White Paper: Open Digital Health – accelerating transparent and scalable health promotion and treatment

In this White Paper, we outline recommendations from the perspective of health psychology and behavioural science, addressing three research gaps: (1) What methods in the health psychology research toolkit can be best used for developing and evaluating digital health tools? (2) What are the most feasible strategies to reuse digital health tools across populations and settings? (3) What are the main advantages and challenges of sharing (openly publishing) data, code, intervention content and design features of digital health tools? We provide actionable suggestions for researchers joining the continuously growing Open Digital Health movement, poised to revolutionise health psychology research and practice in the coming years. This White Paper is positioned in the current context of the COVID-19 pandemic, exploring how digital health tools have rapidly gained popularity in 2020-2022, when world-wide health promotion and treatment efforts rapidly shifted from face-to-face to remote delivery. This statement is written by the Directors of the not-for-profit Open Digital Health initiative (n = 6), Experts attending the European Health Psychology Society Synergy Expert Meeting (n = 17), and the initiative consultant, following a two-day meeting (19-20th August 2021).Peer reviewe

Effects of digital Just-In-Time nudges on healthy food choice – A field experiment

Novel digital applications enable intervening in health behavior at moments hitherto impossible. Handheld self-scanning solutions in supermarkets allow providing nudges immediately in response to the product choice. While a nudge presented at this moment, in the optimal state of vulnerability/opportunity and receptivity, may serve as a cue to action and trigger healthier choices, post-choice biases instead predict that changing decisions is challenging. We investigated whether visibility nudges (product suggestions) and descriptive and evaluative nutritional labeling nudges provided immediately in response to choice can stimulate healthier food choices. Experimental manipulations were integrated in the self-scanning function of a smartphone application that allowed scanning and purchasing products in the physical supermarket. We compared: 1) a control version without adaptations, 2) a visibility nudge version in which after scanning an unhealthy product a pop-up with a healthier alternative appeared, 3) a version similar to version 2 but with additionally a descriptive nutritional label nudge denoting the healthiness of the alternative, and 4) a version similar to version 2 but with additionally an evaluative nutritional label nudge denoting the healthiness of the alternative. Sales data were collected during a 5-week period. The percentage of healthier products purchased was significantly higher for the visibility nudge version in which the healthier alternative was suggested without any additional nudge (37.7% healthier) compared to the control condition (29.9%), and the versions with an additional descriptive (30.0%) or evaluative nutritional label nudge (28.2%). The findings imply that saliently suggesting a healthier alternative stimulates healthier purchasing behavior but that an additional nudge emphasizing health may cancel this effect out

Effects of digital Just-In-Time nudges on healthy food choice – A field experiment

Novel digital applications enable intervening in health behavior at moments hitherto impossible. Handheld self-scanning solutions in supermarkets allow providing nudges immediately in response to the product choice. While a nudge presented at this moment, in the optimal state of vulnerability/opportunity and receptivity, may serve as a cue to action and trigger healthier choices, post-choice biases instead predict that changing decisions is challenging. We investigated whether visibility nudges (product suggestions) and descriptive and evaluative nutritional labeling nudges provided immediately in response to choice can stimulate healthier food choices. Experimental manipulations were integrated in the self-scanning function of a smartphone application that allowed scanning and purchasing products in the physical supermarket. We compared: 1) a control version without adaptations, 2) a visibility nudge version in which after scanning an unhealthy product a pop-up with a healthier alternative appeared, 3) a version similar to version 2 but with additionally a descriptive nutritional label nudge denoting the healthiness of the alternative, and 4) a version similar to version 2 but with additionally an evaluative nutritional label nudge denoting the healthiness of the alternative. Sales data were collected during a 5-week period. The percentage of healthier products purchased was significantly higher for the visibility nudge version in which the healthier alternative was suggested without any additional nudge (37.7% healthier) compared to the control condition (29.9%), and the versions with an additional descriptive (30.0%) or evaluative nutritional label nudge (28.2%). The findings imply that saliently suggesting a healthier alternative stimulates healthier purchasing behavior but that an additional nudge emphasizing health may cancel this effect out

Embodying an overweight body in Virtual Reality: using qualitative methods to understand the full-body illusion in young healthy-weight adults

In Virtual Reality, it is possible to experience ownership of a body that looks different than your own body, by substituting the real body for a virtual avatar body (also known as Virtual Body Ownership / VBO). Recent studies focused on how such full body illusions can be utilized to tackle health problems. For example, they enable to virtually experience the consequences of unhealthy behaviors, such as becoming overweight due to excessive unhealthy snacking. While the number of quantitative studies employing a full body illusion while manipulating appearance characteristics has been growing, little is known about what users actually experience at the moment of embodying a (dissimilar) virtual body. The full body illusion is a rich experience in which people are completely secluded from the ‘real’ world, and research methods that are specifically useful to understand people’s experiences have never been employed in this realm. We argue that qualitative research methods would be helpful in understanding what participants go through while in the full body illusion, and why equivocal findings emerge. This will enhance our understanding of psychological processes or conditions that could play a role in experienced emotions, perceptions and intentions to change health behavior. This study therefore aims a) to get a more thorough understanding of how embodying an overweight virtual body is experienced, and which factors enhance or inhibit this experience; and b) to explore the affective impact (feelings/emotions regarding the own body), perceptual impact (thoughts/perceptions regarding the own body and regarding being overweight) and impact on health behavior intentions that the virtual experience could have

Neural Activity in Self-Related Brain Regions in Response to Tailored Nutritional Messages Predicts Dietary Change

Overweight and obesity have become international public health problems, so there is an urgent need to implement effective interventions that prevent these concerning health issues. Designing personalized (tailored) dietary communications has become one of the most effective tools in reducing unhealthy eating behavior, when compared with one-size-fits-all messages (untailored). However, more research is required to gain a complete understanding of the underlying mechanisms by which tailored nutritional messages elicit reductions in unhealthy dietary behavior. To the best of our knowledge, our study may be the first to use neuroimaging, namely functional magnetic resonance imaging (fMRI), aiming to evaluate the neural basis of tailored and untailored nutritional messages and assess how these neural responses predict unhealthy food intake reduction after a month receiving tailored nutritional messages. To that goal, 30 participants were scanned while reading tailored and untailored nutritional messages. Subsequently, for a month, they received tailored interventions encouraging healthy food intake. The neural findings reveal that when compared to untailored communications, tailored messages elicit brain networks associated with self-relevance, such as the precuneus, the middle temporal gyrus, the hippocampus, the inferior orbitofrontal cortex (OBC), the dorsomedial prefrontal cortex (dMPFC), and the angular gyrus. Interestingly, among these self-related brain areas, the dMPFC, OFC, angular gyrus, and hippocampus forecast reductions in unhealthy food intake after a one-month tailored intervention for the cessation of unhealthy eating. These results may offer implications for clinicians, practitioners, and/or policymakers who should implement substantial efforts in creating individualized campaigns focused on their target's perceived needs, goals, and drivers in relation to eating healthy to reduce overweight issues. This research therefore constitutes a step forward in showing a direct association between the neural responses to tailored nutritional messages and changes in real-life healthy eating behavior

Brands in virtual reality games: Affective processes within computer-mediated consumer experiences

Virtual reality (VR) marketing is here to stay—or at least that is what is generally believed. Head-mounted display (HMD) VR hardware is rapidly becoming more accessible to the general public, and businesses have started adopting VR as an experiential marketing platform. In this study, we examine two affective mechanisms that play a role in the workings of branded VR games in an HMD VR context: (1) virtual product appeal and (2) emotional response. We conducted a between-subjects (branded VR game vs. non-branded VR game) lab experiment (N = 81) among young adults who were recruited via the university's lab recruitment system. During the experiment, participants used HTC Vive hardware with hand-held controllers. The results show that virtual product appeal strengthens the effect of brands in VR games on brand attitude. Moreover, brands in VR games elicit emotional responses, which subsequently drive brand attitude and purchase intention

Stimulating Sustainable Food Choices Using Virtual Reality:Taking an Environmental vs Health Communication Perspective on Enhancing Response Efficacy Beliefs

Personal response efficacy beliefs are vital in instigating, maintaining, and catalyzing environmental behavior change. In this experimental study (N = 249), we investigated whether such efficacy beliefs could be stimulated using Virtual Reality. In a VR-supermarket, participants would see interactive pop-ups displaying impact messages when they picked up products, these are messages that display the (environmental or health) impact of a product. Our results show that these impact messages are effective in stimulating personal response efficacy beliefs and subsequently pro-environmental food choices. The heightened personal response efficacy beliefs positively affected maintaining and catalyzing behavior change (i.e. positive spill-over) up to two weeks after the VR-experience. The effectiveness of the impact messages did not depend on appeal type (health vs environmental appeal) or modality (text + visual vs text only) of the message. Theoretical and practical implications are discussed

White Paper: Open Digital Health – accelerating transparent and scalable health promotion and treatment

In this White Paper, we outline recommendations from the perspective of health psychology and behavioural science, addressing three research gaps: (1) What methods in the health psychology research toolkit can be best used for developing and evaluating digital health tools? (2) What are the most feasible strategies to reuse digital health tools across populations and settings? (3) What are the main advantages and challenges of sharing (openly publishing) data, code, intervention content and design features of digital health tools? We provide actionable suggestions for researchers joining the continuously growing Open Digital Health movement, poised to revolutionise health psychology research and practice in the coming years. This White Paper is positioned in the current context of the COVID-19 pandemic, exploring how digital health tools have rapidly gained popularity in 2020-2022, when world-wide health promotion and treatment efforts rapidly shifted from face-to-face to remote delivery. This statement is written by the Directors of the not-for-profit Open Digital Health initiative (n = 6), Experts attending the European Health Psychology Society Synergy Expert Meeting (n = 17), and the initiative consultant, following a two-day meeting (19-20th August 2021).Peer reviewe