Health and prevention psychology aims to address health-related issues to either prevent individuals from starting or continuing an unhealthy behavior (ie, primary prevention), help them to detect or reduce illness in early stages (ie, secondary prevention), or support individuals in their journey against consequences of heavier injuries or diseases (ie, tertiary prevention, [1]). Although secondary and tertiary prevention are more individual-based depending on the illness or signs or symptoms individuals need to learn to cope with, primary prevention is broader and aimed at a larger audience. Therefore, primary or universal prevention is designed to prevent individuals from the general population from getting injured or sick and aims to enable people to live a sustainable and healthy lifestyle [2,3].

In this sense, health promotion campaigns have started to integrate technological innovations such as virtual reality (VR). We refer to VR as a type of human-computer interface immersing users into a computer-generated 3D virtual environment (VE) they can interact with in a naturalistic fashion, usually via an avatar (ie, representation of the user in the VE [4]). More pragmatically, we labeled as VR any type of device that has the ability to sensorily detach the user from the outside world (at least sight, but also sounds, smell, and touch in some cases). This includes the use of a cave automatic VE (users are surrounded by walls displaying the VE) or a head-mounted display (HMD), which blocks the user’s field of view outside of the VE and from which the user cannot turn away by simply looking away (ie, computer screens or 360° videos will not be considered VR in this definition).

The main aim of VR is to recreate a realistic, ecological context and experience while keeping some degree of experimental control over it [5-7]. Systematic reviews have reported promising results from VR-based interventions in other disciplines (eg, clinical psychology [8] and social psychology [9,10]). However, to our knowledge, there has been no review of the use of VR technologies for primary health promotion and prevention. Therefore, instead of focusing on specific research questions related to a topic, outcome, or population, the goal of this review was to map the current state of the art of the use of VR in such areas and identify gaps and future directions.

VR technology has emerged as a promising tool in health promotion and prevention psychology, allowing for immersive experiences that can enhance user engagement and motivation [17,18]. VR enables researchers to create safe, ecological, and standardized VEs, where health promotion interventions can be effectively delivered and evaluated. VR presents key advantages as a tool for research and intervention in health promotion and primary prevention [7].

First, VR can be combined with devices aimed at mimicking more natural movements (eg, the use of handheld controllers or haptic devices instead of a mouse and keyboard) and can encompass the integration of full-body motor and haptic feedback when using a bodysuit. This freedom and wholeness of movement can help enhance learning through direct practice, visualization, and ultimately embodied cognition (ie, cognition linked to the body [7,19]). Hence, VR can be a relevant tool to create interventions aimed at learning health-related behaviors that require practicing skills (eg, detecting testicular disorders [20]).

Second, due to its ability to elicit embodiment, VR is well suited to elicit and enhance perspective-taking and empathy [7,21]. For example, embodying an obese avatar could enhance taking the perspective of being overweight, leading to a more effective learning of the consequences of obesity and, in turn, a greater intention to take care of individual health (ie, reduce the attitude-intention-behavior gap). Through the feeling of presence, individuals can visualize themselves in a specific situation, hence allowing a deeper sense of self-reflection [20], potentially leading to more persistent changes in behavior. VR can recreate ecological situations and environments in which users can embody an avatar and act in the virtual world as if it were real, through the feeling of presence [12].

Our goal was to identify and map how VR has been used in the field of health promotion and primary prevention. In this scoping review, we addressed three broad research questions:

Based on the findings of the scoping review, we drafted a list of recommendations and perspectives for the use of VR in health promotion and primary prevention.

The scoping review protocol was drafted according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews) checklist [22,23]. We also conducted a synthesis without meta-analysis [24] (Checklist 1).

We included any peer-reviewed and published empirical article, written in English, that described a study conducted on human subjects deploying any kind of immersive VR device (eg, HMD, cave automatic VE), including 360° videos when used in a VR setup, focusing on any research question in the field of health promotion or primary prevention, from January 1, 2010, to September 16, 2024. We chose to limit the search to the last 14 years in order to generate a recent state-of-the-art overview of the field. We excluded studies conducted on nonhumans or focused on secondary or tertiary prevention interventions, such as psychotherapeutic treatments (eg, VR exposure therapy) and medical interventions (eg, rehabilitation), or specialized educational programs unrelated to prevention (eg, skills improvement for health practitioners). Pilot studies were not excluded from this review because of their critical role in assessing the feasibility and acceptability of interventions that may inform future primary, secondary, or tertiary prevention efforts. We excluded studies using the term “virtual reality” that described computer-based VEs involving a virtual world (eg, Second Life) or computer-related or motion-sensing devices (eg, Kinect, joystick) when they were associated with a nonimmersive VR setup (eg, non-VR video or serious game). We also used the population-concept-context framework to define our inclusion criteria. The population includes adolescents, young adults, and specific populations at risk for health issues (eg, individuals with anxiety or those at risk for substance use). The concept focuses on the application of VR technology to promote health behaviors, enhance knowledge, and improve emotional well-being. The context refers to contextual factors including the environments where VR interventions are delivered, such as schools, community centers, or health care facilities.

We searched 3 databases from January 1, 2010, until September 16, 2024 (PubMed and PsycINFO). For each database, we combined 2 sets of keywords; the first set focused on health promotion and prevention psychology. For PubMed, the search strings were (“health prevention” OR “health promotion” OR “health risk communication” OR “health communication” OR “preventive psychology” OR “behavior change” OR “attitude change”) AND (“virtual reality” OR “immersive virtual reality” OR “immersive virtual environment”). For PsycINFO, the search strings were (“health prevention” OR “health promotion” OR “health risk communication” OR “health communication” OR “preventive psychology” OR “behavior change” OR “attitude change”) AND (“virtual reality” OR “immersive virtual reality” OR “immersive virtual environment”).

Studies that did not employ VR technology, were not peer-reviewed, were reviews or meta-analyses, or lacked empirical data were excluded from the review. The screening process was conducted in 2 stages to enhance the rigor of the selection. In the first stage, titles and abstracts of the identified studies were reviewed to determine their relevance based on the inclusion criteria. This initial screening allowed the authors to eliminate studies that were clearly outside the scope of the review. In the second stage, full-text articles of the remaining studies were assessed to confirm their eligibility for inclusion. The extraction process was conducted independently by multiple reviewers to enhance reliability and minimize bias. Any discrepancies in data extraction were resolved through discussion and consensus among the reviewers. This meticulous approach to data extraction allowed the authors to synthesize findings across studies effectively and draw meaningful conclusions regarding the efficacy and feasibility of VR interventions in health promotion and primary prevention.

The data charting process involved collecting information on study characteristics, intervention details, measured outcomes, user experience, type of materials, and sample characteristics (see Multimedia Appendix 1). Of note, approximately 63% of the studies included in the review were categorized as pilot or feasibility studies. We also recorded the type of VR technology used (eg, immersive headsets, desktop VR), the duration of the intervention, and the focus of the VR content (eg, health education, behavior change). On average, participants spent approximately 12.8 (SD 11.1) minutes using VR. We focused on health-related outcomes such as knowledge acquisition, behavioral intentions, and psychological well-being. User experience was assessed through qualitative data that provided insights into participants’ enjoyment, ease of use, and perceived effectiveness of the VR interventions. Many studies found that participants found the VR experience both enjoyable and engaging, which in turn led to higher participation rates compared to non-VR interventions.

Primary variables included study characteristics such as authorship, year of publication, study design, and sample size, which provided context for the research findings. Participant demographics, including age, gender, and health status, were also collected to understand the populations included in the studies. Intervention details were documented, focusing on the type of VR technology used, the duration of the intervention, and the specific health issues addressed. Measured outcomes were categorized into primary outcomes, such as knowledge acquisition and behavioral intentions, and secondary outcomes, including user engagement and satisfaction. User experience data were collected to assess participants’ enjoyment, ease of use, and any challenges encountered during the VR interventions. In addition, limitations of the studies were noted, including issues such as small sample sizes and methodological limitations, which are critical for contextualizing the findings. It is important to note that while immersion and presence are key concepts in understanding the effectiveness of VR, these variables were not measured consistently across studies, which may affect the interpretation of results. The data elements collected were intended to provide a structured review of the existing literature, as well as identify trends, gaps, and implications for future research in the field of VR-based health interventions.

We found that approximately 37% of the included studies were pilot or feasibility studies. These studies primarily focused on evaluating the usability and acceptability of VR interventions, which are critical for assessing the feasibility of larger-scale research. Although pilot studies provide valuable insights into user experiences and preliminary results, their small sample sizes and limited generalizability limit the ability to draw firm conclusions about the effectiveness of VR-based interventions. Mixed results have been found when comparing VR interventions to traditional methods, suggesting that VR does not always offer a clear advantage in achieving health outcomes. Key variables such as immersion and presence, which are critical to understanding how VR might influence health behaviors, have not been systematically evaluated. We found a lack of focus on larger, more diverse samples and aim to replicate existing studies to strengthen the evidence supporting the use of VR in health promotion efforts.

All search results were stored in Zotero, an open-source reference manager, and duplicates were removed. Titles and abstracts were screened first, removing articles that clearly did not match eligibility criteria. Second, full texts of the remaining articles were downloaded to define final eligibility for inclusion. For each step, 2 reviewers conducted the screening independently and compared and discussed these discrepancies until a full consensus was reached.

Data extraction was done by 1 reviewer, who extracted the following items from the included articles: (1) title and authors, (2) goal(s) of the study, (3) design of the study, (4) study sample characteristics, (5) VR device used, (6) main results, and (7) limitations reported by the authors. A second reviewer verified that all data were correctly extracted. Following the data extraction, we conducted a narrative analysis and synthesis of the results. Results and implications of the data extracted from the included studies were discussed by 2 reviewers in relation to the 3 research questions of the scoping review.

The initial search identified 4295 unique articles, which were reduced to 51 eligible articles (see the PRISMA flowchart in Figure 1). Included studies were conducted in Asia (11 studies, 22%), Europe (18 studies, 35%), the Middle East (1 study, 2%), and North America (21 studies, 41%). The total sample size across all studies was 4647 participants, with an average of 91.1 participants per study. Study samples included slightly more women, with 2651 women (53%) and 1958 men (42.7%). The mean age of participants across the studies was 31.6 (SD 5.45) years. Studies primarily included adults, with 29 studies (57%) focused on adults, followed by 14 studies (28%) focused on adolescents, 7 studies (14%) focused on senior adults, and 1 study (2%) focused on children. Specific populations studied included students (7 studies, 29%), people with cognitive impairment (3 studies, 12%), and people with obesity (3 studies, 12%). Other populations studied included former smokers (1 study, 4%), NHS staff (1 study, 4%), parents (2 studies, 8%), smokers (2 studies, 8%), adults who had been in lockdown (1 study, 4%), and unvaccinated adults (1 study, 4%, see Figure 2 for details).

The 51 included studies focused on various health-related topics (Table 1), the most predominant ones being nutrition (17%) and risky behaviors (4%). All studies used HMD, except for Lemieux et al [25], where the device used was not mentioned. HMDs were mainly Oculus (Quest, Go, or Rift, 24%), HTC Vive (17%), or Samsung Gear VR (15%). Almost half of the studies (43%) were coupled with 1 or 2 handheld controllers. Most studies (56%) included an active interaction with the VE by using 1 or 2 handheld controllers or the bodysuit to interact with the VE. About 49% of VR exposure lasted a maximum of 10 minutes, including 22% of studies with under 5 minutes of VR exposure. We estimated an average time of 12.8 (SD 11.1) minutes spent using VR, according to the information given in the articles.

This scoping review identified 51 studies published over the past 14 years that explored the use of VR in health promotion and prevention psychology. Our findings revealed three primary applications of VR: (1) as a tool to deliver interventions, either in feasibility testing or actual implementation; (2) as a means to address fundamental research questions; and (3) as an assessment tool for health-related outcomes. Although VR shows significant promise in creating immersive and engaging interventions, our review highlights the variability in effectiveness and common challenges such as small sample sizes, short follow-up periods, and limited methodological standardization.

VR technology use for health promotion and prevention research is relatively recent, with studies in this review indicating its potential as a promising tool to deliver and assess interventions. For instance, VR was effective in simulating realistic scenarios to engage participants in skills-based learning and decision-making tasks, such as risk-reduction behaviors [42,61]. VR allows researchers to create safe, ecological, and standardized VEs in which it is possible to deliver and evaluate health promotion and preventive interventions [42]; recreate situations or environments that can elicit strong emotional, physiological, behavioral, or psychological responses (eg, mortality salience [29]); and assess outcomes (eg, cravings, food choices) with a multimeasure approach included in VR technologies (eg, psychological, physiological, and behavioral measures). This scoping review identified 51 studies concerning the use of VR technology in the field of health promotion and prevention psychology published within the past 14 years. We mapped (1) the goals and research questions addressed through the use of VR in this field, (2) its effects in the identified areas, and (3) its main challenges or limitations. We identified three main applications of VR in this field: (1) as a tool to deliver an intervention, either (1a) pilot or feasibility testing VR materials or procedures or (1b) using VR to deliver an actual intervention (eg, skills learning, comparing VR vs other intervention modalities) to test its relative efficacy; (2) as a tool to address fundamental research questions; and (3) as an assessment tool.

Due to the relative novelty of VR in this field, only 51 eligible studies were published in the past 14 years. Research so far has mostly focused on feasibility or pilot studies, aimed at testing the ability of VR to be integrated into interventions [69], with a minority of studies focusing on answering fundamental research questions through the use of VR [28]. Most studies employed semiexperimental designs without a control or comparison group and often had a short or no follow-up, limiting the validity and generalizability of results. Studies also included relatively small samples and were often nonrepresentative of the general population (eg, students). However, as the use of VR in the field of health promotion and prevention is still in its infancy, it appears natural to see a stronger focus on pilot or feasibility studies in the published literature.

When considering whether VR is effective in health prevention, it should first be noted that the effectiveness of VR interventions was variable. For instance, while some studies indicated that VR could enhance user engagement and motivation [59], others found no significant differences in outcomes compared to traditional methods [71]. This highlights the need for further research to clarify the conditions under which VR is most effective. This scoping review showed that sometimes VR use is not systematically more effective in achieving target outcomes than its nonimmersive equivalents [41,54,71]; we supposed that to be more effective, VR should be used for its specific immersive characteristics, such as gamification or embodiment, which directly involve the user. For example, skills practice in VR was more effective than role-playing in real life to learn about risk behaviors and ways to avoid them (eg, buying condoms for safer sex) due to VR scenarios’ ability to recreate a situation that is realistic, induce emotional changes in the user as the scenario goes on, and finally, make the user have a real first-person experience [42]. Similar results appeared in [61], in which VR was used to represent a vaccination intervention to stop flu spread (ie, participants used handheld controllers to actively send immune cells to prevent flu transmission), whereas in other conditions, participants were just passively watching (a video on a 2D screen or a pamphlet).

It is important to consider the limitations of this review when interpreting the findings. First, as the use of VR in health promotion and prevention psychology is a relatively recent phenomenon, our literature search focused on the last 14 years (2010‐2024). This resulted in the inclusion of 51 eligible articles, which may have excluded earlier or less accessible studies. However, the majority of included studies (63%) were published between 2020 and 2024, reflecting the increasing affordability and accessibility of VR technology for research in recent years. Therefore, the likelihood of missing pivotal studies is low. Second, the search strategy did not include gray literature, which may have reduced the total number of eligible articles and introduced publication bias by excluding studies with nonsignificant or null results (the file drawer effect). To address this gap, future reviews should consider including gray literature to provide a more comprehensive overview of the field. Third, some studies lacked sufficient reporting of critical aspects such as sample characteristics (eg, size and demographics) and details of VR implementation (eg, exposure duration, type of VR technology used). This limited our ability to draw broad conclusions about the efficacy and applicability of VR in this area. Addressing these reporting gaps in future research will improve the comparability and quality of evidence in this rapidly evolving area of study. Fourth, although our literature search was updated during the initial revision, which was completed just a few weeks prior to this submission, we recognize that VR research is advancing rapidly. It is therefore possible that new studies may emerge shortly after the conclusion of our search period, which may influence the results of future reviews. To address this, future updates could consider conducting more frequent searches or establishing a continuous review process to ensure that all emerging data are included in real time. However, we are confident that this review accurately reflects the state of the literature as of our latest search.

This scoping review provides an overview of VR’s emerging role in health promotion and prevention psychology, highlighting its potential to create immersive and engaging interventions. Although VR has shown promise in delivering health interventions and answering fundamental research questions, its effectiveness remains variable, and many studies are limited by methodological constraints. Future research should prioritize replication, longitudinal designs, and standardized methodologies to strengthen the evidence base and realize the full potential of VR in this field.