Abstract
In 2019, 424,000 people were injured and 3,142 killed by distracted driving in the United States (National Highway Traffic Safety Administration, 2021a). Distracted driving is defined by the NHTSA as “any activity that diverts attention from driving.” This includes three types of distractions, visual (averting your eyes off the road), manual (removing your hands from the steering wheel), and cognitive (thinking about other things beyond driving; NHTSA, 2021, para. 2). Texting while driving (TWD) falls into this definition of distracted driving as it encompasses a visual, manual, and cognitive component. While TWD is a behavior found in a number of age ranges in the United States, it is most prevalent in younger portions of the population.
Young adults between the ages of 20 to 29 years engage in TWD more often than older and younger age groups, they also have greater health risks (Berlin et al., 2021). A study by Hill et al. (2015) found that college age student’s opinions of their driving skills were largely overestimated. For example, over 60% of the college students surveyed in the study reported they were better drivers than their peers and were immune to distractions. An additional survey of college students has shown TWD was a common behavior while driving, although students recognized the activity was dangerous and could result in injuries or even death (Harrison, 2011).
The prevalence of TWD has led many, including researchers, industry leaders, policy makers, and even the public to classify it as a public health issue. Many educational programs and interventions have been created over the past decades with differing degrees of success. These programs have employed enlisted a number of media outlets and communication channels including radio and print advertisements, television, Internet campaigns, videos, websites, social media platforms, and even interactive driving simulations (Cismaru, 2014). Beyond this array of media selections, what is constant is the recognition of the value of new technologies as a means of delivering health messages to the public (Wright, 2020).
One such technology, virtual reality (VR) has been portrayed as a promising technology to be used in healthcare as it offers unparalleled interactivity and engagement compared to more traditional mediums (i.e., print, radio, and television; Cismaru & Nimegeers, 2017). The VR industry is expected to grow to a 600 billion industry by 2025, and over 90 million Americans will become first time VR consumers by the end of 2022 (CBS Interactive, 2022). Therefore, the potential of utilizing VR technologies to bring awareness to health issues such as TWD is growing. The ability for a user to experience the consequences of negative health behaviors in an immersive environment without the real-world costs (i.e., mental or physical harm) can be utilized as a novel approach to health education.
However, at present few studies have examined whether VR holds-up to its promises and antidotes. To examine whether VR has the persuasive power to deliver health messages and become a significant intervention for TWD, it is first necessary to review the concepts of narrative persuasion and transportation.
Literature Review
Narrative Persuasion and Transportation
Narratives in public health messages are viewed as a potential means of behavioral modification. Instead of simple warnings or statistical based messages, narratives may offer health practitioners a more persuasive means of influencing positive health behaviors in the public (Braddock & Dillard, 2016; Hinyard & Kreuter, 2007). Narratives can be defined as “a cohesive, causally linked sequence of events that takes place in a dynamic world subject to conflict, transformation, and resolution through non-habitual, purposeful actions performed by characters” (Baddock & Dillard, 2016, p. 5). Narratives offer a number of persuasive advantages over other forms of communication by inducing emotional appeals, increasing elaboration and inference, and reducing counterarguments (Bilandzic & Busselle, 2013; Green & Brock, 2000; Green & Clark, 2013; Slater & Rouner, 2002). One of the more unique persuasive features of narratives is the ability to induce transportation (Green & Brock, 2000). Narrative transportation has been defined as “a combination of attention, imagery, and feelings, in which an individual becomes immersed in a narrative world” (Green 2021, p. 87). Research has shown transportation leads to persuasion by immersion in a narrative. During this immersive mental state, persuasion occurs by reducing counter arguing, increasing identification with the narrative’s characters, developing mental imagery, triggering emotional reactions, and establishing elements of causality (Green, 2021). As immersion in the narrative is an important aspect of transportation it is critical to examine how a person can be immersed and transported in VR.
Immersion and Virtual Reality
Since transportation can be defined as immersion into a narrative world, a question arises as to how immersion can occur in VR. VR simulations contain 3D imagery, spatialized sound, and even tactile feedback, all which attempt to “…let the user experience a computer-generated world as if it were real—producing a sense of presence, or ‘being there,’ in the user’s mind” (Bowman & McMahan, 2007, p.2). By replicating senses and experiences an individual would experience in the real world, they may experience immersion and furthermore transportation. Although it there appears a simple correlation between immersion and transportation, research exists calling into question the immersive features of VR.
A recent study by Barreda-Ángeles et al. (2020) suggested that VR videos (involving 360° content) allow more freedom of attention (i.e., an individual has the ability to “look” anywhere in the video) and this freedom may detract from important narrative elements (Barreda-Ángeles et al., 2020; Newton & Soukup, 2016). Although the study focuses on non-fiction formats, it is not beyond imagination to consider whether all VR environments might detract from immersion and ultimately transportation. Results from this study found viewing a 360° video through a head mounted display lowers attention, detail recognition and recall (Barreda-Ángeles et al., 2020). The authors suggest this finding might be due to the participants ability and free will of exploring the virtual environment, thus lowering attention to important narrative elements.
The idea of free is an important element of VR storytelling. Designing VR is quite different from designing traditional 2D or “frame bound” video (Pillai et al., 2017). In a traditional 2D video a viewer is “frame-bound,” in other words they have a fixed reference frame where their attention is focused throughout the duration of the film. In contrast, a VR environment allows the viewer to select their own reference frame or “perspective,” (i.e., look in any direction). Every direction and even objects within a virtual world have the potential to become a reference frame. This freedom poses potential problems both VR simulation designers and health practitioners seeking to use the technology for distributing health messages.
Beyond reference frames, VR environments can contain both effective and ineffective visual cues which allow users to focus on the main story elements (Pillai et al., 2017). Effective visual cues include using contrasting graphics and meaningful motion. Ineffective cues include having too much time between actions, prolonging similar actions, including too many visual elements, and incorrectly orienting visual elements compared to the next story element (Pillai et al., 2017).
The above findings are indeed an extension of a larger body of work focused on studying the impact of how the narrative’s medium influences its mechanisms of persuasion. The study of how VR simulations either increase or decrease transportation and persuasion is in its infancy. Transportation can occur in a variety of media including printed materials, films, spoken narratives, and even VR (Green, 2021). Although one medium has not been found to elicit more transportation than others, some more vivid mediums may enhance or detract from the transportation experience. VR appears to increase immersion and engagement on the surface but may also detract from transportation given the spatial freedom and visual elements afforded by the medium. Does the increase in immersion and engagement outweigh the negative modalities? This discussion leads to the following hypothesis.
Gender and Transportation
Gender has been periodically measured as an influencing moderator in transportation studies, however prior research has not found consistent results in how an individual’s gender impacts transportation. For example, in a series of experiments Green and Brock (2000) found significant differences in transportation effects depending on the gender of the participant. Women demonstrated higher transportation scores and emotional effects for transportation in two of the four experiments. Further, they reported that women demonstrated higher emotion involvement, but this result was only found for one of the narratives. Green and Brock (2000) suggested that although gender differences were occasionally found in transportation studies, they were not “…theoretically interesting and did not typically replicate across studies” (p. 707). The author of the current study proposes that further exploration is needed given the inconsistency of the findings of gender on transportation, and that the ability of identification with a protagonist is potentially greater in more immersive VR environments.
An additional study found a limited effect for gender in a transportation sub-scale, mainly engagement. The study examined the effects of an anti-tobacco video PSA on tobacco attitudes. Again, women had higher levels of engagement (i.e., one transportation sub-scale) when transported compared to men (Williams et al., 2011). In a similar vein, as Green and Brock (2000) the researchers suggested to the type of narrative could be a playing a role in increasing transportation. Some narratives may simply appeal more to women than men. The narratives in this particular study featured personal interviews describing individuals’ journeys, family relations, and hardships in their efforts to quit smoking. The narratives were only 5 minutes in duration. In the discussion, researchers did not propose what narrative elements might appeal to women more than men but eluded that women may have been more transported than men given that the narratives included a family/emotional feature.
Gender differences have also been found in studies examining health issues including drinking and driving. In a 2017 study by Gebbers et al. (2017) the researchers examined the link between transportation and narrative persuasion as it is related to health behavior. Results from the study demonstrated some gender differences in transportation scores, women displayed higher transportation scores than men (Gebbers et al., 2017). The narrative video employed in this study featured a young woman who is involved in a fatal car accident. The authors of this study did not extrapolate as to why women exhibited higher transportation scores than men. However, the identification or lack of identification with of the gender of the protagonist was not measured.
This finding was again mirrored in an earlier 2014 study by Van Laer et al. (2014). Gender did significantly influence transportation; however, the effects were small (Van Laer et al., 2014).
Other studies have examined the impact of gender on transportation as a component of identification (Ivanov et al., 2009; Uskul & Oyserman, 2010). Identification has been defined as “a process that consists of increasing loss of self-awareness and its temporary replacement with heightened emotional and cognitive connections with a character” (Cohen, 2001, p 251). The similarity between the protagonist and reader has been found to positively influence both identification and transportation (Slater & Rouner, 2002). Unfortunately, as with the influence of gender, the impact of identification with characters are mixed, some studies finding no effects of identification on transportation (Cohen et al., 2018; De Graaf et al., 2016), while other studies have found evidence in support of the premise (Chen et al., 2016; Moyer-Gusé & Nabi, 2010).
A study by Mazzocco et al. (2010) reported no relationship between the protagonist’s gender and the gender of the participant as a factor influencing transportation, but the study did not examine gender directly and involved a variety of narrative subject matter. The authors did, however, suggest some narratives may appeal more to men and others to women. A study by Banerjee and Greene (2016) examined the assumption whether the matching a protagonist’s gender with the reader (i.e., participant) would elicit greater transportation. They found significant effects for gender. A female protagonist elicited more transportation than male protagonists. Additionally, female participants scored higher transportation scores than the male participants. However, there were not differences in transportation with gender-matched narratives and protagonists.
From these studies there appears to be a complex interaction between gender and transportation. Across the studies examining gender and transportation themes involving narrative plots and emotional reactions appear to be common explanations as to why women may exhibit higher transportation score than men. There is a line of sociological research suggesting that women are “women are socialized to assume an expressive role where they focus on facilitating interpersonal harmony within the family. Thus, compared to men, women are socialized to be more empathetic” (Argo et al., 2008, p. 616). The influence of these social factors, and the inconsistency of gender effects in transportation studies suggests more research needs to be conducted in this area.
Therefore, this study seeks to examine if gender has an impact on transportation in a VR environment. At this point gender effects in on transportation has not been examined in VR narratives. Given the some of the emotional narrative elements of the VR simulation used in this study and the ambiguity of the gender of the assumed avatar, the author proposes the following hypothesis:
Social Norms
Social norms are commonly defined as rules or behaviors that are accepted by society in a given culture or location (Schultz et al., 2007). The focus theory of normative conduct identifies two types of social norms, descriptive, and injunctive (Cialdini et al., 1990). These two norms has been examined in distracted driving studies (Carter et al., 2014; Lawrence, 2015).
Descriptive norms refer to behaviors that are typical or normal, while injunctive norms are behaviors that are morally approved or disproved (Cialdini et al., 1990). For example, most individuals will admit that texting while driving is a bad idea and even against the law in some states (an injunctive norm), but they will continue to engage in TWD (the descriptive norm). The focus theory of normative conduct highlights the need for a norm to be important while an individuals in engaging in the related behavior. When conjunctive norms align with descriptive norms related to a specific health behavior, it reinforces the behavior. In contrast when conductive norms and descriptive norms are opposed to the behavior in negatively impacts the behavior (Carter et al., 2014; Rimal & Real, 2005). For example, people might accept that TWD is a dangerous behavior (injunctive norm), but continue to engage in this behavior as they observe a large number of people continue to TWD regardless of the dangers (descriptive norm).
A growing number of studies have examined the role of social norms in TWD behaviors. However, the impact of social norms in these studies present a complex picture. Several studies suggest descriptive and injunctive norms for TWD are in conflict, and are very apparent in younger demographics (Lawrence, 2013; Schroeder et al., 2013). Nemme and White (2010) found that injunctive norms did not prevent individuals from reading text messages while driving as it was a only a predictor of sending text messages. Gauld et al. (2014) also found and ineffective impact of injunctive norms. Mainly, injunctive norms were associated with texting among young adults, but did not predict the behavior while driving. Kim and Wang (2022) examined the impact of social norm messages vs legal sanction messages on attitudes of texting while driving. The legal sanction messages had a greater impact that the social norm messages on dissuading texting while driving behaviors.
Currently there have been no studies examining the effects of social norm messages within a virtual reality simulation designed to raise awareness of the consequences of TWD. Therefore the following hypothesis is proposed:
Method
This study implemented a randomized, two-by-two experimental design. The first independent variable was the modality of presentation (VR vs. 2D). The VR condition involved participants viewing the stimulus through a head mounted display, in contrast the 2D condition presented the stimuli on a computer monitor. The second independent variable was the presence or absence of a social norm message (message vs. no message).
Participants
To determine a sample size for the study, a statistical power analysis was conducted as limited prior work has been conducted on this topic. A statistical power program (Faul et al., 2007) was implemented with an effect size of .05, and statistical level of significance of .05 was computed. The sample was calculated to be at least 100 participants.
A convenience sample of 134 student participants was recruited from a large state university located in the SouthEastern United States. The study took a total of 25 minutes to complete and the participants were given class credit for their participation. The following data is presented from the participants (43 males,
Devices
The HTC Vive is a VR system comprised of a head mounted display (HMD), handheld controllers, and base stations. The HMD featured a 1,080 × 1,200-pixel display, a 90 Hz refresh rate and 110° field of view (HTC Corporation, 2021). The base stations are two wall mounted sensors tracking the position and overall orientation of the headset and controllers. The positional data collected by the base stations is then transmitted to the virtual simulation. The HTC Vive system was connected to an Intel desktop computer with an Advanced Micro Devices central processing unit, 32 gibibytes of random-access memory, and a Ryzen 7-1700X, 8 core graphics display unit. Participants were seated in an adjustable seat designed to mimic the same position as the virtual driver in the VR simulation.
Stimulus Materials
The simulation was a publicly available VR video titled “It Can Wait” (AT&T, 2015). The 360° simulation was developed by AT&T and Reel FX in 2015. The simulation allows users to experience the dangers of TWD including a simulated car wreck. The simulation begins with a series of near accidents where the simulation’s avatar is distracted by a cell phone while driving. A description of each scene in the simulation as well as the transition can be found in Table 1. The avatar’s gender was not specified or clear from the simulation.
Descriptions for each scene and transition in the simulation.
The simulation was implemented in Unity3D via the SteamVR plugin and the HTC Vive HMD. A full length 2D video of this simulation can be found here at this URL: https://vimeo.com/250847472. For this simulation hand-controllers were not used and the participant was seated throughout the simulation to mimic the position and actions of the virtual avatar. The HMD allowed the participant to interact with the simulation by turning their head to view a 360° virtual environment. The 2D condition consisted of the same simulation displayed on a 24″ LED monitor, with the participant seated approximately one-foot away from the monitor.
A social norm message was added to the end of the simulation. The message was “Take the stop texting while driving pledge.” It was included in the message condition and was absent in the non-message condition. This message was displayed for approximately 5 seconds after the conclusion of the simulation.
Procedure
Participants arrived at the media research facility at a previously scheduled timeslot. Participants completed an informed consent document and were told a cover story (i.e., they volunteered for a study investigating the effectiveness of VR public service announcements). After completing an informed consent document, the participants were introduced to the HTC Vive system and all of the hardware. Participants were randomly assigned to one of the four conditions (VR + message, VR + no message, 2D + message, or 2D + no message). Each condition was assigned a number and a random number generator was used to create a table of those four conditions. Each participant was then assigned to one of the four conditions based on the table.
They then experienced the simulation for 2:55 minutes. Following the simulation, participants completed a short questionnaire measuring transportation. Upon completion of the study the participants were debriefed about the true nature of the study and thanked for their time.
Measures
Transportation
Transportation was measured in the questionnaire using ten items from a scale developed by Green and Brock (2000). Minor wording changes were implemented for viewing video content. For example, one item asked was, “I wanted to learn how the video ended.” This scale consisted of self-report items on a 10-point Likert scale with “1 = strongly disagree” and “10 = strongly agree.” The Bartlett’s test was significant (
Data Analysis
All of the statistical analyses were performed using SPSS (SPSS Inc., 2021). The results were obtained through one-way ANOVAs and a .05 significance level was established.
Results
H1 predicted that transportation would be higher for individuals in the VR condition than those individuals in the 2D condition. No significant mediation effects for the mode of presentation on transportation existed at the
H2: proposed that a participant’s gender would influence the level of transportation. Mainly, females would experience greater transportation than men. There was a significant effect,
H3: predicted that participants who viewed the social norm message will have greater behavior intention of refraining from texting while driving than those who did not view the message.
The results of a binary logistic regression showed that there was not a significant association between social norm messages and behavioral intention (χ2(2) = 0.582,
Discussion
The purpose this study was to examine transportation in a VR simulation and to determine if VR as well as individual demographics impacted an individual’s ability to be transported. Overall, our results support some previous findings in transportation literature (Banerjee & Greene, 2016, Green & Brock, 2000; Williams et al., 2011) and offers further insights into designing persuasive content for VR.
Given the limited amount of research conducted on health messages in VR, the findings of this study were surprising. VR technologies promise a more engaging and immersive experience for individuals than 2D technologies. As such, increased engagement should result in a greater degree of immersion, presence, and perhaps transportation which leads to persuasion. The reality, however, is that specific VR features may detract from transportation and decrease persuasion. In this study, transportation scores were slightly higher in the VR condition, however, this was not statistically significant from the 2D condition.
The reason for this finding is not clear, however it could be partially explained by the overt freedom the participants experienced during the simulation (as noted in the literature review).
Allowing the participants, the freedom to change their own “frame of reference” may impact the participant’s ability to focus attention on the important narrative elements within the simulation. For example, the It Can Wait Simulation featured several repetitive scenes (i.e., driving and looking down at a cell phone) and other events occurring in the peripheral vision of the participant. As noted by Pillai et al. (2017), prolonged similar actions, multiple elements, and incorrectly oriented visual elements are ineffective visual story cues and may lead to the participant becoming distracted or disconnected from the narrative’s plot. The seven distinct locations featured within the simulation simply fade-in into each new location as the participant progresses through the simulation. This feature creates a narrative discrepancy within this fictional simulation.
Green (2021) suggested that transportation can occur in both factual and fictional narratives so as long as the narrative events develop in consistent ways (similar to real world rules and real world behaviors). The following are some examples of how this simulation might have violated this principle. First, the simulation is brief only lasting proximately 3 minutes. Within this short timeframe the participant might not realize it is a narrative norm to disappear and reappear in different locations as you drive a car. A second discrepancy involves specific user interactions with the cell phone. The avatar consistently picks up the cell phone during the simulation. This narrative behavior might conflict with the real-world habits of the user as not all drivers may pick-up their cell phone at every audio notification. A final discrepancy potentially impacting the level of transportation is the simulation’s audio. As the VR simulation progresses the driver of the car has several events where they are close to injuring bystanders (including a baby). In these events the people who were almost injured responded with negative comments to the driver (i.e. the participant). Repeated events (i.e., close calls) ending with an accident potentially conflicts with the real-world rules and behaviors. Drivers rarely encounter a sequence of near potential accidents in constantly changing locations.
Another important element of transportation is the ability to form mental imagery and connect those thoughts to personal real-world experiences (Green, 2021). Once again, the sudden transition from one scene to the next within the virtual simulation might impact the ability to sustain a consistent mental flow, as each of the seven scenes contained significant visual and audio differences. A virtual simulation with a more consistent plot and environment might elicit more transportation by allowing the individual to construct or connect more of the virtual environment to the mental imagery of past experiences.
On a practical level, the narrative discrepancies, narrative rules, time limitations, and negative feedback may contribute to a decrease in transportation and highlight the importance of VR designers to partner with health communication experts and user experience professionals. It takes a holistic approach to develop engaging VR content.
The researcher also found a significant effect of gender on transportation. This finding is consistent with pervious literature (Banerjee & Greene, 2016, Green & Brock, 2000; Williams et al., 2011) suggesting some gender differences exist in transportation scores. The researcher cannot directly explain this finding, instead some narratives may appeal more to men than women and vice versa. In addition, the design of the VR simulation, mainly the abstract nature of the avatar might have decreased the overall transportation scores for both women and men. The VR simulation’s avatar did not have any apparent sexual characteristics or notable features. This could pose a barrier to transportation. Past research with non-VR media has shown that the similarities between the protagonist and reader has been found to positively influence both identification and transportation (Slater & Rouner, 2002). In video game research individuals tend to identify more with customized avatars that share similar features such as biological sex and even gender (Lewis et al., 2008; Trepte et al., 2009). It is possible that the correlation between avatar similarity and transportation extends to VR.
Future studies should examine whether the avatar’s characteristics (i.e., physical appearance, biological sex, and gender) can play a role in the identification and degree of transportation in VR simulations. Allowing the customization of an avatar’s appearance before the start of a VR simulation could increase both identification and transportation of the individual and lead to greater persuasion.
On a practical level, narrative quality plays a key factor in transportation (Green, 2021). Health narratives should not be designed by one entity or even by a VR design company. Instead representatives from all the relevant areas involved in the health campaign should be involved. Health practitioners with expertise in communication health theories, design creatives, animators, writers, and software programmers should be working as a cohesive unit when designing health messages for a virtual simulation. Each profession has critical pieces of knowledge. Utilized in the correct ratios, this knowledge can be used to create not only an interactive VR simulation, but one which is able to create ethical persuasion and elicit positive behavioral change.
The last area of interest is the lack of significant effects for the social norm message. There are a few possibilities for this result. First, self-report measures can be subject to social desirability bias. The majority of individuals in the study (100 of the 134 participants) responded in the affirmative to the question “Do you want to take a drive distraction free pledge?”. However, only 58% of those who intended to sign the pledge actually completed the pledge that followed the question. A second possibility as to the lack of significance of this hypothesis is the weak influence of the injunctive message. The social norm message reminding the participant of the consequences of TWD might not have aligned with their own personal observations of descriptive norms in the real world. This conflict between the injunctive norm message and the descriptive message is supported by previous studies highlighting the diminishing effects of conflicting messages.
Limitations
A few limitations need to be mentioned regarding the study. First, although researchers have made advancements in measuring transportation with the Transportation Scale Short Form (Appel et al., 2015) and the Video Transportation Scale (Williams et al., 2011), the researcher decided to use the original 10-item transportation scale developed by Green and Brock (2000) given its established validity and reliability. More studies are needed to establish the original transportation scale as a reliable and valid measure of transportation in a VR environment. Additionally, future studies need to examine other self-report methods and physiological measures which may be more sensitive to measuring transportation.
Second, the study utilized a convenience sample and the overall sample size was somewhat small for this study. Therefore, the generalizability of the findings are limited. However, given the current public health issue posed by distracted driving in this demographic, the findings of this study can be seen as limited but insightful. In the future, a larger sample consisting of a wider range of the population could reveal further insights.
A final complication and the lack of effect-size could be attributed to the time limitations of the simulation. A longer VR simulation and potentially a pre-familiarization period with the virtual environment could potentially lead to a stronger transported state. However, transportation can be elicited by brief narratives (Green, 2021). Future studies need to examine whether the duration of the VR environment or video has an impact on transportation.
Conclusion
VR has the potential of providing a new delivery method for health messages. However, there is a limited amount of research examining the effectiveness of VR simulations in eliciting pro-health responses. This study has contributed to this new field of health communication research by examining one of the key factors in the narrative persuasion process, transportation. The findings highlight the complexity of attempting to achieve transportation and persuasion within a VR simulation. Health professionals should take a two-pronged approach to designing VR simulations, balancing both the structural components of the narrative and the individual characteristics of the target population.