title: The feasibility and impact of delivering a mind-body intervention in a virtual world.
abstract: BACKGROUND
  Mind-body medical approaches may ameliorate chronic disease. Stress reduction is particularly helpful, but face-to-face delivery systems cannot reach all those who might benefit. An online, 3-dimensional virtual world may be able to support the rich interpersonal interactions required of this approach. In this pilot study, we explore the feasibility of translating a face-to-face stress reduction program into an online virtual setting and estimate the effect size of the intervention.
  
  
  RESULTS
  Domain experts in virtual world technology joined with mind body practitioners to translate an existing 8 week relaxation response-based resiliency program into an 8-week virtual world-based program in Second Life™ (SL). Twenty-four healthy volunteers with at least one month's experience in SL completed the program. Each subject filled out the Perceived Stress Scale (PSS) and the Symptom Checklist 90- Revised (SCL-90-R) before and after taking part. Participants took part in one of 3 groups of about 10 subjects. The participants found the program to be helpful and enjoyable. Many reported that the virtual environment was an excellent substitute for the preferred face-to-face approach. On quantitative measures, there was a general trend toward decreased perceived stress, (15.7 to 15.0), symptoms of depression, (57.6 to 57.0) and anxiety (56.8 to 54.8). There was a significant decrease of 2.8 points on the SCL-90-R Global Severity Index (p<0.05).
  
  
  CONCLUSIONS
  This pilot project showed that it is feasible to deliver a typical mind-body medical intervention through a virtual environment and that it is well received. Moreover, the small reduction in psychological distress suggests further research is warranted. Based on the data collected for this project, a randomized trial with less than 50 subjects would be appropriately powered if perceived stress is the primary outcome.
authors.affiliation: The Benson-Henry Institute for Mind Body Medicine, Boston, Massachusetts, United States of America. dhoch@partners.org
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Hoch
authors.forename: Alice J
authors.initials: AJ
authors.lastname: Watson
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Linton
authors.forename: Heather E
authors.initials: HE
authors.lastname: Bello
authors.forename: Marco
authors.initials: M
authors.lastname: Senelly
authors.forename: Mariola T
authors.initials: MT
authors.lastname: Milik
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Baim
authors.forename: Kamal
authors.initials: K
authors.lastname: Jethwani
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Fricchione
authors.forename: Herbert
authors.initials: H
authors.lastname: Benson
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Kvedar
mesh_terms: D000328:Adult; D001007:Anxiety / Q000628:therapy; D003863:Depression / Q000628:therapy; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D026441:Mind-Body Therapies; D010865:Pilot Projects; D015397:Program Evaluation; D013315:Stress, Psychological; D055815:Young Adult