Mobile Virtual reality vs. Mobile 360 Video to Promote Enrollment in the Diabetes Prevention Program Amongst Hispanic Adults (Preprint)

Abstract

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 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, participants completed a baseline survey that collected information about demographics and risk perceptions. All participants then viewed two 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 or not to enroll in the DPP (e.g. 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 heath 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.

116 participants provided complete data. Most participants were middle-aged (mean age= 44.6 yrs.; 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 overall (37.9%) but did not differ by group (OR for enrolling in VR group= 1.78; 95% CI: 0.75-4.3, p=0.19). Individuals who rated the distance needed to travel to attend the DPP as more important were less likely to enroll in the DPP (OR = 0.56, 95% CI:0.33-0.92; p=0.03). 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= 0.54) and did not change within subjects ( mean 0.02, t=0.21, p=0.83). Participant feedback suggested that the videos are emotionally engaging and educational.

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 is discussed.