Virtual Reality Interventions for the Improvement of Depression, Anxiety and Pain in Patients With Head and Neck Cancer and Caregivers

PRIMARY OBJECTIVE:

I. Feasibility and acceptability of 3D mindfulness VR- vs 2D in HNC patients undergoing C/RT.

SECONDARY OBJECTIVES:

I. Assess patient- and caregiver-preference for 3D VR and non-immersive interventions.

II. Preliminary efficacy in reduction in depressive symptoms, anxiety and pain.

OUTLINE: Participants are assigned to 1 of 2 arms.

ARM A: Participants receive 3D mindfulness VR headset consisting of 6 resilience skills training sessions over 30 minutes three times a week (TIW) for 6-7 weeks then weekly for 4 weeks. Participants also wear a Fitbit activity tracker to monitor heart rate, sleep and activity throughout the study.

ARM B: Participants receive 2D non-immersive VR headset consisting of 2 scenarios - walk in the nature and beach TIW for 6-7 weeks then weekly for 4 weeks. Participants also wear a Fitbit activity tracker to monitor heart rate, sleep and activity throughout the study.

Inclusion criteria

• PATIENTS: Documented informed consent of the participant and/or legally authorized representative

• Assent, when appropriate, will be obtained per institutional guidelines
• PATIENTS: ≥ 18 years
• PATIENTS: Self-reported normal or corrected to normal vision and hearing
• PATIENTS: Ambulatory (permitted to use walking aids such as cane or crutch)
• PATIENTS: Ability to read and understand English for questionnaires
• PATIENTS: Scheduled to undergo C/RT for their HNC
• CAREGIVERS: Documented informed consent of the participant and/or legally authorized representative

• Assent, when appropriate, will be obtained per institutional guidelines
• CAREGIVERS: ≥ 18 years
• CAREGIVERS: Self-reported normal or corrected to normal vision and hearing
• CAREGIVERS: Ability to read and understand English for questionnaires
• CAREGIVERS: A care giver identified by the patient and defined as a person who knows the patient well and is involved in the patient's medical care

Exclusion criteria

• PATIENTS: An employee who is under the direct/ indirect supervision of the principal investigator (PI)/ a co-investigator/ the study manager
• PATIENTS: A direct study team member
• PATIENTS: Inability to complete the surveys
• PATIENTS: Serious mental illness
• PATIENTS: Previous head and neck cancer treatment
• PATIENTS: History of any psychiatric disease treatment with anti-depressants, substance abuse, post-traumatic stress disorder (PTSD), chronic pain (> 3 months)
• PATIENTS: Cancer in or around the eyes or ears; visual, hearing or cognitive impairment
• CAREGIVERS: An employee who is under the direct/ indirect supervision of the PI/ a co-investigator/ the study manager
• CAREGIVERS: A direct study team member
• CAREGIVERS: Inability to complete the surveys
• CAREGIVERS: Serious mental illness
• CAREGIVERS: History of any psychiatric disease treatment with anti-depressants, substance abuse, PTSD