Co-designing accessible digital mindfulness for veterans with spinal cord injury: protocol for developing and testing VA CALM-SCI for virtual reality.
7 affiliations
- 1Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, United States.
- 2Department of Medicine, Baylor College of Medicine, Houston, TX, United States.
- 3South Central Mental Illness Research, Education, Clinical Center, a Virtual Center, Houston, TX, United States.
- 4VHA Office of Rural Health's Veterans Resource Center in Salt Lake City, Salt Lake City, UT, United States.
- 5Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States.
- 6Department of Psychological and Brain Sciences, Texas A & M University, College Station, TX, United States.
- 7Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, United States.
Abstract
Introduction
Virtual reality (VR)-based mindfulness programs are gaining traction as innovative, engaging, and low-cost tools to address chronic pain, depression, and anxiety. However, these programs are often designed for neurologically normative populations while lacking accessibility for people with disabilities, such as spinal cord injury (SCI). This protocol describes a participatory co-design approach adapting the Department of Veterans Affairs Compassionate Awareness Learning Module (VA CALM) content for individuals with SCI to improve access and accessibility and then evaluate the feasibility and acceptability of delivering this program via VR to enhance effectiveness and engagement.Methods and analysis
This 2-phase formative study uses the Method for Program Adaptation through Community Engagement (MPACE) to guide our co-design process. In Phase 1, 10 Veterans with SCI will complete VA CALM to identify needed adaptations. Quantitative measures will assess mindfulness, pain (interference, catastrophizing, and acceptance), depression, anxiety, and quality of life (QOL). Qualitative data include field notes, facilitator reflections, and focus groups. A 10-member steering committee of clinicians and Veterans will review findings and adjudicate adaptations. In Phase 2, preliminary VA CALM-SCI modules will be delivered via a VR platform. Feasibility and acceptability will be evaluated for usability, user experience, and embodiment alongside qualitative feedback.Discussion
This study advances equitable digital health by co-designing accessible mindfulness content for SCI and testing a VR delivery model that may reduce travel burden, enhance engagement, and expand clinical capacity. Findings will inform future efforts in developing and testing this adapted program and reinforce the value of prioritizing accessibility and inclusion when developing future healthcare innovations.
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BibTeX
@article{touchett2026codesigning,
title = {{Co-designing accessible digital mindfulness for veterans with spinal cord injury: protocol for developing and testing VA CALM-SCI for virtual reality.}},
author = {Hilary Touchett and Kathryn Kanzler and Zina Trost and Jan Lindsay and Felicia Skelton},
journal = {Frontiers in digital health},
year = {2026},
month = oct,
doi = {10.3389/fdgth.2026.1923501},
url = {https://europepmc.org/article/MED/42924092},
note = {CC BY},
}
RIS
TY - JOUR
TI - Co-designing accessible digital mindfulness for veterans with spinal cord injury: protocol for developing and testing VA CALM-SCI for virtual reality.
AU - Hilary Touchett
AU - Kathryn Kanzler
AU - Zina Trost
AU - Jan Lindsay
AU - Felicia Skelton
PY - 2026
DA - 2026/10/08
JO - Frontiers in digital health
DO - 10.3389/fdgth.2026.1923501
UR - https://europepmc.org/article/MED/42924092
AB - Introduction Virtual reality (VR)-based mindfulness programs are gaining traction as innovative, engaging, and low-cost tools to address chronic pain, depression, and anxiety. However, these programs are often designed for neurologically normative populations while lacking accessibility for people with disabilities, such as spinal cord injury (SCI). This protocol describes a participatory co-design approach adapting the Department of Veterans Affairs Compassionate Awareness Learning Module (VA CALM) content for individuals with SCI to improve access and accessibility and then evaluate the feasibility and acceptability of delivering this program via VR to enhance effectiveness and engagement.Methods and analysis This 2-phase formative study uses the Method for Program Adaptation through Community Engagement (MPACE) to guide our co-design process. In Phase 1, 10 Veterans with SCI will complete VA CALM to identify needed adaptations. Quantitative measures will assess mindfulness, pain (interference, catastrophizing, and acceptance), depression, anxiety, and quality of life (QOL). Qualitative data include field notes, facilitator reflections, and focus groups. A 10-member steering committee of clinicians and Veterans will review findings and adjudicate adaptations. In Phase 2, preliminary VA CALM-SCI modules will be delivered via a VR platform. Feasibility and acceptability will be evaluated for usability, user experience, and embodiment alongside qualitative feedback.Discussion This study advances equitable digital health by co-designing accessible mindfulness content for SCI and testing a VR delivery model that may reduce travel burden, enhance engagement, and expand clinical capacity. Findings will inform future efforts in developing and testing this adapted program and reinforce the value of prioritizing accessibility and inclusion when developing future healthcare innovations.
SN - 2673-253X
ER -