A Mobile Virtual Reality-Based Intervention for Stress Reduction Among Young Adults: Pilot Randomized Controlled Trial.

Background: Young adults experience disproportionately high levels of stress, creating significant health challenges. This demographic often underuses traditional stress management methods due to perceived ineffectiveness, inconvenience, or stigma. Given these challenges, mobile virtual reality (VR) offers a novel, engaging, and accessible alternative stress management tool that may be more appealing to young adults.

Objective: This pilot randomized controlled trial (RCT) evaluated the preliminary effects of MindCo Relief (MR), a mobile VR-based stress management app, accompanied by online coaching, on perceived stress, resilience, anxiety, depressive symptoms, and quality of life (QoL).

Methods: Young adults aged 18 to 29 years were recruited to participate in the study. A total of 70 participants with moderate-to-high stress levels at baseline were randomized to an intervention (n=34) group and a control (n=36) group. Moderate-to-high stress was defined as a sum score of 14 or more on the Perceived Stress Scale-10 (PSS-10). The intervention group completed an 8-week VR mindfulness program with access to in-person coaching, while the control group received no intervention. The primary outcome was self-reported perceived stress (PSS-10). Secondary measures included resilience (measured by the Connor-Davidson Resilience Scale-2), anxiety (measured by the Generalized Anxiety Disorder-7 scale), depressive symptoms (measured by the Patient Health Questionnaire-9), and QoL (measured by the General Well-Being Schedule). Primary analyses used linear mixed-effects models to assess the intervention effect over the 8-week study period. Secondary analyses examined whether the percentage of program modules completed and the number of coaching sessions attended were associated with changes in the primary and secondary outcomes.

Results: The mean age of the participants was 23 (SD 3.41) years, and they were predominantly female (n=52, 74%), students (n=46, 66%), and insured (n=63, 90%). No significant differences were observed between the intervention and control groups in terms of sex (P=.89), student status (P=.56), insurance status (P=.68), race and ethnicity (P=.18), or age (P=.32). Linear mixed-effects models showed a significant interaction between time and intervention, with the intervention group showing greater reductions in stress (β=-3.84, SE 1.37; P=.007), anxiety (β=-3.21, SE 0.97; P=.002), and depressive symptoms (β=-3.13, SE 1.13; P=.007) and a greater increase in QoL (β=9.99, SE 2.92; P=.001). No significant interaction was found for resilience (β=0.83, SE 0.43; P=.06). In the secondary analyses, neither the percentage of modules completed nor the number of coaching sessions attended was significantly associated with changes in the primary or secondary outcomes.

Conclusions: This study provided preliminary evidence that mobile VR can help reduce stress among young adults by providing immersive environments that promote relaxation and adaptive stress responses. The findings support further exploration of VR's role in mental health care. Future research should examine the efficacy and long-term effects of this mobile VR software using larger, more diverse samples. Strategies to sustain VR engagement are also warranted.

Trial Registration: ClinicalTrials.gov NCT06970652; https://clinicaltrials.gov/study/NCT06970652.