Gibson Bryan, Simonsen Sara, Jensen Jakob D, Yingling Leah, Schaefer Julia, Sundaresh Vishnu, Zhang Yue, Altizer Roger
Department of Biomedical Informatics, School of Medicine, University of Utah, Salt Lake City, UT, United States.
College of Nursing, University of Utah, Salt Lake City, UT, United States.
JMIR Diabetes. 2022 Mar 17;7(1):e26013. doi: 10.2196/26013.
Hispanic adults are at increased risk of developing type 2 diabetes. The Diabetes Prevention Program (DPP) reduces the risk of developing type 2 diabetes; however, the rate of enrollment is very low.
The goal of this pilot project was to determine whether presenting brief motivational mobile videos in virtual reality vs 360° video has differential effects on risk perceptions and enrollment in the DPP.
Adults with prediabetes were recruited at a clinic serving a low-income Hispanic community. After consenting, the participants completed a baseline survey that collected information about demographics and risk perceptions. All participants then viewed 2 videos. Per random assignment, the videos were presented either using the participant's smartphone alone (360° video) or were viewed with their smartphone in a virtual reality (VR) cardboard headset. Two weeks later, a follow-up survey collected measures of enrollment in the DPP, risk perceptions, health literacy, the importance of contextual factors related to the decision of whether to enroll in the DPP (eg, distance to the class), and qualitative feedback on the interventions. We used logistic regression to determine whether enrollment in the DPP differed by intervention mode, while accounting for health literacy and contextual factors related to the DPP. We used unpaired t tests to examine differences in change in risk perceptions between groups. Paired t tests were used to examine within-subject changes in risk perceptions.
A total of 116 participants provided complete data. Most participants were middle-aged (mean age 44.6 years; SD 11.9) Hispanic (114/116), female (79/116), with low health literacy (mean score 12.3/20; SD 3.4). Enrollment in the DPP was 44/116 (37.9%) overall but did not differ by group (odds ratio for enrolling in VR group 1.78, 95% CI 0.75-4.3; P=.19). Individuals who rated the distance needed to travel to attend the DPP as more important were less likely to enroll in the DPP (odds ratio 0.56, 95% CI 0.33-0.92; P=.03). Risk perceptions did not differ by group (mean change in 360° video group -0.07, mean change in VR group 0.03, t=0.6, P=.54) and did not change within subjects (mean 0.02, t=0.21, P=.83). Participant feedback suggested that the videos are emotionally engaging and educational.
The videos presented in 360° video and mobile VR had equal efficacy in promoting enrollment in the DPP. Future work to rigorously evaluate this intervention, its mechanism of action, and potential moderators of the efficacy are discussed.
西班牙裔成年人患2型糖尿病的风险增加。糖尿病预防计划（DPP）可降低患2型糖尿病的风险；然而，其参与率非常低。
本试点项目的目标是确定在虚拟现实中展示简短的激励性移动视频与360°视频相比，对风险认知和DPP参与率是否有不同影响。
在为低收入西班牙裔社区服务的诊所招募患有糖尿病前期的成年人。在获得同意后，参与者完成了一项基线调查，收集有关人口统计学和风险认知的信息。然后，所有参与者观看了2个视频。根据随机分配，视频要么仅使用参与者的智能手机播放（360°视频），要么使用智能手机在虚拟现实（VR）纸板头显中观看。两周后，一项后续调查收集了DPP参与情况、风险认知、健康素养、与是否参与DPP的决定相关的背景因素的重要性（例如，到课程的距离）以及对干预措施的定性反馈的测量数据。我们使用逻辑回归来确定DPP的参与情况是否因干预模式而异，同时考虑健康素养和与DPP相关的背景因素。我们使用非配对t检验来检查组间风险认知变化的差异。配对t检验用于检查个体内部风险认知的变化。
共有116名参与者提供了完整数据。大多数参与者是中年（平均年龄44.6岁；标准差11.9）西班牙裔（114/116）、女性（79/116），健康素养较低（平均得分12.3/20；标准差3.4）。DPP的总体参与率为44/116（37.9%），但两组之间没有差异（VR组参与的优势比为1.78，95%置信区间为0.75 - 4.3；P = 0.19）。认为参加DPP所需行程距离更重要的个体参与DPP的可能性较小（优势比0.56，95%置信区间为0.33 - 0.92；P = 0.03）。两组之间的风险认知没有差异（360°视频组的平均变化为 - 0.07，VR组的平均变化为0.03，t = 0.6，P = 0.54），个体内部也没有变化（平均0.02，t = 0.21，P = 0.83）。参与者反馈表明这些视频在情感上具有吸引力且具有教育意义。
360°视频和移动VR中展示的视频在促进DPP参与方面具有同等效果。讨论了未来严格评估该干预措施、其作用机制以及疗效潜在调节因素的工作。
