Virtual self-conversation using motivational interviewing techniques to promote healthy eating and physical activity: A usability study

Introduction We aim to examine the usability of a Virtual Reality (VR) platform, called ConVRSelf, which has been designed to address the needs of People Living With Obesity (PLWO). Methods Fourteen participants with a desire to eat healthier and exercise more (6 normal weight and 8 PLWO; Mean age = 41.86, SD = 13.89) were assigned to the experimental group (EG) or the control group (CG). EG participants, after being trained on motivational interviewing skills, engaged in a virtual self-conversation using embodiment and body swapping techniques, which aimed to normalize and resolve their ambivalence to change lifestyle habits. CG participants, embodied in their virtual bodies, participated in a pre-established discourse with a virtual counselor giving them psychoeducational advice about how to change lifestyle habits. A mixed-methods design was used, involving a semi-structured interview and self-report questionnaires, including readiness to change habits (Readiness Rulers), body ownership (Body Ownership Questionnaire, BOQ), and system usability (System Evaluation Questionnaire, SEQ). Thematic content analysis was carried out for qualitative data while statistical data analysis was carried out using SPSS 20.0. Results Participants from both groups showed high readiness to change lifestyle (Readiness Rulers) before engaging with the virtual experiences, which was maintained at the same level after the interventions and their scores on the SEQ and BOQ were satisfactory. Regarding qualitative information obtained from the interviews, almost all participants found the VR experience to be novel, interesting, and enjoyable. A higher acceptability was observed among PLWO from the EG than normal weight participants from the same group, a promising finding for the ConVRSelf platform, which had been specifically designed to address the needs of PLWO. Conclusion The ConVRSelf system is well-accepted by participants and is ready to be tested with PLWO in a clinical setting.

[1]  M. Slater,et al.  Clinical efficacy of a virtual reality tool for the treatment of obesity: study protocol of a randomised controlled trial , 2022, BMJ Open.

[2]  Maria V. Sanchez-Vives,et al.  Impact of virtual embodiment and exercises on functional ability and range of motion in orthopedic rehabilitation , 2022, Scientific Reports.

[3]  David Sánchez-Carracedo.  El estigma de la obesidad y su impacto en la salud: una revisión narrativa , 2022, Endocrinología, Diabetes y Nutrición.

[4]  Verónica Orvalho,et al.  The Influence of Embodiment as a Cartoon Character on Public Speaking Anxiety , 2021, Frontiers in Virtual Reality.

[5]  L. Goodwin,et al.  Use of motivational interviewing in behavioural interventions among adults with obesity: A systematic review and meta‐analysis , 2021, Clinical obesity.

[6]  M. Gagner,et al.  Obesity in adults: a clinical practice guideline , 2020, Canadian Medical Association Journal.

[7]  Gerhard Andersson,et al.  The COVID-19 pandemic: The ‘black swan’ for mental health care and a turning point for e-health , 2020, Internet Interventions.

[8]  Mel Slater,et al.  Manipulating the Perceived Shape and Color of a Virtual Limb Can Modulate Pain Responses , 2020, Journal of clinical medicine.

[9]  Mel Slater,et al.  An experimental study of a virtual reality counselling paradigm using embodied self-dialogue , 2019, Scientific Reports.

[10]  Mel Slater,et al.  Decreasing Pain Ratings in Chronic Arm Pain Through Changing a Virtual Body: Different Strategies for Different Pain Types. , 2019, The journal of pain : official journal of the American Pain Society.

[11]  Dae-Hee Lee,et al.  Comparison of the aperture and midportion femoral tunnel widening after anterior cruciate ligament reconstruction , 2019, Medicine.

[12]  Eduardo Serrano-Troncoso,et al.  Mobile Health Adoption in Mental Health: User Experience of a Mobile Health App for Patients With an Eating Disorder , 2019, JMIR mHealth and uHealth.

[13]  S. Begg,et al.  Integrated motivational interviewing and cognitive behaviour therapy for lifestyle mediators of overweight and obesity in community-dwelling adults: a systematic review and meta-analyses , 2018, BMC Public Health.

[14]  M. Delgado-Rodríguez,et al.  Systematic review and meta-analysis. , 2017, Medicina intensiva.

[15]  M. Slater,et al.  Virtual reality in the assessment, understanding, and treatment of mental health disorders , 2017, Psychological Medicine.

[16]  A. Jackson,et al.  Improved Outcomes Following a Single Session Web-Based Intervention for Problem Gambling , 2017, Journal of Gambling Studies.

[17]  Mel Slater,et al.  Virtual Embodiment of White People in a Black Virtual Body Leads to a Sustained Reduction in Their Implicit Racial Bias , 2016, Front. Hum. Neurosci..

[18]  G. Riva,et al.  Virtual Reality Body Swapping: A Tool for Modifying the Allocentric Memory of the Body , 2016, Cyberpsychology Behav. Soc. Netw..

[19]  Brenda K. Wiederhold,et al.  Future Directions: How Virtual Reality Can Further Improve the Assessment and Treatment of Eating Disorders and Obesity , 2016, Cyberpsychology Behav. Soc. Netw..

[20]  Rosa María Baños,et al.  Using Virtual Reality to Distract Overweight Children from Bodily Sensations During Exercise , 2016, Cyberpsychology Behav. Soc. Netw..

[21]  Grace Choi,et al.  A Second Chance at Health: How a 3D Virtual World Can Improve Health Self-Efficacy for Weight Loss Management Among Adults , 2016, Cyberpsychology Behav. Soc. Netw..

[22]  Andrea Gaggioli,et al.  Virtual Reality-Enhanced Cognitive-Behavioral Therapy for Morbid Obesity: A Randomized Controlled Study with 1 Year Follow-Up , 2016, Cyberpsychology Behav. Soc. Netw..

[23]  Wen-Bin Chiou,et al.  The Power of the Virtual Ideal Self in Weight Control: Weight-Reduced Avatars Can Enhance the Tendency to Delay Gratification and Regulate Dietary Practices , 2016, Cyberpsychology Behav. Soc. Netw..

[24]  Giuseppe Riva,et al.  Testing Augmented Reality for Cue Exposure in Obese Patients: An Exploratory Study , 2016, Cyberpsychology Behav. Soc. Netw..

[25]  Mel Slater,et al.  Conversations between self and self as Sigmund Freud—A virtual body ownership paradigm for self counselling , 2015, Scientific Reports.

[26]  S. Forbes,et al.  REpeated AutoLogous Infusions of STem cells In Cirrhosis (REALISTIC): a multicentre, phase II, open-label, randomised controlled trial of repeated autologous infusions of granulocyte colony-stimulating factor (GCSF) mobilised CD133+ bone marrow stem cells in patients with cirrhosis. A study protocol , 2015, BMJ Open.

[27]  Alexander J. Rothman,et al.  NIH working group report: Innovative research to improve maintenance of weight loss , 2015, Obesity.

[28]  Mel Slater,et al.  Body ownership causes illusory self-attribution of speaking and influences subsequent real speaking , 2014, Proceedings of the National Academy of Sciences.

[29]  Maria V. Sanchez-Vives,et al.  Modulation of pain threshold by virtual body ownership , 2014, European journal of pain.

[30]  M. Slater,et al.  Illusory ownership of a virtual child body causes overestimation of object sizes and implicit attitude changes , 2013, Proceedings of the National Academy of Sciences.

[31]  James L. Netterville,et al.  Clinical Practice Guideline , 2013, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[32]  Anne P. Massey,et al.  Innovation in Weight Loss Programs: A 3-Dimensional Virtual-World Approach , 2012, Journal of medical Internet research.

[33]  T. Wadden,et al.  Lifestyle Modification for Obesity: New Developments in Diet, Physical Activity, and Behavior Therapy , 2012, Circulation.

[34]  Maria V. Sanchez-Vives,et al.  First Person Experience of Body Transfer in Virtual Reality , 2010, PloS one.

[35]  S. Dabbo,et al.  Motivational Interviewing: Preparing People to Change Addictive Behavior , 1993 .

[36]  J. Bailenson,et al.  Virtual Self-Modeling: The Effects of Vicarious Reinforcement and Identification on Exercise Behaviors , 2009 .

[37]  Justin M. Harris,et al.  If I Were You: Perceptual Illusion of Body Swapping , 2008, PloS one.

[38]  Jonathan D. Cohen,et al.  Rubber hands ‘feel’ touch that eyes see , 1998, Nature.

[39]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[40]  Carolina Cañellas Bastús.  La entrevista motivacional. Ayudar a las personas a cambiar , 2020 .

[41]  S. Russell-Mayhew,et al.  Effective Psychological and Behavioural Interventions in Obesity Management , 2020 .

[42]  Chantal Wouters,et al.  An exploratory study , 2003 .

[43]  S. Albiol-Pérez,et al.  2013 7th International Conference on Pervasive Computing Technologies for Healthcare and Workshops Seq: Suitability Evaluation Questionnaire for Virtual Rehabilitation Systems. Application in a Virtual Rehabilitation System for Balance Rehabilitation , 2022 .