Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
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Effects of Health Education Using Virtual Reality for Adolescents: A Systematic Review and Meta-Analysis

  • Park, SoMi (Wonju College of Nursing, Yonsei University) ;
  • Chung, ChaeWeon (College of Nursing, Research Institute of Nursing Science, Seoul National University) ;
  • Kim, Gaeun (College of Nursing, Research Institute of Nursing Science, Keimyung University)
  • Received : 2023.01.04
  • Accepted : 2023.03.23
  • Published : 2023.04.30
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Abstract

Purpose: This study aimed to evaluate the effects of health interventions using virtual reality (VR) on improving knowledge, attitudes, and skills; and inducing behavioral change among adolescents. Methods: This study is a systematic review and meta-analysis following PRISMA guidelines. We searched Cochrane, MEDLINE, Embase, CINAHL, Scopus, Web of Science, and Korean databases between database inception and April 10, 2021. Based on heterogeneity, a random- or fixed-effects model was used, as appropriate, to calculate effect sizes in terms of the standardized mean difference (SMD) and odds ratio (OR). Studies were selected if they verified the effects of health education using VR on adolescents; there was an appropriate control group; and if the effects of education were reported in terms of changes in knowledge, attitudes, skills, or behaviors. Results: This analysis included six studies (n = 1,086). The intervention groups showed greater responses in knowledge and attitudes (SMD = 0.57, 95% confidence interval (CI) [0.12 to 1.02]), skills related to health behavior (SMD = - 0.45, 95% CI [- 0.71 to - 0.19]), and behavioral change after 12 months (OR = 2.36, 95% CI [1.03 to 5.41]). Conclusion: The results confirm the effectiveness of health interventions using virtual reality (VR). Although the analysis include a small number of studies, a case can be made for health interventions using VR to be utilized as educational methods and strategies to prevent risky behaviors among adolescents.

Keywords

Acknowledgement

This study received financial support from a National Research Foundation of Korea grant funded by the Korean government (2021R1A2C1003083).

References

  1. Mokdad AH, Forouzanfar MH, Daoud F, Mokdad AA, El Bcheraoui C, Moradi-Lakeh M, et al. Global burden of diseases, injuries, and risk factors for young people's health during 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013. The Lancet. 2016;387(10036):2383-2401. https://doi.org/10.1016/S0140-6736(16)00648-6
  2. World Health Organization (WHO). Adolescent health [Internet]. Geneva: WHO; 2021 [cited 2021 Oct 23]. Available from: https://www.who.int/health-topics/adolescent-health
  3. Marques A, Loureiro N, Avelar-Rosa B, Naia A, Matos MG. Adolescents' healthy lifestyle. Jornal de Pediatria. 2020; 96(2):217-224. https://doi.org/10.1016/j.jped.2018.09.002
  4. Korea Disease Control and Prevention Agency (KDCA). The 16th(2020) Korea youth risk behavior survey [Internet]. Cheongju: Korea Disease Control and Prevention Agency; 2021 [cited 2021 Oct 23]. Available from: www.kdca.go.kr/ yhs/yhshmpg/result/yhsresult/statsBookList.do
  5. Radovic A, Badawy SM. Technology use for adolescent health and wellness. Pediatrics. 2020;145(Suppl 2):S186-S194. https://doi.org/10.1542/peds.2019-2056G
  6. 6.Kim YH. Analysis of mobile phone ownership and usage behavior of children and adolescents. KISDI STAT Report. 2018;18(20):1-7.
  7. Kim SJ, Park SG, Moon SH. Analysis on smartphone usage types of youth: Q methodological approach. Korean Journal of Youth Studies. 2015;22(12):1-26.
  8. Chung B, Min S, Lee Y, Han Y. Internet usage survery of Korea 2019 [Internet]. Daegu: National Information Society Agency; 2020 [cited 2021 Oct 23]. Available from: https://www.nia.or.kr/common/board/Download.do?bcIdx-=21930&cbIdx=99870&fileNo=6
  9. Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, et al. Our future: A Lancet commission on adolescent health and wellbeing. The Lancet. 2016;387(10036):2423-2478. https://doi.org/10.1016/S0140-6736(16)00579-1
  10. Breitkreuz KR, Kardong-Edgren S, Gilbert GE, Anderson P, DeBlieck C, Maske M, et al. Nursing faculty perceptions of a virtual reality catheter insertion game: A multisite international study. Clinical Simulation in Nursing. 2021;53:49-58. https://doi.org/10.1016/j.ecns.2020.10.003
  11. Davis AL, Avis KT, Schwebel DC. The effects of acute sleep restriction on adolescents' pedestrian safety in a virtual environment. Journal of Adolescent Health. 2013;53(6):785-790. https://doi.org/10.1016/j.jadohealth.2013.07.008
  12. Ng YL, Ma F, Ho FK, Ip P, Fu K. Effectiveness of virtual and augmented reality-enhanced exercise on physical activity, psychological outcomes, and physical performance: A systematic review and meta-analysis of randomized controlled trials. Computers in Human Behavior. 2019;99:278-291. https://doi.org/10.1016/j.chb.2019.05.026
  13. Tschannen D, Yaksich JD, Aebersold M, Villarruel A. Fidelity after SECOND LIFE facilitator training in a sexual risk behavior intervention. Simulation & Gaming. 2016;47(1):130-150. https://doi.org/10.1177/1046878115627279
  14. Park S, Park C. Tangible counseling education system development for youth suicide prevention. In: Kim HS, Shin D, Lee W, Jeon S, Park NC, Jung H, et al., editors. Extended abstracts of HCI Korea 2016. Proceedings of HCI KOREA 2016 Conference; 2016 Jan 27-29; High1 Resort, Gangwon, Korea. Seoul: HCI Society of Korea; 2016. p. 25-27.
  15. van Dijk MR, Koster MPH, Willemsen SP, Huijgen NA, Laven JSE, Steegers-Theunissen RPM. Healthy preconception nutrition and lifestyle using personalized mobile health coaching is associated with enhanced pregnancy chance. Reproductive Biomedicine Online. 2017;35(4):453-460. https://doi.org/10.1016/j.rbmo.2017.06.014
  16. So YH. The impact of academic achievement by presence and flow-mediated variables in a simulation program based on immersive virtual reality. Journal of Communication Design. 2016;57:57-69.
  17. Dellazizzo L, Potvin S, Luigi M, Dumais A. Evidence on virtual reality-based therapies for psychiatric disorders: Meta-review of meta-analyses. Journal of Medical Internet Research. 2020;22(8):e20889. https://doi.org/10.2196/20889
  18. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. PLoS Medicine. 2021;18(3):e1003583. https://doi.org/10.1371/journal.pmed.1003583
  19. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al. Cochrane handbook for systematic reviews of interventions version 6.2 [Internet]. London: Cochrane; 2021 [cited 2021 Feb 22]. Available from: https://training. cochrane.org/handbook
  20. Sterne JA, Hernan MA, Reeves BC, Savovic J, Berkman ND, Viswanathan M, et al. ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions. BMJ (Clinical Research Ed.). 2016;355:i4919. https://doi.org/10.1136/bmj.i4919
  21. Sterne JAC, Savovic J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ (Clinical Research Ed.). 2019; 366:l4898. https://doi.org/10.1136/bmj.l4898
  22. Barsom EZ, Duijm RD, Dusseljee-Peute LWP, Landman-van der Boom EB, van Lieshout EJ, Jaspers MW, et al. Cardiopulmonary resuscitation training for high school students using an immersive 360-degree virtual reality environment. British Journal of Educational Technology. 2020;51(6):2050-2062. https://doi.org/10.1111/bjet.13025
  23. Creutzfeldt J, Hedman L, Medin C, Stengard K, Fellander-Tsai L. Retention of knowledge after repeated virtual world CPR training in high school students. Studies in Health Technology and Informatics. 2009;142:59-61. https://doi.org/10.3233/978-1-58603-964-6-59
  24. Hadley W, Houck C, Brown LK, Spitalnick JS, Ferrer M, Barker D. Moving beyond role-play: Evaluating the use of virtual reality to teach emotion regulation for the prevention of adolescent risk behavior within a randomized pilot trial. Journal of Pediatric Psychology. 2019;44(4):425-435. https://doi.org/10.1093/jpepsy/jsy092
  25. Khalil GE, Wang H, Calabro KS, Mitra N, Shegog R, Prokhorov AV. From the experience of interactivity and entertainment to lower intention to smoke: A randomized controlled trial and path analysis of a web-based smoking prevention program for adolescents. Journal of Medical Internet Research. 2017;19(2):e44. https://doi.org/10.2196/jmir.7174
  26. Park YS, Kang MK. A study on the development and verification of effectiveness of online sex education program using interactive virtual reality techniques for adolescents. The Korea Journal of Youth Counseling. 2003;11(1):42-55.
  27. Woodruff SI, Conway TL, Edwards CC, Elliott SP, Crittenden J. Evaluation of an internet virtual world chat room for adolescent smoking cessation. Addictive Behaviors. 2007; 32(9):1769-1786. https://doi.org/10.1016/j.addbeh.2006.12.008
  28. Kyaw BM, Saxena N, Posadzki P, Vseteckova J, Nikolaou CK, George PP, et al. Virtual reality for health professions education: Systematic review and meta-analysis by the digital health education collaboration. Journal of Medical Internet Research. 2019;21(1):e12959. https://doi.org/10.2196/12959
  29. Chen FQ, Leng YF, Ge JF, Wang DW, Li C, Chen B, et al. Effectiveness of virtual reality in nursing education: Meta-analysis. Journal of Medical Internet Research. 2020;22(9):e18290. https://doi.org/10.2196/18290
  30. Weser VU, Duncan LR, Pendergrass TM, Fernandes CS, Fiellin LE, Hieftje KD. A quasi-experimental test of a virtual reality game prototype for adolescent E-cigarette prevention. Addictive Behaviors. 2021;112:106639. https://doi.org/10.1016/j.addbeh.2020.106639
  31. Ma M, Jain LC, Anderson P. Future trends of virtual, augmented reality, and games for health. In: Ma M, Jain LC, Anderson P, editors. Virtual, Augmented Reality and Serious Games for Healthcare 1. Berlin: Springer; 2014. p. 1-6.
  32. Fisher JD, Fisher WA, Amico KR, Harman JJ. An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychology. 2006;25(4):462-473. https://doi.org/10.1037/0278-6133.25.4.462
  33. Bracq MS, Michinov E, Arnaldi B, Caillaud B, Gibaud B, Gouranton V, et al. Learning procedural skills with a virtual reality simulator: An acceptability study. Nurse Education Today. 2019;79:153-160. https://doi.org/10.1016/j.nedt.2019.05.026
  34. Bayram SB, Caliskan N. Effect of a game-based virtual reality phone application on tracheostomy care education for nursing students: A randomized controlled trial. Nurse Education Today. 2019;79:25-31. https://doi.org/10.1016/j.nedt.2019.05.010
  35. Rourke S. How does virtual reality simulation compare to simulated practice in the acquisition of clinical psychomotor skills for pre-registration student nurses? A systematic review. International Journal of Nursing Studies. 2020;102: 103466. https://doi.org/10.1016/j.ijnurstu.2019.103466
  36. Gutierrez RA. Afterword: Virtual sex ed. Sexuality Research & Social Policy. 2011;8(1):73-76. https://doi.org/10.1007/s13178-011-0044-3
  37. Shafii T, Benson SK, Morrison DM, Hughes JP, Golden MR, Holmes KK. A pilot randomised controlled trial of an interactive computer-based intervention for sexual health in adolescents and young adults. Sexually Transmitted Infections. 2015;91(Suppl 2):A33. https://doi.org/10.1136/sextrans-2015-052270.98
  38. Permana RH, Suryani M, Adiningsih D, Paulus E. The storyboard development of virtual reality simulation (VRS) of nursing care in respiratory system disorders course. Indonesian Nursing Journal of Education and Clinic. 2018;3(2):121-130. https://doi.org/10.24990/injec.v3i2.202
  39. Foronda C, Gattamorta K, Snowden K, Bauman EB. Use of virtual clinical simulation to improve communication skills of baccalaureate nursing students: A pilot study. Nurse Education Today. 2014;34(6):e53-e57. https://doi.org/10.1016/j.nedt.2013.10.007
  40. Alboksmaty A, Agaku IT, Odani S, Filippidis FT. Prevalence and determinants of cigarette smoking relapse among US adult smokers: A longitudinal study. BMJ Open. 2019;9(11): e031676. https://doi.org/10.1136/bmjopen-2019-031676
  41. Hughes JR, Peters EN, Naud S. Relapse to smoking after 1 year of abstinence: A meta-analysis. Addictive Behaviors. 2008;33(12):1516-1520. https://doi.org/10.1016/j.addbeh.2008.05.012
  42. Eckhardt L, Woodruff SI, Elder JP. Related effectiveness of continued, lapsed, and delayed smoking prevention intervention in senior high school students. American Journal of Health Promotion. 1997;11(6):418-421. https://doi.org/10.4278/0890-1171-11.6.418
  43. Witt KJ, Oliver M, McNichols C. Counseling via avatar: Professional practice in virtual worlds. International Journal for the Advancement of Counselling. 2016;38(3):218-236. https://doi.org/10.1007/s10447-016-9269-4
  44. Kilani N, Rajaobelina L. Impact of live chat service quality on behavioral intentions and relationship quality: A meta-analysis. International Journal of Human-Computer Interaction. Forthcoming 2022 Nov 22.
  45. Romero-Ayuso D, Toledano-Gonzalez A, Rodriguez-Martinez MDC, Arroyo-Castillo P, Trivino-Juarez JM, Gonzalez P, et al. Effectiveness of virtual reality-based interventions for children and adolescents with ADHD: A systematic review and meta-analysis. Children. 2021;8(2):70. https://doi.org/10.3390/children8020070
  46. Shin YB, Kim JJ, Kim MK, Kyeong S, Jung YH, Eom H, et al. Development of an effective virtual environment in eliciting craving in adolescents and young adults with internet gaming disorder. PLoS One. 2018;13(4):e0195677. https://doi.org/10.1371/journal.pone.0195677
  47. Lauwens Y, Rafaatpoor F, Corbeel K, Broekmans S, Toelen J, Allegaert K. Immersive virtual reality as analgesia during dressing changes of hospitalized children and adolescents with burns: A systematic review with meta-analysis. Children. 2020;7(11):194. https://doi.org/10.3390/children7110194
  48. Miles DR, van den Bree MB, Gupman AE, Newlin DB, Glantz MD, Pickens RW. A twin study on sensation seeking, risk taking behavior and marijuana use. Drug and Alcohol Dependence. 2001;62(1):57-68. https://doi.org/10.1016/s0376-8716(00)00165-4
  49. Smith SJ, Farra S, Ulrich DL, Hodgson E, Nicely S, Matcham W. Learning and retention using virtual reality in a decontamination simulation. Nursing Education Perspective. 2016;37(4):210-214. https://doi.org/10.1097/01.NEP.0000000000000035
  50. Rahani VK, Vard A, Najafi M. Claustrophobia game: Design and development of a new virtual reality game for treatment of claustrophobia. Journal of Medical Signals and Sensors. 2018;8(4):231-237. https://doi.org/10.4103/jmss.JMSS_27_18
  51. Verkuyl M, Hughes M. Virtual gaming simulation in nursing education: A mixed-methods study. Clinical Simulation in Nursing. 2019;29:9-14. https://doi.org/10.1016/j.ecns.2019.02.001