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Co-designing a virtual reality based mindfulness application to address diabetes distress using Artificial Intelligence-informed Experience-Based Co-Design (AI-EBCD): a feasibility study

Shraboni Ghosal, Mengying Zhang, Emma Stanmore, Jackie Sturt, Angeliki Bogosian, David Woodcock, Nicola Milne, Womba Mubita, Glenn Robert, Siobhán O’Connor

medRxiv March 11, 2026 preprint DOI: 10.64898/2026.03.10.26348062 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Qualitative co-design study
Population Adults with type 2 diabetes and mindfulness practitioners
Topics Meditation
Key findings Participants largely preferred a simple design and layout for practising mindfulness in a virtual environment, with customisable options and culturally appropriate interactive features. The authors report that the workshops identified new design features, functionality, and content that informed software design documentation for a prototype VR mindfulness app for people experiencing diabetes distress.

Abstract

Abstract More than one third of adults with diabetes can experience diabetes distress due to the demands of daily self-care. As a cognitive therapy, mindfulness can alleviate diabetes distress but face-to-face programmes can be difficult to access and pay for, and apps lack personalisation and feedback. Virtual reality (VR) may support mindfulness practice, but no VR app tailored to people experiencing diabetes distress exists. We interviewed mindfulness practitioners and conducted co-design workshops (using focus groups, questionnaires, artistic methods, generative artificial intelligence tools and prioritization techniques) with adults with type 2 diabetes to gather perspectives on designing a VR mindfulness app. We analysed data using descriptive statistics and the framework approach. Most participants preferred a simple design and layout to use the virtual environment to practice mindfulness, with customisable design options and interactive features that were culturally appropriate. We identified new design features, functionality, and content that informed a software design specific documentation to build a prototype VR mindfulness app for people experiencing diabetes distress. Further research should include more diverse populations to elicit detailed specifications for software design and include safety features to minimise risk when using VR technologies to practice mindfulness.

Comparable studies

Other qualitative studies on meditation, most cited first.

Study Year Design Participants
The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists Western Buddhist meditation practitioners and experts in Theravāda, Zen, and Tibetan... 2017 Qualitative study with mixed-methods
The Effects of Mindfulness-based Stress Reduction on Nurse Stress and Burnout Nurses in a hospital system 2004 Implementation study with mixed methods
An exploratory mixed methods study of the acceptability and effectiveness of mindfulness -based cognitive therapy for patients with active depression and anxiety in primary care Primary care patients with recurrent depression or recurrent depression and anxiety 2006 Exploratory mixed methods study n = 13
A qualitative study of mindfulness‐based cognitive therapy for depression Participants in mindfulness-based cognitive therapy in a mental-health context 2001 Qualitative study n = 7
Effortless awareness: using real time neurofeedback to investigate correlates of posterior cingulate cortex activity in meditators' self-report Meditators 2013 Qualitative study using grounded theory methodology

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