Immersive virtual environments (IVEs) are systems comprised of digital devices that simulate multiple layers of sensory information so that users experience sight, sound, and even touch like they do in the physical world. Users are typically represented in these environments in the form of virtual humans and may interact with other virtual representations such as health-care providers, coaches, future selves, or treatment stimuli (e.g., phobia triggers, such as crowds of people or spiders). These virtual representations can be controlled by humans (avatars) or computers algorithms (agents). Embodying avatars and interacting with agents, patients can experience sensory-rich simulations in the virtual world that may be difficult or even impossible to experience in the physical world but are sufficiently real to influence health attitudes and behaviors. Avatars and agents are infinitely customizable to tailor virtual experiences at the individual level, and IVEs are able to transcend the spatial and temporal boundaries of the physical world. Although still preliminary, a growing number of studies demonstrate IVEs’ potential as a health promotion and therapy tool, complementing and enhancing current treatment regimens. Attempts to incorporate IVEs into treatments and intervention programs have been made in a number of areas, including physical activity, nutrition, rehabilitation, exposure therapy, and autism spectrum disorders. Although further development and research is necessary, the increasing availability of consumer-grade IVE systems may allow clinicians and patients to consider IVE treatment as a routine part of their regimen in the near future.
Sun Joo (Grace) Ahn and Jesse Fox
Jonathan van 't Riet, Jorinde Spook, Paul E. Ketelaar, and Arief Hühn
Many of us use smartphones, and many smartphones are equipped with the Global Positioning System (GPS). This enables health promoters to send us messages on specific locations where healthy behavior is possible or where we are at risk of unhealthy behavior. Until now, the practice of sending location-based messages has been mostly restricted to commercial advertisements, most often in retail settings. However, opportunities for health promotion practice are vast. For one, location-based messages can be used to complement environmental interventions, where the environment is changed to promote health behavior. Second, location-based messages incorporate opportunities to tailor these messages to individual characteristics of the recipient, increasing perceived relevance. Finally, location-based messages offer the distinct possibility to communicate context-dependent social norm information. Five preliminary studies tested the effects of location-based messages targeting food choice. The results suggest that sending location-based messages is feasible and can be effective. Future studies should explore which messages are most effective under which circumstances.
Mia Liza A. Lustria
In today’s saturated media environment, it is incumbent for designers of health education materials to find more effective and efficient ways of capturing the attention of the public, particularly when the intent is to influence individual behavior change. Tailoring is a message design strategy that has been shown to amplify the effectiveness of health messages at an individual level. It is a data-driven and theory-informed strategy for crafting a message using knowledge of various factors that might influence the individual’s responsiveness to the message, such as their information needs, beliefs, motivations, and health behaviors. It also enhances the persuasiveness of a message by increasing its perceived relevance, drawing attention to the message, and encouraging deeper elaboration of the information. Tailoring content based on known antecedents of the intended behavioral outcomes has been shown to enhance tailoring effectiveness. Compared to generic messages, tailored messages are perceived to be more personally relevant, command greater attention, are recalled more readily, and encourage more positive evaluations of the information overall. Various meta-analyses have demonstrated the effectiveness of tailored interventions promoting a number of health behaviors, such as smoking cessation, healthy diet and nutrition, physical activity, and regular recommended health screenings. Advances in information and communication technologies have led to more sophisticated, multimodal tailored interventions with improved reach, and more powerful expert systems and data analysis models. Web technologies have made it possible to scale the production and delivery of tailored messages to multiple individuals at relatively low cost and to improve access to expert feedback, particularly among hard-to-reach population groups.
Yvonnes Chen and Joseph Erba
Media literacy describes the ability to access, analyze, evaluate, and produce media messages. As media messages can influence audiences’ attitudes and behaviors toward various topics, such as attitudes toward others and risky behaviors, media literacy can counter potential negative media effects, a crucial task in today’s oversaturated media environment. Media literacy in the context of health promotion is addressed by analyzing the characteristics of 54 media literacy programs conducted in the United States and abroad that have successfully influenced audiences’ attitudes and behaviors toward six health topics: prevention of alcohol use, prevention of tobacco use, eating disorders and body image, sex education, nutrition education, and violent behavior. Because media literacy can change how audiences perceive the media industry and critique media messages, it could also reduce the potential harmful effects media can have on audiences’ health decision-making process. The majority of the interventions have focused on youth, likely because children’s and adolescents’ lack of cognitive sophistication may make them more vulnerable to potentially harmful media effects. The design of these health-related media literacy programs varied. Many studies’ interventions consisted of a one-course lesson, while others were multi-month, multi-lesson interventions. The majority of these programs’ content was developed and administered by a team of researchers affiliated with local universities and schools, and was focused on three main areas: reduction of media consumption, media analysis and evaluations, and media production and activism. Media literacy study designs almost always included a control group that did not take part in the intervention to confirm that potential changes in health and risk attitudes and behaviors among participants could be attributed to the intervention. Most programs were also designed to include at least one pre-intervention test and one post-intervention test, with the latter usually administered immediately following the intervention. Demographic variables, such as gender, age or grade level, and prior behavior pertaining to the health topic under study, were found to affect participants’ responses to media literacy interventions. In these 54 studies, a number of key media literacy components were clearly absent from the field. First, adults—especially those from historically underserved communities—were noticeably missing from these interventions. Second, media literacy interventions were often designed with a top-down approach, with little to no involvement from or collaboration with members of the target population. Third, the creation of counter media messages tailored to individuals’ needs and circumstances was rarely the focus of these interventions. Finally, these studies paid little attention to evaluating the development, process, and outcomes of media literacy interventions with participants’ sociodemographic characteristics in mind. Based on these findings, it is recommended that health-related media literacy programs fully engage community members at all steps, including in the critical analysis of current media messages and the production and dissemination of counter media messages. Health-related media literacy programs should also impart participants and community members with tools to advocate for their own causes and health behaviors.