When the shopping gets tough, the tough train in virtual reality: a virtual reality approach to promote healthy grocery shopping

In the so-called obesogenic environment, dietary choices are influenced by both internal and external influences. Grocery outlets are a key external influence on dietary choices, where both psychological temptations (e.g. hedonic cues pointing out to palatable foods) and biological temptations (e.g. Low blood glucose levels leading to feeling of (hedonic) hunger) have a strong influence on unhealthy dietary choices. Indeed, epidemological studies indicate that, when peope move to an area with substantial amounts of health-harming food outlets that have a large proportion of unhealthy products, diabetes incidence rates increase almost four-fold, relative to people who did not move (to such an area). Innovative training methods employing new persuasion technologies are needed to make sure people engage in healthier grocery shopping. In the present proposal, we suggest that important properties of task-focused mindset training can be readily incorporated into mobile app-based virtual training to enhance healthier grocery shopping, even under high loads of external and internal temptations. Specifically, we will employ task-focused grocery shopping list training under both conditions of low and high blood glucose levels (internal temptations) and under conditions of low and high food cues and shopping distractions (external temptations) during a 5-day (study 1) and 10-day (study 2) training program. Training will be done during lab sessions for consecutive days, and assessment of grocery shopping will be done the day after training completion. Training conditions will be experimentally manipulated in 2x2 between-subjects design. Specifically, we will manipulate food cues (low versus high distraction) and blood glucose levels (low versus high) in healthy controls (study 1), and we will manipulate the same external temptations in study 2 in healthy controls, pre-diabetic adults and diabetic adults, where diabetes status will function as a between-subject factor. After training completation, healthy and unhealthy grocery shopping will be assessed in a highly realistic virtual reality supermarket available at the host institutions laboratory (study 1 and study 2) and we will also assess real-life healthy and unhealthy grocery shopping during one month after training completion (study 2 only ). It is hypothesized that those who are trained under high levels of internal and external temptations are better able to make healthier grocery shopping choices in both the virtual and real-life supermarket settings. The present proposal can be considered an out-of-the-box idea, because it is the first study to combine expertise from diverse fields related to diabetes and diabetes prevention, such as persuasion technology, endocrinology, communication science, clinical psychology, and developmental psychology. The outcomes of the study will not only be informative for scientific knowledge and diabetes prevention and curation, but the developed virtual training app module will also be made freely available. A consultation group of both diabetes patients and grocery outlet representatives will provide input throughout the research period.