Health literacy practices in 3D social virtual world

BACKGROUND: Social Virtual Worlds (VWs), for example, Second Life are online 3D multiuser virtual environments (MUVE). Access by users or ‘residents’ of these environments is through the creation of a representation of themselves, known as an avatar. These social immersive environments have been used to present health information using interactive games, simulations, support groups and healthcare seminars. The use of these environments during COVID-19 increased especially in countries with strict lockdown rules. However, limited published studies have investigated the health literacy (HL) skills and practices undertaken by individuals or communities in virtual worlds. Therefore, this study aimed to advance understanding of the social skills and health literacy practices used by individuals and communities within this immersive ‘place’ and the influence on physical world health behaviour. METHODS: 25 semi-structured interviews were conducted with participants within the virtual world Second Life. RESULTS: Findings demonstrated that participants used their social VW networks within the VW to search for, access, experience, appraise, understand, and make decisions to use health information. These social methods allowed reciprocal sharing of information, access to people within multiple VW groups who had different VW knowledge, skills, and health literacy practices. Additionally, this maximised the health literacy resources available, meaning improvements to individual or community HL. CONCLUSIONS: An adapted framework of social skills and cultural literacy competencies used within VWs to improve individual and community HL be discussed and how this leads to distributed HL within the community. This framework is the first collection of social skills and adult HL used within VWs and make a unique contribution to ncreasing the understanding of the type of literacies used in social VWs to manage health information in online and offline communities.