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Virtual Reality Cue Refusal Video Game for Alcohol and Cigarette Recovery Support: Summative Study.

ABSTRACT: BACKGROUND:New technologies such as virtual reality, augmented reality, and video games hold promise to support and enhance individuals in addiction treatment and recovery. Quitting or decreasing cigarette or alcohol use can lead to significant health improvements for individuals, decreasing heart disease risk and cancer risks (for both nicotine and alcohol use), among others. However, remaining in recovery from use is a significant challenge for most individuals. OBJECTIVE:We developed and assessed the Take Control game, a partially immersive Kinect for Windows platform game that allows users to counter substance cues through active movements (hitting, kicking, etc). METHODS:Formative analysis during phase I and phase II guided development. We conducted a small wait-list control trial using a quasi-random sampling technique (systematic) with 61 participants in recovery from addiction to alcohol or tobacco. Participants used the game 3 times and reported on substance use, cravings, satisfaction with the game experience, self-efficacy related to recovery, and side effects from exposure to a virtual reality intervention and substance cues. RESULTS:Participants found the game engaging and fun and felt playing the game would support recovery efforts. On average, reported substance use decreased for participants during the intervention period. Participants in recovery for alcohol use saw more benefit than those in recovery for tobacco use, with a statistically significant increase in self-efficacy, attitude, and behavior during the intervention. Side effects from the use of a virtual reality intervention were minor and decreased over time; cravings and side effects also decreased during the study. CONCLUSIONS:The preliminary results suggest the intervention holds promise as an adjunct to standard treatment for those in recovery, particularly from alcohol use.

SUBMITTER: Metcalf M

PROVIDER: S-EPMC5928331 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Virtual Reality Cue Refusal Video Game for Alcohol and Cigarette Recovery Support: Summative Study.

Metcalf Mary M Rossie Karen K Stokes Katie K Tallman Christina C Tanner Bradley B

JMIR serious games 20180416 2

<h4>Background</h4>New technologies such as virtual reality, augmented reality, and video games hold promise to support and enhance individuals in addiction treatment and recovery. Quitting or decreasing cigarette or alcohol use can lead to significant health improvements for individuals, decreasing heart disease risk and cancer risks (for both nicotine and alcohol use), among others. However, remaining in recovery from use is a significant challenge for most individuals.<h4>Objective</h4>We dev ...[more]

PMID: 29661748

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Project description:BackgroundPeople with mild to borderline intellectual disability (MBID; IQ=50-85) are at risk for developing an alcohol use disorder (AUD). One factor contributing to this risk is sensitivity to peer pressure. Hence, tailored trainings are needed to practice alcohol refusal in impacted patients. Immersive virtual reality (IVR) appears promising to engage patients in dialogs with virtual humans, allowing to practice alcohol refusal realistically. However, requirements for such an IVR have not been studied for MBID/AUD.ObjectiveThis study aims to develop an IVR alcohol refusal training for patients with MBID and AUD. In this work, we cocreated our peer pressure simulation with experienced experts in addiction care.MethodsWe followed the Persuasive System Design (PSD) model to develop our IVR alcohol refusal training. With 5 experts from a Dutch addiction clinic for patients with MBID, we held 3 focus groups to design the virtual environment, persuasive virtual human(s), and persuasive dialog. Subsequently, we developed our initial IVR prototype and conducted another focus group to evaluate IVR and procedures for clinical usage, resulting in our final peer pressure simulation.ResultsOur experts described visiting a friend at home with multiple friends as the most relevant peer pressure situation in the clinical setting. Based on the identified requirements, we developed a social-housing apartment with multiple virtual friends present. Moreover, we embedded a virtual man with generic appearance to exert peer pressure using a persuasive dialog. Patients can respond to persuasive attempts by selecting (refusal) responses with varying degrees of risk for relapse in alcohol use. Our evaluation showed that experts value a realistic and interactable IVR. However, experts identified lacking persuasive design elements, such as paralanguage, for our virtual human. For clinical usage, a user-centered customization is needed to prevent adverse effects. Further, interventions should be therapist delivered to avoid try-and-error in patients with MBID. Lastly, we identified factors for immersion, as well as facilitators and barriers for IVR accessibility.ConclusionsOur work establishes an initial PSD for IVR for alcohol refusal trainings in patients with MBID and AUD. With this, scholars can create comparable simulations by performing an analogous cocreation, replicate findings, and identify active PSD elements. For peer pressure, conveying emotional information in a virtual human's voice (eg, paralanguage) seems vital. However, previous rapport building may be needed to ensure that virtual humans are perceived as cognitively capable entities. Future work should validate our PSD with patients and start developing IVR treatment protocols using interdisciplinary teams.

Project description:Immersive virtual reality (VR) environments create a very strong sense of presence and immersion. Nowadays, especially when student isolation and online autonomous learning is required, such sensations can provide higher satisfaction and learning rates than conventional teaching. However, up until the present, learning outcomes with VR tools have yet to prove their advantageous aspects over conventional teaching. The project presents a VR serious game for teaching concepts associated with computer hardware assembly. These concepts are often included in any undergraduate's introduction to Computer Science. The learning outcomes are evaluated using a pre-test of previous knowledge, a satisfaction/usability test, and a post-test on knowledge acquisition, structured with questions on different knowledge areas. The results of the VR serious game are compared with another two learning methodologies adapted to online learning: (1) an online conventional lecture; and (2) playing the same serious game on a desktop PC. An extensive sample of students (n = 77) was formed for this purpose. The results showed the strong potential of VR serious games to improve student well-being during spells of confinement, due to higher learning satisfaction. Besides, ease of usability and the use of in-game tutorials are directly related with game-user satisfaction and performance. The main novelty of this research is related to academic performance. Although a very limited effect was noted for learning theoretical knowledge with the VR application in comparison with the other methodologies, this effect was significantly improved through visual knowledge, understanding and making connections between different concepts. It can therefore be concluded that the proposed VR serious game has the potential to increase student learning and therefore student satisfaction, by imparting a deeper understanding of the subject matter to students.Supplementary informationThe online version contains supplementary material available at 10.1007/s10055-021-00607-1.

Project description:BackgroundHigh quality head-mounted display based virtual reality (HMD-VR) has become widely available, spurring greater development of HMD-VR health games. As a behavior change approach, these applications use HMD-VR and game-based formats to support long-term engagement with therapeutic interventions. While the bulk of research to date has primarily focused on the therapeutic efficacy of particular HMD-VR health games, how developers and researchers incorporate best-practices in game design to achieve engaging experiences remains underexplored. This paper presents the findings of a narrative review exploring the trends and future directions of game design for HMD-VR health games.MethodsWe searched the literature on the intersection between HMD-VR, games, and health in databases including MEDLINE, Embase, CINAHL, PsycINFO, and Compendex. We identified articles describing HMD-VR games designed specifically as health applications from 2015 onwards in English. HMD-VR health games were charted and tabulated according to technology, health context, outcomes, and user engagement in game design.FindingsWe identified 29 HMD-VR health games from 2015 to 2020, with the majority addressing health contexts related to physical exercise, motor rehabilitation, and pain. These games typically involved obstacle-based challenges and extrinsic reward systems to engage clients in interventions related to physical functioning and pain. Less common were games emphasizing narrative experiences and non-physical exercise interventions. However, discourse regarding game design was diverse and often lacked sufficient detail. Game experience was evaluated using primarily ad-hoc questionnaires. User engagement in the development of HMD-VR health games primarily manifested as user studies.ConclusionHMD-VR health games are promising tools for engaging clients in highly immersive experiences designed to address diverse health contexts. However, more in-depth and structured attention to how HMD-VR health games are designed as game experiences is needed. Future development of HMD-VR health games may also benefit from greater involvement of end-users in participatory approaches.

Dataset Information

Virtual Reality Cue Refusal Video Game for Alcohol and Cigarette Recovery Support: Summative Study.

Publications

Virtual Reality Cue Refusal Video Game for Alcohol and Cigarette Recovery Support: Summative Study.

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