Towards an Effective Web-Based Virtual Health Intervention: The Impact of Media Platform, Visual Framing, and Race on Social Presence and Transportation Ratings

Effectively delivering health-promoting messages can persuade users to adopt healthy life-saving behaviors. Research in health-promoting media messages shows that higher social presence and transportation ratings can positively impact users’ trust and intentions to adopt healthy behaviors. Hence, social presence and transportation are essential measures for the quality of virtual health communication. This study aims to identify the factors that can increase social presence and transportation in the context of virtual human interventions for promoting colorectal cancer screening. To promote colorectal cancer screening and increase awareness, we developed a virtual healthcare assistant named ALEX (Agent Leveraging Empathy for eXams). ALEX is a web-based intervention that incorporates high-fidelity 3D models with human voices and gestures to inform patients about colorectal cancer risks and screening information. In this paper, we study the effect of three independent variables on users’ self-reported ratings of the social presence and transportation scales: 1) media platforms (smartphones vs. computers), 2) visual framing conditions (near vs. far), and 3) ALEX-user race relationship (concordance vs. dis-concordance). We conducted a between-subjects user study with 755 users (genders: male, female; races: Black, White; and age range: 50–73) using Qualtrics. All users completed the web-based virtual appointment with a gender-concordant ALEX on their preferred media platform and then completed the post-survey. The results show that the main effect of media platform was significant (\(F_{1,747}= 5.18, p = 0.02\)), but there were no significant differences between visual framing conditions and the Alex-user race relationship (\(p>0.05\)). Our analysis indicates that smartphones can induce higher social presence and transportation than computers.