The first intervention study of AI4Coping has also been finalized. The main objective of this randomized controlled trial (RCT) was to examine whether olfactory stimulation enhances the stress-reducing effects of virtual forest bathing (Schuil et al., submitted). Results showed that questionnaire-based psychological stress parameters improved significantly through the VR forest bathing intervention compared to the active control condition (2D forest bathing) and the passive control (grey screen). However, olfactory stimulation did not demonstrate an additional stress-reducing effect.

The Potential of VR interventions

The presented results align with recent research highlighting the great potential of VR interventions in reducing stress (Ladakis et al., 2024; Lee et al., 2022; Xu et al., 2024). As shown in our systematic review and meta-analysis, nature-based VR experiences are frequently used and have proven effective in stress reduction. Moreover, the almost limitless possibilities for creating immersive virtual environments, combined with their accessibility regardless of location, make VR a particularly powerful and scalable component of future digital health strategies. By offering immersive and controllable environments, VR allows users to disengage from real-world stressors, immerse themselves in diverse virtual settings, and engage in guided relaxation, mindfulness, or exposure-based exercises. Especially for hospital patients and older adults, VR may represent a valuable therapeutic tool. In a subsequent study within the AI4Coping project, the effectiveness of a VR forest-bathing intervention enriched with mindfulness exercises will be evaluated among neurological patients in early-stage rehabilitation in an acute-care hospital setting. In the long term, if the mindfulness-based VR intervention proves effective in reducing stress and improving well-being, it could be implemented across various target groups, including patients undergoing surgery or chemotherapy, older adults, and people without access to real natural environments.

Within the AI4Coping project, VR will also be used for presentation training to potentially reduce public speaking anxiety. The objective of this study is to examine the efficacy of an immersive, VR-based visualization intervention in reducing public speaking anxiety and enhancing performance, while also exploring the role of VR-induced presence in its effectiveness. The intervention, which involves a VR visualization of a successful speech in front of a virtual audience combined with positive affirmations, represents a novel approach in this field and holds considerable potential for applications in clinical and non-clinical settings.

A distinct part of the project focuses on kitchen hygiene training using a VR intervention. The aim of this study is to evaluate whether VR-based hygiene training is more effective in improving hygiene competence than conventional training and to identify potential influencing factors.

The Challenge of Providing, Acceptance, and Intention of Use

The application areas of VR interventions to reduce mental stress and promote well-being are wide-ranging. In order to fully exploit the potential of VR for individual stress reduction, it is crucial to make this technology accessible and to promote its use. Beyond effectiveness, the application and use of VR interventions for stress reduction are driven by acceptance and willingness to use among providers and end users. While studies suggest the acceptance of VR in therapeutic contexts (Waldmann & Seidel, 2019), the factors determining its use for stress reduction in private settings remain largely unexplored (Janzik, 2022). According to theoretical technology acceptance models such as TAM (Davis, 1987) and UTAUT (Venkateh & Davis, 2022), factors such as perceived usefulness, ease of use, and general attitudes toward using VR may determine the level of acceptance and, consequently, its use for stress reduction. On the one hand, a lack of personal, financial, or time resources to acquire VR technology, insufficient experience and knowledge, or doubts about its effectiveness constitute barriers at the provider level. On the other hand, there are certain barriers on the part of end users, such as limiting health conditions, individual needs, or personal values and attitudes (Kouijzer et al., 2023). Moreover, ethical issues, such as the risk of manipulation, questions of equity, and other related concerns, are crucial for the application of new technologies, especially in the field of health care and promotion (Halbig et al., 2022).

Therefore, the acceptance, intention to use, and potential barriers for the application of VR in stress reduction are also being examined within the context of the AI4Coping project. In a first step, the levels of acceptance, intention to use, and their determinants are investigated in the German population through a representative online survey. In a second step, qualitative interviews and focus groups will be conducted to explore ways to alleviate concerns and facilitate the implementation of VR technologies for individual stress reduction.

Conclusion and Outlook

As new technologies are increasingly integrated into health care and health promotion, their potential for improving individual well-being is substantial. The benefit, especially for reducing perceived stress, could be enhanced by providing targeted solutions that consider individual needs and conditions, while also addressing current concerns and barriers to use. However, further research is warranted. The project AI4Coping in Coburg seeks to contribute to this effort by advancing innovative approaches to strengthen overall mental health.

Author Contributions: Conceptualization, investigation, writing: H.S. & I.S.; review and editing: K.M. & J.G.; All authors have read and agreed to this version of the manuscript.

Institutional Review Board Statement: Not applicable.

Informed Consent Statement: Not applicable.

Data Availability Statement: No data was used in this commentary article.

Conflicts of Interest: The authors declare no conflicts of interest.

Funding: This research was funded by the Bavarian State Ministry of Science and the Art (StMWK)—grant No. H.2-F1116.CO/52/2 of the Collaborative Research Project “AI4Coping – Artificial Intelligence for Sustainable Support in Stress Management” (Speaker: Prof. Dr. Karin Meissner; Co-Speaker: Prof. Dr. Jens Grubert).