Identifying behaviour change techniques, technical features and implementation options for a virtual reality...

In this study, individuals working in healthcare or virtual reality (VR) were invited to contribute towards developing a VR intervention to encourage adults to quit smoking, by building upon user-generated ideas from a previous co-design study with adult smokers.

Three online focus groups were with healthcare workers (n = 26), and one was with VR experts (n = 4). Transcripts were analysed using thematic analysis.

In the first theme, experts agreed that previous co-design content showing the outcomes of quitting or not quitting could be helpful. Suggested behaviour change techniques included 'prompt comparative imagining of future outcomes', and 'imaginary reward'. Experts suggested a format where users could customise an avatar and select what content they see, creating a tailored narrative. There was a subtheme about the potential unsuitability of co-design content based on extreme fear appeals, which experts thought could trigger fatalism or defensiveness. The second theme covers considerations to make VR safe and inclusive. For example, making the experience seated for those with limited mobility, hygiene protocols and a screening process to exclude smokers at risk of harm (individuals with frailty, photosensitive epilepsy or a serious mental health condition). The last theme outlines the benefits and potential barriers of implementing VR with the 'ask, advise, act' model for smoking cessation used in healthcare contexts.

Findings suggest that VR has the potential to deliver embodied, interactive and customisable smoking cessation messages, rooted in behavioural theory. The suggestions will inform the development of a prototype which will subsequently be evaluated.