Translating behavioral interventions into virtual reality: the Transcend Framework for immersive health design

, a positive psychological intervention designed for use during hemodialysis. The aim of this paper is to outline a clear, reproducible process for translating behavioral interventions into immersive digital formats that supports broader research, clinical, and implementation applications. The framework comprises five stages: (1) identifying the target population; (2) assessing feasibility and adapting the curriculum for VR; (3) pre-production planning, including storyboarding and design specification; (4) previsualization and asset creation of immersive environments; and (5) iterative VR development and testing to refine usability, accessibility, and engagement. Each stage emphasizes user-centered design and attention to physical limitations, cognitive load, and accessibility to ensure feasibility and effectiveness. Interactive, visually rich, modular environments foster engagement, while gamified activities enhance experiential learning and skill acquisition, and culturally attuned content ensures inclusivity. Continuous, data-informed refinement guided by end-user feedback ensures usability and sustained engagement. This methodological framework provides a practical roadmap for developing and optimizing VR-based behavioral health interventions and demonstrates how immersive technology can advance health education, promote behavior change, and enable scalable, equitable implementation across clinical contexts.