A Novel Virtual Reality-Based Nature Meditation Program for Older Adults' Mental Health: Results from a Pilot Randomized Controlled Trial

Objectives: The rapid aging of the global population necessitates innovative interventions to address older adults' mental health. This pilot study evaluated the feasibility, acceptability, and preliminary efficacy of a 4-week, 8-session nature-mindfulness-compassion program using immersive virtual reality (Embodied-and-Embedded-Mindfulness-Compassion-Framework - Virtual-Reality (EEMCF-VR)) for older adults' mental health. Methods: Following a mixed-methods, two-arm, open-label RCT design, 24 older adults (M-age = 75.1, SD = 6.58) were randomly assigned to EEMCF-VR (n = 12) or a psychoeducational pamphlet control group (n = 12). Participants completed self-report assessments of stress, positive and negative emotions, coping self-efficacy, psychosocial well-being, mindfulness, and nature connectedness at baseline (T1), midpoint (T2), post-intervention (T3), and 4-week follow-up (T4). Additionally, the EEMCF-VR group completed program feedback (T3) and simulator sickness (T1-T3) questionnaires. Results: EEMCF-VR met feasibility benchmarks (recruitment targets achieved, attrition < 15%) and was well-tolerated (minimal simulator sickness). Participant feedback indicated high acceptability. The EEMCF-VR group reported significantly lower stress and negative emotions at T2 and T4 compared to controls. Qualitative analysis highlighted perceived benefits and components to retain (e.g. video content) or refine (e.g. headset weight). Conclusions: EEMCF-VR demonstrated feasibility and acceptability, with promising effects on stress and mood, warranting investigation in larger trials. Clinical ImplicationsEEMCF-VR shows potential as a scalable intervention to reduce older adults' emotional distress.