Experiencing Change: A Scoping Review of Behavior Change with Extended Reality

Paper Title

Experiencing Change: A Scoping Review of Behavior Change with Extended Reality

Publication Info

• Topic area: Behavior change interventions using immersive technologies (XR, VR, AR).
• Keywords: Extended Reality, Virtual Reality, Augmented Reality, Behavior Change, Immersive Technologies, Behavior Change Techniques, Mechanisms of Action, Experience-Centric Interventions, Scoping Review, Psychological Barriers.

Background and Problem

• Problem / challenge: Existing behavior change technologies (e.g., wearables, apps) are predominantly information-centric and show limited long-term effectiveness. Immersive technologies promise to overcome these limitations but lack a comprehensive synthesis of their effectiveness and underlying mechanisms.
• Significance: XR technologies can shift behavior change interventions from information-centric to experience-centric approaches, potentially enabling more impactful and sustained behavioral outcomes.
• Motivation and related work: Prior reviews have focused on specific populations, technologies, or domains, leaving gaps in understanding how XR-specific qualities (e.g., presence, embodiment) influence behavior change. This paper synthesizes evidence across 53 studies to address these gaps.

Solution

• Proposed approach: A scoping review of 53 studies on XR-based behavior change interventions, analyzing their technical and psychological components, behavior change techniques (BCTs), mechanisms of action (MoAs), effectiveness, and unique advantages.
• Novelty:
  1. Systematic mapping of XR-specific components to behavior change theories (BCTs and MoAs).
  2. Analysis of XR's unique advantages for addressing psychological barriers to behavior change.
  3. Evaluation of short-term and long-term effectiveness of XR interventions.
  4. Development of a framework for theory-driven XR behavior change interventions.
• Procedure and key techniques:
  • Conducted a scoping review using broad XR and behavior change keywords across multiple databases.
  • Analyzed studies based on technical features, psychological qualities, BCTs, MoAs, effectiveness, and XR's unique advantages.
  • Categorized interventions by their relation to the physical world and virtual elements used.

Results

• Concrete findings:
  • 70% of studies assessing short-term effectiveness reported positive effects, while 67% of long-term studies showed sustained impact.
  • 47% of studies comparing XR to non-XR interventions found XR to be more effective.
  • Most interventions used VR (74%) over AR (25%) and focused on health (40%) and environmental behaviors (34%).
• Advantage over baselines: XR interventions often outperformed non-XR counterparts in creating vivid, immersive experiences that enhance knowledge, feedback processes, and perceived consequences.
• Experiments / evaluation:
  • Behavioral outcomes were measured in 27 studies, intentions in 12, and behavior-related constructs in 9.
  • Short-term effectiveness was measured in 68% of studies, with fewer addressing long-term effects (17%).
  • Common BCTs included "Natural Consequences" (31 studies) and "Feedback and Monitoring" (14 studies). Common MoAs included "Knowledge" (31 studies) and "Feedback Processes" (21 studies).
• Limitations and future work:
  • Limited use of XR's unique experiential qualities (e.g., perceptual manipulations, multimodal feedback).
  • Sparse data on long-term effects and ethical considerations.
  • Future work should explore XR's potential for habit formation, address ethical concerns, and develop a formalized design space for XR interventions.

Summary

This scoping review highlights the potential of XR technologies to enhance behavior change interventions by leveraging immersive, experience-centric approaches. While 70% of short-term studies and 67% of long-term studies reported positive effects, most interventions relied on traditional behavior change techniques, underutilizing XR's unique capabilities like presence and embodiment. The proposed framework for theory-driven XR interventions aims to bridge behavioral sciences and HCI, fostering more effective and ethically grounded applications. Future research should focus on long-term impacts, ethical implications, and expanding XR's design space to fully realize its potential.