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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 virtual reality (VR) as an object of inquiry and as a research tool. Her early work demonstrated the unique capabilities of VR 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 (IVETA) research facility in the NIH Clinical Center.

As the head of the IVETA, 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 and measurement approaches supported by the testing area. She has conducted research on immersive VR techniques and affordances in health and medicine, and has also authored conceptual and review papers to push these areas forward. For example, she and her colleagues have validated the VR Buffet, a tool for fine-grained assessment of food choice behavior, and have evaluated VR as a potential platform for future communication of genomics information.

Dr. Persky's substantive research program also sits at the edge of emerging technologies. Her work 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 VR 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 stigmatization, bias, and related processes.

Dr. Persky's investigations of the clinical encounter often employ immersive VR clinical simulations. Use of a VR-based clinic allows for randomized, experimental approaches to be employed even while the research setting retains elements of a realistic clinical encounter. This approach also affords crucial nonverbal behavior measurement opportunities. 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 genomic underpinnings of obesity risk can significantly reduce the extent to which medical students stereotype and avoid eye contact with obese patients. However findings from this work also raise concerns that dissemination of genomic knowledge could undercut providers' efforts to engage patients in health-promoting behaviors. From the perspective of the patient, her research has shown that patients are interested in engaging in genomics-informed weight management care. Her work has also demonstrated that provider-initiated communication of obesity-related genomic information can be variable 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's research has examined the influence of several potential moderators and mechanisms related to genomic information receptivity among patients 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.

Individuals also increasingly learn about and discuss genomic advancements and associated health-relevant information outside of the clinical context in physical and digital communities. 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, eating behavior, obesity, and diabetes. These processes can have important implications for psychological and physical well-being. Dr. Persky's work underscores potential difficulties in communicating complex concepts related to processes like gene-environment interaction, genomic influence on health-relevant behavior, and epigenetics processes. At times, these messages can backfire, causing individuals to engage in defensive processing, or weaken perceptions of efficacy and control. At other times, these messages can effect change, although through routes that present challenges. 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 line of work aims to provide a route to increased health-promoting behavior alongside ultimately positive affective experiences.

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 emerging experiential media, social media and other public health-relevant channels.

Immersive Virtual Environment Test Unit Members

Christopher Fortney: Lab Manager
Brittany Hollister: Postdoctoral Fellow
Haley Yaremych: Postbaccalaureate Fellow
Margaret Rose: Postbaccalaureate Fellow



Last Updated: February 25, 2019