Leveraging Immersive Virtual Reality to Prevent Child Injuries in the Home: Proof-of-Concept Study.

Background: Injury is the leading cause of death among US children, with over 2700 deaths due to unintentional injuries among children aged <6 years in 2023. Many of these deaths occur in the home and involve addressable safety hazards. Evidence-based parenting programs (EBPPs), in which parents work with a provider to learn parenting skills, offer an infrastructure for disseminating home safety content. However, few programs have structured modules on home safety, with most home safety education coming from printed materials or websites. Immersive virtual reality (IVR) allows participants to engage in activities in a simulated, risk-free environment. IVR's technological affordances create a training environment that supports experiential learning and helps learners internalize and transfer knowledge more effectively to real-world situations. Objective: This study aimed to (1) design an IVR home safety program for parents of children aged <6 years in line with our conceptual model, (2) obtain feedback from parents and EBPP providers on the initial design, and (3) test an initial prototype of the program with parents. Methods: The prototype was developed using human-centered design principles. The team first identified key components for program content using existing research and theory. Qualitative data were then collected from EBPP provider interviews (n=5) and focus groups with parents (n=7) regarding implementation constraints, program content, barriers/facilitators for engagement, and feedback on the use of IVR. Thematic analysis was used to identify themes from the qualitative data. The initial prototype was then pilot tested with parents of children aged <6 years (n=5). Results: The IVR program addresses knowledge and skill enhancement in three key areas: (1) home safety hazard identification, (2) hazard removal/mitigation, and (3) parental supervision. Using surveillance data, we identified leading causes of unintentional injuries in the home environment among US children aged <6 years, including sleep-related deaths, firearm injuries, and drowning. Hazards and corresponding tasks in the IVR program were developed for these leading causes. Findings from interviews with providers indicate that they are open to the use of IVR in EBPPs and envision uses for both group and individual settings. They expressed concerns about the cost of incorporating IVR into their usual programs. Parents were interested in IVR, especially if presented in brief sessions. They also noted a desire for the virtual environment to look realistic and "lived in." Conclusions: Currently, home safety information is delivered in a didactic or pamphlet-driven format in most EBPPs, which is not ideal for behavior change. This IVR home safety program will provide unique benefits in training, including (1) real-world simulations, (2) hands-on learning, (3) a risk-free environment, and (4) IVR scenario-based assessment. This study provides support for the use of IVR in engaging parents in home safety education and presents considerations for future research.