Susan Persky

The independent and interactive effects of embodied-agent appearance and behavior on self-report, cognitive, and behavioral markers of copresence in immersive virtual environments

The current study examined how assessments of copresence in an immersive virtual environment are influenced by variations in how much an embodied agent resembles a human being in appearance and behavior. We measured the extent to which virtual representations were both perceived and treated as if they were human via self-report, behavioral, and cognitive dependent measures. Distinctive patterns of findings emerged with respect to the behavior and appearance of embodied agents depending on the definition and operationalization of copresence. Independent and interactive effects for appearance and behavior were found suggesting that assessing the impact of behavioral realism on copresence without taking into account the appearance of the embodied agent (and vice versa) can lead to misleading conclusions. Consistent with the results of previous research, copresence was lowest when there was a large mismatch between the appearance and behavioral realism of an embodied agent.

Assessing hypothetical scenario methodology in genetic susceptibility testing analog studies: a quantitative review

Hypothetical scenario methodology is commonly employed in the study of genetic susceptibility testing uptake estimation. The methodology, however, has not been rigorously assessed and sizeable gaps exist between estimated and actual uptake for tests that have recently become available. This quantitative review explores the effect of several theoretically based factors on genetic test uptake accuracy among a sample of 38 articles. These factors include verbal immediacy and temporal proximity of test scenarios, method of decision assessment, content of testing detail provided, processing demand required, and study features related to administration and sample. A number of assessed factors influenced uptake accuracy. Among these, temporal proximity of the genetic susceptibility test appeared to be the most consistent. There was also some evidence for effects of verbal immediacy and decision-assessment method on interest in testing. We recommend strategies for increasing accuracy using hypothetical scenario methodology to examine genetic susceptibility test uptake prediction.

Immersive virtual video game play and presence: Influences on aggressive feelings and behavior

Immersive virtual environment technology (IVET) allows developers to create simulated environments that can engage users in context relevant behaviors and that can produce relatively intense user experiences for purposes such as entertainment (e.g., video games), phobia desensitization, and training. We predicted that playing a violent video game using an IVET platform would lead to increased presence and aggressive feelings and behavior compared to playing on a less immersive desktop platform. The results of two experiments supported this hypothesis. The data suggest that presence mediated the relationship between playing platform and aggressive feelings but not the relationship between playing platform and aggressive behavior. Finally, we explored the utility of using cardiovascular measures within this research paradigm.

Medical student bias and care recommendations for an obese versus non-obese virtual patient.

Objective:This study examined the independent effect of a patients weight on medical students’ attitudes, beliefs and interpersonal behavior toward the patient, in addition to the clinical recommendations they make for her care.Design:A total of 76 clinical-level medical students were randomly assigned to interact with a digital, virtual female patient who was visibly either obese or non-obese.Methods:Interactions with the patient took place in an immersive virtual (virtual reality) clinical environment that allowed standardization of all patient behaviors and characteristics except for weight. Visual contact behavior was automatically recorded during the interaction. Afterward, participants filled out a battery of self-report questionnaires.Results:Analyses revealed more negative stereotyping, less anticipated patient adherence, worse perceived health, more responsibility attributed for potentially weight-related presenting complaints and less visual contact directed toward the obese version of a virtual patient than the non-obese version of the patient. In contrast, there was no clear evidence of bias in clinical recommendations made for the patients care.Conclusion:Biases in attitudes, beliefs and interpersonal behavior have important implications because they can influence the tone of clinical encounters and rapport in the patient–provider relationship, which can have important downstream consequences. Gaining a clear understanding of the nature and source of weight bias in the clinical encounter is an important first step toward the development of strategies to address it.

Psychological and Behavioral Responses to Genetic Test Results Indicating Increased Risk of Obesity: Does the Causal Pathway from Gene to Obesity Matter?

Background: Common obesity-associated genetic variants may exert their effects through increasing eating or decreasing metabolism. Such differences might influence individual responses to obesity genetic test results.Methods: This was an experimental analogue study: 191 participants were asked to imagine they had received a genetic test result indicating high eating-based (n = 37) or high metabolism-based (n = 41) risk of obesity, an enzyme test result indicating high eating-based (n = 35) or high metabolism-based (n = 41) risk of obesity, or no risk information (n = 37). Outcomes included perceived risk, self-efficacy (confidence in ability to eat healthily), response-efficacy (confidence that eating healthily will reduce risk), and intention to eat healthily. Results: The groups receiving increased obesity risk information reported greater perceived risk and intention to eat healthily than the no risk information group (both p < 0.01). There were main effects of test type on perceived risk (genetic vs. enzyme: 3.91 vs. 3.55, p = 0.031) and of causal pathway on worry (eating vs. metabolism: 3.33 vs. 2.86, p = 0.049), but no effects of either manipulation on any other outcomes. Conclusion: Personal risk information indicating increased obesity risk may increase motivation to eat healthily, regardless of whether the risk is described as genetic or non-genetic or as acting through an eating-based or metabolism-based causal pathway.

Impact of Genetic Causal Information on Medical Students’ Clinical Encounters with an Obese Virtual Patient: Health Promotion and Social Stigma

BackgroundHealth care providers will increasingly encounter information about the genetics of obesity as genetics research progresses.PurposeThis study explores whether information about the genetics of obesity reduces medical student stigmatization of obese patients, and how it affects rates of health behavior-related referral.MethodsOne hundred and ten third and fourth year medical students were randomly assigned to read about genetic or behavioral mechanisms of obesity, or a control topic. Students interacted with an obese virtual patient in a virtual clinic and completed a battery of measures.ResultsRates of most health behavior screening recommendations (weight loss, exercise, and diet consultations) were lower among participants exposed to genetic causal information than control. The genetic causal information group exhibited less negative stereotyping of the patient than control, F(1,105) = 5.00, p = 0.028, but did not differ in anticipated patient adherence, F(1,105) = 3.18, p = 0.077.ConclusionsInformation highlighting genetic contributions to obesity may lead to both positive and negative outcomes. Communication about the genetics of obesity should discuss the multi-factorial and non-deterministic nature of genetic risk.

Immersive Virtual Environments Versus Traditional Platforms: Effects of Violent and Nonviolent Video Game Play

An experiment focused on the effects of platform (desktop computer, immersive virtual environment; IVE), content (violent, nonviolent), and player gender on video game play outcomes. Results revealed an interaction such that participants reported higher levels of aggressive feelings when playing a violent video game in an IVE compared to violent game play on a desktop platform or nonviolent game play on either platform. Physiological results supported these findings. No gender effects were found, nor did platform intensify any effects for nonviolent game play. The findings suggest that the intensifying effects of IVEs for game play and aggression are content specific and provide further evidence that attention to playing platform is crucial in understanding violent video game effects.

Presence relates to distinct outcomes in two virtual environments employing different learning modalities.

Presence in virtual learning environments (VLEs) has been associated with a number of outcome factors related to a users ability and motivation to learn. The extant but relatively small body of research suggests that a high level of presence is related to better performance on learning outcomes in VLEs. Different configurations of form and content variables such as those associated with active (self-driven, interactive activities) versus didactic (reading or lecture) learning may, however, influence how presence operates and on what content it operates. We compared the influence of presence between two types of immersive VLEs (i.e., active versus didactic techniques) on comprehension and engagement-related outcomes. The findings revealed that the active VLE promoted greater presence. Although we found no relationship between presence and learning comprehension outcomes for either virtual environment, presence was related to information engagement variables in the didactic immersive VLE but not the active environment. Results demonstrate that presence is not uniformly elicited or effective across immersive VLEs. Educational delivery mode and environment complexity may influence the impact of presence on engagement.

Employing immersive virtual environments for innovative experiments in health care communication

OBJECTIVE This report reviews the literature for studies that employ immersive virtual environment technology methods to conduct experimental studies in health care communication. Advantages and challenges of using these tools for research in this area are also discussed. METHODS A literature search was conducted using the Scopus database. Results were hand searched to identify the body of studies, conducted since 1995, that are related to the report objective. RESULTS The review identified four relevant studies that stem from two unique projects. One project focused on the impact of a clinicians characteristics and behavior on health care communication, the other focused on the characteristics of the patient. Both projects illustrate key methodological advantages conferred by immersive virtual environments, including, ability to maintain simultaneously high experimental control and realism, ability to manipulate variables in new ways, and unique behavioral measurement opportunities. CONCLUSION Though implementation challenges exist for immersive virtual environment-based research methods, given the technologys unique capabilities, benefits can outweigh the costs in many instances. PRACTICE IMPLICATIONS Immersive virtual environments may therefore prove an important addition to the array of tools available for advancing our understanding of communication in health care.

Immersive virtual environment technology: a promising tool for future social and behavioral genomics research and practice.

Social and behavioral research needs to get started now if scientists are to direct genomic discoveries to address pressing public health problems. Advancing social and behavioral science will require innovative and rigorous communication methodologies that move researchers beyond reliance on traditional tools and their inherent limitations. One such emerging research tool is immersive virtual environment technology (virtual reality), a methodology that gives researchers the ability to maintain high experimental control and mundane realism of scenarios; portray and manipulate complex, abstract objects and concepts; and implement innovative implicit behavioral measurement. This report suggests the role that immersive virtual environment technology can play in furthering future research in genomics-related education, decision making, test intentions, behavior change, and health-care provider behaviors. Practical implementation and challenges are also discussed.