Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
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Journal of medical Internet research
Stimulating Future-Oriented Thinking and Goal-Achievement Through the Future Self Using Virtual Reality and a Smartphone App: Randomized Controlled Trial
BACKGROUND: Research suggests that identification with one's future self-encompassing vividness, connectedness, and valence-plays a key role in motivating future-oriented choices and goal pursuit. Interventions aiming to strengthen future self-identification have been shown to reduce maladaptive behaviors and promote well-being, but traditional approaches often rely heavily on imagination. Emerging technologies offer novel opportunities to make the future self more vivid and tangible, potentially reducing cognitive burden, and enhancing intervention effectiveness. OBJECTIVE: This randomized controlled trial evaluated the effectiveness of a digital intervention on the following primary outcomes: future self-identification, future orientation, consideration of future consequences, self-defeating behavior, goal commitment, and goal achievement. METHODS: In this parallel, 3-arm randomized controlled trial, 321 first-year students from a large public university in the Netherlands were randomized (1:1:1) with blocks of 9 to a smartphone app-based future-self intervention, an immersive virtual reality (VR) version of the same intervention, or an active goal-setting control condition. Participants assigned to the smartphone or VR condition engaged with the intervention over a 3-week period, during which they interacted with their 10-year-old self, their future self. Participants in the control condition received no further support. Each of the 3 conditions consisted of 107 participants, who were all included in the analyses following the intention-to-treat principle. Due to the nature of the intervention, blinding was not possible. RESULTS: Compared to the goal-setting control condition, both intervention conditions yielded significant short-term improvements on all 3 aspects of future self-identification (smartphone: dvividness=0.49; dvalence=0.44; dconnectedness=0.43; VR: dvividness=0.35; dvalence=0.44; dconnectedness=0.43), and a small decline in vividness (smartphone: d=-0.36; VR: d=-0.23) and connectedness (smartphone: d=-0.36; VR: d=-0.32) at 6-month follow-up. Additionally, the intervention buffered declines in future orientation during the study period (smartphone: d=.16; VR: d=0.18), and VR delivery led to significantly higher weekly goal achievement (d=0.88). However, effects on future orientation were not sustained over time (smartphone: d=-0.18; VR: d=-0.25), resulting in similar levels across conditions at 6-month follow-up. Furthermore, no significant effects emerged for other primary or secondary outcomes, such as self-defeating behavior (smartphone: doverall=-0.10; VR: doverall=-0.03), impulsivity (smartphone: doverall=-0.07; VR: doverall=-0.09), or academic performance (η2partial=0.00). No adverse events were reported in any of the conditions. CONCLUSIONS: This randomized controlled trial innovatively compares smartphone and immersive VR future-self interventions. Findings suggest that digital interventions leveraging visual and interactive representations of the future self can strengthen future self-identification and future orientation, and support (short-term) goal pursuit. Together, they highlight the potential of scalable digital future self approaches for educational and preventive health contexts.
15 May 2026
Read appraisal →Language, speech, and hearing services in schools
Intervention Efficacy for Children With Mild Bilateral Sensorineural Hearing Loss
PURPOSE: This study aimed to compare the efficacy of hearing aid (HA) and frequency modulation (FM) systems in improving language, articulation, and speech perception outcomes among children with mild bilateral sensorineural hearing loss (MBHL) over a 12-month intervention period. METHOD: A prospective repeated-measures design was employed, enrolling 43 Cantonese-speaking children aged 6-7 years, with a pure-tone average of 26-40 dB HL. Participants were randomly assigned to either the HA group (n = 16) or the FM group (n = 16). A nontreatment control group (n = 11) was formed from children who declined the intervention. The outcome measures included the Hong Kong Cantonese Articulation Test, the Hong Kong Cantonese Oral Language Assessment Scale, and the Cantonese Hearing-in-Noise Test. Assessments were conducted at baseline and 12 months post-intervention. RESULTS: The FM group demonstrated significant improvements in language abilities (p < .01, Cohen's d = 0.53), particularly in word definition, expressive vocabulary, and Cantonese grammar, outperforming both the HA and control groups (p < .05). Articulation improvements were greater in the FM group, with significant gains in consonant production (p < .01). No significant improvements were observed in speech perception across the groups. CONCLUSIONS: FM systems are more effective than HAs in enhancing language and articulation outcomes in children with MBHL, particularly in noisy classroom environments. These findings highlight the importance of individualized intervention strategies and the potential of FM systems to support auditory access and language development. Future research should explore long-term outcomes and the role of contextual factors in intervention efficacy.
5 Apr 2026
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