Liberating housebound obese individuals using augmented virtual reality

The NHS costs attributable to overweight and obesity are projected to double to £10 billion per year by 2050, and the wider costs to society and business are estimated to reach almost £50 billion per year. NICE guidelines state that obesity treatment needs to include strategies to increase people's physical activity levels, improve eating behaviour and reduce energy intake. Lifestyle coaching sessions including education and physical activities are often delivered to groups in local community centres and schools. However, some of the most severely affected members of society do not have cost-effective access to these life-changing treatments because they find travel difficult or impossible. So here we propose to use technology deployed 'in the wild' to help specific groups of housebound obese individuals: people with learning disability or with psychological problems such as anxiety or depression that keep them at home and others who are functionally limited because of their physical condition. We know that there is much to be gained from engaging overweight and obese individuals in moderate physical activity. Even small improvements in this group could greatly enhance their wellbeing and personal health so one of our goals will be to see how much impact we can make on an individual's ability to engage in everyday activities.

Virtual worlds are live, online, interactive 3-dimensional environments in which users interact using speech or text via a personalised avatar. Accessible from home all that is required is a modern computer and internet connection. Primarily used for social reasons, healthcare practitioners are increasingly utilising virtual worlds for team training, conferences, patient support groups and collaborative team-working.

Our group at Imperial College London is currently working with the Imperial College Healthcare NHS Trust and MoreLife (a provider of weight loss interventions for obese and overweight children and adults) to provide virtual world group coaching for weightloss. MoreLife, our official project partner, delivers a 12-week educational programme across the internet, where participants attend as avatars and do not have to travel, or expose their real selves in public. In these groups they learn about food intake and nutrition, and are encouraged to engage in more physical activity and exercise. A slideshow illustrating the virtual world pilot project can be seen here: http://tinyurl.com/healthrez.

Here we propose to take this several steps further by using the Microsoft Kinect Sensor to enable housebound individuals to attend group sessions incorporating physical activities specially designed to help them transform their lives. The Kinect is a motion sensing input device developed by Microsoft initially for the Xbox video game console and more recently for the Windows PC. Incorporating depth-sensing webcams, it can directly capture the user's movements and transmit them across the internet where they are mirrored by their avatars, without the need for anyone to see a video image of the real person. A movie demonstration is available here: http://tinyurl.com/healthrezk.

Our potential users, their carers and our partners' instructors are very enthusiastic about this project and we hope to show that by deploying this extremely cost-effective and scalable digital technology we can improve this disadvantaged group's health and wellbeing and thereby provide them with life opportunities previously denied them. We have already shown in a previous study that virtual worlds can be used to provide health care-related information to people with learning disability, and we will continue this work with the Grace Eyre Foundation in Brighton and with other charitable foundations.

Beneficiaries will include:

Academia: We hope to show that body sensors can be used in this new cross-disciplinary area of application, and is of interest both nationally and internationally, as it will enable behavioural information to be delivered or monitored remotely across the internet.

The National Health Service: We know that even small improvements in physical activity in the 3 groups we are working with can have a major impact on their cardiovascular and general health, and thereby help to prevent the development of further co-morbidities that place demands on the NHS's limited resources.

The National Health Service, Local Authorities and Public Health organisations: By demonstrating how behaviour change services can be delivered remotely over the internet we are also pointing the way to the possibility of new modes of service provision, and a general transformation of the way that healthcare and social services may be delivered in the future. This has implications for policymakers nationally and internationally.

The following disadvantaged groups in society: People with learning disability with a propensity towards overweight and obesity, the obese and morbidly obese, people with temporary mental health issues that cause them to become overweight. The families of these individuals will also benefit. These groups should benefit by being able to participate more fully in social activities, by better health and wellbeing and by a sense of achievement after possibly years of experiencing only failures.

Businesses, such as MoreLife, who provide weight management services for the overweight and obese, as they should be able to use the technologies and techniques we develop.

Third sector organisations including charitable trusts such as the Grace Eyre Foundation, and institutions such as Schools who struggle with the problems caused by overweight and obesity.

In the long run technology-enabled remote service delivery has the potential to enhance the efficiency and sustainability of many public services.