Trying out a virtual reality café for young people with eating disorders

Approved 27/01/2026, West of Scotland REC 5 (West of Scotland Research Ethics Service, Level 2, Administration Building, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, United Kingdom; -; ggc.wosrec5@nhs.scot), ref: 25/WS/0200

Feasibility of recruitment and retention will be measured by assessing the number of potentially eligible patients in the clinical settings during the study period, the number of patients approached to participate via each recruitment route during the study period, the number of participants consenting to participate during the study period, the number of potential participants declining to participate (and reasons given) during the study period, and the number of participants who consent to participate who remain in the trial at 3-month follow-up.

The Feasibility of Assessment Battery will be measured by assessing the number of participants completing all measures at baseline and the number of participants completing all measures at the end of session 1 and at 6-week and 3-month follow-ups.

Feasibility of the intervention will be measured by:
1. Documenting which clinician delivers the intervention (patient’s own clinician or a member of the NHS research team with experience of working in mental health) during the study period
2. Assessing VR engagement metrics, including:
2.1. Participant goal-setting re which scenarios they want to try and how many times they want to try it, captured at the end of the study period
2.2. Number (and which) VR sessions are completed, captured at the end of the study period
2.3. Time spent using VR, captured at the end of the study period
2.4. How often scenarios are repeated, captured at the end of the study period
2.5. Whether participants and clinicians think further sessions would have been useful for each participant, captured at the end of the study period

Fidelity to the treatment will be measured by asking both the participant and the clinician to complete a brief measure, documenting whether they (1) set goals in relation to the VR scenario they would try, (2) tried one or more VR scenarios, and (3) discussed the experience of completing the scenario and reviewed their goals, completed at the end of each VR session.
1. Acceptability of the VR intervention to participants, through the proxy measures above, as well as by questions on satisfaction, perceived burden, ease of use and likelihood of recommending to others, collected 6 weeks after the first VR session.
2. Any adverse reactions to VR (e.g., motion sickness; stopping a session due to distress), collected during the study period.

Questionnaire measures:
1. Anxiety and avoidance in relation to cafes will be measured using a bespoke questionnaire at baseline, end of VR session 1, 6 weeks after the first session, and at the 3-month follow-up
2. Self-efficacy in relation to cafes will be measured using a bespoke questionnaire at baseline, end of VR session 1, 6 weeks after the first session, and at the 3-month follow-up
3. Behaviours in relation to visiting cafés will be measured using a bespoke questionnaire at baseline, end of VR session 1, 6 weeks after the first session, and at the 3-month follow-up
4. Eating disorder symptoms will be measured by the Eating Disorder Examination Questionnaire (EDEQ) at baseline, 6 weeks after the first session, and at the 3-month follow-up
5. Symptoms of Avoidant/Restrictive Food Intake Disorder (ARFID) will be measured by the Short ARFID questionnaire at baseline, 6 weeks after the first session, and at the 3-month follow-up
6. Impact of having an eating disorder on life will be measured by the Clinical Impairment Assessment (CIA) at baseline, 6 weeks after the first session, and at the 3-month follow-up
7. General anxiety will be measured by the General Anxiety Disorder-7 (GAD-7) (18-25 year olds) or Revised Children’s Anxiety and Depression Scale (RCADS) (14-17 year olds) at baseline, 6 weeks after the first session, and at the 3-month follow-up
8. Depression will be measured by the Patient Health Questionnaire-9 (PHQ-9) (18-25 year olds) or Revised Children’s Anxiety and Depression Scale (RCADS) (14-17 year olds) at baseline, 6 weeks after the first session, and at the 3-month follow-up
9. VR side effects will be measured by the Simulator Sickness Questionnaire (SSQ) at baseline and at the end of each VR session
10. Sense of presence/place illusion will be measured at the end of the first VR session

Service use measures:
Service use measures will be gathered from electronic health records encompassing the study period until the 3-month follow-up:
1. Recorded diagnosis, comorbidities and prescribed medication
2. Nature of “treatment as usual” being received
3. Number and timing of clinical contacts within the eating disorders team, by professional group, before and after consenting to study participation
4. Number and timing of clinical contacts within the mental health trust, by professional group before and after consenting to study participation
5. BMI/% weight for height at the point of (1) starting treatment, (2) joining the study and (3) at 3-month follow-up (to help inform whether, for those for whom weight restoration is part of treatment, there is an optimum time during weight restoration to engage in this treatment)
6. Number of GP contacts during study participation
7. Number of contacts with other health professionals during study participation
8. Number of A&E contacts during study participation
9. Duration of admission [for inpatients] before and after consenting to study participation
10. Legal status of admission [for inpatients] before and after consenting to study participation

VR headset measures:
1. Head, hand and eye-tracking data will be collected via VR headsets in all VR sessions during the study period

Qualitative data collection:
1. Qualitative interviews will be conducted with a subset of trial participants, decliners, parents/carers, and clinicians during the study period