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Background: For adolescents and young adults, a cancer diagnoses can magnify feelings of social isolation at an inherently vulnerable developmental stage. Prior studies have highlighted the importance of peer groups during cancer treatment. Support groups help foster connection and resilience, but patients find in-person participation difficult due to a variety of factors. Additionally, physical changes brought on by cancer makes these patients hesitant to meet in person. The COVID-19 pandemic magnified these difficulties. Virtual reality (VR) allows for the creation of a therapist-curated, computer-generated social space that potentially enables support groups for this population., Objective: This protocol describes a pilot study examining the efficacy, feasibility, and acceptability of a social VR support group intervention for adolescent and young adult patients with cancer., Methods: We approached 20 participants aged 17-20 years, and 16 agreed to participate. Moreover, 1 participant dropped out due to hospitalization. Participants attended virtual, professionally facilitated support groups using Meta Quest VR headsets. The groups consisted of 4 participants and 1 facilitator, amounting to a total of 22 individual sessions. Each session lasted 45-60 minutes and took place weekly for 4-6 weeks. The primary aim of this study was to collect quantitative and qualitative data on the feasibility and acceptability of the intervention. Feasibility was measured through session participation rates and overall retention rates. The acceptability of the intervention was explored through brief in-person interviews with participants at the end of the final intervention session. The secondary aim of this study was to collect data on the preliminary efficacy of the intervention in decreasing symptoms of participant depression and anxiety and increasing positive affect and resiliency., Results: In total, 15 patients aged 17-20 years participated in 22 sessions between November 5, 2019, and July 8, 2021. The median age was 19 (IQR 17-20) years. Overall, 10 (62%) participants identified as male, 5 (31%) as female, and 1 (6%) as transgender female. Furthermore, 5 (31%) participants identified as Hispanic, 1 (6%) identified as non-Hispanic Asian, 3 (19%) identified as non-Hispanic Black, 6 (38%) identified as non-Hispanic White, and 1 (6%) identified as other race or ethnicity. Hematologic malignancies or bone marrow failure was the most common diagnosis (8/16, 50%). The mean attendance rate was 72.8% (SD 25.7%) and retention was 86.7% (SD 0.35%). Moreover, 45% (10/22) of sessions had to be postponed by a week or more due to unexpected participant scheduling issues., Conclusions: The use of VR to deliver psychosocial support for adolescents and young adults with cancer may reduce common barriers associated with attending in-person peer support groups while improving quality-of-life measures. The data from this study will inform future studies focused on conducting VR support groups in other rare disease populations, including older adults with cancer., International Registered Report Identifier (irrid): DERR1-10.2196/48761., (©Asher Marks, Amanda Garbatini, Kimberly Hieftje, Vidya Puthenpura, Veronica Weser, Claudia-Santi F Fernandes. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 09.11.2023.)

Background: Black adolescent girls aged between 14 and 19 years are more likely than White girls to be diagnosed with a sexually transmitted infection (STI). As STI diagnosis is associated with an increase in the risk for HIV acquisition, an early intervention specifically tailored to Black adolescent girls is warranted. A web-based video game intervention has the potential to reach this demographic. Because studies of social and behavioral determinants of disease demonstrate the protective role of peer group structures on individual outcomes, a multiplayer game can facilitate opportunities to exchange and evaluate information, learn social norms, develop behavioral skills, and allow peers to influence attitudes and behavior. No prior research has examined the feasibility of a web-based multiplayer game intervention for this population., Objective: This study describes the protocol for a randomized controlled trial (RCT) pilot-testing the feasibility, acceptability, and limited efficacy of a multiplayer game-based intervention for increasing HIV and STI testing and condom use in Black adolescent girls., Methods: We enrolled 79 Black adolescent girls aged 14 to 19 years residing in the United States into a 2-arm parallel RCT. The intervention is a theory-based, community-informed, multiplayer game that can be played with peers on the web using videoconferencing software. The goal of the game is to empower Black adolescent girls to make healthy decisions regarding dating, relationships, and sex, thus reducing HIV and STI infection. Control condition participants received a list of resources after playing a time and attention control game. All study procedures were conducted via the internet. We conveniently sampled Black adolescent girls using web-based advertisements. Study assessments occurred at enrollment, 1 week, 1 month, and 4 months after enrollment. The primary outcome of this study is increased HIV and STI testing by Black adolescent girls. Secondary outcomes include increased condom use, self-efficacy to use condoms, positive attitudes toward condom use, intentions, harm perceptions, HIV and STI and pre-exposure prophylaxis knowledge, positive sexual norms, sexual communication with partners, and reduced incidence of sexual risk behaviors associated with HIV and STI transmission. Secondary outcomes also included assessment of intervention feasibility and acceptability., Results: From February to April 2022, a total of 79 Black adolescent girls were enrolled, with 40 (51%) having been randomized into the intervention condition and 39 (49%) into the control condition. At baseline, participant ages ranged from 14 to 19 (mean 16.4, SD 1.23) years., Conclusions: Web-accessible game interventions overcome common impediments of face-to-face interventions presenting a unique opportunity to reach Black adolescent girls and improve their sexual health and self-efficacy. Trial data will provide information about the limited efficacy of the intervention and inform future web-based studies and a larger RCT aimed at improving the sexual health of Black adolescent girls., Trial Registration: ClinicalTrials.gov NCT04108988; https://clinicaltrials.gov/ct2/show/NCT04108988., International Registered Report Identifier (irrid): DERR1-10.2196/43666., (©Veronica Weser, Ijeoma Opara, Mariana Budge, Lindsay Duncan, Claudia-Santi F Fernandes, Sydney Hussett-Richardson, Brandon Sands, Kimberly Hieftje. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 23.01.2023.)

Gendered racism can impact how Black teen girls perceive themselves in relation to the world and influence their behaviors. This form of discrimination tends to manifest in stereotypes that promote the victimization and mistreatment of Black teen girls. This qualitative study, using Black feminist thought through a Black Girlhood lens as a guiding framework, aims to understand how Black teen girls are affected by gendered-racist stereotypes and how these stereotypes impact sexual decision making among this group. Using a sample of (N = 27) Black teen girls, three major themes arose: (1) experiencing the effects of racist-sexist stereotypes, (2) feeling powerless and invisible due to stereotypes, and (3) navigating the pressure to have sex due to stereotypes. Implications for this study include incorporating elements of Black Feminist Thought through a Black girlhood lens within prevention programing while also providing Black teen girls with the tools to challenge negative stereotypes with support from adult allies in school and family settings.

Humans evolved to be endurance animals. Our ancestors were persistence hunters; they would chase animals, including gazelles, until they ran them into exhaustion. Put simply, people evolved in an ecological niche that selected for endurance and efficiency of locomotion. To locomote to any destination, one could take countless different paths, each requiring different amounts of energy. Because the ground is typically not flat or homogeneous, the straight direct path is often not the most energetically efficient. For hills below 14°, the direct straight path up the hill is the most energetically efficient. However, for hills above 14°, walkers would minimize their absolute energy expenditure by taking a zigzagged path so that their gradient of ascension is 14° [1]. In three experiments, we assessed the degree to which people make bioenergetically efficient decisions about locomotion through path selection. In Experiment 1, people were immersed into a virtual environment and adjusted the angle of ascension of a virtual path up hills of various gradients so that when taking the path, they would expend the least amount of energy when they reached the top. The second experiment was of a similar design, but was conducted in the real word. In the last experiment, in a virtual environment, participants choose between two paths up hills of various gradient, where these paths varied in the energy required for ascent. Participants made these judgements both before and after motor experience with gradient climbing on an incline trainer. For steep hills, we found that people choose much straighter paths over the bioenergetically optimal zigzagged paths. Motor experience did lead to higher probability for choosing optimal paths for steep hills, but lead to less optimal paths for shallower ones. These results show clearly that individuals show a straight path bias when deciding how to ascend hills., Competing Interests: The authors have declared that no competing interests exist.

The embodiment of tools and rubber hands is believed to involve the modification of two separate body representations: the body schema and the body image, respectively. It is thought that tools extend the capabilities of the body's action schema, whereas prosthetics like rubber hands are incorporated into the body image itself. Contrary to this dichotomy, recent research demonstrated that chopsticks can be embodied perceptually during a modified version of the rubber hand illusion (RHI) in which tools are held by the rubber hand and by the participant. In the present research, two experiments examined tool morpho-functional (tool output affordance, e.g., precision grasping) and sensorimotor (tool input, e.g., precision grip) match as a mechanism for this tool-use dependent change to the body image. Proprioceptive drift in the RHI occurred when the tool's output and the user's input matched, but not when this match was absent. This suggests that this factor may be necessary for tools to interact with the body image in the RHI.

Bodily boundaries are computed by integrating multisensory bodily signals and can be experimentally manipulated using bodily illusions. Research on tool use demonstrates that tools alter body representations motorically to account for changes in a user's action repertoire. The present experiment sought to unify perceptual and motoric accounts of tool embodiment using a modified Rubber Hand Illusion (RHI) that also addressed the skill and practice aspects of the tool use literature. In Experiment 1, synchronous multisensory stimulation induced perceptual embodiment of a tool, chopsticks. The embodiment of chopsticks was stronger for more skilled participants, and if the illusion was preceded by tool use. In Experiment 2, the illusion was not elicited with a different type of tool, a teacup, showing that not all objects can be incorporated. This experiment helps to clarify the role of perceptual and motoric embodiment and suggests future avenues for research into tools embodiment using this method., (Copyright © 2017 Elsevier Inc. All rights reserved.)