Background: Mental health conditions pose a major challenge to health care providers and society at large. The World Health Organization predicts that by 2030, mental health conditions will be the leading cause of disease burden worldwide. The current need for mental health care is overwhelming. In New Zealand, 1 in 6 adults has been diagnosed with common mental disorders, such as depression and anxiety disorders, according to a national survey. Cognitive behavioral therapy (CBT) has been shown to effectively help patients overcome a wide variety of mental health conditions. Virtual reality exposure therapy (VRET) might be one of the most exciting technologies emerging in the clinical setting for the treatment of anxiety and depression. Objective: This study aims to investigate the virtual reality (VR) technologies currently being used to help support the treatment of depression and anxiety. We also aim to investigate whether and how CBT is included as part of VRET and look at the VR technologies and interventions that have been used in recent studies on depression and anxiety. Methods: We performed a scoping review. To identify significant studies, we decided to use already aggregated sources from the Google Scholar database. Overall, the goal of our search strategy was to limit the number of initial results related to VR in mental health to only a relevant minimum. Results: Using our defined keywords, Google Scholar identified >17,300 articles. After applying all the inclusion and exclusion criteria, we identified a total of 369 articles for further processing. After manual evaluation, 34 articles were shortlisted; of the 34 articles, 9 (26%) reported the use of CBT with VR. All of the articles were published between 2017 and 2021. Out of the 9 studies, CBT was conducted within a VR environment in 5 (56%) studies, whereas in the remaining 4 (44%) studies, CBT was used as an addition to VRET. All 9 studies reported the use of CBT either in vivo or in a virtual environment to be effective in supporting the treatment of anxiety or depression. Conclusions: Most studies demonstrated the use of VR to be effective for supporting the treatment of anxiety or depression in a range of settings and recommended its potential as a tool for use in a clinical environment. Even though standalone headsets are much easier to work with and more suitable for home use, the shift from tethered VR headsets to standalone headsets in the mental health environment was not observed. All studies that looked at the use of CBT either in vivo or in a virtual environment found it to be effective in supporting the treatment of anxiety or depression.

The growing attention towards immersive technologies such as augmented reality (AR), virtual reality (VR), mixed reality (MR), extended reality (XR), and the metaverse are revolutionizing cultural heritage education and tourism. Such technologies offer immersive and interactive experiences that transform the user’s exploration of museums, cultural heritage sites, educational content, and historical landmarks. This article presents a structured framework that addresses the advancement and application of these technologies in cultural heritage education to improve user experience, learning, emotional connection, and motivation. To further explore recent trends, issues, and opportunities, the article offers a comprehensive overview of the impact of state-of-the-art immersive technology on user experience within heritage education environments . The study also outlined standard questionnaires and effective methodologies for user experience evaluations. Furthermore, the article addresses the influence of standards and guidelines recommended by standardized bodies and organizations on XR and metaverse applications. It discussed how these standards and recommendations can play a role in setting protocols that shape the development of immersive heritage education environments. Finally, we introduce an architecture model for XR and metaverse applications that can assess developers, researchers, and stakeholders to enable immersive and interactive educational experiences, bridging geographical and physical barriers. This research is intended to help academic and industry stakeholders understand the integration of digital heritage preservation tools and user experience standards critical to advancing educational engagement in cultural heritage.

It is well documented that exergames are enjoyable to play and can significantly improve older adults’ health and well-being. However, there is limited research on exploring factors affecting these users’ acceptance of such games, especially in virtual reality (VR), a relatively newer technology. This study proposes an extended version of the Technology Acceptance Model (TAM). We use variables from TAM related to older Chinese adults and specific to VR exergames to explore and confirm critical factors that could influence these users’ acceptance of such games in VR. We tested the proposed model with 51 older Chinese adults (aged 65 and above) after playing three commercial VR exergames (Beat Saber, FitXR, Dance Central). Results show that these older adults who are younger and retired and have a higher education, better financial means, and a good health condition have a more positive view of VR exergames. In addition, Perceived Usefulness, Perceived Ease of Use, and Perceived Enjoyment positively affect the intention to play VR exergames. Self-Satisfaction has a positive impact on Perceived Ease of Use and Perceived Usefulness. However, unlike previous studies, our results suggest that Facilitating Conditions have a negative effect on Perceived Ease of Use. Finally, we discuss the theoretical and practical implications of our results.

Gamification is the application of game mechanisms in non-gaming environments with the objective of enhancing user experience. In this paper, we investigate the effectiveness of gamification in educational context, i.e. teaching numeracy at a primary school level. We study the appealing characteristics of engaging computer games from children’s point of view, and investigate whether embedding the proposed characteristics into an educational tool enhances children’s learning. The main characteristics we identify are levels of difficulties, feedback from the current level, and graphical presentation. They were then embedded into a Java-based open source programme based on “Who wants to be a millionaire” TV show, with the aim of teaching children numeracy (level 5 New Zealand curriculum). Two versions were created: feature enriched game (FEG) with all the features enabled and feature devoid game (FDG) with no extra features. We present the results of an evaluation study done with primary school children (n = 120) over a period of two weeks. The effectiveness of the educational tool was measured using a pre-test and a post-test, as well as other indicators such as the frequency and duration of interaction. Results show that the FEG version was more effective in enhancing children’s learning and they found it more engaging.

Background: In recent years, there has been an increase in the number of students with depression, anxiety, and perceived stress. A solution that has been increasingly used for improving health and well-being is exergaming. The effects and acceptability of exergames have been studied widely but mostly with older adults. The feasibility and usability of exergames among university students, especially those of immersive virtual reality (iVR) exergames, remain unexplored. Objective: This study aimed to explore the feasibility of a 6-week iVR exergame–based intervention in reducing anxiety, depression, and perceived stress among university students and to examine the usability and acceptability of such games. Methods: A total of 31 university students were recruited to participate in a 6-week study in which they needed to play a boxing-style iVR exergame called FitXR (FitXR Limited) twice per week (30 minutes per session). Their anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory-II), and perceived stress (Perceived Stress Scale) levels were measured before and after intervention. Results: A total of 15 participants completed the 6-week study. Our results suggested that participants’ mean depression scores decreased significantly from 8.33 (SD 5.98) to 5.40 (SD 5.14) after the intervention (P=.01). In addition, most participants (14/15, 93%) believed that the iVR exergame has good usability. Furthermore, most participants (14/15, 93%) were satisfied with the iVR gameplay experience and would play the iVR exergame again in the future. Of the 15 participants, 11 (73%) would recommend the iVR exergame to their friends. Conclusions: The results gained from this study show that the iVR exergame has good usability, is highly acceptable, and has the potential to reduce depression levels among university students.

Background: Depression and anxiety are common and debilitating mental disorders with severe negative repercussions at both individual and societal levels. Although virtual reality (VR) has emerged as a safe and effective tool for the treatment of anxiety disorders, studies of the therapeutic application of VR to treat depression are more limited. Objective: The purpose of this study was to test whether a novel type of individualized VR (iVR) can be used to improve self-compassion and decrease depressive symptoms and to evaluate the usability and acceptability of this approach, as rated by participants. The iVR system was designed and developed based on the feedback obtained from a previous study, with improved appearance and feel of the avatar and enhanced graphical quality. Methods: A total of 36 young adult participants were recruited from a university community social media site. Participants were aware that the study was investigating a treatment for depression but were not recruited based on depression diagnosis. Participants were asked to complete 2 iVR sessions, spaced 2 weeks apart. At baseline and upon completion of each iVR session, participants were asked to complete validated measures of self-compassion and depression. Upon completion of both iVR sessions, additional measures were administered to assess participants’ perceptions about the perceived usability and system acceptability of the iVR approach. Results: Self-compassion was assessed at the beginning of session 1 (preintervention baseline) and at the end of session 1 (postintervention assessment). Owing to COVID-19 constraints, 36% (13/36) of the participants were unable to complete the follow-up iVR session. Self-compassion was assessed again for the remaining 64% (23/36) of the participants at the end of session 2 (postintervention assessment). Within-group analyses revealed that self-compassion was significantly increased at the end of both session 1 (P=.01) and session 2 (P=.03) relative to baseline. There was also a nonsignificant trend for depressive symptoms to be low at the end of session 2 relative to baseline. Both quantitative and qualitative participant data supported the iVR approach as being acceptable and usable. Conclusions: Although these data must be treated as preliminary owing to the small sample size and potential selection bias, the data provide encouraging initial evidence that iVR might be a useful tool to enhance self-compassion and reduce depressive symptoms, highlighting the need for randomized controlled trials in the future.