Creepy, but Persuasive: In a Virtual Consultation, Physician Bedside Manner, Rather than the Uncanny Valley, Predicts Adherence

Care for chronic disease requires patient adherence to treatment advice. Nonadherence worsens health outcomes and increases healthcare costs. When healthcare professionals are in short supply, a virtual physician could serve as a persuasive technology to promote adherence. However, acceptance of adv...

Full description

Bibliographic Details
Main Authors: Zhengyan Dai, Karl F. MacDorman
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-09-01
Series:Frontiers in Virtual Reality
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/frvir.2021.739038/full
_version_ 1818641644947243008
author Zhengyan Dai
Karl F. MacDorman
author_facet Zhengyan Dai
Karl F. MacDorman
author_sort Zhengyan Dai
collection DOAJ
description Care for chronic disease requires patient adherence to treatment advice. Nonadherence worsens health outcomes and increases healthcare costs. When healthcare professionals are in short supply, a virtual physician could serve as a persuasive technology to promote adherence. However, acceptance of advice may be hampered by the uncanny valley effect—a feeling of eeriness elicited by human simulations. In a hypothetical virtual doctor consultation, 441 participants assumed the patient’s role. Variables from the stereotype content model and the heuristic–systematic model were used to predict adherence intention and behavior change. This 2 × 5 between-groups experiment manipulated the doctor’s bedside manner—either good or poor—and virtual depiction at five levels of realism. These independent variables were designed to manipulate the doctor’s level of warmth and eeriness. In hypothesis testing, depiction had a nonsignificant effect on adherence intention and diet and exercise change, even though the 3-D computer-animated versions of the doctor (i.e., animation, swapped, and bigeye) were perceived as eerier than the others (i.e., real and cartoon). The low-warmth, high-eeriness doctor prompted heuristic processing of information, while the high-warmth doctor prompted systematic processing. This pattern contradicts evidence reported in the persuasion literature. For the stereotype content model, a path analysis found that good bedside manner increased the doctor’s perceived warmth significantly, which indirectly increased physical activity. For the heuristic–systematic model, the doctor’s eeriness, measured in a pretest, had no significant effect on adherence intention and physical activity, while good bedside manner increased both significantly. Surprisingly, cognitive perspective-taking was a stronger predictor of change in physical activity than adherence intention. Although virtual characters can elicit the uncanny valley effect, their effect on adherence intention and physical activity was comparable to a video of a real person. This finding supports the development of virtual consultations.
first_indexed 2024-12-16T23:30:27Z
format Article
id doaj.art-9e7c7c0e9cca45e9985d841fc483b5e0
institution Directory Open Access Journal
issn 2673-4192
language English
last_indexed 2024-12-16T23:30:27Z
publishDate 2021-09-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Virtual Reality
spelling doaj.art-9e7c7c0e9cca45e9985d841fc483b5e02022-12-21T22:11:54ZengFrontiers Media S.A.Frontiers in Virtual Reality2673-41922021-09-01210.3389/frvir.2021.739038739038Creepy, but Persuasive: In a Virtual Consultation, Physician Bedside Manner, Rather than the Uncanny Valley, Predicts AdherenceZhengyan DaiKarl F. MacDormanCare for chronic disease requires patient adherence to treatment advice. Nonadherence worsens health outcomes and increases healthcare costs. When healthcare professionals are in short supply, a virtual physician could serve as a persuasive technology to promote adherence. However, acceptance of advice may be hampered by the uncanny valley effect—a feeling of eeriness elicited by human simulations. In a hypothetical virtual doctor consultation, 441 participants assumed the patient’s role. Variables from the stereotype content model and the heuristic–systematic model were used to predict adherence intention and behavior change. This 2 × 5 between-groups experiment manipulated the doctor’s bedside manner—either good or poor—and virtual depiction at five levels of realism. These independent variables were designed to manipulate the doctor’s level of warmth and eeriness. In hypothesis testing, depiction had a nonsignificant effect on adherence intention and diet and exercise change, even though the 3-D computer-animated versions of the doctor (i.e., animation, swapped, and bigeye) were perceived as eerier than the others (i.e., real and cartoon). The low-warmth, high-eeriness doctor prompted heuristic processing of information, while the high-warmth doctor prompted systematic processing. This pattern contradicts evidence reported in the persuasion literature. For the stereotype content model, a path analysis found that good bedside manner increased the doctor’s perceived warmth significantly, which indirectly increased physical activity. For the heuristic–systematic model, the doctor’s eeriness, measured in a pretest, had no significant effect on adherence intention and physical activity, while good bedside manner increased both significantly. Surprisingly, cognitive perspective-taking was a stronger predictor of change in physical activity than adherence intention. Although virtual characters can elicit the uncanny valley effect, their effect on adherence intention and physical activity was comparable to a video of a real person. This finding supports the development of virtual consultations.https://www.frontiersin.org/articles/10.3389/frvir.2021.739038/fulladherenceanthropomorphismdoctor–patient communicationheuristic–systematic modelinteractive narrativespersuasive technologies
spellingShingle Zhengyan Dai
Karl F. MacDorman
Creepy, but Persuasive: In a Virtual Consultation, Physician Bedside Manner, Rather than the Uncanny Valley, Predicts Adherence
Frontiers in Virtual Reality
adherence
anthropomorphism
doctor–patient communication
heuristic–systematic model
interactive narratives
persuasive technologies
title Creepy, but Persuasive: In a Virtual Consultation, Physician Bedside Manner, Rather than the Uncanny Valley, Predicts Adherence
title_full Creepy, but Persuasive: In a Virtual Consultation, Physician Bedside Manner, Rather than the Uncanny Valley, Predicts Adherence
title_fullStr Creepy, but Persuasive: In a Virtual Consultation, Physician Bedside Manner, Rather than the Uncanny Valley, Predicts Adherence
title_full_unstemmed Creepy, but Persuasive: In a Virtual Consultation, Physician Bedside Manner, Rather than the Uncanny Valley, Predicts Adherence
title_short Creepy, but Persuasive: In a Virtual Consultation, Physician Bedside Manner, Rather than the Uncanny Valley, Predicts Adherence
title_sort creepy but persuasive in a virtual consultation physician bedside manner rather than the uncanny valley predicts adherence
topic adherence
anthropomorphism
doctor–patient communication
heuristic–systematic model
interactive narratives
persuasive technologies
url https://www.frontiersin.org/articles/10.3389/frvir.2021.739038/full
work_keys_str_mv AT zhengyandai creepybutpersuasiveinavirtualconsultationphysicianbedsidemannerratherthantheuncannyvalleypredictsadherence
AT karlfmacdorman creepybutpersuasiveinavirtualconsultationphysicianbedsidemannerratherthantheuncannyvalleypredictsadherence