Using Virtual Reality for Health Communication

Have you seen the commercials? Celebrities and influencers are using virtual reality devices to watch movies and play games.

​There’s no escaping it. VR is the future.

What is virtual reality?

Virtual reality (VR) is an interactive, 3D computer-generated environment. Most commonly accessed via headsets and head-mounted displays, VR can provide users with an immersive 360° experience. Once users are in the virtual world, they are able to see everything around them, as if in the real world.

​With augmented reality (AR), a type of VR, the virtual world is superimposed onto the real world. AR is commonly accessed via mobile device cameras, screens and apps. You can also access AR via 3D projection mapping, which superimposes the virtual world onto the real world without headsets or mobile devices.

Why use virtual reality?

Because it’s not a fad. It’s here to stay.

By 2020, the VR software and hardware market is projected to reach $40.4B in total revenue. Companies like Google, Facebook, Samsung, and Sony are racing to innovate in VR gear, with about 250 VR headset styles already available online for purchase. Some of the most popular VR devices include: Samsung Gear VR, Sony PlayStation VR, Oculus Rift, Google Cardboard, HTC Vive (powered by SteamVR), Microsoft HoloLens, and Razer OSVR.
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About 22.4M Americans are already using VR, and by 2020, a projected 1B people will access VR worldwide. In particular, VR has strong appeal amongst millennials (about 44% of people interested in VR are ages 18-34) and males (69% of people intending to buy a VR device are men).

Virtual reality has already been used in journalism, architecture, business, and manufacturing. There have also been several applications of virtual reality in health and medicine, including use of the technology to treat pain, anxiety attacks, PTSD and other medical issues; to train medical students and food handlers; to assist in the development of social skills; to reduce cravings for tobacco use; and to improve patient-provider communication.

With VR technology, you can:

1. Bring Digital Elements into Real-World Experiences ​

VR and AR technology is being used by social and digital media platforms and other big brands to enhance consumer experiences via the following features:

• Lenses, filters, frames, and stickers - These features add interactive, responsive special effects to the cameras of desktops and mobile devices. These digital elements can be applied to any images or videos taken with those cameras.
• 3D animations - These features are similar to lenses except the digital elements are 3D and animated. The animations can be added to images and videos.
• 3D projections - These features use projection mapping to turn varying surfaces into interactive, 3D displays or to superimpose projected, 3D images into real-world spaces.
• Virtual body motion - This feature uses motion tracking and plane detection via cameras and/or other sensors to digitize body motion and allow for movement in a virtual environment.
• Responsive virtual content - This feature uses spatial scanning and detection via cameras to scan real-world 3D objects, so that apps can detect them. Once recognized by an app, these reference objects trigger the appearance of pre-programmed virtual content.​

What you’ll need: Facebook AR Studio, Snapchat Lens Studio, Oculus Rift’s Quill, Amazon Sumerian, Apple’s ARKit, and MapMapper are a few of the developer tools and software programs available to create AR/VR/3D content.

2. Develop Immersive, 360-Degree Content

360-degree video and images can take experiential storytelling to the next level. For 360-degree content, video footage and images are captured from multiple angles and then stitched together. For video, this is done via a special rig of multiple cameras or one camera with multiple lenses. For images, this can be done on a mobile device via apps like Street View. While interactivity of 360-degree content is low -- the location of viewers is fixed and limited to the angles captured by the camera(s) -- viewers do gain a sense of depth and detail that goes beyond traditional content. They can engage with 360-degree content on multiple planes and that spatial element makes for an immersive experience.

What you’ll need: YouTube, Facebook, and Twitter all have applications for uploading and launching 360-degree video and images. Once published online, 360-degree content can then be viewed in 360x180 format on VR devices.

3. Transport People into Your Narrative​

The immersive and experiential nature of VR provides an opportunity to not only create a narrative, but to also transport people deep into the world of your narrative. VR presents a new framework for storytelling, because with VR, users can quite literally walk in someone else’s shoes. With virtual environments, you’re transporting users into a different world not just visually, but spatially. They can interact with the world. They can "live" in that world. Think about it this way: When you’re watching a movie, you can be transfixed and glued to the screen. You can feel as though you’re connecting with the story that is unfolding in front of you and getting a great glimpse of the world in which that story is taking place. But with VR, you’re in the story. You’re not just seeing it; you’re experiencing it. You are immersed and surrounded by it. And sometimes, you can be an active part of it.

What you’ll need: VR content development and design companies can assist you in building a virtual environment and experience that aligns with your health communication and marketing goals. 

Trying to figure out budget? Check out this VR cost calculator.

Try the VR Calculator

How is VR being used for health communication and marketing?

The application of VR to health communication and marketing is still being explored. Here’s what’s been found so far on virtual reality, augmented reality, virtual environments and health:

• Users are seeking health information in virtual environments. Virtual worlds can offer users access to health information and services. Second Life, a computer-based, online virtual world, offers 68 health-related services. The most common type of health-related services offered are educational or informational in nature. For example, the National Library of Medicine created an island, “HealthInfo Island,” within Second Life that allows users to attend lectures and interact with librarians. Additionally, virtual worlds like Second Life offer users spaces to discuss health-related topics. Users’ avatars can interact with each other and chat. Users can also connect around common interests/topic areas via Second Life’s groups.

• The experience of virtual elements in the physical world (AR) may enhance learning.  In one study, users were shown content in the same room and location either via 3D projection mapping or on a 2D surface. Users were better able to recognize and remember content that was shared via 3D projection mapping. The experience of augmented reality may be more remarkable and notable than traditional 2D media.​

• The more immersed users are in VR environments, the more their emotions may be elicited and their attitudes changed. Narrative transportation theory posits that immersion into a narrative, including cognitively, emotionally, and visually (via imagery), is a key part of changing attitudes, beliefs, and behavior. Researchers are studying what happens when people are exposed to public health messages within narratives constructed in immersive, VR environments. So far, they’ve found that the more immersed users are in VR-based video games, the less they are able to argue against messages and the more their attitudes are influenced. The graphics, dimensions, and other technological features of the virtual environment can all contribute to the level of immersion users experience. Another study found that users’ level of mastery within a game positively predicted anti-tobacco attitudes.

• Virtual environments may reduce fear and stigma related to seeking sensitive health information. Some virtual environments allow users to create anonymous avatars, which embody them in the virtual world. The anonymity of these avatars may reduce fear of being tracked while accessing sensitive health-related information. A randomized controlled trial among HIV-negative gay and bisexual men, ages 18 to 24, demonstrated that a web-based, interactive simulation game may reduce sexual stigma and be predictive of reduced sexual risk behaviors. The characters, dialogue, storylines, and avatars of the virtual environment used in the trial were carefully designed to encourage positive self-appraisal, increase self-worth, and decrease feelings of isolation, while HIV and risk-reduction messages were shared in a non-judgmental manner.

• Virtual selves and virtual doppelgängers may increase the perceived relevance of brands and risk-related health messages. The “virtual self” can be an avatar, profile picture, username or other digital representation of a user in the virtual world. When users create avatars in a virtual environment that bear photo resemblance to them, the avatars are considered virtual doppelgängers. One study examined if virtual doppelgängers increased the perceived personal relevance of risk messages when used in conjunction with traditional health communication materials. Compared to unfamiliar, computer-controlled virtual agents, virtual doppelgängers were more effective at increasing perceived relevance of risk messages related to consumption of sugar-sweetened beverages. Users may be more receptive of messages that are shared by avatars that look like them. Another study assessed the use of self-endorsed advertisements (SEAs) to promote positive brand attitudes. SEAs can range from a user sharing selfies on social media that they have decorated with branded filters, frames, or other AR elements (self-created SEAs) to branded banner ads that include a user’s virtual self (third party-created SEAs). This study found that self-created SEAs, when compared to third party-created SEAs, led to greater self-referencing (i.e., processing new information through memories that summarize a person's beliefs and experiences). Greater self-referencing led to greater self-brand congruity (i.e., the perceived alignment of a brand with a person’s sense of self) and ultimately a more favorable brand attitude.

• Experiencing negative health effects in VR environments may increase perceived risk and susceptibility. To promote the selection of lower calorie food options, one study used VR to simulate the weight of caloric density. Providing users the ability to feel the difference in caloric density between a baked potato and potato chips -- the chips are lighter in mass but have 5x the caloric density of a baked potato -- allowed users to better understand the concept of caloric density and to select snack items lower in calories. The sensory-rich detail of the immersive VR simulation better communicated the abstract idea of caloric density than statistics and print materials. That being said, less immersive virtual simulations have also had success with increasing perceived risk. In a different study, participants were given a pamphlet with an embedded simulation designed to demonstrate the negative health effects of consuming soft drinks. The simulation showed the effects of a virtual agent drinking one soft drink per day for two years. In just two minutes, participants were able to see the body changes and weight gain of the virtual agent over the 2-year period. Additionally, the simulation showed the 20 pounds of fat gained by the virtual agent (in liquid form) being spilled onto a scale. Compared to being shown a pamphlet with statistics or a pamphlet with before-and-after pictures, the simulation was most effective at increasing perceived likelihood and susceptibility, as well as perceived relevance.

• The physical/sensory stimuli and spatial presence of VR may lead to behavior change. One study examining the persuasive effects of anti-smoking messages shared in an immersive VR environment compared to those shared on a 2D flat screen found that physical stimuli in the VR environment led to greater intention to share anti-smoking messages. Additional studies in 2013, 2014, and 2015 support the finding that there may be benefit to creating simulated experiences in VR for behavior change. VR-based public health interventions have resulted in behavioral changes related to post-traumatic stress disorder, diet, diabetes, obesity, environmental protection, and preparedness for floods and terrorist attacks.​

Additional Resource: There’s a great book on virtual environments and health, if you’re looking for additional information: The Digital Patient: Advancing Healthcare, Research, and Education.

Preview the Book

What is the future of VR?

Besides upgrading virtual environments like Second Life to be compatible with VR headsets, the next phase of VR is creating virtual experiences that can be shared by multiple people. There are VR applications and technology that allow multiple users to join and interact in the same virtual space, and this technology is being explored and built upon.

• AltSpaceVR lets users create avatars and join up with friends and family to play games or attend events like concerts together in the virtual world.
• vTime allows user to create avatars and lounge campfire style in pre-rendered virtual environments with up to three friends or strangers.
• Rec Room allows for multiplayer VR gaming. Gamers can join with other players online to play dodgeball, disc golf, 3D paint charades, paintball, laser gun shooting, and more.
• Oculus Rooms (created by Facebook Reality Labs) allows users to create customizable virtual chat rooms. In these chat rooms, they can have face-to-face interactions with up to three friends.
• Oculus TV allows users to stream and watch movies and TV together while in different physical locations.

As public health communication and marketing professionals, we must examine effective ways to adapt our strategies and tactics as the digital landscape changes. Share your experiences with virtual reality for health communication in the comments below. And sign up for our newsletter to get updates from us!

Last updated: December 5, 2018

By: Monique Thornton, MPH