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NCT Number: NCT07835568

Thrive at Home: A Virtual Reality Social Intervention for Older Adults

The goal of this clinical trial is to evaluate whether a virtual reality (VR) based social platform can improve mental health and social connection for older adults who receive in-home care. Specifically, the study aims to determine if the VR program reduces loneliness, depressive symptoms, and boredom while increasing social connection and well-being among older adult participants. It also explores whether access to the VR program reduces caregiver burden and depressive symptoms for family caregivers.

Researchers will compare an immediate-start group to a waitlist control group to assess whether the VR program improves outcomes compared to standard home care alone. Both groups will eventually receive the intervention. Older adult participants will use a VR headset at home to join group activities three times a week. These sessions include social activities with local peers and live-hosted group activities. A family caregiver or home care professional may be present during sessions if needed for support.

Over a 12-week study period, older adult participants will complete three surveys assessing their mood, social connection, and well-being. Family caregivers of participating older adults are also invited to join an optional caregiver substudy. Caregivers who enroll in the substudy will not participate in the VR activities themselves, but will complete three surveys at the same time points over the 12 weeks to share their own well-being and caregiving experiences.

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Key information

Conditions

Mental Health (Depression) Alzheimer Dementia (AD) Alzheimer Disease Behavior Behavioral Symptoms Brain Diseases Caregiver Burden Caregiver Wellbeing Central Nervous System Diseases Cognition Disorders Cognitive Dysfunction Dementia Depression Loneliness Mental Disorders Mental Health and General Well-being Mild Cognitive Impairment(MCI) Nervous System Diseases Neurocognitive Disorders Neurodegenerative Diseases Personal Satisfaction Psychological Well-Being Stress, Psychological Tauopathies Well Being

Age range

65 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

About this study

Approximately 90% of older adults in the United States prefer to age in place at home. However, older adults aging at home may experience social isolation and limited opportunities for meaningful social and cognitive engagement, which are associated with depression, cognitive decline, and increased mortality risk. Although home care services are designed to support physical and daily living needs, they may have limited capacity to provide ongoing social and cognitive engagement. The Thrive at Home study tests whether a networked virtual reality (VR) social platform can help address this gap by connecting older adults receiving home care with one another and with residents of nearby senior living communities.

This is a decentralized, randomized controlled trial using a waitlist control design. Two hundred fifty (250) home-dwelling adults aged 65 and older who are receiving in-home care will be enrolled from home care agency offices across approximately 25 U.S. cities. Participants span the cognitive range from unimpaired through moderate dementia, with a Montreal Cognitive Assessment (MoCA) score of 12 or above required for eligibility. Participants are randomized 1:1 to either Group 1 (Immediate Treatment) or Group 2 (Waitlist Control).

Intervention Timeline & Dosing:

  • Group 1 (Immediate Treatment): Begins the VR social program within 1-3 weeks after baseline and participates for a 6-week primary intervention period, followed by a 4-week monitoring period during which platform access continues and spontaneous use is tracked.
  • Group 2 (Waitlist Control): Continues standard home care alone for the first 6 weeks, and then crosses over to receive an abbreviated 4-week version of the VR social program.

Both arms eventually receive the intervention, protecting participant welfare while preserving a rigorous between-group, standard-of-care comparison at the primary 6-week timepoint. The intervention consists of three VR group activities per week: two local social sessions hosted by a community activity director, and one live, expert-hosted session of the participant's choosing. Sessions are conducted entirely from the participant's home while seated. Participants with a MoCA score below 18, or any participant requiring physical assistance, will have a caregiver or home care professional present during sessions for support.

Data Collection & Endpoint Structure:

Data are collected at three primary milestones: baseline (T1), end of the 6-week primary intervention period (T2, approximately Week 7), and end of the 12-week study period (T3).

  • The primary efficacy analyses compare changes from baseline in the immediate intervention group to the waitlist control group at the primary 6-week endpoint (T1 to T2).
  • Outcomes assessed at T3 are exploratory; they evaluate treatment replication in the waitlist group (T1 to T3) and long-term maintenance of gains in the immediate intervention group (T2 to T3).

Primary outcomes for older adults (home care clients) include validated measures of depressive symptoms, loneliness, thriving, and boredom. Secondary outcomes include cognitive function, vitality, mental health (anxiety, positive affect, negative affect), social health (companionship, social connectedness), and satisfaction with home care services. Full specification of each measure, instrument, and assessment timepoint is provided in the registry's outcome measure tables.

Additional Exploratory Frameworks:

Beyond the primary and secondary endpoints tracked within the registry tables, this trial incorporates an extensive exploratory framework to evaluate broader psychosocial, behavioral, neuropsychiatric, and technical impacts. These observational and hypothesis-generating metrics will be analyzed and reported in subsequent secondary publications to better understand the holistic mechanisms of the intervention. For the primary participants (older adults), these exploratory dimensions are structured across five core domains:

  • Social Network Dynamics & Relational Health: Assessment of newly formed interpersonal relationships, including the count and nature of new friendships, psychological barriers to social connection, and the individual's motivation, effort, and success in establishing new social ties.
  • Psychosocial Well-Being & Mechanisms of Engagement: Evaluation of sub-domains of mental health, including self-connection, reminiscence behaviors, perceptions of aging and senior living environments, and mid-intervention psychological mediators (such as perceived co-presence, mutual personal disclosure, and group responsiveness).
  • Behavioral, Cognitive, & Digital Biomarkers: Analysis of objective telemetry and speech data, including headset-derived kinesic engagement (movement tracking) and recorded session audio to evaluate vocal and linguistic markers of emotion and memory. Subjective cognitive stimulation and behavioral/neuropsychiatric symptom severity are also tracked.
  • Health Status & System Utilization: Longitudinal tracking of subjective general health ratings and quantitative healthcare resource utilization over the study period.
  • Comprehensive User Experience (UX) & Intervention Feasibility: A robust post-intervention battery evaluating hardware and software usability, physical and cognitive comfort, personal enjoyment, user satisfaction, and long-term platform recommendation metrics.

All unlisted exploratory variables will be managed as purely descriptive and hypothesis-generating analyses, with full parameters specified in the trial's internal protocol and Statistical Analysis Plan (SAP).

Family Caregiver Substudy:

Family caregivers are co-enrolled on a voluntary, non-randomized basis (n ≈ 125) and linked to their primary participant's randomized arm. The caregiver substudy was not included in the trial's power calculations; all caregiver outcomes are analyzed as exploratory, per the Statistical Analysis Plan. For this optional substudy, core exploratory outcomes tracked in the registry include caregiver burden, perceived stress, depressive symptoms, caregiver empowerment (caregiving self-efficacy, and personal self-efficacy), and satisfaction with home care services. Additional exploratory data will be collected and analyzed in subsequent secondary publications regarding broader caregiving relationship dynamics, secondary psychosocial well-being sub-domains, and qualitative intervention feedback. Due to the hypothesis-generating nature of these extended variables, they are fully specified within the internal protocol and SAP rather than listed as individual registry tracking rows.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

PRIMARY PARTICIPANTS (OLDER ADULTS):

  • Aged 65 years or older.
  • Living in a private residence and receiving home care services from a participating provider, with services expected to continue for the duration of the study (approximately 4 months).
  • Montreal Cognitive Assessment (MoCA) score of 12 or above.
  • Fluent in English, sufficient to participate in group virtual reality (VR) sessions and complete verbal surveys.
  • Adequate vision and hearing to complete surveys and engage with VR experiences (mild impairments acceptable if corrected).
  • Has a family caregiver or home care professional available to support them at every VR session if the MoCA score is below 18 or the participant cannot physically manipulate the headset independently.

FAMILY CAREGIVERS (OPTIONAL SUBSTUDY):

  • Aged 18 years or older.
  • Identifies as the primary family caregiver for an enrolled primary participant (living with or visiting the primary participant at least twice per week).
  • Fluent in English and able to complete online surveys on a personal digital device (e.g., smartphone, laptop, tablet, or computer).

Exclusion criteria

PRIMARY PARTICIPANTS (OLDER ADULTS):

  • History of severe motion sickness or vertigo.
  • History of seizures or epilepsy.
  • Frequent and distressing hallucinations.
  • Aphasia or other communication barriers preventing verbal participation.
  • Severe disorientation or delirium.
  • Frequent and severe outbursts or emotional dyscontrol, or frequent and severe aggressive tendencies. (Typical sundowning is not exclusionary.)
  • Total vision loss not overcome by VR, or uncorrected hearing impairment that makes group conversation impracticable.
  • Residence in a senior living community or other congregate housing.
  • Presence of a harmful, aggressive, or abusive relationship with a family caregiver living in the home.

FAMILY CAREGIVERS (OPTIONAL SUBSTUDY):

  • Presence of an aggressive or abusive relationship with the enrolled primary participant.

Treatment and study plan

Full Virtual Reality Social Intervention

Behavioral

Participants engage in a 6-week VR-based social intervention that includes three (30-min) virtual reality (VR) group activities per week using the Rendever platform. This includes two Rendever Thrive Program social sessions hosted by a community Activity Director and one live RendeverLive, expert-hosted group programming event (e.g., guided virtual tours, music, trivia). All sessions are completed entirely from the participant's home while safely seated.

Abbreviated Virtual Reality Social Intervention

Behavioral

Following the completion of the primary 6-week control period and primary outcome assessments, waitlist participants receive an abbreviated 4-week version of the VR-based social intervention. Participants engage in three (30-min) group activities per week using the Rendever platform, structured identically to the experimental group but limited to a 4-week duration for exploratory replication purposes. All data collected during this abbreviated 4-week crossover period are monitored for descriptive and hypothesis-generating purposes as detailed in the internal Statistical Analysis Plan, rather than tracked as distinct registry outcome rows.

Primary outcomes

  1. Depressive Symptoms (CES-D)

    Time frame: Baseline (T1), Week 7 (T2), Week 12 (T3)

    Depressive symptoms are assessed with a modified version of the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). To increase measurement sensitivity, items are rated on a numerical response scale ranging from 0 to 100 rather than the standard 4-point Likert scale. Total scores are calculated as the mean across all 20 items (range: 0 to 100), where higher scores indicate greater depressive symptom severity.

  2. Loneliness (UCLA Loneliness Scale)

    Time frame: Baseline (T1), Week 7 (T2), Week 12 (T3)

    Loneliness is assessed with a modified version of the 20-item UCLA Loneliness Scale (Version 3). To increase measurement sensitivity, items are rated on a numerical response scale ranging from 0 to 100 rather than the standard 4-point Likert scale. Total scores are calculated as the mean across all 20 items (range: 0 to 100), where higher scores indicate greater subjective loneliness.

  3. Thriving (BIT)

    Time frame: Baseline (T1), Week 7 (T2), Week 12 (T3)

    Thriving is assessed with a modified version of the 10-item Brief Inventory of Thriving (BIT). To increase measurement sensitivity, the standard 5-point Likert scale is replaced with a 7-point Likert scale for each item. Total scores are calculated as the mean across all 10 items (range: 1 to 7), where higher scores indicate greater thriving.

  4. Boredom (Short Boredom Proneness Scale)

    Time frame: Baseline (T1), Week 7 (T2), Week 12 (T3)

    Boredom is assessed using a modified Short Boredom Proneness Scale. Items are modified to assess state (vs. trait) boredom. Participants respond to 7 items on a 7-point Likert scale. Total scores are calculated as the mean across all 7 items (range: 1 to 7), where higher scores indicate greater state boredom.

Secondary outcomes

  1. Global Cognitive Function (MoCA)

    Time frame: Screening (T1), Week 7 (T2), Week 12 (T3)

    Global cognitive function is assessed using the st andard Montreal Cognitive Assessment (MoCA), covering attention, memory, language, and executive function. Items are scored according to standard clinical administration guidelines to derive a single aggregate performance metric. Total scores range from 0 to 30, where higher scores indicate greater overall cognitive function.

  2. Anxiety Symptoms (GAD-7)

    Time frame: Screening (T1), Week 7 (T2), Week 12 (T3)

    Anxiety symptoms are assessed with a modified version of the 7-item Generalized Anxiety Disorder scale (GAD-7). To increase measurement sensitivity, items are rated on a numerical response scale ranging from 0 to 100 rather than the standard 4-point Likert scale. Total scores are calculated as the mean across all 7 items (range: 0 to 100), where higher scores indicate greater anxiety symptom severity.

  3. Positive and Negative Affect (PANAS)

    Time frame: Baseline (T1), Week 7 (T2), Week 12 (T3)

    Positive and negative affective states are assessed using a customized 12-item scale adapted from the Positive and Negative Affect Schedule (PANAS), comprising 6 positive items and 6 negative items. To increase measurement sensitivity, items are rated on a numerical response scale ranging from 0 to 100 rather than the standard 5-point Likert scale. Two separate subscores - Positive Affect and Negative Affect - are calculated as the mean across the 6 items (range: 0 to 100), where higher scores indicate greater intensity of that dimension. An overall affect balance score is also calculated as the positive subscale mean minus the negative subscale mean (range: -100 to +100), where higher positive scores indicate greater net positive emotional well-being.

  4. Vitality (Subjective Vitality Scale)

    Time frame: Baseline (T1), Week 7 (T2), Week 12 (T3)

    Vitality is assessed with a modified 5-item Subjective Vitality Scale. To increase measurement sensitivity, items are rated on a numerical response scale ranging from 0 to 100 rather than the standard 7-point Likert scale. Total scores are calculated as the mean across all 5 items (range: 0 to 100), where higher scores indicate greater vitality.

  5. Companionship (PROMIS Companionship)

    Time frame: Baseline (T1), Week 7 (T2), Week 12 (T3)

    Companionship is assessed with a modified version of the 4-item PROMIS Companionship Short Form 4a. To increase measurement sensitivity, items are rated on a numerical response scale ranging from 0 to 100 rather than the standard 5-point Likert scale. Total scores are calculated as the mean across all 4 items (range: 0 to 100), where higher scores indicate greater companionship.

  6. Social Connectedness

    Time frame: Baseline (T1), Week 7 (T2), Week 12 (T3)

    Social connectedness is assessed with a 15-item multidimensional self-report scale written for this study, which incorporates peer, community, global, and societal connection. Items are rated on a continuous bipolar Global Hedonic Intensity scale ranging from -100 (most unpleasant) through 0 (neutral) to +100 (most pleasurable). Total scores are calculated as the mean across all 15 items (range: -100 to +100), where higher positive scores indicate a greater sense of social connectedness.

  7. Satisfaction with Home Care Services (CMS HHCAHPS, Adapted)

    Time frame: Baseline (T1), Week 7 (T2), Week 12 (T3)

    Satisfaction with home care services is assessed with a 6-item measure adapted from the Centers for Medicare & Medicaid Services (CMS) Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS). The measure includes items assessing perceived quality of care, overall ratings of care, and willingness to recommend the home care agency. Item responses are converted to a common 0-to-100 scale and averaged to produce a total score ranging from 0 to 100, with higher scores indicating greater satisfaction with home care services.

Other outcomes

  1. Exploratory, Family Caregiver: Depressive Symptoms (CES-D)

    Time frame: Baseline (T1), Week 7 (T2), Week 12 (T3)

    Depressive symptoms are assessed with a modified version of the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). To increase measurement sensitivity, items are rated on a numerical response scale ranging from 0 to 100 rather than the standard 4-point Likert scale. Total scores are calculated as the mean across all 20 items (range: 0 to 100), where higher scores indicate greater depressive symptom severity.

  2. Exploratory, Family Caregiver: Caregiver Burden (BSFC)

    Time frame: Baseline (T1), Week 7 (T2), Week 12 (T3)

    Caregiver burden is assessed with a modified version of the 28-item Burden Scale for Family Caregivers (BSFC). To increase measurement sensitivity, the standard 4-point Likert scale is replaced with a 7-point Likert scale for each item. Total scores are calculated as the mean across all 28 items (range: 1 to 7), where higher scores indicate greater subjective caregiver burden.

  3. Exploratory, Family Caregiver: Perceived Stress (PSS)

    Time frame: Baseline (T1), Week 7 (T2), Week 12 (T3)

    Perceived stress is assessed with a modified version of the 4-item Perceived Stress Scale (PSS-4). To increase measurement sensitivity, items are rated on a numerical response scale ranging from 0 to 100 rather than the standard 5-point Likert scale. Total scores are calculated as the mean across all 4 items (range: 0 to 100), where higher scores indicate greater perceived stress.

  4. Exploratory, Family Caregiver: Self-efficacy (Caregiver Empowerment Scale Subscores)

    Time frame: Baseline (T1), Week 7 (T2), Week 12 (T3)

    Caregiver self-efficacy is assessed using two subscales from a modified Caregiver Empowerment Scale (CES), comprising 7 items measuring caregiving self-efficacy and 16 items measuring personal self-efficacy in a caregiving context. To increase measurement sensitivity, the standard 5-point Likert scale is replaced with a 7-point Likert scale for each item. Two separate subscores - Caregiving Self-efficacy and Personal Self-efficacy - are calculated as the mean across their respective items (range: 1 to 7 for each subscale), where higher scores indicate greater self-efficacy in that dimension.

  5. Exploratory, Family Caregiver: Home Care Satisfaction (CMS HHCAHPS, Adapted)

    Time frame: Baseline (T1), Week 7 (T2), Week 12 (T3)

    Satisfaction with home care services is assessed with a 6-item proxy measure adapted from the Centers for Medicare & Medicaid Services (CMS) Home Health Consumer Assessment of Healthcare Providers and Systems (HHCAHPS). The measure includes items assessing perceived quality of care, overall ratings of care, and willingness to recommend the home care agency. Item responses are converted to a common 0-to-100 scale and averaged to produce a total score ranging from 0 to 100, with higher scores indicating greater satisfaction with home care services.

Study contacts

Contact information is provided by the study sponsor or research team.

Jennifer Stamps, Ph.D.

CONTACT

[email protected]

1 + (847) 693-7254 ext. Option 2

Tamara Afifi, Ph.D.

CONTACT

[email protected]

1 + (805) 679-1812

Sponsors and collaborators

Lead sponsor

University of California, Santa Barbara

Other

Collaborators

  • National Institute on Aging (NIA)
  • National Institutes of Health (NIH)
  • Rendever, Inc.

Registry information

Official study title

Improving Mental Health and Social Connectivity for Older Adults Through Virtual Reality-Based Social Interventions

Acronym: Thrive at Home

Important dates

Study start
2026
Primary completion
2028
Study completion
2028
First posted
Sep 23, 2026
Registry last updated
Sep 23, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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