Findings from the second study of my PhD full Thesis available from https://www.researchgate.net/publication/314506853_Living_in_3D_Social_Virtual_Worlds_and_the_Influence_on_Health_Literacy_Health_Behaviour_and_Wellbeing

1. Dr Evelyn McElhinney, Senior Lecturer, Department of Nursing and
Community Health, Glasgow Caledonian University, Scotland
The importance of positive health assets from
participation in 3D social virtual world
communities to self-management of long term
conditions in the physical world.

2. Positive health assets
Positive health assets have been defined as:
… any factor (or resource), which enhances the ability of
individuals, groups, communities, populations, social
systems and /or institutions to maintain and sustain health
and well-being and to help to reduce health inequities. These
assets can operate at the level of the individual, group,
community, and/or population as protective (or promoting)
factors to buffer against life’s stresses.
(Morgan and Ziglio 2007 p. 2)

3. The Immersive Setting
3D Social Virtual World
- Avatar based multi user social networks
- User represented by ‘virtual self’ – avatar –
sense of embodiment
- Sense of immersion –place, presence, social
presence
- Multiple social activities – multiple
communication tools – text based local chat,
group chat, private instant message, local voice
chat and private voice call – visual, auditory,
interactive

4. Research Aim and Questions
AIM
To explore and advance understanding of the nature and mechanisms of action of
engaging in 3D VW communities on people’s ability to live or cope with their long
term conditions in the physical world.
1. How does the number and type of social connections with others in 3D
virtual worlds influence access to and understanding of health
information for supporting self-management of long term conditions in
the physical world?
2. What are the features of 3D VW communities that help or hinder the
ability to live or cope with long term conditions in the physical world
over time?
3. Is the concept of building health ‘community social capital’ a
meaningful concept in virtual worlds?
McElhinney (2015)

5. Methodology and methods
4 longitudinal case study (people) over 3 months age
45 - 60
Two Focus Groups x 10 people Age 18 - 80
Paula 51-60 Ann 41-51 John 51-60 Mary 51-60
Cancer survivor housebound stroke chronic pain,
chronic pain, deaf depression, PTSD
Methods

6. Two Main Themes
Sense of Belonging to Place
and People

7. Belonging to Place
Sense of Place “the ability to grasp and appreciate the
distinct qualities of places” (Relph 2007 p. 19).
‘a life without places is as unimaginable as a life without
people” (Relph 2007 p. 17).

8. Biophilia
“the innate tendency to focus on life and lifelike
processes” (Wilson 1984 p. 1).
humans are genetically biased to experience positive mental
well-being after interacting with nature – Biophilia Hypothesis
(Kellert and Wilson 1995)
Technobiophilia
“the innate attraction to life and lifelike processes as
they appear in technology” (Thomas 2013 p.1)

9. Sense of Belonging to Place and People
Belonging to place - technobiophilia
Depression is always nearby asking about the futility of every action and thought.
Logging in to Second Life, even to be alone in relaxing scene to feel more in control
somehow provides resources of imagination and creativity. Third Life is an area in
Second Life where no one is ever around. If this place goes away it will be very sad.
Sitting atop a mountain to review the waves crashing and hear the birds soaring is not
as good as physical nature, but my mind suspends disbelief and I feel immersed. The
mountain is full of secret passageways. (Paula, First Diary December 2013)

10. Sense of Belonging to Place
Belonging to place - technobiophilia
I go to baja the ocean sim and read and do my homework also a friend has a
waterfall on his sim and it is inside a cave. Makes me feel relaxed, gives me
a place to work and think. This is where I would go if I could, they make me
think of friends on SL that might not be online that might be bored, they live
near the ocean…I go with friends, we go places, I like being around people I
also like being alone. I am pretty spunky; I can entertain myself when my
friends are not online. (Ann, Second interview June 2014)

11. Sense of Belonging to Place
Belonging to place - technobiophilia
I like how they feel. When I am focused on anything beautiful, I feel good. :) and I think
the main dif between beauty here and in rl is that here I have much more
companionship. Beauty shared is somehow enhanced for me. ;). (Researcher: smiles, so
is there particular places or the look of areas you like? If so, can you describe them?)
Yes, natural, forests, gardens, places with nice music, meditation sites etc. Home I love
my home spend much time here. (Mary, Second Interview June 2014)

12. Sense of Belonging to People – Focus Groups
Here I can forget that I'm sitting in a bed (for the umpteenth
time), interact with friends, choose interesting things to do,
even go out for a meal (which really is silly in Second Life), go
dancing, host a dance, etc. Not only can I play, but I can do
things in SL that are impossible for me to do now. And all the
while I can forget I have limitations. SL is great for people like
me (Michelle Focus group age 51-60)
It has definitely helped, before I discovered SL, I was
suffering from severe depression, seeing a therapist, in
group therapy, meds, etc. and once I joined SL, it totally
turned my life around…. it was kind of funny, because the
more I was at SL, the happier I felt, within a few months,
my therapist outright asked me - what has happened to
make you change so much. I was afraid to tell her about
SL, figured she'd think I'd lost it for good {laughing}
(Kath, Focus Group age 51-60)

13. Sense of Belonging People
Case Study
SL helps you relax and enjoy your life I love
dancing and going to live concerts and
meeting new people…I think the friendships
you make in Second Life yeah, um are real
friendships because that is all we have got.
(John, First interview, February 2014)
Friendship, beautiful surroundings...these things mean
so much. I just think of it as love...love that motivates ppl
[people] here to share beauty they create with
others...love expressed by hugs, discussion, concern...
all of it… just love...and the power of love to heal and
give us a focus outside of rl [real life] ‘issues’ that we
cannot control and sometimes, feel victimized by. Love
and laughter have had a huge positive effect on my
physical issues as well as on my feelings of loneliness
and isolation in rl. (Mary, First Diary May 2014)

14. Sense of Belonging to Place and People
Belonging with People - Social Networks
PAULA JOHN
ANN
MARY

15. John
Professional Network
Ann
Friendship Network
A sense of belonging, family, self-confidence, a belief in
your own abilities again, and someone to communicate
with, they become your surrogate family and dear friends.
(John, First Interview February 14)
Friendships keep me busy and my mind off my pain helps
prevent me from becoming seriously depressed. I have
met others via [health support organisation] who have
[condition removed] I was very surprised by that. I have
also met other deaf on SL so it helps me by making me
feel like I am still a part of life. (Ann, First Interview
January 2014)

16. Building Resilience – Regaining Control
Since I have come to SL, my blood pressure has been
reduced from 230 to 98. I went from late stage [condition
removed] numbers to normal numbers for 2 yrs now. I
sleep better than before, and I am just plain happier. I had
gotten to the point where pain was causing me to question
why I am still living if I have to live this way. I have had to
change my lifestyle very dramatically, and I was really
getting depressed before Lisa brought me to SL. Now, I
have something very pleasant to look forward to every
single day, and I am much happier overall. The difference it
has made in my life overall and in dealing with pain
specifically is really beyond my ability to articulate
(Mary, Third Diary July 2014)

17. Core Concept – McElhinney (2015)
ANTONOVSKY (1987, 1996)

18. Questions
Twitter @evmcelhinney
Thesis available on researchgate or via British
Library
https://www.researchgate.net/publication/3145068
53_Living_in_3D_Social_Virtual_Worlds_and_the_
Influence_on_Health_Literacy_Health_Behaviour_
and_Wellbeing

19. References
ANTONOVSKY, A., (1987). Unraveling the mystery of health: How people
manage stress and stay well. San Francisco, CA: Jossey-Bass.
ANTONOVSKY, A., (1996). The salutogenic model as a theory to guide health
promotion. Health Promotion International. 11(1), pp. 11-18.
KELLERT, S.R. and WILSON, E.O., (1995). The Biophilia Hypothesis.
Washington, DC: Island Press.
McElhinney, E (2015) Living in 3D Social Virtual Worlds and the Influence on
Health Literacy, Health Behaviour and Wellbeing (unpublished thesis) Glasgow
Caledonian University
https://www.researchgate.net/publication/314506853_Living_in_3D_Social_Virtual
_Worlds_and_the_Influence_on_Health_Literacy_Health_Behaviour_and_Wellbei
ng
THOMAS, S., (2013). Technobiophilia: Nature and Cyberspace. London:
Bloomsbury.