Bringing the Green Environment From Outdoors to Indoors Through Virtual Reality for Psychological Well-Being: Quasi-Experimental Study

Abstract Background Urban green spaces support psychological well-being, yet access is often limited for city residents. Virtual reality (VR) offers a promising indoor alternative, but evidence on sustained mental health effects of longer-term VR nature exposure remains limited. Objective This exploratory pilot study aimed to explore the effectiveness of a 12-week VR green environment intervention in influencing self-reported psychological outcomes among urban residents. Methods A nonrandomized control group pretest-posttest design was used with healthy urban adults aged 20 to 50 years. The experimental group received weekly 30-minute VR green environment sessions for 12 weeks, while the control group received no intervention. Self-reported psychological outcomes were assessed using standardized questionnaires and analyzed using generalized estimating equations. Results Of the 60 participants recruited, 55 (91.6%) completed the study, with 30 (54.5%) in the experimental group and 25 (45.5%) in the control group. Significant group-by-time effects indicated that the experimental group showed reductions in distress (β=−5.17; P =.03), depression (β=−2.37; P =.003), anxiety (β=−3.20; P =.05), and somatization (β=−6.27; P =.004) scores, whereas the control group showed symptom deterioration. No serious adverse events were reported. Conclusions This exploratory pilot investigation suggests that repeated VR green environment exposure has the potential to be a feasible health promotion tool for supporting psychological well-being among urban adults. These findings are preliminary and should not be interpreted as evidence of clinical therapeutic effectiveness.