Elsevier

Journal of Pediatric Health Care

Volume 35, Issue 5, September–October 2021, Pages 552-558
Journal of Pediatric Health Care

Research Methods
Pivoting to “No Contact”: A Protocol for Conducting a Virtual Reality Relaxation Home Study for Teens Amidst the COVID-19 Pandemic

https://doi.org/10.1016/j.pedhc.2021.01.002Get rights and content

Prior to the COVID-19 pandemic, our team planned to pilot a self-administered virtual reality environment for stress reduction. The purpose of this manuscript is to describe our pivot to a “no contact” protocol, including participant feedback and lessons learned. Our protocol included virtual reality study kit sanitization, delivery, and return; remote screening, consent, enrollment, and data collection; and virtual study visits. All study participants found the protocol to be acceptable. Lessons learned include strategies for institutional review board approval and improved orientation to the study technology. Despite a global pandemic, our “no contact” protocol was feasible and acceptable.

Section snippets

INTRODUCTION

Adolescents in the United States are experiencing unprecedented levels of stress compared with previous generations (American Psychological Association, 2018). Sources of adolescent stress include everyday stressors, such as academic pressures, interpersonal peer and family relationships, and extracurricular activities (Pew Research Center, 2019). National trends in threats to safety are other significant sources of adolescent stress, including assault, gun violence, racial discrimination, and

NATURE TREKS VR

Nature Treks VR (Greener Games, Telford, UK) is a commercially available VR application consisting of a suite of color-themed natural environments. Available environments within Nature Treks VR include White Winter (a snowy landscape), Red Fall, Orange Sunset, Green Meadows, Blue Ocean, and Red Savanna. Unlike typical VR games, there is no objective, competition, or time-bound activity. Rather, Nature Treks VR aims to promote relaxation through an immersive experience of soothing audio while

IN-PERSON PROTOCOL FOR VR HOME STUDY

The in-person protocol for the present study was adapted from our protocol for a recent VR home study for older teens. The protocol included two in-person visits; the first visit comprised consent, baseline surveys, and onboarding, whereas the second visit included postintervention surveys and an exit interview. During the initial visit, participants were provided the VR Study Kit for use at home, which consisted of an Oculus Go (Oculus, Menlo Park, CA) VR headset preloaded with Nature Treks

ADAPTATION TO “NO CONTACT” PROTOCOL

The COVID-19 pandemic necessitated a swift pivot to a “no contact” protocol for our 2020 VR Home Study. Whereas we previously planned in-person sessions to deliver study kits and orient subjects to the use of the VR headset and Nature Treks VR environments, we swiftly developed a remote “no contact” protocol (Table). This protocol included VR Study Kit sanitization, delivery, and return; remote screening, consent, enrollment, and data collection; and virtual study visits.

Screening and Enrollment

REDCap, a secure web-based data capture and management system, was used for participant screening, consent, and data collection (Harris et al., 2009). Although we retained our original recruitment strategies, such as posting on social media channels and listservs, we adopted an entirely remote screening, consent, and data collection strategy. All recruitment materials contained a web link and quick response (QR) code to the REDCap study eligibility screening; interested participants were asked

VIRTUAL STUDY VISITS

As an alternative to the planned in-person study visits, we arranged for videoconference visits at the beginning, midway, and end of the study via Zoom (Zoom Video Communications, Inc., San Jose, CA). We prearranged the Zoom meetings to automatically record and transcribe each session, which included the Zoom recording disclaimer advising the participant that the session would be recorded. Following the delivery of the VR Study Kits, one research team member met with every participant for a

RESULTS

Twenty-one individuals completed the online eligibility screening. Seven were excluded because of being over 19 years of age. Eleven out of 14 eligible individuals enrolled in the study, and all completed the study and final data collection session. Participants were aged 18.8 ± 0.4 years, and six were male. Six participants identified as Asian, two were more than one race, two preferred not to identify their race, and one identified as White. Three participants described their ethnicity as

LESSONS LEARNED

Although study participants indicated overall acceptability of our protocol, there are several lessons learned that warrant discussion, including IRB approval, confusion over “no contact,” and improved orientation to the study technology. Securing IRB approval of the “no contact” protocol was especially onerous, in large part because of the uncertainty regarding COVID-19 transmission and relatively sparse literature on VR equipment cleaning guidance. Given the absence of published studies

Jennifer Sonney, Assistant Professor, Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA.

References (21)

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Jennifer Sonney, Assistant Professor, Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, WA.

Elin A. Björling, Senior Research Scientist, Human Centered Design and Engineering, University of Washington, Seattle, WA.

Sofia Rodriguez, Graduate Student, Human Centered Design and Engineering, University of Washington, Seattle, WA.

Nora Carr, Graduate Student, Human Centered Design and Engineering, University of Washington, Seattle, WA.

This project was supported by the University of Washington ALACRITY Center (NIH/NIMH P50MN115h37, PI Arean). Jennifer Sonney also receives funding support from the NIH/NCATS KL2TR002317 and HRSA/HHS T72MC00007 University of Washington PPC (PI, Redding). Study data were collected and managed using REDCap electronic data capture tools hosted at the Institute of Translational Health Sciences, supported by NIH/NCATS UL1TR002319. The study sponsors did not play any role in the study design, conduct or analysis and interpretation of data, or writing of this report. Information or content and conclusions are those of the authors and should not be construed as the official position or policy of the study sponsors nor should any endorsements be inferred.

All authors have seen and approved this manuscript. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflicts of interest: None to report.

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