User-Agent Bond in Generalizable Environments: Long-Term Risk-Reduction via Nudged Virtual Choices.

Avatars or agents are digitized self-representations of a player in mediated environments. While using agents to navigate through mediated environments, players form bonds with their self-agents or characters, a process referred to as identification. Identification can involve automatic, but temporary, self-concept "shifts in implicit self-perceptions" (Klimmt et al., 2010, p. 323) of the media user by adopting or emphasizing the action choices on behalf of the social expectation of the avatar in the mediated environment. In the current study, we test the possibility that users' identification with video game avatars-a bond built between avatars and players- would account for subsequent behavior changes. We did so by using 3-month longitudinal data involving a narratively-based serious game: Socially Optimized Learning in Virtual Environments (SOLVE), a 3D-interactive game designed to reduce risky sexual behaviors among young men who have sex with men (n = 444). Results show that video game identification predicts both the reduction of risky sexual behaviors over time, and reduction in the number of non-primary partners with whom risky sex occurs. And when players identify with the game character, they tend to make healthier choices, which significantly mediates the link between video game identification and reduction of risky behaviors.

Protean Kinematics: A Blended Model of VR Physics.

Avatar research largely focuses on the effects of the appearance and external characteristics of avatars, but may also warrant further consideration of the effects of avatar movement characteristics. With Protean kinematics, we offer an expansion the avatar-user appearances-based effects of the Proteus Effect to a systematic exploration into the role of movement in affecting social perceptions (about others) and idealized perceptions (about self). This work presents both a theoretical (typology) and methodological (physics-based measurement) approach to understanding the complex blend of physical inputs and virtual outputs that occur in the perceptual experience of VR, particularly in consideration of the collection of hippocampal (e.g., place cells, grid cells) and entorhinal neurons (e.g., speed cells) that fire topologically relative to physical movement in physical space. Offered is a novel method that distills the blend of physical and virtual kinematics to contribute to modern understandings of human-agent interaction and cognitive psychology.

Friends over Doctors? The Influences of Source and Perceived Customization on College Drinking.

College drinking, often associated with college binge drinking, is a critical issue in the United States and may lead to harmful consequences such as academic failure, injury, sexual assault, and even death. Health interventions targeted at reducing problematic drinking are needed to help prevent these harmful behaviors among college students. The current work explores the intersection of different types of information sources (e.g., authority and peer) and perceived customization on various health-related outcomes related to college drinking (e.g., trust, attitudes, and behavioral intentions). Undergraduate students (N = 448) were presented with health information regarding college drinking in a 2 (perceived customization or non-customization) × 3 (authority, peer, or technology source) between-subjects experimental design. We found a strong effect of peer source of health information, somewhat surprisingly more effective than information from a professional source (i.e., a medical physician). Moreover, the results underscore the importance of not only promoting perceived customization but also fostering a sense of agency with such interface features. Theoretical and practical implications for health-related outcomes are discussed.

An Experimental Investigation into Promoting Mental Health Service Use on Social Media: Effects of Source and Comments.

Mental health is an increasingly prevalent topic of public interest, but remains a complex area requiring focused research that must account for negative perceptions surrounding mental health issues. The current work explores the roles of social media information source credibility and valence of social media comments on health outcomes in such a mental health context. We used a 2 (message source: professional vs. layperson) × 3 (valence of comments: positive vs. negative vs. mixed) online experiment to examine the effects of source and valence of comments on trust, attitudes and intentions related to mental health information and services among 422 undergraduate students. Results supported the hypothesized model in which source influenced cognitive trust while comments influenced affective trust. Cognitive and affective trust both impacted attitudes towards mental health information which encourages the intention to share such information on social media. Additionally, affective trust impacted attitudes towards mental services which influenced intentions to seek them out. Source and valence of comments on social media impact different behavioral intentions regarding the use of mental health services. This study provides insights for future social media campaigns promoting mental health service use.

Associations of Social Media Use, Patient-centered Communication, and Knowledge with Perceived Human Papillomavirus Vaccine Effectiveness.

Objectives: Given the effectiveness of human papillomavirus (HPV) vaccination in preventing cervical cancer and other diseases, as well as the low rates of HPV vaccination in the United States, it is important to examine the determinants of perceived HPV vaccine effectiveness. In this study, we examined the associations between potential factors associated with perceived HPV vaccine effectiveness. Methods: We utilized data (N = 718) from the nationally representative 2017 Health Information National Trends Survey (HINTS). We examined the associations of health-related social media use, patient-centered communication, and HPV knowledge with perceived HPV vaccine effectiveness in preventing cervical cancer. We reported descriptive statistics, and conducted bivariable analyses, multivariable analysis, and mediation analyses. Results: Perceived HPV vaccine effectiveness was associated with sex, age, education, health-related social media use, and HPV knowledge. Additionally, HPV knowledge mediated the associations of health-related social media use and patient-centered communication with perceived HPV vaccine effectiveness. Conclusions: Improving health-related information from social media, patient-centered communication, and HPV knowledge may increase perceived HPV vaccine effectiveness and ultimately, vaccine adoption.

A Picture Worth a Thousand Texts? Investigating the Influences of Visual Appeals in a Text Message-Based Health Intervention.

Healthy eating among young people may curb obesity and improve health, but strong messaging is needed for healthy eating interventions. In the current work, we evaluated the usefulness of visual appeals in a pilot text message-based healthy eating intervention among college students. A 2 (gain vs. loss) × 2 (image vs. no image) design with pretest and posttest questionnaires (N = 111) revealed text-only messages with loss frames had an influence on affective risk response, while both gain- and loss-framed text messages with visual appeals had positive effects on attitudes and intentions. This pilot study provides evidence to support the feasibility of using visual appeals in text message-based health interventions. The implications of the current study are discussed.

An Experimental Investigation of Human Presence and Mobile Technologies on College Students' Sun Protection Intentions: Between-Subjects Study.

BACKGROUND: Health promotion and education programs are increasingly being adapted and developed for delivery through digital technologies. With this shift toward digital health approaches, it is important to identify design strategies in health education and promotion programs that enhance participant engagement and promote behavior change. OBJECTIVE: This study aimed to examine the impact of an experiment testing various mobile health (mHealth) skin cancer prevention messages on sun protection intentions and message perceptions among American college students. METHODS: A sample of 134 college students aged 18 years or older participated in a 2×2×2 between-subjects experimental study, designed to examine the individual and combinatory effects of multiple dimensions (human presence, screen size, and interactivity) of digital technologies. The primary study outcome was intention to use sun protection; secondary outcomes included attitudes toward the information, two dimensions of trust, and information processing. RESULTS: Generally, intention to use sun protection was positively associated with the presence of human characters in the health educational messages (P<.001), delivering educational health messages on a large screen (ie, iPad; P<.001), and higher interactivity (P<.001). Only human presence produced more favorable attitudes (P=.02). Affective trust was positively associated with human presence (P=.006) and large screen size (P<.001), whereas cognitive trust was positively associated with human presence (P<.001) and small screen size (P=.007). Moreover, large screen size led to more heuristic processing (P=.03), whereas small screen size led to more systematic processing (P=.04). CONCLUSIONS: This experimental study demonstrates that the impact of mHealth skin cancer prevention messages differs based on platform and delivery design features. Effects on behavioral intentions, attitudes, and trust were found for conditions with human presence, highlighting the importance of including this feature in mHealth programs. Results from this experimental study can be used to optimize the design of mHealth educational interventions that promote sun protection.

Virtual prognostication: When virtual alcohol choices predict change in alcohol consumption over 6-months.

Narrative games, in which users interact with virtual agents, are increasingly being used in health interventions to change targeted behaviors. In virtual social interactions, based on similar real-life contextual cues, past behavior can predict virtual choices. Here, based on theories in learning and interactivity, we examined the whether following a virtual intervention, choices in social interactions may be particularly diagnostic of future behavior changes. To test this, we needed to: (1) leverage a contextualized risk (e.g., involving alcohol consumption) scenario (e.g., having one more drink with my partner) given a target audience (e.g., sexually risky young men who have sex with men (YMSM)), (2) include within this context an evidence-based virtual intervention (e.g., promoting alcohol reduction), (3) instantiate and record a virtual choice (water or alcohol) in a virtual dating game scenario intervention with IA for that target audience, and (4) assess pre and 6-months post-intervention YMSM's alcohol use. Using a Socially Optimized Learning Environment (SOLVE) intervention game with IA and alcohol use measures, we found that virtual water choice (versus virtual alcohol choice) significantly predicted real-life alcohol consumption change. Furthermore, personality factors (e.g., Behavioral Approach System) predicted virtual choices and alcohol consumption change. Implications of these findings are discussed.

Causal Inference in Generalizable Environments: Systematic Representative Design.

Causal inference and generalizability both matter. Historically, systematic designs emphasize causal inference, while representative designs focus on generalizability. Here, we suggest a transformative synthesis - Systematic Representative Design (SRD) - concurrently enhancing both causal inference and "built-in" generalizability by leveraging today's intelligent agent, virtual environments, and other technologies. In SRD, a "default control group" (DCG) can be created in a virtual environment by representatively sampling from real-world situations. Experimental groups can be built with systematic manipulations onto the DCG base. Applying systematic design features (e.g., random assignment to DCG versus experimental groups) in SRD affords valid causal inferences. After explicating the proposed SRD synthesis, we delineate how the approach concurrently advances generalizability and robustness, cause-effect inference and precision science, a computationally-enabled cumulative psychological science supporting both "bigger theory" and concrete implementations grappling with tough questions (e.g., what is context?) and affording rapidly-scalable interventions for real-world problems.