Cognitive Behavioral Theory-Assisted Virtual Reality for Chronic Cancer Pain (VR-CAN): Device Prototype Development and Feasibility Testing

Cognitive Behavioral Theory-Assisted Virtual Reality for Chronic Cancer Pain (VR-CAN): Device Prototype Development and Feasibility Testing is sponsored by National Institutes of Health (NIH). Develops and tests a virtual reality device integrating cognitive behavioral theory to manage chronic cancer pain.

**We're sorry but RePORTER doesn't work properly without JavaScript enabled. Please enable it to continue. ** * Email:%20device%20prototype%20development%20and%20feasibility%20testing%20%0A%0A%20https://reporter.

nih. gov/project-details/11115251) Cognitive behavioral theory-assisted virtual reality for chronic cancer pain (VR-CAN): device prototype development and feasibility testing Project Number 1R21CA299799-01 Contact PI/Project Leader GRONINGER, J. HUNTER PROJECT ABSTRACT Over 50% of patients living with cancer experience pain early in the disease course, increasing to at least 75% of patients who have progressed to more advanced stages.

Opioid therapies remain a cornerstone to chronic cancer pain management – nevertheless, clinical literature and expert opinion reinforce that maximizing effective, appropriate non-pharmacologic therapies is critical to achieving the best possible pain control, well-being, and return to function.

Virtual reality (VR) is a rapidly developing technology that can temporarily immerse individuals in a calm, pleasant environment, and has demonstrated efficacy in acute and chronic pain management settings by providing distraction from pain and lowering pain sensation.

Nevertheless, despite growing evidence supporting the efficacy of VR-based interventions for analgesia, few data are available that provide an understanding of its role in mitigating persistent pain in patients with cancer and existing studies have used off-the-shelf VR products that are not evidence- based or designed to meet the unique and complex needs of patients with cancer pain.

This collaboration between Duke University and MedStar Health leverages experience conducting clinical trials of VR to mitigate cancer pain in both inpatient and outpatient settings (both sites), expertise in the development and implementation of behavioral pain and symptom management interventions for patients with cancer (Duke), and experience developing VR applications for healthcare settings (MedStar).

Following the NIH Behavioral Intervention Development Stage Model, our shared goal is to develop (i.e., patient focus groups, provider and expert interviews, patient beta testing) and pilot test (RCT N=40) a new VR therapy that integrates evidence-based strategies and is uniquely co-designed by patients living with chronic cancer pain. Aim 1.

Iteratively develop and refine a CBT-assisted VR prototype for patients with chronic cancer pain (VR-CAN) based on literature and the investigative team’s research and clinical expertise, and feedback collected via focus groups with patients living with moderate-severe chronic cancer pain from both urban (Washington DC) and suburban/rural (Durham, NC) communities (n=24) and interviews with providers (n=6; oncologists, nurses), and experts in the field (N=6; e.g., VR technology, cancer survivorship, non-pharmacological pain management).

Leveraging human factors science, this prototype will then be tested for usability in the lab by patient participants (N=6), iteratively modified based on feedback, and then at home by unique participants (N=6) daily for one week. Aim 2.

Conduct a randomized controlled trial to examine the feasibility (primary aim), acceptability, usability, safety, and initial clinical impact (pain, psychological distress, pain self-efficacy, pain catastrophizing) of the developed VR-CAN prototype compared to a tablet-based two-dimensional video control group. Aim 3 (Exploratory).

Collect and evaluate qualitative post-intervention data on VR-CAN participants’ (60%; n=12) preferences, thoughts, and feelings about the VR-CAN protocol in order to optimize and manualize the VR- CAN protocol that can be efficacy tested in a larger, fully powered randomized controlled trial. This work has significant potential to decrease burden for a cancer population that experiences high symptom burden and disability.

Public Health Relevance Statement PROJECT NARRATIVE While chronic cancer pain affecting as many as 75% of patients is typically addressed using pharmacologic interventions, experts and patients alike support maximizing any relevant non- pharmacologic interventions as well, such as cognitive behavioral therapy.

Virtual reality, a novel technology that can temporarily immerse users in a calm, pleasant environment, has been increasingly shown to facilitate improvement in different acute and chronic pain syndromes by providing distraction from pain and lowering pain sensation.

To address the significant needs of patients living with chronic cancer pain, we propose to develop and pilot test a prototype device that will leverage cognitive behavioral therapy principles to deliver a novel virtual reality pain therapy. No NIH Spending Category available.

Absence of pain sensation Acute Pain Acute pain management Address Affect Behavior Therapy Behavioral Breathing Cancer Pain Management Cancer Patient Cancer Survivorship Caring Chronic Cancer Pain Chronic pain syndrome Client satisfaction Clinical Cognitive Cognitive Therapy Collaborations Communities Complex Conduct Clinical Trials Control Groups Coping Skills Data Development Devices Disease District of Columbia Dizziness Environment Expert Opinion Feedback Feeling Focus Groups Goals Guided imagery Health Home Human Individual Inpatients Interruption Intervention Interview Literature Long-term Follow-up Malignant Neoplasms Manuals Modeling Muscle relaxation phase Nonpharmacologic Therapy Nurses Occupations Oncologist Opioid Outpatients Pain Pain management Participant Patient Self-Report Patients Persistent pain Personal Satisfaction Pharmacotherapy Population Protocols documentation Provider Psychological Factors Questionnaires Randomized, Controlled Trials Reporting Research Role Rural Safety Science Self Efficacy Site Symptom Burden Symptoms System Tablets Technology Testing Thinking United States National Institutes of Health Universities Vision Voice Work active control cancer pain chronic pain management cognitive modulation of pain cognitive process design disability distraction efficacy testing efficacy trial evidence base experience feasibility testing health application health care settings improved new technology novel opioid therapy pain catastrophizing pain outcome pain reduction pain sensation pilot test post intervention preference prototype psychological distress quality of life improvement satisfaction side effect skills sound suburb symptom management theories therapy development two-dimensional usability virtual clinical trial virtual environment virtual reality virtual reality environment virtual reality intervention [Special Emphasis Panel[ZCA1 SRB-2 (J1)]](https://public.

csr. nih. gov/StudySections/SmallBusinessAndTechnologyTransfer) Administering Institutes or Centers National Cancer Institute Assistance Listing Number Project Funding Information for 2025 No Sub Projects information available for 1R21CA299799-01 Publications are associated with projects, but cannot be identified with any particular year of the project or fiscal year of funding.

This is due to the continuous and cumulative nature of knowledge generation across the life of a project and the sometimes long and variable publishing timeline. Similarly, for multi-component projects, publications are associated with the parent core project and not with individual sub-projects.

No Publications available for 1R21CA299799-01 No Patents information available for 1R21CA299799-01 The Project Outcomes shown here are displayed verbatim as submitted by the Principal Investigator (PI) for this award. Any opinions, findings, and conclusions or recommendations expressed are those of the PI and do not necessarily reflect the views of the National Institutes of Health. NIH has not endorsed the content below.

No Outcomes available for 1R21CA299799-01 No Clinical Studies information available for 1R21CA299799-01 No news release information available for 1R21CA299799-01 No Historical information available for 1R21CA299799-01 No Similar Projects information available for 1R21CA299799-01 ## Select options for export: