VR-CARE: A protocol for a mixed-methods study and pilot trial with embedded process evaluation to develop and evaluate virtual reality training for risk reduction in care homes

<b>Introduction</b><br/> <br/>Risk reduction training for UK care home staff is limited, not standardised, and challenging to implement. Virtual Reality (VR) is an immersive, engaging method of education delivery that is being adopted in health and social care. VR may be an effective education tool in care homes, but this research has yet to be conducted.<br/>The VR-CARE project aims to create a new VR risk reduction training programme for care homes that combines hand hygiene and falls prevention modules, and to evaluate this through a pilot trial to inform a future randomised controlled trial (RCT).<br/> <br/><b>Methods and analysis<br/></b><br/>There are two research phases with patient and public involvement and engagement (PPIE) activities embedded throughout. Care home stakeholders are collaborating to design the training and toolkit, oversee methods, review resources for accessibility, support recruitment, and ensure the project meets the needs of the workforce and positively impacts resident care.<br/> <br/>In Phase 1, we will use a mixed-methods and user-centred design approach to develop the VR training and an accompanying implementation toolkit needed to deliver it. The training will be developed and tested by 15 care home staff across three rounds to identify and inform changes that maximise usability and acceptability. We will conduct up to 20 interviews with staff from VR companies and care homes to support toolkit development. <br/> <br/>Phase 2 is a mixed-methods pilot cluster RCT, with a waitlist control and process evaluation with up to 80 unregistered staff members from six North England care homes, to develop the measures and methods to inform a future trial. The process evaluation will generate knowledge about VR as a training mechanism in care homes. This phase will focus on the practicality of using VR, broader impacts (e.g., on residents), contextual considerations and how it might be scaled up.<br/><br/><b>Ethics and dissemination<br/><br/></b>The University of Manchester Proportionate University Research Ethics Committee has approved Phase 1 (Reference: 2025-24416-44642). We will obtain further approval before commencing Phase 2.<br/><br/>Outputs will include user-friendly and acceptable VR risk reduction training for care homes, accompanied by an implementation toolkit adaptable for other VR training in social care settings. Materials (e.g., training overviews, infographics, and videos) will be developed to support uptake. Findings will be presented at conferences and published in journals. Lay summaries will be co-created with our PPIE group, and additional dissemination methods will be co-developed to broaden reach.<br/>