Other Emerging Technology Applications

In addition to the more prevalent technologies already discussed, intervention researchers have also begun to use other BITs to deliver interventions such as virtual reality applications and gaming. For example, research is emerging on the use of “virtual humans” (or “conversational agents”) in changing patient behavior. Virtual humans are images of men and women programmed into a device or application that are made to interact with the user typically through the use of automated prompts or messages. How these images are employed and what dialogues they are given to exchange with the user are dictated by the researcher/therapist; the virtual human can act as an informational agent that instructs a user on how to perform an activity or when to take certain types of medication. The virtual human can also act as a coach or cheerleader providing motivation and words of encouragement to the user. Although the use of virtual humans in behavioral interventions is relatively new, there has been significant progress showing that use of these applications can be used to effectively change behaviors including physical activity, fruit and vegetable consumption, and breastfeeding (Bickmore, Schulman, & Sidner, 2013; Zhang et al., 2014).

Another growing body of research has focused on virtual environments or a “virtual world.” A virtual world, as defined by Boulos, Hetherington, and Wheeler (2007), is a “. . . computer-based, simulated multi-media environment, usually running over the Web, and designed so that users can ‘inhabit’ and interact via their own graphical self representations known as avatars” (p. 233). One of the most popular virtual worlds currently available is Second Life, and research has shown that virtual worlds such as Second Life can provide innovative avenues through which health information can be presented and shared (by both individuals and organizations such as the U.S. Centers for Disease Control and Prevention) on such topics as HIV, sexually-transmitted diseases and sexual health, and perceptual abnormalities (e.g., hallucinations experienced by those suffering from a mental health disorder; Beard, Wilson, Morra, & Keelan, 2009). A recent study on the feasibility and efficacy of a behavioral treatment delivered through Second Life showed that virtual worlds can be used to help improve symptoms associated with social anxiety (Yuen et al., 2013).

A final application involves the use of gaming (the act of playing games) as a way to deliver a behavioral intervention. Mohr et al. (2013) argue that gaming can act as an avenue for researchers and therapists to deliver information to patients as well as to promote participation and adherence to intervention protocols. However, they also note that more work is needed to examine the efficacy of interventions that involve gaming, but the limited data that is available is promising. For example, a recent review conducted by Baranowski and Frankel (2012) demonstrated how gaming applications can be used to battle childhood obesity and help change dietary practices.

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