a Black male VC over an 18-month time span. Feedback from the men enhanced the visual appearance of the VC, including its movement, clothing, facial expressions, and environmental surroundings. Heuristics, including social presence, novelty, and authority, were all recognized by the final version of the VC, and creditably was established. The VC was named Agent Leveraging Empathy for eXams (ALEX) and referred to as “brother-doctor,” and participants stated “wanting to interact with ALEX over their regular doctor.”

Conclusions

Involving Black men in the development of a digital health care intervention is critical. This population is burdened by cancer health disparities, and incorporating their perceptions in telehealth interventions will create awareness of the need to develop targeted messages for Black men.

Customizing Your Demons: Anxiety Reduction via Anthropomorphizing and Destroying an "Anxiety Avatar"

Character customization is a prominent feature in digital games, affording users the ability to tailor one’s virtual self-representation (avatar) to match aspects of their actual or ideal self, influencing psychological well-being. The mental health implications of character customization can be partially explained by self-discrepancy theory, which argues that achieving congruence with one’s avatar reduces cognitive dissonance. However, the role of undesirable self-concepts such as mental health ailments have largely been overlooked in this context despite forming part of one’s identity. In theory, customization of an avatar representing undesirable self-concepts presents a self-regulatory paradox: individuals desire to reduce discrepancies with a self-representation, yet they also desire to enlarge discrepancies with a disliked-self. To reconcile this, two experiments explored the psychological implications of imbuing avatars with undesirable self-concepts. In Study 1 (N = 90), participants customized an avatar to represent anxiety within themselves (i.e., an anxiety avatar). Customization significantly reduced state anxiety compared to a control group, supporting the proposed discrepancy-reduction mechanism. Study 2 (N = 122) employed a 2 (customization: yes, no) × 2 (destruction: yes, no) between-subjects design, with participants either destroying or observing an anxiety avatar. Destruction of customized anxiety avatars resulted in the largest reduction in anxiety among all conditions, supporting the proposed discrepancy-enlargement mechanism. Theoretical and practical implications for the use of avatar-based e-mental health interventions are discussed.

"Energy is a Finite Resource": Designing Technology to Support Individuals across Fluctuating Symptoms of Depression

While the HCI field increasingly examines how digital tools can support individuals in managing mental health conditions, it remains unclear how these tools can accommodate these conditions' temporal aspects. Based on weekly interviews with five individuals with depression, conducted over six weeks, this study identifies design opportunities and challenges related to extending technology-based support across fluctuating symptoms. Our findings suggest that participants perceive events and contexts in daily life to have marked impact on their symptoms. Results also illustrate that ebbs and flows in symptoms profoundly affect how individuals practice depression self-management. While digital tools often aim to reach individuals while they feel depressed, we suggest they should also engage individuals when they are less symptomatic, leveraging their energy and motivation to build habits, establish plans and goals, and generate and organize content to prepare for symptom onset.

Gaming Avatar Can Influence Sustainable Healthy Lifestyle: Be Like an Avatar

Online gaming is consistently changing with the use of new technologies and seen as making an impact on consumers’ sustainable lifestyles. The gaming avatars have influenced low avatar identification players to engage in physical and learning activities through massively multiplayer online (MMO) game genre. The fundamental purpose of the study is to classify the association of an avatar with consumer’s behavioural intention for exercise and to consume healthy food. This study incorporates three theories: social cognitive theory (SCT), social determination theory (SDT) and player-avatar identification (PAI) theory to determine its four dimensions’ impact on exercise and healthy food intention to attain a sustainable healthy lifestyle. SCT is related to human cognitive behaviour in the light of immersive experience, self-presence, and enjoyment. SDT related to the physical aspects of consumers that are exercise intention and consumption of healthy food. The results have shown that immersive experience, self-presence and enjoyment do impact the consumer’s behavioural intention towards an individual’s sustainability.

Does exergaming drive future physical activity and sport intentions?

We studied how usability and playability of sport exergames affect future intentions of participation in physical activity or actual sport. We employed questionnaires to measure participants' enjoyment, usability, game-experience, and future intentions of physical activity and real sport. We compared the outcomes based on players' gender, previous real-swimming, and exergame experience. Psychological parameters were not different between groups but players without exergame experience enjoyed the game more. Physical activity intentions increased for all participants but not swimming intentions. The limitations of current gaming systems and their effects on players' gaming experience and intentions are discussed.

Reconstructing Personal Stories in Virtual Reality sas a Mechanism to Recover the Self

Advances in virtual reality present opportunities to relive experiences in an immersive medium that can change the way we perceive our life stories, potentially shaping our realities for the better. This paper studies the role of virtual reality as a tool for the creation of stories with the concept of the self as a narrator and the life of the self as a storyline. The basis of the study is the philosophical notion of the self-narrative as an explanatory story of the events in one’s life that constitutes the notion of one’s self. This application is suitable for cases when individuals need to recreate their self, such as during recovery after traumatic events. The analysis of the effects of virtual reality shows that it enables a person to engage in a process of deeper self-observation to understand and explain adverse events and to give meaning to these events to form a new story, which can complement the therapeutic outcomes of exposure treatments. This study proposes concrete examples of immersive scenarios used to reconstruct personal stories. Several possible levels of experience are proposed to suggest that recovery can be achieved through the gradual retelling of the self-narrative, addressing all of the underlying narratives. Considering the ethical challenges that might arise, this paper explores the ways in which immersion in virtual reality can benefit a person’s view toward life as a story and his or her self as its author, comparing this idea with previous research on the application of virtual reality for trauma treatment. The analysis also emphasizes the perception of narrative authorship in virtual reality as an essential method for recovering the self-narrative and improving a patient’s mental health during self-actualization.

Redesign Me: Virtual Reality Experience of the Line of Life and Its Connection to a Healthier Self

Virtual Reality is used in various ways for creating a storytelling experience. It gives us the opportunity to imagine one’s life events as a story, and in settings that are intended to aid the self, such as treatment of trauma, anxiety, phobia, etc. This paper discusses the ways that challenging experiences change the way people perceive their life narratives and form their memories. This paper suggests that virtual reality (VR) can be used for the exploration of alternative scenarios in order to see one’s overall line of life in a new and healthier way. Considering the theoretical background of the narrative self, this research proposes a novel view of VR immersion as a medium for constructing a new storyline and attitude to the past. The approach would also influence attitudes regarding the present and future, and thus better shape the narrative of the self, which can lead to healthier life experiences.