Draxtor Despres pointed me towards Second Life shows new promise as virtual forum for diabetes education, an article written by Nidhi Subbaraman for the technical section of the Boston Globe’s on-line edition.
In it, Ms Subbaraman reports on a Boston Medical Centre trial which utilised Second Life to help diabetes sufferers better manage their condition, and which has paved the way for an even more in-depth examination of the use of virtual world environments in matters of personal healthcare.

The trial was initiated by 2009 by Dr. Suzanne Mitchell, a family physician at Boston Medical Centre and assistant professor at the Boston University School of Medicine. The intent was to investigate whether and how virtual group sessions held in Second Life might help diabetes sufferers made changes to their eating habits and lifestyles to better manage their illness.
In particular, the trial involved African-American women, many from low-income families and / or holding down busy jobs. This demographic was specifically targeted because the U.S. Department of Health and Human Services Office indicates that a quarter of African-American women over age 55 have type 2 diabetes, which is a significantly high percentage.
Half of the study participants attended hospital classes to help them cope with their condition, the other half were provided with computers and modems and shown how to access Second Life and attend classes in-world. As Ms. Subbabaman notes:
Some days the virtual group “met” at the Second Life BMC classroom, but the group also took field trips into the on-line world. Once, the course leaders led a session on diet and explained how slow, mindful eating was one way to control portions and manage diet. The participants found that when their avatars sat down to eat at the cafeteria location, their utensils moved very slowly, echoing the lesson. Another time the group met at an exercise facility within Second Life, where participants could try out the treadmill or exercise bikes, or take a swim.
Not only did the trial reveal the participants attending virtual activities faired at least as well as those attending regular hospital classes, it also showed that they formed friendships and their own support network, swapping recipes, and trying to encourage friends to join them in-world as well. Most interestingly of all, the study suggested that those participating in the virtual aspect of the study reported exercising more than the group that met in class, suggesting the virtual experience might result in lasting lifestyle changes.
This isn’t the first time that activities in Second Life and virtual environments like it have been shown to have a positive impact on people’s lifestyle choices. In 2012, for example, I reported on a study led by Dr. Elizabeth Behm-Morawitz at the University of Missouri which showed that people who have a strong sense of self-presence with their avatar enjoy an improved self-image and took better care of themselves health-wise, and tended to enjoy better relationships with others.

However, as Ms. Subbabaman reports, the work carried out by Dr. Mitchell and her colleagues has now resulted in the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) awarding them a US $3.5 million grant to finance a further 5-year study into how the use of Second Life can help people diagnosed with diabetes better manage their condition.
“We know that in order to actively participate as partners in healthcare, patients with diabetes need self-management support,” Dr. Mitchell said in a BMC press release announcing the grant and the study. “What is remarkable about this study is we’ll be educating and interacting with some of the patients, and they’ll be interacting with each other, all through group visits in a virtual world.”
As with the initial trial, participants will be placed in either the control group (classroom education) or asked to join Second Life. Those involved in the Second life element of the study will not only be monitored to see how participation in in-world group session helps them better understand their condition, but also how the relationship with their avatar in general has an impact on their self-care and willingness to undertake lifestyle changes.
In this Dr. Mitchell and her colleagues are very keen to chart what is called the “Proteus Effect”. This is a term coined by Nick Yee in his 2014 book, The Proteus Paradox: How Online Games and Virtual Worlds Change Us– and How They Don’t to define the increasingly complex relationship we have with our digital Doppelgängers, and how it can have a profound and often positive effect on us (also see my article from January 2014).
The Proteus Effect was very much in evidence during the original BCM trial, and was also the effect noted by Dr. Elizabeth Behm-Morawitz’s study, so Dr. Mitchell is keen to explore how deeply it may affect and benefit people afflicted with diabetes.
Currently, it is estimated that some 387 million people globally live with diabetes, and the World Health Organisation estimates that the disease could be the 7th leading cause of death by 2030. given this, studies like the one announced by Dr. Mitchell and her colleagues could offer important new insights into the ways and means by which virtual world environments could encourage better self-management for the disease.
What’s more, it is possible the results of this study could be applicable to helping people better manage a range of long-term illnesses and conditions for themselves and alongside of medical support. As such, it will be interesting to see how this study progresses, and I very much hope that I’ll be able to carry further updates on the study in the future.
Further Reading
- Second Life shows new promise as virtual forum for diabetes education – Nidhi Subbaraman, Boston Globe
- BMC Receives Award to Study Impact of Diabetes Self-Management Education Delivered Through a Virtual World – Boston Medical Centre
- Women in Control: A Virtual World Study of Diabetes Self-Management – US Dept. of Health and Human Services
- The Proteus Paradox: How Online Games and Virtual Worlds Change Us – and How They Don’t – Nick Yee
- Mirrored selves: The influence of self-presence in a virtual world on health, appearance, and well-being – Dr. Elizabeth Behm-Morawitz
Don’t forget that 2015 marks the first Team Diabetes season in Second Life, raising money in support of the American Diabetes Association. In particular, November 2015 will see the Art in Hats event, which will lead up to World Diabetes Day. on November 14th. I’ll have up-to-date news on activities occurring throughout Art in Hats in due course.