Computers as Persuasive Media Simulation

Overview

When it comes to shaping attitudes and behavior, experience makes a difference. [1 ]Those in the business of persuading understand and apply this principle. AOL gives out trial memberships on CD. Auto dealers encourage customers to take a test drive. Government programs send at-risk kids to visit correctional facilities to get a glimpse of prison life. The goal in these and other scenarios is to provide a compelling experience that will persuade people to change their attitudes or behaviors.

Computers can shape attitudes and behavior by providing compelling simulated experiences.

The experience principle can be applied to persuasive technologies as well. When computers are used as persuasive media—particularly when they are used to create simulations—they can have a powerful impact on shaping attitudes and behaviors in the real world. [2 ]This chapter will focus on computers as persuasive media—the second corner of the functional triad (Figure 4.1).

Figure 4.1: Computers as persuasive media.

Computer simulations can create experiences that mimic experiences in the real world, or they can create hypothetical worlds that are experienced as “real.” Simulations can be as simple as an Indy 500 race game on a handheld computer or as complex as virtual reality. [3 ]People often react to virtual experiences as though they were real-world experiences. [4 ]And it’s this reaction that sets the stage for influence dynamics to play out.

Technology innovators have only begun to explore the persuasive possibilities of computer-simulated experiences. This is perhaps the most promising new path for computers as persuasive technologies.

This chapter will outline three classes of computer-based simulations and explore the current and potential use of simulations to change attitudes and behavior. For each type of simulation, I’ll present examples, highlight key advantages, and offer relevant principles for designing and understanding computer simulation.

[1 ]E. Reed, The Necessity of Experience (New Haven, CT: Yale University Press, 1996).

[2 ]For example, see the following:

a. D. M. Towne, T. de Jong, and H. Spada (eds.), Simulation-Based Experiential Learning (Berlin: Springer-Verlag, 1993).

b. Cognition and Technology Group at Vanderbilt, The Jasper experiment: An exploration of issues in learning and instructional design, Educational Technology Research and Development, 40 (1): 65–80 (1992).

c. T. Manning, Interactive environments for promoting health, in R. S. Street, W. R. Gold, and T. Manning (eds.), Health Promotion and Interactive Technology: Theoretical Applications and Future Directions (Hillsdale, NJ: Lawrence Earlbaum, 1997), pp. 67–78.

[3 ]There are various definitions of “virtual reality.” According to M. W. Krueger: “The terms virtual worlds, virtual cockpits, and virtual workstations were used to describe specific projects. In 1989, Jaron Lanier, CEO of VPL, coined the term virtual reality to bring all of the virtual projects under a single rubric. The term therefore typically refers to three dimensional realities implemented with stereo viewing goggles and reality gloves.” M. W. Krueger, Artificial Reality, 2nd ed. (Reading, MA: Addison-Wesley, 1991), p. xiii.

[4 ]You’ll find a considerable body of evidence about people responding to interactive technologies as they respond to real-life experiences in Byron Reeves and Clifford Nass, The Media Equation: How People Treat Computers, Television, and New Media Like Real People and Places (Stanford, CA: Cambridge University Press, 1996).

Persuading through Computer Simulation

From the standpoint of persuasion, the technological elements of a simulation are less important than what the user actually experiences. Drawing on how people experience computer simulations, I propose three categories of simulation that are relevant to persuasive technologies: [5 ]

Within each of these categories, theories from social science—especially psychology—offer insight into computers as persuasive sensory media. The pages that follow discuss each type of simulation in turn.

[5 ]Other taxonomies for simulations exist. For example, see the following:

a. M. B. Gredler, A taxonomy of computer simulations, Educational Technology, 26: 7–12 (1986).

b. In 1999, Kurt Schmucker wrote “A Taxonomy of Simulation Software” for Apple Computer. Available at http://www.apple.com/education/LTReview/spring99/simulation/.

c. S. M. Alessi and S. R. Trollip, Computer-Based Instruction, Methods and Development (Englewood Cliffs, NJ: Prentice Hall, 1985).

d. T. de Jong, Learning and instruction with computer simulations, Education & Computing, 6: 217–229 (1991).

e. T. de Jong, Discovery learning with computer simulations of conceptual domains, IST memo 96–02, University of Twente, The Netherlands (1996).

Cause and Effect Simulations Offering Exploration and Insight

Computing technology has long allowed people to simulate dynamic systems— the weather, population growth, the economy, and so on. With these technologies, people can vary the inputs, or causes, and observe the outputs, or effects, almost immediately. Suppose city planners are concerned about their city’s population boom. With a good simulation program (say, a professional version of SimCity) city officials can input various levels of growth and then observe how each level would affect other variables, such as traffic congestion or the demand for phone lines. Using cause-and-effect simulators, planners don’t have to wait for city populations to grow before making the necessary arrangements. It’s a powerful way to understand different scenarios. [6 ]

Principle of Cause and Effect

Simulations can persuade people to change their attitudes or behaviors by enabling them to observe immediately the link between cause and effect.

Cause-and-effect simulations can be powerful persuaders. The power comes from the ability to explore cause-and-effect relationships without having to wait a long time to see the results[7] and the ability to convey the effects in vivid and credible ways. [8 ]Because these simulations can clearly show cause and- effect relationships, they enable users to gain insight into the likely consequences of their attitudes or behaviors.

Cause-and-effect simulations enable users to explore and experiment in a safe environment, free of real-world consequences. [9 ]In such an environment it is less threatening to try out new attitudes or behaviors that might then be transferred to the real world. In addition, people who are in exploration mode expect to find new things, to be enlightened, to be surprised. This frame of mind makes it easier to form new attitudes and adopt new behaviors[10] in a simulated environment—attitudes and behaviors that then might be transferred to the real world.

By compressing time, a computer simulation can immediately show the link between cause and effect, which can help to change attitudes or behavior. You may know intellectually that eating burgers and fries every day can lead to heart disease in the future, but the effects aren’t apparent immediately in the real world. A cause-and-effect simulation could make this link clear and compelling, prompting you to change your eating habits.

It’s also important to realize that cause-and-effect simulations can persuade in subtle ways because users may not recognize the biases built into simulations. When absorbed in a simulation, people can easily forget that the outcomes are determined by rules defined by human beings who may have injected their own biases into the simulation. The natural inclination is to accept the simulation as true and accurate. [11 ](I’ll say more about the issue of accuracy later in this chapter.) People usually don’t scrutinize the content of a simulation, in part because their minds are busy processing other aspects of the experience. [12 ]Because of this, those who design simulated experiences can get across their message without seeming to preach.

[6 ]See the following:

a. D. A. Sisk, Simulation games as training tools, in Sandra M. Fowler and Monica G. Mumford (eds.), Intercultural Sourcebook: Cross-cultural Training Methods, vol. 1 (Yarmouth, ME: Intercultural Press, 1995).

b. R. S. Street and Rimal, Health promotion and technology: A conceptual foundation, in R. S. Street, W. R. Gold, and T. Manning (eds.), Health Promotion and Interactive Technology: Theoretical Applications and Future Directions (Hillsdale, NJ: Lawrence Earlbaum, 1997), pp. 1–18.

[7]T. de Jong, Learning and instruction with computer simulations, Education & Computing ,6: 217–229 (1991).

[8 ]L. P. Rieber, Animation, incidental learning, and continuing motivation, Journal of Educational Psychology, 83: 318–328 (1991).

[9 ]See the following:

a. E. M. Raybourn, Computer game design: New directions for intercultural simulation game designers, Developments in Business Simulation and Experiential Exercises, vol. 24 (1997). See www.unm.edu/~raybourn/games.html.

b. P. Pedersen, Simulations: A safe place to take risks in discussing cultural differences, Simulation & Gaming,26 (2): 201–206 (1995).

c. P. Carbonara, Game over, Fast Company (Dec. 1996).

[10]See the following:

a. D. A. Sisk, Simulation games as training tools, in Sandra M. Fowler and Monica G. Mumford (eds.), Intercultural Sourcebook: Cross-Cultural Training Methods , vol. 1 (Yarmouth, ME: Intercultural Press, 1995) pp. 81–92.

b. T. M. Shlechter, Computer-based simulation systems and role-playing: An effective combination for fostering conditional knowledge, Journal of Computer-Based Instruction, 19(4): 110–114 (1992).

[11 ]D. T. Gilbert, How mental systems believe, American Psychologist, 46(2): 107–109 (1991).

[12 ]R. E. Petty and J. T. Cacioppo, Communication and Persuasion: Central and Peripheral Routes to Attitude Change (New York: Springer-Verlag, 1986).

Cause and Effect Simulation Sources of Persuasive Power

HIV Roulette A Cause and Effect Simulator

One example of a persuasive cause-and-effect simulation is a kiosk called HIV Roulette. [13 ]Located in San Francisco’s Exploratorium, this exhibit (Figure 4.2) seems unremarkable at first; it’s just a simple kiosk. But those who take the time to sit down and “play” gain immediate insights into how their sexual behavior can affect their HIV status.

Figure 4.2: HIV Roulette is a kiosk that simulates the health risks of sexual contact.

Here’s how it works: First, the user views images of hypothetical people. The user then selects the gender and behavior of the group he or she wishes to simulate contact with, and their geographic location. Then the computer does a calculation—spins the roulette wheel, if you will—and reports whether the behavior is likely to result in contracting HIV or another sexually transmitted disease.

The report is based on real data, taking into account various factors, including the hypothetical partner’s history of sexual behavior and intravenous drug use. Most people who play HIV Roulette quickly see that the risks involved in sexual behavior depend not only on the partner selected, but also on all the people in that person’s sexual history.

HIV Roulette allows people to safely explore the health consequences of sexual activity. Most people play HIV Roulette in a predictable way: [14 ]At first, they are careful and cautious, choosing low-risk sexual partners. Then they begin making risky sexual choices, just to see what happens, until the computer reports they have contracted HIV. Sometimes this takes longer than players expect; sometimes it happens sooner. By graphically showing the consequences of specific behavior (Figure 4.3), based on real data, the simulation attempts to persuade users to engage in safer sex. You see that just a single sexual encounter can expose you to literally hundreds of indirect sexual contacts, depending on the sexual history of each partner. Of course, you don’t need a computer to calculate how quickly indirect sexual contacts add up. However, by having the HIV Roulette computer do the calculations for you and present the results graphically, the exponential risks due to indirect sexual partners become more readily apparent, more “in your face” and harder to ignore.

Figure 4.3: A report is generated at the end of each round of HIV Roulette.

Rockett s New School Learning Social Skills

Rockett’s New School, a game targeted to preteen girls, is another example of a cause-and-effect simulation. [15 ]The objective of the game is to help the protagonist, an eighth-grade student named Rockett (Figure 4.4), navigate social situations at a new school. The story begins when Rockett arrives at her school for the first time. Periodically the narrative stops and the user must make a decision for Rockett—such as what she should say or what attitude she should adopt toward events. The user then vicariously experiences the effects of those decisions.

Figure 4.4: In the game Rockett’s New School, users decide how the main character will respond to social situations.

Although the product is marketed as a game, the rules that underlie the simulation make the experience more than mere diversion. [16 ]One goal of the product is to shape how players respond to social situations in their own lives.

The Rockett simulation has a bias if you make choices that reflect Rockett’s self-confidence, generally Rockett fareswell; people like her, and she feels good about what she’s done. In contrast, if you make choices for Rockett that stem from fear or self-doubt, she doesn’t fare as well. For example, after Rockett arrives at class on the first day, the teacher invites her to introduce herself. At this point you must decide what attitude Rockett will have. If you choose a timid approach, the narrative then unfolds with students responding with slight derision and Rockett feeling as though she’s made a fool of herself. If you choose a confident attitude for Rockett, the teacher praises her and her classmates find their new classmate to be witty and interesting.

Some might say this program is being simplistic or downright misleading, that the world doesn’t necessarily reward sincerity or outspokenness. But this is the bias the designers have chosen. [17 ]They have deliberately created this game to inspire girls to build qualities like confidence, adventurousness, and empathy.

Implications of Designer Bias

This brings up an important aspect of simulations: the possibility of built-in bias of the designers. Although simulations can be informative, engaging, and persuasive, nothing guarantees that they are accurate. The rules built into the system may not be based on the best knowledge of cause-and-effect relationships but rather on the bias of the designer.

SimCity, the popular game developed by Will Wright to show the impact of planning decisions on the growth of urban areas, has been a focal point for spirited debate about the issue of designer bias. Technology watcher Ester Dyson notes that SimCity has been the poster child of the simulation-as subtle- propaganda debate. While people have asserted different types of political bias inherent in the game’s simulation rules, one example stands out. Dyson writes: “When asked about the effects of raising taxes, a 14-year-old experienced with SimCity replied, ‘Why, the citizens riot, of course.’” [18 ]

In the February 1990 issue of Byte (now defunct), columnist Jerry Pournelle wrote:

The simulation is pretty convincing—and that’s the problem, because it’s a simulation of the designer’s theories, not of reality. Case in point: the designer prefers rail transportation to automobiles. It’s costly, but it doesn’t pollute. In fact, you can design a whole city with nothing but rail transport, not a single road in the place. In the real world, such a city would soon strangle in garbage. [M]y point is not to condemn these programs. Instead, I want to warn against their misuse. For all too many, computers retain an air of mystery, and there’s a strong temptation to believe what the little machines tell us. [19 ]

Of course, “what the little machines tell us” depends on what the designers programmed into the simulation.

It’s impossible to create a simulation that is truly objective, since the designer cannot know precisely how all variables would interact in the real world, so bias is inevitable. Consider the above examples of Rockett and SimCity. Although research and facts can help build the underlying rules to the simulation, for some types of simulations, especially those involving social issues, data is insufficient or conflicting. Much like the writing of history is an inevitably biased interpretation of the past, those who create simulations are likely to introduce bias of some sort into their work.

Should those who create simulations reveal their biases to the users? I believe they should, if the simulation was designed not just as entertainment but to help people make health, financial, and other choices about their lives.

However, revealing bias is not always desirable, practical, or effective. There is no standard way in simulations to let users know about the designer’s biases— no type of initial information screen or “about this simulation” section. Certainly, designers could—and perhaps should—try to expose users to the assumptions underlying a simulation. But if the product is designed to sell or to promote an ideology, it’s unlikely that creators will risk undermining their effectiveness by admitting to biases, however small. Yet you can also imagine how the creators of a simulation could boost their credibility by impressing the user with how accurate the facts are underlying the simulations. (One product called Great Cities does this by acknowledging its biases up front and allowing users to review and even change the rules and assumptions of the simulation.20)

The other challenge surrounding disclosure of biases is that the creators themselves may not recognize their biases. We are often blind to our own biases and assumptions.

In my view, the most reasonable path is also one that will take time and effort: educating people—both researchers and end users—about how interactive simulations will inevitably have biases built into the rules underlying the experience. As interactive simulations become a greater part of our information and entertainment landscape, we would do well to add simulations to the list of things that require a critical eye and careful evaluation.

[13 ]See an online description at http://www.exploratorium.edu/exhibit_services/exhibits/h/hivroulette.html.

[14 ]Personal conversation with Charles Carlson, director of Life Sciences, San Francisco Exploratorium.

[15 ]The Purple Moon Web site has been taken down (due to an acquisition), but you can see what this site was like by visiting http://web.archive.org/web/20000815075140/http:// www.purplemoon.com. For limited information and a couple of reviews about the product Rockett’s New School, see http://www.cdaccess.com/html/shared/rocketts.htm. This product can also be purchased from various online retailers.

[16 ]Brenda Laurel, The Utopian Entrepreneur (Cambridge, MA: MIT Press, 2001).

[17 ]Brenda Laurel, The Utopian Entrepreneur (Cambridge, MA: MIT Press, 2001).

[18 ]One source for this is an article by Ester Dyson at http://web.archive.org/web/20001121023100/ http://www.mg.co.za/pc/games/1999/03/11mar-simulation.htm.

[19 ]For an article by Ted Friedman (“Semiotics of SimCity”) about simulations, including Jerry Pournelle’s quote from the now-defunct Byte magazine about simulations having embedded values and messages, see http://www.firstmonday.dk/issues/issue4_4/friedman/.

Environment Simulations Creating Spaces for Persuasive Experiences

Environment simulations—those that provide users with new surroundings— can be another form of persuasive technology. Sometimes the surroundings are immersive, as in high-end virtual reality applications. More often, the virtual environments are much simpler and use basic technology. Alcohol 101 is a desktop application that simulates a college party. Hewlett- Packard’s MOPy is a screen saver that simulates a fish swimming in an aquarium. Life Fitness Rower simulates rowing while spectators cheer you on and other people compete against you. Even these simple systems can be engaging because immersion is a function of the mind, not of the technology. [21 ]In fact, in learning simulations, some argue that realism can detract from the learning experience. [22 ]

Principle of Virtual Rehearsal

Providing a motivating simulated environment in which to rehearse a behavior can enable people to change their attitudes or behavior in the real world.

Like cause-and-effect scenarios, simulated environments provide a safe “place” to explore new behaviors and perspectives. [23 ]And unlike real environments, virtual environments are controllable; [24 ]users can start or stop the experience at any time, and when they return for additional virtual experiences, they can pick up where they left off.

Simulated environments can persuade through creating situations that reward and motivate people for a target behavior; allow users to practice a target behavior; control exposure to new or frightening situations; and facilitate role-playing, adopting another person’s perspective.

Environment Simulation: Sources of Persuasive Power

The health and fitness industry is among the leaders in using environment simulations to motivate and influence people. [25 ]These technologies leverage the fact that our environment plays a key role in shaping our behaviors and thoughts. [26 ]

LifeFitness VR Rowing Machine Competing in a Virtual Environment

Exercising alone and without media can be boring or tedious, so it’s not surprising that early innovators of exercise equipment sought ways to make the time pass more quickly and enjoyably, such as adding LED displays to show an exerciser’s progress on an imaginary jogging track. Today, many types of exercise devices add simulation to make workouts more compelling. By simulating a new environment, fitness companies have found that they can increase their customers’ motivation and enjoyment while changing their attitudes and behaviors related to exercise.

Principle of Virtual Rewards

Computer simulations that reward target behaviors in a virtual world, such as giving virtual rewards for exercising, can influence people to perform the target behavior more frequently and effectively in the real world.

One early example of using simulation to promote exercise is the Life-Fitness VR Rowing Machine (Figure 4.5). This stationary rowing device includes a screen that depicts you, the exerciser, rowing a boat on virtual water. As you row faster, your boat moves through the water faster. You row past scenery, distance markers, and landmarks. You can also race against a virtual competitor, who helps set a pace for you. For added motivation, some versions of the product depict a shark that chases you.

Figure 4.5: The LifeFitness VR Rowing Machine provides a virtual environment to motivate users.

The LifeFitness VR Rowing Machine uses a number of persuasive strategies to motivate users to exercise more effectively. It provides feedback, competition, and rewards. In addition, the simulated environment distracts or “ dissociates” users from focusing on the discomfort that comes with exercise.

The Tectrix VR Bike Pedaling to Explore a Virtual Environment

The Tectrix27 VR Bike (Figure 4.6) is another example of how an environment simulation can motivate and reward people for performing certain behaviors—in this case, exercising more effectively. As you work out on this device, you can explore a virtual world, navigating by plane or snowmobile and choosing whichever route you prefer.

Figure 4.6: The Tectrix VR Bike simulates a journey by land, sea, or air.

When you pedal faster, you travel faster in your virtual world. You can snowmobile though the mountains or explore a tropical island by plane. As you do so, a fan embedded near the monitor blows on your face, adding a tactile dimension to the simulated environment. To turn or maneuver, you must lean fromside to side in the bike seat. If you choose to go down the beach and under the sea, you get a view of life in the deep blue. In some versions of this product, your exercise bike becomes the input device for multiplayer competition in a virtual world. (My gym in Santa Rosa has two of these bikes, and I’ve seen that the competition mode is popular, especially with younger members.)

Although the VR bike has yet to become common in health clubs (perhaps because of the hefty price tag), research on the effects of these devices shows that they do succeed in changing users’ attitudes and behaviors toward exercise. [28 ]In one study, 18 people rode the bikes using the virtual environment simulation, and 18 people rode the bikes without the simulation. During the 30-minute period of the study, people using the VR version of the bike had higher heart rates and burned more calories.

Despite the increased performance for those using the VR exercise equipment, when asked how much effort they exerted during the 30-minute exercise period, the two groups showed no significant differences in perceived exertion. In other words, even though the VR group worked harder in the exercise, they didn’t feel like they worked harder; [29 ]the simulated environment led to greater physical exertion with less awareness of the effort. This finding matches other research demonstrating that people enjoy running more and that they run harder when exercising outside rather than on a treadmill. [30 ]

These studies confirm what we know through common sense and experience: the context for an activity makes a difference. The research also shows that a virtual environment can offer some of the same beneficial effects as the real world.

Managing Asthma in a Simulated Environment

Other health products have leveraged the power of simulation to achieve persuasive ends in maintaining chronic health conditions. One such product is Click Health’s Bronkie the Bronchiasaurus (Figure 4.7), a Nintendo-based video game designed to help kids with chronic asthma to manage the condition. [31 ]In the United States, 15 million people have asthma (one-third of them under the age of 18). People who manage their asthma successfully enjoy much better health than those who don’t. [32 ]

Figure 4.7: Bronkie the Bronchiasaurus is a Nintendo game with a persuasive goal: getting kids to manage their asthma more effectively.

The game puts players into a new environment—a prehistoric dinosaur world—where they take on the role of Bronkie, a dinosaur who has asthma. In this Nintendo setting, players try to find and reassemble pieces of a wind machine, a device that will clear dust from the air. During the game, players must manage Bronkie’s asthma or they cannot continue their quest.

To manage Bronkie’s asthma, players have to perform asthma management tasks that are similar to those for human asthmatics. They must help Bronkie use an inhaler and avoid smoke and dust, among other things.

On the one hand, Bronkie is a game; it’s fun to play. But on the other hand, this product is a vehicle for practicing self-care. This type of “influtainment” is a powerful strategy, especially for the target age group, kids aged 8 to 14.

Research on the Bronkie video game shows striking results. Asthmatic kids who play Bronkie for as little as 30 minutes report increased self-efficacy in caring for their chronic condition. They not only believe they can take successful action in managing their asthma, but they are more likely to do so than those with low self-efficacy. [33 ]The research showed that playing this video game not only had an immediate impact on participants in the study, but that the effects continued long after the session was over.

Although the study showed other positive outcomes as well (more knowledge, more sharing with friends about their condition, etc.), the key point of this example is that by practicing behaviors in a simulated environment, people can increase their self-efficacy in performing those behaviors. This in turn leads to increased likelihood of performing the behaviors in the real world.

The interactive nature of the game is important. One study compared the Bronkie video game with a videotape on the same topic. Kids who watched the videotape reported decreased self-efficacy, as opposed to increased self-efficacy for those who played the interactive video game. [34 ]The implication is that interactive experiences can boost self-efficacy more than passive experiences. Unlike the interactive Bronkie video game, the videotape doesn’t allow for rehearsing behavior, apparently causing viewers to feel less assured about their ability to perform the behavior in the real world.

Using Simulation to Overcome Phobias

Not only can environment simulations lead to increased self-efficacy, they can also reduce fear (an attitude) and the behavior it spawns. While virtual reality has been lauded for training fighter pilots and medical doctors, a lesser known use of this immersive technology is in helping people to overcome their phobias—specifically, to change their attitudes and behaviors related to their phobias.

About 10% of the general population has a phobia toward something, such as spiders, heights, or flying in planes. Virtual reality therapy technologies can help people change their phobic attitudes and reactions. [35 ]

Researchers at the University of Washington have created a virtual reality application designed to treat arachnophobia—fear of spiders (Figure 4.8). In undergoing this treatment, patients wear a head-mounted display, which immerses them in a virtual room. The therapist or the patient can control the patient’s exposure to virtual spiders. The strategy is to help the patient become less anxious about spiders by increasing exposure to them in a safe, virtual world. [36 ]

Figure 4.8: Simulations have been successful in helping people overcome phobias, such as fear of spiders.

Patients might start by seeing a small virtual spider far away. Later, they can work up to being at ease viewing larger spiders up close. In some cases, patients may pretend to touch the spider. Little by little, most patients feel less anxiety toward situations involving spiders.

Research at the University of Washington has shown that the reduction of fear in the virtual world transfers to the real world. In their first case study, [37 ]the results of which were later confirmed by a larger study, [38 ]the research team worked with a woman who had severe arachnophobia. Using a VR system called Spider World for various one-hour sessions, this woman (called “Miss Muffett” in the study report) was progressively desensitized to spiders: little by little the woman would get closer to virtual spiders and have more interactions with them. The simulation was effective:

In later sessions, after [Miss Muffett] had lost some of her fear of spiders, she was sometimes encouraged to pick up the virtual spider and/or web with her cyberhand and place it in orientations that were most anxiety provoking. Other times, the experimenter controlled the spider’s movements (unexpected jumps, etc). Some virtual spiders were placed in a cupboard with a spider web. Other virtual spiders climbed or dropped from their thread from the ceiling to the virtual kitchen floor. Eventually, after getting used to them, Miss Muffet could tolerate holding and picking up the virtual spiders without panicking. [39 ]

After this treatment, the woman who previously had an extreme fear of spiders decided to go camping in the woods, where she knew spiders would abound. The VR therapy had changed her attitude, then her behavior, and then parts of her life.

Similarly, researchers at other institutions, such as Georgia Tech, Emory University, and the California School of Professional Psychology in San Diego, have used simulation technology to treat people who are afraid of flying in planes. The simulator takes people through a series of flight-related experiences, from taxiing on the airport runway to flying in bad weather. [40 ]In a study by Barbara Rothbaum and colleagues published in 2002, after eight sessions of flight travel simulations, 90% of people who received virtual reality therapy reported flying during the year that followed, and did so with less anxiety. [41 ]This success rate is comparable to traditional (non computerized) exposure therapy.

Such persuasive technologies can be used for overcoming other phobias, from fear of heights to fear of public speaking. Compared to traditional forms of exposure therapy, virtual reality poses two key advantages: The stimuli ( spiders, planes, etc.) are under the control of the therapist or patient, and the therapy can take place in a private and convenient setting as opposed to, say, an airplane.

In My Steps Helping Doctors to Empathize with Cancer Patients

Technologies that simulate environments also can help to increase empathy by enabling users to view the world from another person’s perspective. [42 ]The resulting attitude change can then lead to changes in behavior.

One such persuasive technology is In My Steps, a virtual reality system created by Ortho Biotech to increase doctors’ empathy toward cancer patients by simulating the frustrations these patients face every day. [43 ]

The In My Steps system, which is built into a van, travels the country and allows doctors to spend 20 minutes in a virtual environment (Figure 4.9)—one that approximates the anemia-induced fatigue some of their patients feel 24 hours a day when undergoing chemotherapy. Wearing headgear and foot operated pedals, the doctors go through routine activities, such as making breakfast and answering the door in the simulated environment of a patient’s home. The doctors can move only at a limited rate, no matter how fast they operate the foot pedals. In the course of the simulation, they experience some of the frustration related to the physical limitations imposed by chemotherapy. For example, when they can’t answer the door quickly enough, a van delivering needed medications drives away.

Figure 4.9: The In My Steps system helps physicians develop empathy for patients suffering from cancer-related fatigue.

This simulated experience has been shown to be effective in helping doctors develop empathy for their patients, which in turn leads to changed behavior: about 60% of the doctors going through the simulation reported that they would change the way they treat cancer-related fatigue. [44 ]

From the standpoint of persuasion, for most simulated environments to be successful, users must take what they’ve learned in the virtual world and apply it in their real-world lives. [45 ]Otherwise, the simulation is just another gee-whiz technology experience, not a vehicle for changing attitudes or behavior. One way to increase the likelihood of transferring virtual behavior to the real world is to incorporate a virtual component into a real-world situation. That’s the purpose of object simulations, our next topic of discussion.

[21 ]The Great Cities simulation makes explicit the assumptions underlying the simulation. It even allows players to change the underlying assumptions. For more on the Great Cities simulation, contact the people at http://arts4sv.org/. (The software is not available directly through the Web; you need to send them email to purchase it). Also, Dan Gillmor wrote a column for the San Jose Mercury News about this product on October 20, 2000. To read this article online for free, see http://www.arts4sv.org/pdf/2000–10-C3.pdf.

[22 ]R. T. Hays and M. J. Singer, Simulation Fidelity in Training System Design (New York: Springer-Verlag, 1989).

[23 ]Some experts in simulations for learning and training argue that increased realism may detract from the learning experience. See, for example:

a. P. Standen, Realism and imagination in educational multimedia simulations, in Clare McBeath and Roger Atkinson (eds.), Proceedings of the 3rd International Interactive Multimedia Symposium, Perth, Western Australia. January 21–25 1996, pp. 384–390. Standen is available online at http://cleo.murdoch.edu.au/gen/aset/confs/iims/96/ry/standen.html.

b. R. T. Hays and M. J. Singer, Simulation Fidelity in Training System Design (New York: Springer-Verlag, 1989).

[24 ]See the following:

a. E. M. Raybourn, Computer game design: New directions for intercultural simulation game designers, Developments in Business Simulation and Experiential Exercises, vol. 24 (1997). See www.unm.edu/~raybourn/games.html.

b. P. Pedersen, Simulations: A safe place to take risks in discussing cultural differences, Simulation & Gaming,26 (2): 201–206 (1995).

[25 ]H. Brody, Kick that habit (the virtual way), Technology Review, (March/April): 29 (1999).

[26 ]R. S. Street, W. R. Gold, and T. Manning (eds.), Health Promotion and Interactive Technology: Theoretical Applications and Future Directions (Hillsdale, NJ: Lawrence Earlbaum, 1997).

[28 ]The significant impact of environment on behavior was one of the main tenants of B. F. Skinner and other behaviorists, though various other perspectives on human behavior would also support this idea. In the area of health promotion, the impact of the environment on behavior has been clearly shown. See for example:

a. N. Humpel, N. Owen, and E. Leslie, Environmental factors associated with adults’ participation in physical activity: A review, Am. J. Prev. Med. 22(3): 188–199 (2002).

b. D. Stokols, Establishing and maintaining healthy environments: Toward a social ecology of health promotion, Am. Psych., 47(1): 6–22 (1992).

[29 ]Tectrix was acquired by Cybex in 1998.

[30 ]J. P. Porcari, M. S. Zedaker, and M. S. Maldari, Virtual motivation, Fitness Management, Dec: 48–51 (1998).

[31 ]J. P. Porcari, M. S. Zedaker, and M. S. Maldari, Virtual motivation, Fitness Management, December, 1998, 48–51.

[32 ]R. Ceci and P. Hassmen, Self-monitored exercise at three different PE intensities in treadmill vs. field running, Medicine and Science in Sports and Exercise, 23: 732–738 (1991).

[33 ]For more on health-promoting video games, see www.clickhealth.com.

[34 ]D. A. Lieberman, Three studies of an asthma education video game, in Report to NIH: National Institute of Allergy and Infectious Diseases (April 1995).

[35 ]See the following:

a. D. A. Lieberman, Three studies of an asthma education video game, in Report to NIH: National Institute of Allergy and Infectious Diseases (April 1995).

b. D. A. Lieberman, Interactive video games for health promotion: Effects on knowledge, self-efficacy, social support, and health, in R. S. Street, W. R. Gold, and T. Manning (eds.). Health Promotion and Interactive Technology: Theoretical Applications and Future Directions (Hillsdale, NJ: Lawrence Earlbaum, 1997), pp. 103–120.

[36 ]D. A. Lieberman, Three studies of an Asthma Education Video Game, in Report to NIH: National Institute of Allergy and Infectious Diseases (April 1995).

[37 ]For a readable overview of VR therapy, you can see an article from researchers at the University of Washington: http://www.hitl.washington.edu/research/exposure/. Another academic center innovating in VR therapy is Georgia Tech. You can find a brief description of their work, a list of publications, and a list of researchers at http://www.cc.gatech.edu/gvu/virtual/Phobia/phobia.html.

In addition, this type of therapy would be supported by psychology theories proposed by Albert Bandura. See A. Bandura, Self Efficacy: The Exercise of Control (New York: W.H. Freeman, 1997).

[38 ]For more on overcoming fear of spiders using computing technology, seewww.hitl.washington.edu/projects/therapeutic.

[39 ]A. S. Carlin, H. Hoffman, and S. Weghorst, Virtual reality and tactile augmentation in the treatment of spider phobia: A case study, Behavior Research and Therapy, 35(2): 153–158 (1997).

[40 ]H. G. Hoffman, A. Garcia-Palacios, C. Carlin, T. A. Furness III, and C. Botella-Arbona, Interfaces that heal: Coupling real and virtual objects to cure spider phobia, International Journal of Human-Computer Interaction (in press).

[41 ]This quotation about “Miss Muffet” is from an article on the University of Washington research team’s Web site at http://www.hitl.washington.edu/research/exposure/.

[42 ]For more on overcoming the fear of flying, see a paper by the Georgia Tech researchers at http://www.cs.northwestern.edu/~watsonb/school/docs/cga.pdf and a press release at www.cspp.edu/news/flying.htm.

To see how VR therapy for fear of flying has moved from the research lab into a commercial venture, visit www.virtuallybetter.com.

[43 ]B. O. Rothbaum, L. Hodges, P. L. Anderson, L. Price, and S. Smith, 12-month follow-up of virtual reality exposure therapy for the fear of flying, Journal of Consulting and Clinical Psychology, 70: 428–432 (2002).

[44 ]T. M. Shlechter, Computer-based simulation systems and role-playing: An effective combination for fostering conditional knowledge, Journal of Computer-Based Instruction, 19(4): 110–114 (1992).

[45 ]Other companies have also aimed to make healthcare providers more empathetic toward cancer patients, such as a system by Medical Consumer Media. See C. Stubbs, Intersense smoothes out the rough spots in virtual reality, Red Herring, April: 34 (1999). See also http://www.redherring.com/mag/issue65/news-one.html.

Object Simulations Providing Experiences in Everyday Contexts

Environment simulations create a virtual world into which people must mentally transport themselves. Object simulations do the opposite: these products go with users into a real-world setting. This approach enables users to experience more directly how their daily routines would be affected by what is being simulated.

Computer technologies that simulate objects can be powerfully persuasive because they fit into the context of a person’s everyday life, they are less dependent on imagination or suspension of disbelief, and they make clear the likely impact of certain attitudes or behaviors.

Object Simulation: Sources of Persuasive Power

Designers who face hard-to-influence user groups should consider creating object simulations because of their unique persuasive powers. Two notable examples of object simulators both target teenagers: one deals with pregnancy, the other with drunk driving.

Principle of Simulations in Real-World Contexts

Portable simulation technologies designed for use during everyday routines can highlight the impact of certain behaviors and motivate behavior or attitude change.

Baby Think It Over An Infant Simulator

Perhaps the best-known object simulator used for persuasive purposes is the Baby Think It Over infant simulator. Used as part of many school programs, Baby Think It Over is a high-tech doll that looks like a human baby (Figure 4.10). [46 ]It’s so realistic looking, in fact, that when I carry the device with meto lectures and seminars, many people initially think that I’m carrying a real baby. The doll has a simple computer embedded inside. Used as part of many school parenting programs, Baby Think It Over helps teenagers understand how much attention a baby requires. The point is to persuade teenagers to avoid becoming teen parents.

Figure 4.10: The Baby Think It Over Infant Simulator is designed to persuade teens to avoid becoming parents.

The doll contains an embedded computer that triggers a crying sound at random intervals. To stop the crying, the caregiver must pay immediate attention to the doll. The caregiver must insert a key into the back of the baby and hold it in place to stop the crying. Sometimes the care routine takes 2 or 3 minutes; other times the crying lasts for more than 15 minutes. If the key is not inserted and held properly, the embedded computer records the neglect, which later shows up on a tiny display locked inside. After a week or weekend of tending the infant simulator, students give the doll back to the teacher, who can unlock and view the display inside the doll.

The Baby Think It Over intervention program requires teens to take the infant simulator everywhere they go—to soccer practice, to parties, even to bed. When the infant simulator cries, demanding attention, the teen caregiver experiences firsthand how much a baby would impact his or her life.

Unlike reading books or listening to lectures, working with the infant simulator doesn’t require teens to use much imagination to apply the new knowledge in their own lives. The teens get the point quickly. They show up at school sleepy after a night with interruptions from the crying. They may opt out of attending parties because they know their infant simulator will cry and perhaps embarrass them. At the end of the intervention period (usually a few days), teens are eager to return the infant simulator to their teachers and regain their normal, comparatively carefree lives. [47 ]

Studies have confirmed the effectiveness of infant simulators in changing teens’ attitudes. In one study of 150 adolescents who participated in a Baby Think It Over program, 95% of the teens stated afterward that they felt they were not yet ready to accept the responsibility of parenting. [48 ]Perhaps nothing else—short of caring for a real baby—could have the same level of impact on how teens view the responsibilities of parenting. Simulated objects can be effective persuaders.

Drunk Driving Simulator

Another example of a persuasive object simulator is the Neon Drunk Driving Simulator (Figure 4.11), which is designed to prevent drunk driving among teenagers. Daimler Chrysler sponsors this specialized Dodge Neon automobile, which simulates what it’s like to drive while under the influence of alcohol. [49 ]With a laptop computer and other special equipment installed, the Drunk Driving Simulator responds sluggishly and unpredictably to a driver’s inputs. A handful of these cars tour the United States, making stops at high schools and giving teens a chance to experience how alcohol impairs their ability to drive safely.

Figure 4.11: The Neon Drunk Driving Simulator provides a sobering experience of the dangers of driving drunk.

The typical test drive goes as follows: Students first drive the car under normal conditions. They drive around a track, making turns and avoiding obstacles. On the second lap, the car is switched to “drunk” mode. Students then attempt to navigate the course as before, but with unpredictable steering and braking. They immediately feel the loss of control: they might hit orange pylons, which represent children, or miss turns that were easy to make on the previous lap. In this way, sober students can experience firsthand the plausible effects of drunk driving.

One study of more than 2,000 students who participated in a Drunk Driving Simulator program concluded that the technology has a significant impact on teens’ attitudes toward getting in a car with a drunk driver. [50 ]In addition, the stories students tell after the experience—the genuine fear they felt—show that this simulated car has an impact. [51 ]

Here’s what one of my own students had to say about his experience with the Drunk Driving Simulator in high school:

They set up the program so everyone could watch the students drive and watch them fail. I remember seeing my friends try and fail. But part ofme was thinking that it didn’t really look so tough. I thought I’d be the one kid who could drive the car and manage to not knock over all the orange cones. And of course I got in the car and failed miserably. Even though I was highly motivated to succeed, I still managed to hit about half the cones. I think lots of people approached the simulation with the attitude that they were going to prove everybody wrong. And then when they failed, they had to stop and think a little. [52 ]

As the previous examples show, one key advantage of object simulators, compared with the other two simulation types discussed in this chapter, is that these devices are used in the context of real life. Users don’t have to imagine how a virtual scenario might impact their lives; they can experience it firsthand through the object simulators. Object simulators are an excellent use of persuasive technology for abstract concepts such as parental responsibility, for promoting critical target behaviors (such as avoiding drunk driving), and for groups, such as teenagers, who are difficult to persuade.

As this chapter has shown, interactive technology can provide experiences that change people’s attitudes and behaviors, through simulating cause- and effect situations, virtual environments, and objects. The products can take many forms—Web experiences, stand-alone kiosks, mobile phones, and more. Although the forms of the technology may differ, the key principle is the same: when it comes to persuasion, experience makes a difference.

For updates on the topics presented in this chapter, visit www.persuasivetech.info.

[46 ]For more information on In My Steps, visit the following sites:

http://www.cnn.com/HEALTH/9809/25/virtual.reality.cancer/index.html

http://www.procrit.com/cancer/cancer_04_05e.htm

http://content.health.msn.com/content/article/1728.55144

http://www.uicc.org/publ/pr/home/00022401.shtml

[47 ]J. S. Brown, Process versus product: A perspective on tools for communal and informal electronic learning, Journal of Education Computer Research, 1: 179–201 (1985).

[48 ]Manufactured by BTIO Educational Products Inc. See www.btio.com.

[49 ]For peer-reviewed studies on Baby Think It Over, see the following:

a. Jennifer W. Out, Baby Think It Over: Using role-play to prevent teen pregnancy, Adolescence, 36(143): 571–582 (2001).

b. William Strachan and Kevin M. Gorey, Infant simulator lifespace intervention: Pilot investigation of an adolescent pregnancy prevention program, Child & Adolescent Social Work Journal, 14(3): 171–180 (1997).

[50 ]For a synopsis of this Canadian study by Brenda Clark and other research on the effectiveness of the Baby Think It Over infant simulator, see http://www.btio.com/cms.asp?SID=22 (click on “Studies” in the left-hand channel).

[51 ]Advanced Animations created the Drunk Driving Simulator. See http://www.advancedanimations.com.

[52 ]For a summary of the research, see http://apha.confex.com/apha/128am/techprogram/paper_13286.htm.

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