Examining the Effects of Virtual Reality Exercise on Mental Health

Subjective vitality will be assessed using a six-item subjective vitality scale. Participants will respond to the six subjective vitality items on a seven point Likert-type scale anchored by 1 (not at all true) to 7 (very true). The six items will be mean scored (potential range 1-7), with higher scores reflecting higher subjective vitality and a more positive outcome.

Participants will respond to the 14-item Hospital Anxiety and Depression Scale, which includes a depression subscale (7 items) and an anxiety subscale (7 items). Participants will respond to the 14-items using a four point (0-3) Likert-type scale. The two subscales will be mean scored (potential range 0-3), with higher scores reflecting higher depression and anxiety and more negative outcomes.

Participants will respond to the organization (5 items) and strategic planning (7 items) subscales of the executive function index using a five point Likert-type scale anchored by 1 (Not at all) to 5 (Very much). The two subscales will be mean scored (potential range 1-5), with higher scores reflecting higher organization and strategic planning and more positive outcomes.

Participants will respond to the positive mood valence (2 items), calmness (2 items), and energy (2 items) sub-scales of the multidimensional mood questionnaire using a seven point Likert-type scale. The three subscales will be mean scored (potential range 0-6), with higher scores indicating a more positive mood (valence, calmness, energy) and a more positive outcome.

Participants will complete a single item affect measure on an 11-point Likert-type scale anchored by -5 (very bad) to +5 (very good) to examine the affective response to exercise (Supernatural VR exercise or treadmill running). Higher scores will reflect more positive affective responses and a more positive outcome. Participants will be verbally prompted to respond to the scale during exercise (Supernatural VR exercise or treadmill exercise).

Participants will complete a single item arousal measure on a 6-point Likert-type scale anchored by 1 (low arousal) to 6 (high arousal). Participants will be verbally prompted to respond to the scale during exercise (Supernatural VR exercise or treadmill exercise).

Using the modified Borg Rating of Perceived Exertion scale, participants will rate how hard they feel they are physically exerting themselves on a scale anchored by 0 (nothing at all) to 10 (very strong) during the exercise session (Supernatural VR exercise and treadmill running). Participants will be verbally prompted to respond to the scale during exercise.

Participants will receive a target accuracy score (i.e., number of targets successfully striked/punched) for each workout they complete. Scores range from 0 to 100%, with higher scores reflecting a more positive outcome.

Participants will respond to three items assessing affective attitudes towards physical activity (boring-fun, unpleasant-pleasant, unenjoyable-enjoyable) and three items assessing instrumental attitudes towards physical activity (useless-useful, harmful-beneficial, unwise-wise), for the next five weeks. They will respond to the six items on a seven point Likert-type scale. The two subscales will be mean scored (potential range 1-7), with higher scores reflecting more positive affective attitudes and more positive instrumental attitudes towards physical activity and more positive outcomes.

Participants will respond to three items assessing affective attitudes towards Supernatural physical activity (boring-fun, unpleasant-pleasant, unenjoyable-enjoyable) and three items assessing instrumental attitudes towards Supernatural physical activity (useless-useful, harmful-beneficial, unwise-wise), for the next four/five weeks. They will respond to the six items on a seven point Likert-type scale. The two subscales will be mean scored (potential range 1-7), with higher scores reflecting more positive affective attitudes and more positive instrumental attitudes towards Supernatural physical activity and more positive outcomes.

Perceived opportunity to be regularly physically active over the next five weeks will be assessed using a three item scale. Participants will respond to the items using a seven point Likert-type scale anchored by 1 (strongly disagree) to 7 (strongly agree). The three items will be mean scored (potential range 1-7), with higher scores indicating higher perceived opportunity for physical activity and a more positive outcome.

Perceived opportunity to participate in regular Supernatural physical activity over the next four/five weeks will be assessed using an adapted three item scale. Participants will respond to the items using a seven point Likert-type scale anchored by 1 (strongly disagree) to 7 (strongly agree). The three items will be mean scored (potential range 1-7), with higher scores indicating higher perceived opportunity for Supernatural physical activity and a more positive outcome.

Perceived capability for regular physical activity over the next five weeks will be assessed using a four item scale. Participants will respond to the four items using a seven point Likert-type scale anchored by 1 (strongly disagree) to 7 (strongly agree). The four items will be mean scored (potential range 1-7), with higher scores indicating higher perceived capability for physical activity and a more positive outcome.

Perceived capability for regular Supernatural physical activity over the next four/five weeks will be assessed using a four item scale. Participants will respond to the four items using a seven point Likert-type scale anchored by 1 (strongly disagree) to 7 (strongly agree). The four items will be mean scored (potential range 1-7), with higher scores indicating higher perceived capability for Supernatural physical activity and a more positive outcome.

Participants will complete two items. First participants will report the number of minutes of moderate-to-vigorous physical activity they intend to complete in the next five weeks with a minimum score of 0 minutes and higher values reflecting a more positive outcome. Second, participants will report the strength of their desire to participate in regular physical activity over the next five weeks using a seven-point Likert-type scale ranging from 1 (strongly disagree) to 7 (strongly agree). Higher scores (potential range 1-7) will reflect greater intention to participate in regular physical activity and a more positive outcome.

Participants will complete two items. First participants will report the number of minutes of medium intensity Supernatural physical activity they intend to complete in the next four/five weeks with a minimum score of 0 minutes and higher values reflecting a more positive outcome. Second, participants will report the strength of their desire to participate in regular Supernatural physical activity over the next four/five weeks using a seven-point Likert-type scale ranging from 1 (strongly disagree) to 7 (strongly agree). Higher scores (potential range 1-7) will reflect greater intention to participate in regular physical activity and a more positive outcome.

Participants will respond to the 14-item physical activity regulation scale using a seven point Likert-type scale anchored by 1 (strongly disagree) to 7 (strongly agree). The 14-item measure includes four subscales, which are proactive regulation (4 items), reactive regulation (4 items), social monitoring (3 items), and self-monitoring (3 items).The four subscales will be mean scored (potential range 1-7), with higher scores indicating higher levels of physical activity behaviour regulation and a more positive outcome.

Participants will respond to the 14-item physical activity regulation scale adapted for Supernatural physical activity using a seven point Likert-type scale anchored by 1 (strongly disagree) to 7 (strongly agree). The 14-item measure includes four subscales, which are proactive regulation (4 items), reactive regulation (4 items), social monitoring (3 items), and self-monitoring (3 items).The four subscales will be mean scored (potential range 1-7), with higher scores indicating higher levels of Supernatural physical activity behaviour regulation and a more positive outcome.

Participants will complete the four item self-report behavioural automaticity index. Participants will respond to four items on a five point Likert-type scale anchored by 1 (strongly disagree) to 5 (strongly agree). The four items will be mean scored (potential range 1-5), with higher scores reflecting a stronger physical activity habit and a more positive outcome.

Participants will complete the four item self-report behavioural automaticity index, adapted for Supernatural physical activity. Participants will respond to four items on a five point Likert-type scale anchored by 1 (strongly disagree) to 5 (strongly agree). The four items will be mean scored (potential range 1-5), with higher scores reflecting a stronger Supernatural physical activity habit and a more positive outcome.

Physical activity identity will be assessed using the three item self-identity subscale of the exercise identity scale. Participants will respond to the three items using a seven point Likert-type scale anchored by 1 (strongly disagree) to 7 (strongly agree). The three items will be mean scored (potential range 1-7), with higher score reflecting a greater physical activity self-identity and a more positive outcome.

Supernatural physical activity identity will be assessed using an adapted three item self-identity subscale of the exercise identity scale. Participants will respond to the three items using a seven point Likert-type scale anchored by 1 (strongly disagree) to 7 (strongly agree). The three items will be mean scored (potential range 1-7), with higher score reflecting a greater Supernatural physical activity self-identity and a more positive outcome.

In reference to the past five weeks, participants will report the number of times per week (on average) they engaged in mild, moderate, and vigorous physical activity using the Godin Leisure Time Exercise Questionnaire, and the average duration of mild, moderate, and vigorous physical activity sessions. The researchers will create an indicator of average weekly moderate-to-vigorous physical activity minutes (in past 5 weeks) for each participant using the following equation: (number of moderate bouts x average minutes per bout) + (number of vigorous bouts x average minutes per bout). The scores will have a minimum value of 0 minutes, with more minutes indicating greater participation in moderate-to-vigorous physical activity and a more positive outcome.

In reference to the past one/four/five weeks, participants will report the number of times per week (on average) they engaged in low, medium, and high intensity Supernatural physical activity using the Godin Leisure Time Exercise Questionnaire, and the average duration of the low, medium, and high intensity Supernatural physical activity sessions. The researchers will create an indicator of average weekly medium-high intensity Supernatural physical activity minutes for each participant using the following equation: (number of medium bouts x average minutes per bout) + (number of high bouts x average minutes per bout). The scores will have a minimum value of 0 minutes, with more minutes indicating greater participation in Supernatural physical activity and a more positive outcome.

Participants in the Supernatural condition will log their Supernatural VR physical activity (intensity and duration for each day of the week) at the end of each week. Scores will have a minimum value of 0 minutes, with more minutes indicating greater participation in Supernatural physical activity and a more positive outcome.

The Meta Quest Move application (within Meta Quest 3 headset) estimates the amount of calories expended and 'move minutes' for each application in the headset. The calories expended and move minutes (within a particular time frame) in Supernatural will be extracted from the Meta Quest Move application for each participant. Meta Quest Move does underestimate the number of calories expended during a bout of physical activity and will therefore represent a proxy measure for Supernatural engagement time. A total score for calories burned and 'move minutes' will be recorded for each week of the study, with minimum values of 0 minutes and 0 calories and more minutes and calories expended indicating greater participation in Supernatural physical activity and a more positive outcome.

Accelerometers (wGT3X-BT ActiGraph) will provide direct assessments of participants' moderate-to-vigorous physical activity. Participants will wear the accelerometer for seven days at baseline and seven days post-week 10. The scores will have a minimum value of 0 minutes with more minutes will indicate greater participation in moderate-to-vigorous physical activity and a more positive outcome.

Participants in the Supernatural condition will complete 9 items regarding the feasibility and acceptability of the Supernatural VR exercise game and the Meta Quest 3 headset. Participants will respond to each item on a five point Likert scale anchored by 1 (strongly disagree) to 5 (strongly agree). The 9 items will be mean scored (potential range 1-5), with higher scores indicating higher levels of feasibility and acceptability for both Supernatural VR exercise game and the Meta Quest 3 and a more positive outcomes. Items were derived from a previous Feasibility study. A sub-group of participants in the Supernatural condition will participate in exit interviews regarding the feasibility and acceptability of Supernatural VR exercise game and the Meta Quest 3 headset.

Participants in the Supernatural condition will complete an adapted 10-item system usability scale for the Supernatural VR exercise game, responding to each item on a five point Likert scale anchored by 1 (strongly disagree) to 5 (strongly agree).The 10-items will be mean scored (potential range 1-5), with higher scores indicating higher levels of Supernatural usability and a more positive outcome. A sup-group of participants in the Supernatural condition will participate in exit interviews regarding the usability of the Supernatural VR exercise game.

Participants in the Supernatural condition will complete an adapted 10-item system usability scale for the Meta Quest 3 headset, responding to each item on a five point Likert scale anchored by 1 (strongly disagree) to 5 (strongly agree).The 10-items will be mean scored (potential range 1-5), with higher scores indicating higher levels of Meta Quest 3 usability and a more positive outcome. A sub-group of participants in the Supernatural condition will participate in exit interviews regarding the usability of the Meta Quest 3 headset.

Participants will respond to the neuroticism (12 items), extraversion (12 items), and conscientiousness (12 items) subscales in the five factor inventory. Participants will respond to the 36 personality related items on a five point Likert-type scale anchored by 0 (strongly disagree) to 4 (strongly agree). Each subscale will be mean scored (potential range 0-4), with higher scores reflecting a higher degree of the personality trait.

The environmental module of the International Physical Activity Prevalence Study (IPS) will be used to assess a participants environment for walking and bicycling ability . Participants will be able to respond 17 items on a four point Likert-type scale anchored by 1 (strongly disagree) to 4 (strongly agree). Items will be mean scored (potential range 1 to 4) with higher scores reflecting a more favourable environment for physical activity participation.