Applying the Information-Motivation-Behavioral Skills Model to a Virtual Reality-Assisted Cognitive Health Education Intervention to Promote Screening Uptake: Qualitative Study

Uptake of mild cognitive impairment (MCI) and dementia screening among community-dwelling older adults remains suboptimal globally and is shaped by limited dementia literacy, fear, stigma, and difficulties navigating services. Virtual reality (VR)-assisted education may enhance engagement, but older adults' experiences of such education and the contextual conditions shaping screening intentions require further understanding.

This study aims to explore community-dwelling older adults' understanding, concerns, and attitudes regarding MCI and screening after exposure to a community-based VR-assisted cognitive health education intervention and to examine their perceived information, motivation, and behavioral skills related to screening using the information-motivation-behavioral skills (IMB) model.

Twenty-two community-dwelling older adults were recruited from participating communities between August 23 and September 17, 2025, using purposive sampling with attention to variation in age and educational attainment, supplemented by snowball sampling. All participants completed a 40-minute VR-assisted cognitive health education session comprising a 10-minute immersive 360° video delivered through a Meta Quest 3 head-mounted display followed by 30 minutes of nurse-led face-to-face education. Four researchers coded the original Mandarin transcripts; themes and subthemes were derived inductively from the data and subsequently mapped to the IMB model.

Sixteen data-derived subthemes were subsequently mapped to the 3 domains of the IMB model. Information-related accounts encompassed misunderstanding and lack of knowledge about MCI, the relationship between MCI and dementia, knowledge acquisition and clarification, timing and psychological readiness, information overload, attention to peripheral details, and uncertain awareness of cognitive health status. Motivation-related accounts included fear and stigma associated with screening, perceived reduction in stigma and greater screening acceptability, reconciliation with aging, low self-prioritization, and a pessimistic outlook on treatment. Behavioral-skills accounts included low confidence in self-management, knowledge to action, community-based referral and navigation, and difficulty changing established habits. Across domains, participants' accounts suggested that greater understanding and screening acceptability did not necessarily translate into action when practical navigation and referral support were lacking.

Participants perceived VR-assisted cognitive health education as engaging and helpful for making MCI-related information more concrete, but their accounts also indicated that screening intentions may not translate into action without clear, trusted navigation and referral support. These findings describe participants' experiences and perceived barriers and facilitators rather than estimating intervention effectiveness.