JMIR XR and spatial computing最新文献

{"title":"Evaluating the Effects of Clinician Prescribing and Implementation Materials on Adoption of Virtual Reality Therapeutics: Randomized Feasibility Pilot Study.","authors":"Ashlyn Zebrowski, R Jackson Fernandez, Cameron Pinkelton, Rebecca Kitzmiller, Adam W Kiefer, Laura Stanley, Gita Mody, Carlton Moore, Lukasz Mazur","doi":"10.2196/90626","DOIUrl":"10.2196/90626","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality therapeutics (VRx) are emerging as a form of digital therapeutics (DTx) with growing evidence for improving symptoms such as anxiety, pain, and distress. However, real-world adoption remains limited because successful use depends not only on the therapeutic benefits but also on how the intervention is introduced, supported, and integrated into care, in addition to the therapeutic benefits. Existing literature has identified barriers related to clinician familiarity, prescribing pathways, onboarding, and independent use outside the clinic, but few studies have experimentally evaluated how implementation strategies influence early adoption outcomes.</p><p><strong>Objective: </strong>This feasibility pilot study evaluated how different implementation strategies influence early adoption of a VRx intervention in a nonclinical setting by comparing unguided VRx use, self-directed VRx use with implementation materials, and VRx use with prescriber-led consultation and support.</p><p><strong>Methods: </strong>An institutional review board-approved, 3-arm randomized feasibility pilot study was conducted following the Virtual Reality Clinical Outcomes Research Experts framework and reported using the CONSORT (Consolidated Standards of Reporting Trials) 2010 extension guidelines for pilot and feasibility studies. Participants were randomly allocated to 1 of 3 experimental conditions. Outcomes included technology acceptance, usability, fidelity, and tolerability. Quantitative measures were complemented by qualitative exit interviews. Analyses were exploratory, and the study was not powered for hypothesis testing.</p><p><strong>Results: </strong>Across conditions, brief VRx exposure was associated with significant improvements in overall technology acceptance (<i>P</i><.001), though postintervention scores remained in the neutral range, indicating early shifts rather than strong endorsement. Participants receiving provider-supported implementation demonstrated the most consistent pattern of favorable outcomes, including higher fidelity of use and significantly greater time-based adherence (<i>P</i>=.04). Usability scores were generally favorable across conditions. Tolerability was acceptable, with low levels of reported cybersickness and no discontinuations due to adverse effects. Qualitative findings highlighted the importance of guidance, expectation-setting, and perceived clinical legitimacy in shaping engagement.</p><p><strong>Conclusions: </strong>This study demonstrates that implementation strategy is a key determinant of adoption for virtual reality-based DTx. By experimentally isolating onboarding and provider support components, this work extends prior efficacy-focused research to address implementation design. Findings suggest that brief provider involvement and structured onboarding may enhance engagement and adherence, supporting future evaluation of scalable DTx implementation models in clinical and c","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"3 ","pages":"e90626"},"PeriodicalIF":1.8,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148364434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Reality in Health Professions Education: Qualitative Descriptive Study of Educators' Perspectives.","authors":"Tak Wing Yu, Michael Rowe, Jose Frantz","doi":"10.2196/52925","DOIUrl":"10.2196/52925","url":null,"abstract":"<p><strong>Background: </strong>As virtual reality (VR) technology has become more accessible, the potential of this technology has been increasingly investigated in higher education institutions to improve teaching and learning. While VR can provide immersive experiences to support visualization and active learning, its adoption in health professions education is often limited by high costs, technical complexity, and a lack of pedagogical fit. Furthermore, the educator, who is critical to curriculum design, is underrepresented in the discourse on VR integration, especially in resource-constrained environments in South Africa.</p><p><strong>Objective: </strong>The purpose of this study was to investigate the perceptions of health professions educators regarding the potential value of immersive VR in the educational process, the implementation barriers, and the requirements for successful curriculum integration at a South African university.</p><p><strong>Methods: </strong>A qualitative exploratory descriptive design was used. Eighteen educators (N=18) from a wide variety of health disciplines (including physiotherapy, occupational therapy, nursing, and dentistry) were recruited from the Faculty of Community and Health Sciences. Participants interacted with 3 immersive VR applications (The Body VR, Sharecare You VR, and Wraith VR), which were chosen to represent varying levels of clinical complexity. Semistructured interviews were used to explore their perceptions. Data were analyzed using reflexive thematic analysis in accordance with the framework of Braun and Clarke. Sample size adequacy was determined using information power.</p><p><strong>Results: </strong>Five overall themes were constructed from the data: (1) the experience of VR, where educators enjoyed the engagement but initially felt that VR was a \"gaming\" novelty; (2) teaching and learning preferences, where VR was considered a potential tool for authentic and individualized learning; (3) challenges of VR, where issues of visual overload, cybersickness, and logistical barriers were reported; (4) clinical competency and patient safety, where VR was valued as a safe space to manage errors; and (5) curriculum integration, where there was a preference for scaffolding the use of VR from foundational anatomy in the junior years to procedural simulation.</p><p><strong>Conclusions: </strong>Educators have a favorable view of VR as a powerful supplemental tool that can help boost student engagement and bridge the gap between theory and clinical practice. However, successful implementation involves more than purchasing hardware; it requires a strategic \"scaffolded integration\" approach that ensures VR applications align with specific curricular outcomes. It is the role of institutions to not only provide technical assistance but also pedagogical training and support for infrastructure to transform a technological gimmick into an ongoing educational resource.</p>","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"3 ","pages":"e52925"},"PeriodicalIF":1.8,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmented Reality-Assisted Training Tool for Mental Health Task-Sharers: Pilot Mixed Methods Usability Study.","authors":"Ling Li Vivian Ngiam, Lucas Piotr Wozniak, Catherine Dinh-Le, Ayanna Elon Seals, Victoria K Ngo, Jose Fernando Florez-Arango","doi":"10.2196/80711","DOIUrl":"10.2196/80711","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The growing global mental health (MH) burden, especially in underresourced communities, calls for innovative, scalable, and culturally responsive training approaches to expand care access and improve outcomes. Task-sharing has shown promise in addressing workforce shortages but is limited by training and supervision challenges. Traditional methods, such as role-playing and standardized patients, are resource-intensive and less scalable. Virtual simulations, including augmented reality (AR), present novel opportunities for immersive and interactive training. An AR-assisted training tool can enable culturally sensitive training while fostering empathy, communication skills, and confidence in handling nuanced MH scenarios. However, AR's usability and effectiveness for MH task-sharing training remain underexplored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to assess the usability of an AR-assisted MH task-sharing training tool that uses virtual patient (VP) simulation and evaluate its potential to enhance training. Additionally, we developed design recommendations for future related XR-assisted clinical training tools.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a formative, explorative sequential mixed-methods usability study. A convenience sample of 5 MH trainees or workers (ages 18-60 years; female: n=3, male: n=2; identifying as African American, Asian, and Hispanic) participated. Participants were recruited through a university-affiliated MH training program. The usability testing protocol included a semistructured prestudy interview, orientation to the AR headset (Magic Leap 2), a think-aloud user testing session, and a poststudy quantitative questionnaire and qualitative interview. Usability was assessed using a modified Post-Study System Usability Questionnaire (PSSUQ), which measures system usefulness, information quality, and interface quality. Data were analyzed using descriptive statistics and thematic analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The AR simulation was positively received by participants, demonstrating above-average usability. The overall mean PSSUQ score was 3.46 (SD 1.71), with subscale scores for system usefulness (mean 3.46, SD 1.77), information quality (mean 3.76, SD 1.73), and interface quality (mean 2.83, SD 1.59). Thematic analysis highlighted high realism fostered trainees' empathy toward the VP, while increasing immersion and interaction quality. Despite some hardware limitations and user discomfort that broke immersion, participants recognized the tool's potential and usefulness for training in various MH scenarios. Based on these findings, we proposed design recommendations across environmental context, training structure, VP behavioral realism (body language, voice, eye movement, and technical hardware considerations).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This pilot study is among the first to evaluate AR-based VP simulation for training lay MH task-sharers, filling the t","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"3 ","pages":"e80711"},"PeriodicalIF":1.8,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13297265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Virtual Reality-Based Mindfulness Interventions: Systematic Review and Meta-Analysis.","authors":"Sarah Alicia Barker, Andreas J Miles-Novelo, Albert Rizzo, Regina M Tuma","doi":"10.2196/90003","DOIUrl":"10.2196/90003","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Virtual reality-based mindfulness interventions (VRbMIs) increasingly populate studies as scalable tools for stress and emotion regulation. However, findings across psychological outcomes are heterogeneous, and methodological variation in intervention design, outcome measurement, and reporting practices limits cross-study comparability and cumulative synthesis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020-compliant systematic review and meta-analysis was conducted to evaluate the psychological effects of VRbMIs published between 2023 and 2025, examining methodological quality and outcome consistency across diverse study designs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A PRISMA 2020-compliant systematic search was conducted across PubMed, PsycINFO, Scopus, Semantic Scholar, and CORE from January 2023 to April 2025. Eligible studies included quantitative VRbMIs reporting psychological outcomes. We assessed risk of bias using the Mixed Methods Appraisal Tool and conducted random-effects meta-analyses using Hedges &lt;i&gt;g&lt;/i&gt; where data were sufficient.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;VRbMIs were associated with a large, statistically significant reduction in negative affect and a statistically significant increase in state mindfulness, while effects on depression, stress, and anxiety were small to moderate and nonsignificant. Trait mindfulness was described narratively rather than meta-analyzed and showed limited, inconsistent change across studies. For anxiety, we included 13 studies contributing 27 effect size estimates in the quantitative synthesis. A random-effects model indicated a small-to-moderate, nonsignificant pooled effect (&lt;i&gt;g&lt;/i&gt;=0.44, 95% CI -0.08 to 0.96; &lt;i&gt;t&lt;/i&gt; &lt;sub&gt;26&lt;/sub&gt;=1.74; &lt;i&gt;P&lt;/i&gt;=.09), with substantial between-study heterogeneity (&lt;i&gt;Q&lt;/i&gt; &lt;sub&gt;26&lt;/sub&gt;=381.60; &lt;i&gt;P&lt;/i&gt;&lt;.001; τ&lt;sup&gt;2&lt;/sup&gt;=0.96). Physiological outcomes were reported across a subset of studies and generally aligned with self-reported psychological findings; however, inconsistent measurement and incomplete reporting precluded quantitative synthesis. This analysis represents 35 studies with a combined sample of approximately 1550 participants (1 study did not report sample size).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;VRbMIs demonstrate statistically significant short-term benefits for negative affect and state mindfulness, with consistently positive but nonsignificant trends toward improvement in stress, anxiety, and depression. Effects on positive affect and trait mindfulness were small and less consistent. Physiological findings were promising but limited by inconsistent reporting. These results support the use of VRbMIs as accessible tools for emotional regulation across diverse populations, while highlighting the need for larger trials, standardized outcome reporting, and more rigorous control conditions to strengthen the evidentiary foundation of this rapidly evo","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"3 ","pages":"e90003"},"PeriodicalIF":1.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persuasive Gamified Virtual Reality Experience to Enhance Engagement and Focus in Young Adults With Mild Anxiety Symptoms: Randomized Pilot Experimental Study.","authors":"Mahlet Misrak Argaw, Nuru Jingili, Solomon Sunday Oyelere, Markus B T Nyström","doi":"10.2196/66713","DOIUrl":"10.2196/66713","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Anxiety-related symptoms are prevalent and can negatively affect concentration, motivation, and overall well-being. Traditional treatments such as cognitive behavioral therapy and medication work well for clinical anxiety disorders. However, individuals with anxiety often struggle with access, adherence, and staying engaged in treatment. Emerging technologies such as virtual reality (VR) and gamification offer new opportunities to enhance user engagement and motivational processes within digital mental health applications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study introduces &lt;i&gt;Cleanify&lt;/i&gt;, a gamified VR cleaning simulation designed using the Octalysis framework and the persuasive system design model. The objective was to evaluate whether gamification elements improve user engagement, focus, and satisfaction compared to a nongamified version among individuals experiencing anxiety symptoms. We hypothesized that the gamified version would outperform the nongamified version in enhancing user engagement, immersion, and overall user experience.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A pilot experimental study was conducted with 50 participants aged 18 to 39 years recruited from the general population in northern Sweden. Participants were randomly assigned to either a gamified or nongamified version of the &lt;i&gt;Cleanify&lt;/i&gt; VR application and completed a single 15-minute VR session using the Oculus Quest headset. Baseline anxiety symptoms were assessed using the Generalized Anxiety Disorder-7 scale for descriptive purposes only. Postintervention outcomes included focus and immersion measured using the Flow State Scale and user experience measured using the short version of the User Experience Questionnaire. Group differences were analyzed using 2-tailed independent-sample &lt;i&gt;t&lt;/i&gt; tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants using the gamified VR version demonstrated higher engagement and immersion than those using the nongamified version. The gamified group reached higher in-game levels overall, with a greater proportion of participants reaching level 3 (17/25, 68% vs 8/25, 32%), and reported higher recommendation scores (mean 4.20, SD 0.76 vs 3.36, SD 0.86). Significant group differences were observed for overall flow (&lt;i&gt;t&lt;/i&gt; &lt;sub&gt;48&lt;/sub&gt;=3.87; &lt;i&gt;P&lt;/i&gt;&lt;.001), fluency (&lt;i&gt;t&lt;/i&gt; &lt;sub&gt;48&lt;/sub&gt;=4.36; &lt;i&gt;P&lt;/i&gt;&lt;.001), and absorption (&lt;i&gt;t&lt;/i&gt; &lt;sub&gt;48&lt;/sub&gt;=2.80; &lt;i&gt;P&lt;/i&gt;=.008). User Experience Questionnaire results indicated higher pragmatic quality, hedonic quality, and overall user experience in the gamified condition.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Integrating gamification into a VR environment significantly enhanced user engagement, focus, and immersion in this pilot sample. These findings provide preliminary evidence that gamified VR design elements can positively influence user experience outcomes. Further research incorporating longitudinal designs and clinical outcome measures is needed to determine potent","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"3 ","pages":"e66713"},"PeriodicalIF":1.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Health-Related Symptoms and Behaviors in Children and Adolescents Diagnosed With Diabetes by Using a Virtual Reality-Gamified Self-Care Method: Randomized Controlled Trial.","authors":"Ruhollah Solat, Reza Pourhosein, Hadi Bahrami Ehsan, Ata Pourabbasi, Amin Hashemi, Javad Hatami","doi":"10.2196/81402","DOIUrl":"10.2196/81402","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Self-care plays an important role in improving health symptoms in patients diagnosed with chronic illnesses such as diabetes. Gamification is among the most effective methods for enhancing health monitoring by applying principles of behavioral economics and motivation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to develop an innovative self-care system using a virtual reality (VR)-gamified intervention and to evaluate its effects on patients diagnosed with diabetes metabolic symptoms and health-related behaviors compared to other standard interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study was a randomized controlled trial with a parallel-group design, conducted between December 2024 and February 2025. A total number of 78 patients diagnosed with diabetes were recruited from The Children's Medical Center clinic in a closed, offline setting. Briefing, tutorials, and interventions were partly face-to-face. Eligible participants (n=68) were randomly assigned to the 4 groups using stratified block randomization based on age and sex, with allocation concealment ensured through a sequentially numbered process. Each group received a different type of self-care intervention for 6 weeks, which was health care provider-assisted. One group received the VR gamified intervention, while the other 3 groups received comparator interventions, including the MySugr (mySugr GmbH) monitoring app, traditional counseling, and medication only, respectively. The primary outcomes were fasting blood sugar and health-related behaviors, including physical activity and food intake, while secondary outcomes were long-term metabolic indicators, including hemoglobin A&lt;sub&gt;1c&lt;/sub&gt; (HbA&lt;sub&gt;1c&lt;/sub&gt;) and BMI. All outcomes were measured by self-assessed questionnaires. No blinding was implemented for participants or care providers. However, data analysis was conducted using anonymized group labels. Eight participants were lost to follow-up. Minor missing daily entries were handled by weekly data aggregation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Data from 60 participants were included in the final analysis (VR-gamified group n=16, application group n=14, counseling group n=15, and control group n=15). Linear mixed model showed significant time×group interaction effects for fasting blood sugar (&lt;i&gt;F&lt;/i&gt; &lt;sub&gt;15,280&lt;/sub&gt;=2.046; &lt;i&gt;P&lt;/i&gt;=.01; partial η²=.099), physical activity (&lt;i&gt;F&lt;/i&gt; &lt;sub&gt;15,280.61&lt;/sub&gt;=2.544; &lt;i&gt;P&lt;/i&gt;=.001; partial η²=.120), and food intake (&lt;i&gt;F&lt;/i&gt; &lt;sub&gt;15,336&lt;/sub&gt; &lt;i&gt;=2&lt;/i&gt;.794; &lt;i&gt;P&lt;/i&gt;&lt;.001; partial η&lt;sup&gt;2&lt;/sup&gt;=.111), indicating greater improvement over time in the VR gamification group compared with the other parallel groups. No statistically significant differences were observed for BMI or glycated hemoglobin. No serious adverse events related to the VR intervention were reported.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;VR gamified self-care interventions may potentially contribute to better management of diabetes-","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"3 ","pages":"e81402"},"PeriodicalIF":1.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13252703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148230487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Virtual Reality and Mixed Reality Mindfulness Breathing Exercise for Emotional Well-Being and Cognitive Functions in University Students: Within-Subjects Experimental Design Study.","authors":"Zoey K Y Eun, Charmaine Jiali Koh, Hwajin Yang, Adalia Y H Goh, Meilan Hu, K T A Sandeeshwara Kasturiratna, Andree Hartanto","doi":"10.2196/84239","DOIUrl":"10.2196/84239","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Mindfulness has been shown to enhance emotional well-being and cognitive performance, yet much of this evidence stems from interventions requiring prolonged practice, making them time-consuming and less accessible. Recent studies suggest that brief mindfulness sessions may also yield positive outcomes, but the effectiveness of such interventions in virtual reality (VR) and mixed reality (MR) remains underexplored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study investigates the effects of brief mindfulness breathing exercises delivered through VR and MR on attentional and emotional restoration and self-control capacity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Using a within-subjects experimental design, 102 undergraduate participants (n=83, 81.4% female; mean age 20.87, SD 1.89 ) completed a brief (approximately 15 min) VR and MR mindfulness breathing intervention delivered via a head-mounted display and a duration-matched mind-wandering audio control condition. Participants were undergraduates recruited via convenience sampling from psychology courses in a local university in Singapore. These conditions were separated by a 1-week washout period. Emotional well-being and self-control capacity were measured at baseline and post treatment, using self-report measures, whereas working memory capacity was measured at both time points, using operation span at baseline and rotation span post treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Repeated-measures ANOVAs (α=.05) indicated that VR and MR mindfulness breathing conditions significantly enhanced positive affect (&lt;i&gt;P&lt;/i&gt;&lt;.001, &lt;i&gt;η&lt;sub&gt;p&lt;/sub&gt;&lt;/i&gt; ²=0.366), reduced negative affect (&lt;i&gt;P&lt;/i&gt;&lt;.001, &lt;i&gt;η&lt;sub&gt;p&lt;/sub&gt;&lt;/i&gt; ²=0.279), and improved self-control capacity (&lt;i&gt;P&lt;/i&gt;&lt;.001, &lt;i&gt;η&lt;sub&gt;p&lt;/sub&gt;&lt;/i&gt; ²=0.219), compared with the mind-wandering control condition. In contrast, no significant differences were observed for working memory, and Bayesian analyses provided moderate evidence in support of the null hypothesis for both the main effect of condition and the time×condition interaction (BF&lt;sub&gt;01&lt;/sub&gt;=7.42 and BF&lt;sub&gt;01&lt;/sub&gt;=5.55, respectively). Participants reported significantly greater absorption in the VR and MR conditions than in the control condition (Cohen's &lt;i&gt;d&lt;/i&gt;=-1.61, 95% CI -1.91 to -1.32).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;These findings suggest that a brief VR and MR mindfulness breathing exercise improves emotional well-being and self-control capacity relative to a mind-wandering control but does not yield short-term benefits for working memory. In contrast to existing studies that typically emphasize stress reduction or rely on multisession digital interventions, this study highlights that a single brief VR or MR session can enhance key emotional and self-regulatory outcomes. As such, these results underscore the potential of VR and MR mindfulness interventions as scalable and accessible tools for promoting mental well-being, while also pointing to the need for f","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"3 ","pages":"e84239"},"PeriodicalIF":1.8,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metaverse-Based Psychiatric Consultation for Youths With Mental Health Conditions: Qualitative Descriptive Feasibility Study.","authors":"Mio Ishii, Junichi Fujita, Nao Toyohara, Keiko Ide, Tomoko Moroga, Mizuho Takayama, Takeshi Asami, Tomoyuki Miyazaki","doi":"10.2196/83688","DOIUrl":"10.2196/83688","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Youth mental health is a global public health priority, with rising rates of anxiety and depression, particularly after the COVID-19 pandemic. Despite the early onset and substantial burden of mental disorders in this age group, young people are less likely than adults to seek professional help and face barriers such as workforce shortages, stigma, and low mental health literacy. Although efforts such as outreach initiatives and school-based programs have been implemented, innovative and scalable solutions remain limited. Digital technologies, including the metaverse, may offer flexible and stigma-reducing approaches to mental health care; however, evidence regarding their real-world feasibility and acceptability is scarce.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study investigated the feasibility and user experience of metaverse-based psychiatric consultations for young people with mental health conditions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a qualitative descriptive feasibility study at a single academic institution in Yokohama, Japan, between July and November 2023. A total of 26 participants aged 16 to 25 years (mean age 19.9, SD 2.4; 15 male, 7 female, 3 nonbinary, 1 no response) who self-identified as having mental health concerns were recruited from local psychiatric clinics, schools, universities, and social media. Reported concerns included anxiety, depressive symptoms, and autism spectrum disorder traits. Participants completed a 30- to 40-minute one-on-one metaverse-based consultation with a psychiatrist using avatars in a virtual reality environment, followed by semistructured interviews exploring feasibility, usability, and user perceptions. Data were analyzed using thematic analysis, and data collection continued until no substantially new themes emerged. Reporting followed the APA Journal Article Reporting Standards for qualitative research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All participants completed the study without any adverse psychological events. Five participants experienced minor, transient physical discomfort (eg, headaches and virtual reality-related sickness), which resolved without medical intervention. Thematic analysis identified 3 primary domains: perceived psychological safety through avatar-mediated interaction, enhanced spatial presence facilitating rapport, and increased autonomy within the virtual environment. Metaverse consultations were perceived as particularly beneficial for individuals experiencing interpersonal anxiety, sensory sensitivities (including autism spectrum disorder traits), difficulty leaving home due to psychiatric conditions, psychological resistance to traditional psychiatric settings, or discomfort with physical self-presentation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This qualitative descriptive feasibility study provides preliminary evidence that metaverse-based psychiatric consultations are a feasible and acceptable approach for supporting young peopl","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"3 ","pages":"e83688"},"PeriodicalIF":1.8,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immersive Virtual Reality-Supported Cognitive-Behavioral Therapy for Patients With Mild to Borderline Intellectual Disabilities and Substance Use Disorders: Two Exploratory Studies.","authors":"Samantha Murray, Simon Langener, Hanneke Kip, Randy Klaassen, Saskia Marion Kelders, Dirk Heylen, Joanne VanDerNagel","doi":"10.2196/82601","DOIUrl":"10.2196/82601","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Substance use disorders (SUDs) are prevalent and characterized by high relapse rates. Individuals with mild to borderline intellectual disability (MBID) are more likely to develop SUDs and face barriers within treatment related to difficulties they experience with abstract thinking, verbal skills, and generalizing learned strategies to real-world contexts. Therefore, experiential, context-rich approaches are needed that reduce reliance on retrospective verbal reflection, support in-context identification of triggers, and allow the rehearsal of coping responses. Immersive virtual reality (IVR) may provide realistic, safe environments where patients with SUD and MBID can practice cognitive and behavioral skills with visual and practice-oriented materials.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to generate design input for the development and clinical integration of IVR-supported therapy for individuals with MBID and SUD. Specifically, Study 1 explored alcohol-related triggers in patients with alcohol use disorder, whereas Study 2 examined the feasibility and acceptability of practicing nicotine-related coping strategies in patients with nicotine dependence (ND).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Two explorative studies were conducted at an inpatient clinic for patients with MBID and SUD in the Netherlands. Study 1 included 10 adults with alcohol use disorder and MBID who participated in interviews to determine relevant risk situations, triggers, and therapeutic goals for IVR-cognitive behavioral therapy (CBT). Study 2 included 10 adults with MBID and nicotine dependence who practiced coping strategies within an existing IVR featuring craving-inducing and craving-reduction scenarios. A multiple-method approach was used to gather input for IVR-CBT development and to explore feasibility and acceptability (user evaluation interviews, the Questionnaire of Smoking Urges, and Visual Analog Scale ratings).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In study 1, we identified high-risk situations, including at-home routines (eg, sitting on the couch watching football), supermarkets (eg, confrontation with alcohol and advertisements), social gatherings (eg, invitations and peer pressure), and being outside or traveling (eg, public transport or passing alcohol-related places). Triggers clustered into multisensory cues (eg, seeing or smelling alcohol), social influences (peer pressure and interpersonal conflict), affective states (tension, distress, boredom, or euphoria), and personal habits (eg, rewarding oneself or associations with money). Participants expressed interest in using IVR to identify triggers, discuss affective states, and train refusal skills. In study 2, IVR elicited nicotine craving, which increased during cue exposure and decreased during tutorial and coping phases. The coping elements embedded in IVR included relaxation (eg, mindfulness or breathing exercises), distraction (eg, virtual pets and interactive game","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"3 ","pages":"e82601"},"PeriodicalIF":1.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Factors of Augmented Reality-Based Clinical Task Performance Among Novice Users: Cross-Sectional Quantitative Study.","authors":"Amogh J Vellore, Shovan Bhatia, Michael R Kann, Nicolás M Kass, Regan M Shanahan, Jacquelyn Jardini, Jayne Miner, Sohail R Daulat, Griffin Hurt, Rishi Basdeo, Nicole Don, Jacob T Biehl, Edward G Andrews","doi":"10.2196/81236","DOIUrl":"10.2196/81236","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Augmented reality (AR) can provide risk-free training for medical trainees, yet little is known about which learner characteristics facilitate adoption or inform training design.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to identify which learner characteristics predict AR performance in novices. We hypothesized that higher visuospatial ability and greater video game experience would be associated with faster completion times and fewer errors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this cross-sectional study, 21 undergraduate, graduate, and medical students (median age 22, IQR 21-24 years) without previous AR experience were recruited between June and December 2024. Participants completed a technology experience survey, the mental rotation task (MRT) for visuospatial ability, a standardized 7-task AR protocol mimicking clinical use on the Microsoft HoloLens 2 (hologram manipulation, orbit tracing, anatomical plane visualization, and hologram-to-object registration), and the National Aeronautics and Space Administration Task Load Index for cognitive load assessment. Outcome measures included completion time, slips (unintentional errors), and tracing quality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All analyses used a significance of α=.05. MRT scores did not predict baseline performance time (Pearson &lt;i&gt;r&lt;/i&gt;=0.15, 95% CI -0.32 to 0.55; &lt;i&gt;P&lt;/i&gt;=.54) or error rates (&lt;i&gt;r&lt;/i&gt;=0.18, 95% CI -0.27 to 0.57; &lt;i&gt;P&lt;/i&gt;=.43). Participants with extensive video game experience (&gt;5 hours/week) made fewer slips (unpaired &lt;i&gt;t&lt;/i&gt; test; mean difference -2.62 slips, 95% CI -5.19 to -0.04; &lt;i&gt;P&lt;/i&gt;=.047), without faster completion times (Mann-Whitney test; median difference -22 seconds, 95% CI -7.00 to 57.00; &lt;i&gt;P&lt;/i&gt;=.24). Video game experience did not predict baseline performance time (Pearson &lt;i&gt;r&lt;/i&gt;=-0.35, 95% CI -0.69 to 0.13; &lt;i&gt;P&lt;/i&gt;=.14). Significant learning effects emerged in unadjusted analyses: completion times decreased on attempts 2 and 3 compared with attempt 1 (mixed-effects analysis: mean difference 28.75 seconds, 95% CI 12.98-44.52; &lt;i&gt;P&lt;/i&gt;&lt;.001; 28.00 seconds, 95% CI 10.75-45.25; &lt;i&gt;P&lt;/i&gt;=.002, respectively) with fewer slips (Friedman test: &lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; &lt;sub&gt;2&lt;/sub&gt;=17.8; &lt;i&gt;P&lt;/i&gt;&lt;.001; Dunn post hoc: &lt;i&gt;P&lt;/i&gt;=.008 and &lt;i&gt;P&lt;/i&gt;&lt;.001, respectively). Orbit tracing (Wilcoxon test: median difference -5 seconds; &lt;i&gt;P&lt;/i&gt;=.004) and virtual landmark placement times improved (Friedman test: &lt;i&gt;χ&lt;/i&gt; &lt;sup&gt;2&lt;/sup&gt; &lt;sub&gt;3&lt;/sub&gt;=14.6; &lt;i&gt;P&lt;/i&gt;=.002; Dunn post hoc; &lt;i&gt;P&lt;/i&gt;=.009 and &lt;i&gt;P&lt;/i&gt;=.02), but physical landmark placement did not. Covariate-adjusted models revealed no significant trial-by-covariate interactions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Visuospatial ability does not predict clinically relevant AR performance, while extensive video game experience was associated with fewer errors. Despite previous studies emphasizing inherent learner characteristics in laparoscopy and endoscopy, covariate-adjusted models show","PeriodicalId":521138,"journal":{"name":"JMIR XR and spatial computing","volume":"3 ","pages":"e81236"},"PeriodicalIF":1.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}