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Susan Persky, Ph.D.

Associate Investigator, Social and Behavioral Research Branch
Head, Immersive Virtual Environment Test Unit

Scientific Summary

Virtual worlds Throughout her career, Susan Persky has examined the integration of technological advancements into society. She trained as a social psychologist at the Research Center for Virtual Environments and Behavior at the University of California, Santa Barbara. There, she honed her expertise in examining electronic communication technologies as an object of inquiry and as a research tool. Her early work demonstrated the unique capabilities of virtual reality research tools for heightening realism. This work underscores the potential of such tools for the study of human behavior.

In 2005, Dr. Persky was recruited to the Social and Behavioral Branch to apply her methodological expertise in understanding social and behavioral processes around the translation of emerging genomic technologies for health benefit. Since then, she has split her effort between building a research program and providing leadership of the Immersive Virtual Environment Testing Area research facility in the NIH Clinical Center.

As the head of the Immersive Virtual Environment Testing Area, Dr. Persky provides scientific oversight for projects conducted within the facility. She serves as a methodological expert and liaison, and also as a social-psychology and health communication-based content expert and collaborator. In this role, she has collaborated on several projects that advance the scientific understanding of genes and society. She also leads efforts to refine and extend the methodological approaches supported by the testing area. She has conducted research on new immersive virtual reality-related techniques, and has also authored conceptual and review papers to push these areas forward.

Dr. Persky's substantive research program is based on the notion that it is essential to prepare for and optimally shape the diffusion of genomic information into clinical and public contexts. However, rather than exacerbate disparities, genomic advancements should be shaped to benefit underserved and stigmatized populations. To this end, Dr. Persky focuses on three interrelated areas: 1) developing strategies to maximize benefits and minimize risks associated with incorporating genomic information in health care encounters; 2) using emerging media technologies like virtual reality and social media to study genomics communication and evaluate new platforms for conveying genomics information; and 3) evaluating the impact of genomic knowledge dissemination on dissemination on stigmatization and related processes.

Dr Persky's investigations of the clinical encounter use immersive virtual reality clinical simulations. Use of a virtual reality-based clinic allows for randomized, experimental approaches to be employed even while the research setting retains elements of a realistic clinical encounter. Conceptually, her work assumes that one must understand influences of genomic technologies on both patients and providers. Thus, one thread focuses on the perspective of healthcare providers and one focuses on the patient's perspective.

Dr. Persky's work has shown that providing information about genetic underpinnings of obesity risk can significantly reduce the extent to which medical students stereotype and avoid eye contact with obese patients. However, such information can also reduce the rates at which medical students recommended health behavior and weight management consultations as part of patient care. The latter outcome raises concerns that dissemination of genomic knowledge could undercut providers' efforts to engage patients in health-promoting behaviors.

From the perspective of the patient, however, Dr. Persky's research has demonstrated that provider-initiated communication of obesity-related genomic information can be neutral with respect to its influence on the attitudes and beliefs that underlie patient health behavior. At the same time, however, discussing this information can reduce patients' perceptions that providers stigmatize them based on weight, and thereby benefit patient-provider relationships. 

Dr. Persky also considers factors that modify patients' receptivity to genomic information in clinical contexts. Her research has examined the influence of several potential moderators and mechanisms such as: provider communication approaches, patient emotional state, and social distance between patients and providers. These factors are of particular importance when communicating about conditions that are stigmatized or disproportionally affect underserved populations. For example, Dr. Persky demonstrated that the apparent race of a physician can influence African-American patients' processing of the genomics-based lung cancer risk feedback s/he provides.

Individuals also increasingly learn about and discuss genomic advancements and associated health-relevant information outside of the clinical context. Dr. Persky's research has shown that individuals apply the genetic information they encounter through online social media to their own health beliefs and decisions. Furthermore, this line of work elucidates the influence of the broader genomics-related media and cultural environment on individuals' beliefs about weight. These processes can have important implications for psychological and physical well-being. For example, one project demonstrated that family history-based obesity risk concepts related to young children's risk of obesity caused maternal guilt for child health behavior and for passing down a genetic predisposition for overweight. However, this work showed that guilt can be reduced through enacting healthy child feeding behaviors. This could potentially provide a route to both increased health-promoting parenting behavior and more positive affective experiences for mothers.

Encounters with genomics information online and in daily life can also alter the understanding (or misunderstanding) that individuals bring to the clinic as patients. With this in mind, Dr. Persky has begun to study the intersection between the public, social information environment and the clinical environment. Indeed, there is a need to understand routes of entry for genomic information into the clinic. Furthermore, there may be opportunity for successful communication strategies identified in the clinical context to be scaled up to help shape the public discourse around genomics and health through social media and other public health-relevant channels.

Immersive Virtual Environment Test Unit Members

Peter Hanna, B.S.: Lab Manager

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Last Updated: October 1, 2015