Using immersive virtual reality to improve the beliefs and intentions of influenza vaccine avoidant 18-to-49-year-olds: Considerations, effects, and lessons learned.

OBJECTIVE: Only one-third of adults 18-49 years old in the United States receive a recommended annual influenza vaccination. This study examined whether supplementing vaccine information statements (VIS) with an immersive virtual reality (VR), short video or electronic pamphlet story designed to convey the community immunity benefits of influenza vaccination would improve influenza vaccine avoidant participants' influenza-related perceptions as well as their influenza vaccination-related beliefs, confidence and intentions. METHOD: A one-way between-subjects experimental design compared the effects of adding a supplemental education experience prior to VIS exposure with flu vaccine avoidant 18-to-49-year-olds. The 171 participants recruited from the community were randomly assigned to one of three modality treatment conditions [VR, video, or e-pamphlet (i.e., story board presented via electronic tablet)] or a VIS-only control condition. RESULTS: Compared to the modalities, the VR intervention created a stronger perception of presence (i.e., feeling of "being there" in the story), which, in turn, increased participants' concern about transmitting influenza to others and raised vaccination intention. Increased concern about transmitting influenza to others was associated with positive effects on influenza vaccination-related beliefs, including confidence that one's flu vaccination would protect others. Neither the e-pamphlet nor the video intervention were able to elicit a sense of presence nor were they able to improve the impact of the VIS on the outcome measures. CONCLUSIONS: Immersive VR has much potential to increase understanding of key immunization concepts, such as community immunity, through creative executions that increase a sense of presence. Given the need to increase influenza vaccination uptake among 18-to-49-year-olds, and the projected growth in VR accessibility and use, additional applications and assessments related to vaccination communication and education are needed and warranted. By increasing the ability to convey key vaccine and immunization concepts, immersive VR could help address vaccination hesitancy and acceptance challenges.

Mortality salience effects on selective exposure and web browsing behavior.

Issue-related attitudes appear to drive individuals' selective Website browsing behavior, as a match between issue-related attitudes and Website content results in a greater number of page views. However, this relationship between content domain involvement and selective exposure is more complex than current theories hold, as the relationship emerges only when individuals are not primed to reflect on their mortality. Reminders of mortality, which are common in everyday life, lead to a defense motivation, which influences selective exposure behavior. In the control condition, issue-related attitudes predicted Website browsing, but under a mortality salience induction, these attitudes did not predict browsing behavior. Further, response latencies for the measure of individuals' attitudes toward the Website were influenced by their issue-related attitudes in the mortality salience condition but not in the control condition. The patterns of interactions produced in this experiment (N=215) illustrate the relationship between dispositional and situational factors that drive selective exposure in an online context. The results also underscore the importance of using behavioral and process-dependent measures in addition to self-report measures.